L

A ligament is a fibrous tissue that connects one bone to another. This allows articulation between the bones. Muscles and their tendons then move these bones one upon the other.

Low Back Pain (LBP) is one of the most prevalent health problems in our society and is the cause of considerable disability, use of health services and lost work hours (1). It has been estimated that LBP affects 60% to 85% of the population at some point in their lives (2,3) and up to 15%-30% of the population at any given time (1). During any six month period 72% of adults in the general population will report LBP (1), and 8% of the working population will be disabled in any given year resulting in 40% of all total lost work days (3). LBP is the second most common cause of medical consultation (4,9). Most episodes of LBP will be short-lived with 80%-90% of episodes resolving within 6 weeks (3). However, high recurrence rates have been reported; with between 60% and 86% of LBP patients experiencing a recurrence of pain within one year. (2,8). LBP is a multifactorial disorder with many possible causes. Factors such as heavy physical strain, repetitive lifting, poor posture, age, gender, obesity, static positioning, previous history, physical fitness and genetics have all been mentioned as risk factors (2,3). Additionally, many anatomical structures can contribute to LBP including muscles, joints, nerves, discs, tendons and ligaments. Treatment for LBP varies considerably. Health care practitioners often prescribe a generalized exercise program for the treatment of LBP. There is, however, strong evidence from the literature that a combined physical therapy approach consisting of manual therapy, specific muscle training and education is effective in producing functional and symptomatic improvement in acute and chronic LBP (4-10). Indeed, physical therapy including a specific evaluation of individual characteristics such as posture, strength and flexibility and a tailored exercise program, has been shown to be more effective than a generalized exercise program (5,8,9,10). Furthermore, patients who were given tailored exercise programs experienced fewer recurrences of LBP. One year after treatment recurrence was 30% in individuals who were given specific exercises versus an 84% recurrence in those given only advice and medication (control group). Two to three years after treatment, recurrence in the specific exercise group was 35%, while the control group was 75%.(8)