Protocollo di Flessione

Stenosi del Canale Lombare

Il restringimento del canale vertebrale comprime i nervi durante l'estensione.

QUADRO CLINICO

Sintomi Principali

Gambe pesanti camminando
Sollievo piegandosi in avanti (segno del carrello)

AVVERTENZA CRITICA

Movimenti da Evitare

✗ Iperestensioni della colonna lombare

💡 PERLA CLINICA DI FISIOTERAPIA

Svolgi esercizi in flessione per allargare lo spazio foraminale.

SEQUENZA PROGRESSIVA

Protocollo di Esercizi Prescritto

6 EXERCISES

Clinical back pain images demonstration - LUMBAR ELONGATION

LUMBAR ELONGATION

🎯 Lower Spine & Lats

Decompressione 2-3 mins • 30s

Posizione del Bambino per Decompressione Lombare

Gentle spine elongation that decompresses lumbar vertebrae and releases tight latissimus dorsi.

T8-T9 T9-T10 Erector Spinae Latissimus Dorsi +1

Clinical back pain images demonstration - SPINAL MOBILIZATION

SPINAL MOBILIZATION

🎯 Facet Joints & Discs

Mobilità 2 mins • 5s

Gatto-Mucca (Onda di Mobilità Spinale)

Synchronized flexion and extension to lubricate intervertebral discs and restore spine mobility.

C2-C3 C3-C4 Erector Spinae Rectus Abdominis +1

Clinical back pain images demonstration - ANTI-EXTENSION CORE

ANTI-EXTENSION CORE

🎯 Deep Transverse Core

Rinforzo 3 mins • 3s

Deadbug (Controllo Anti-Estensione Lombare)

Re-trains the deep transverse abdominis to protect the lumbar spine during extremity movement.

L1-L2 L2-L3 Transverse Abdominis Internal Obliques +1

Clinical back pain images demonstration - LUMBAR FACET OPENING

LUMBAR FACET OPENING

🎯 Spinal Canal Foramina

Decompressione 2 mins • 30s

Ginocchio al Petto in Posizione Supina

Relieves facet joint irritation and gently stretches the lower back and gluteus maximus in bed or on floor.

L2-L3 L3-L4 Gluteus Maximus Erector Spinae +1

Clinical back pain images demonstration - POSTERIOR PELVIC TILT

POSTERIOR PELVIC TILT

🎯 Core Dissociation

Mobilità 2 mins • 5s

Basculamento Pelvico Supino (Pelvic Tilt)

Gentle rocking of the pelvis that frees tight lower lumbar segments and activates the deep transverse core.

L3-L4 L4-L5 Transverse Abdominis Internal Obliques +1

Clinical back pain images demonstration - BILATERAL CANAL WIDENING

BILATERAL CANAL WIDENING

🎯 Stenosis Decompression

Decompressione 2 mins • 30s

Entrambe le Ginocchia al Petto (Stenosi)

Maximum posterior pelvic decompression that widens the spinal canal and relieves lumbar stenosis and facet irritation.

L1-L2 L2-L3 Erector Spinae Gluteus Maximus +1

CLINICAL QUESTIONS & ANSWERS

Domande Frequenti: Stenosi Spinale

Q Why does leaning forward on a shopping cart relieve stenosis pain?

Flexing the lumbar spine anteriorly widens the neuroforaminal canals by up to 24%, relieving mechanical compression on passing spinal nerve roots and alleviating leg claudication.

Q Which exercises are dangerous for lumbar spinal stenosis?

Backward bending (extension), prone press-ups, and prone cobras narrow the spinal canal and should be avoided in favor of flexion-biased decompression routines.

LETTERATURA SCIENTIFICA

Evidenze Peer-Reviewed & Linee Guida

•
"Comparison of Flexion-Biased Physical Therapy vs. Standard Care in Lumbar Spinal Stenosis" — JOSPT (2023).