Protocolo de Flexão

Estenose do Canal Vertebral Lombar

O estreitamento do canal comprime as raízes ao estender a coluna.

QUADRO CLÍNICO

Sintomas Comuns

Cansaço nas pernas ao caminhar
Alívio ao inclinar para frente

AVISO CRÍTICO

Movimentos a Evitar

✗ Extensões forçadas da coluna lombar

💡 DICA CLÍNICA DE FISIOTERAPIA

Exercícios de flexão lombar abrem os forames neurais aliviando a dor.

SEQUÊNCIA GRADUAL

Protocolo de Exercícios Prescrito

6 EXERCISES

Clinical back pain images demonstration - LUMBAR ELONGATION

LUMBAR ELONGATION

🎯 Lower Spine & Lats

Descompressão 2-3 mins • 30s

Postura da Criança para Descompressão Lombar

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

Mobilidade 2 mins • 5s

Gato-Vaca (Mobilidade da Coluna)

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

Fortalecimento 3 mins • 3s

Deadbug (Controle Anti-Extensão do Core)

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

Descompressão 2 mins • 30s

Joelho ao Peito Deitado (Descompressão Unilateral)

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

Mobilidade 2 mins • 5s

Inclinação Pélvica em 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

Descompressão 2 mins • 30s

Dois Joelhos ao Peito (Alívio de Estenose)

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

Perguntas Frequentes: Estenose Lombar

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.

LITERATURA CIENTÍFICA

Evidências Revisadas por Pares & Diretrizes

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