Exercise

Question 1

Levator Scapula Stretch

Answer 1

presents as pain in base of neck (hypertonic levator scapula)

for left side:

grab back of chair w/ L hand & lean toward R knee
look down @ R chest
use R hand to reach behind head & apply minimal pressure
inhale deeply & stretch further w/ exhalation

Question 2

Scalene stretch

Answer 2

presents as 1st or 2nd rib SD (hypertonic scalence ms)

for L side:
use R hand to reach over head & grab just above left ear
sidebend head AWAY from affected side
inhale deeply & stretch further on inhalation
*can place hand of affected side under butt palm up for added stretch

Question 3

Prayer stretch

Answer 3

presents as shoulder extension SD

for latissimus dorsi (involved in flexion):
start on knees & place elbows on chair in front
let chest drop & sit back toward heels
**can move elbows closer or increase lumbar spine curve to enhance stretch

Question 4

Subscapularis (IR) gravity stretch

Answer 4

presents as shoulder IR somatic dysfunction

for L side:
lying supine, ABduct left arm 90 degrees & externally rotate to restriction

inhale deeply & exhale fully for 3-5 cycles

Question 5

Pectoralis major & minor stretch

Answer 5

presents as shoulder IR somatic dysfunction

stand in doorway & place hands on door frame
lean chest forward
hold stretch for 10-60 sec
vary height of hands to stretch different parts of muscle

Question 6

Scapular Retraining

Answer 6

presents as shoulder IR somatic dysfunction

targeting rhomboids:
lying supine, push elbows posteriorly & squeeze scapulae together

*chin tuck may enhance exercise

Question 7

Iliopsoas & rectus femoris stretch

Answer 7

presents as hip flexion somatic dysfunction

for L side:
stand in front of chair
place dorsal aspect of L foot on chair, keep both knees bent
push hips forward until stretch is felt

Question 8

Lower extremity adductor stretch

Answer 8

presents as hip adduction somatic dysfunction

w/ back straight, sit as close to wall as possible, soles of feet together

place hands on floor behind hips & press hands into floor

arch back to initiate stretch

Question 9

Trendelenburg sign

Answer 9

w/ ABductor weakness, pelvis will tilt toward unaffected side when stand on 1 leg

if weak hip abductors on R & stands on R leg, pelvis will tilt left

Question 10

Clamshell exercise

Answer 10

gluteus medius (AB) & Ad strengthening

for L side:
from lateral recumbent position, flex hips to 45 degrees & flex knees 90 degrees

keeping feet together, raise left knee 6 inches while exhaling

return to starting position during inhalation

repeat 10-15 times per session

Question 11

Piriformis stretch

Answer 11

presents as pain/tenderness in butt & posterior leg

for L side:
lay supine w/ L hip flexed & adducted & knee flexed

place L foot lateral to R knee

place R hand on lateral aspect of L knee

w/ exhalation, apply gentle pressure to pull knee further to R side of body

Question 12

Quadratus Lumborum stretch

Answer 12

presents as lumbar sidebending somatic dysfunction or low back pain

for L side:
stand w/ feet shoulder width apart
reach R arm down to knee while look @ ceiling
inhale deeply
on exhalation, look down & stretch hand further down knee

Question 13

Stretching Guidelines

Answer 13

stretch after exercise
hold stretch for 10-30 seconds (adult), 30-60 seconds (older adult)

tension of stretch should be comfortable, breathe freely

do not bounce or lock joints

repeat stretch 2-3 times/day for at least 3 days/week

Question 14

Exercise Guidelines

Answer 14

repeat exercise 8-12 times per set

perform 1-3 sets at least 3 days per week

focus on technique

goal is to perform exercise continuously for 3 min

Question 15

Where does this fit in the 5 models of osteopathic care?

Answer 15

biomechanical

Question 16

Balance Training

Answer 16

good for elderly pt w/ freq falls

balance on L leg w/ hands on hip (can hold stationary object)

slowly reach out w/ R leg as far as possible w/o touching floor

repeat w/ varying directions for R leg