Spine

Question 1

What positions can be used for cervical muscle stretches?

Answer 1

Cervical muscle stretches can be done in supine, seated, or standing positions.

Question 2

What is the general movement used to stretch cervical muscles?

Answer 2

Extension of the neck, contralateral-lateral flexion, and rotation (depending on the specific muscle).

Question 3

How is the sternal head of the sternocleidomastoid (SCM) stretched?

Answer 3

Begin with the head in a neutral position, perform a chin tuck, slightly extend the neck, and add contralateral-lateral flexion with ipsilateral rotation. Pillows or towels can support the head during self-stretch.

Question 4

Describe the stretch for the clavicular head of the SCM.

Answer 4

Place the head in a neutral position and perform a chin tuck. This position helps target the clavicular fibers of the SCM.

Question 5

How is the shoulder positioned during scalene stretches?

Answer 5

The shoulder on the stretch side is stabilized at the side to isolate the scalene group.

Question 6

How is the anterior scalene stretched?

Answer 6

The neck is taken into contralateral-lateral flexion and ipsilateral rotation (facing up, towards the ceiling).

Question 7

Describe the stretch for the middle scalene.

Answer 7

The neck is taken into contralateral-lateral flexion only, without rotation.

Question 8

What is the proper positioning to stretch the posterior scalene?

Answer 8

The neck is taken into contralateral-lateral flexion with contralateral rotation (facing down, towards the armpit).

Question 9

How is the levator scapula muscle stretched?

Answer 9

Stabilize the shoulder, take the neck into flexion, contralateral-lateral flexion, and contralateral rotation (facing down, at the armpit). The contralateral arm can add overpressure.

Question 10

Describe the movement for stretching the upper fibers of the trapezius.

Answer 10

Stabilize the shoulder, take the neck into flexion, contralateral-lateral flexion, and ipsilateral rotation (facing up, away from the armpit).

Question 11

What percentage of strength should a client use for isometric neck exercises against static resistance?

Answer 11

Only 10% of their strength.

Question 12

For isometric neck exercises, when might the resistance of gravity be sufficient?

Answer 12

Gravity may be sufficient when performing isometric neck exercises without additional resistance.

Question 13

How should the position be adjusted for different joint angles in supine isometric exercises for the SCM?

Answer 13

Adjust the thickness or height of towels/bolsters under the head to change the joint angle.

Question 14

Describe the bilateral movement for strengthening the SCM in supine position.

Answer 14

The client performs a slight chin-tuck and attempts to forward flex the neck against gravity, with an optional hand for resistance.

Question 15

How is the unilateral movement for strengthening the SCM in supine position performed?

Answer 15

The head is rotated to the contralateral side, and the client attempts to flex the neck forward against gravity, with an optional hand for resistance. The joint angle can be adjusted using towels/bolsters.

Question 16

What position is used for isometric exercises to strengthen the scalenes?

Answer 16

Sidelying, with the cervical spine supported by towels/bolsters, or the client can use seated/standing positions.

Question 17

Describe the movement to strengthen the scalenes in sidelying position.

Answer 17

The client lies on the side to be strengthened and laterally flexes into the bolster/towels or lies with the side to be strengthened uppermost and contracts against gravity. Alternatively, the client can use a hand for resistance to focus on ipsilateral flexion.

Question 18

How can a client add isometric resistance to strengthen the scalenes in sidelying?

Answer 18

The client can use the palm of their hand against their head to add resistance, focusing on an ipsilateral flexion contraction.

Question 19

Which movement is used to strengthen the levator scapula, and what muscles might also participate?

Answer 19

Scapular elevation (shoulder shrugs) is used, though other muscles may also participate due to difficulty isolating the levator scapula.

Question 20

How can joint angle be adjusted for scapular elevation exercises to strengthen the levator scapula?

Answer 20

Adjust the length of belts or yoga straps used for resistance to change the joint angle.

Question 21

What percentage of strength should a client use for isotonic neck exercises against static resistance?

Answer 21

Only 10% of their strength.

Question 22

In isotonic neck exercises, when might the resistance of gravity be sufficient?

Answer 22

Gravity may be sufficient when performing isotonic neck exercises without additional resistance.

Question 23

Describe the position and movement for strengthening the SCM bilaterally in supine position.

Answer 23

In supine with a slight chin-tuck, the client attempts to forward flex the neck against gravity.

Question 24

How is the unilateral isotonic exercise performed to strengthen the SCM in supine position?

Answer 24

The client simultaneously performs forward flexion, ipsilateral flexion, and contralateral rotation of the head, controlling the movement back to neutral. Movements can be broken down if coordination is difficult.

Question 25

What position is used for isotonic exercises to strengthen the scalenes?

Answer 25

Sidelying, with the side to be strengthened as the upper side.

Question 26

Describe the movement to strengthen the scalenes in sidelying position.

Answer 26

The client lifts their head off the support into ipsilateral lateral flexion and controls the movement when lowering it back to neutral.

Question 27

What movement is used to strengthen the levator scapula, and what muscles might also participate?

Answer 27

Scapular elevation (shoulder shrugs) is used, though other muscles may also participate due to difficulty isolating the levator scapula.

Question 28

What equipment can be used to increase resistance for scapular elevation exercises to strengthen the levator scapula?

Answer 28

Weights or therabands can be used for shoulder shrugs.

Question 29

What is the purpose of Cat & Cow poses in the quadruped position?

Answer 29

They are used for self-care stretching of the spine, checking sagittal curvature, and indicating areas of use (hinging) and disuse in the spine.

Question 30

Describe the movement for the “Cat” pose in quadruped.

Answer 30

Protract the scapulae and arch the back into a dome shape, pulling the belly button up toward the ceiling.

Question 31

Describe the movement for the “Cow” pose in quadruped.

Answer 31

Bend and extend the spine, extending the neck.

Question 32

What position is used for the Lumbar Lock assessment/exercise, and what is it designed to check?

Answer 32

In a kneeling position with buttocks on ankles, the Lumbar Lock is used to check thoracic spine rotation independently of the lumbar spine, identifying if it is restricted or unrestricted.

Question 33

Describe the movement for the Lumbar Lock exercise.

Answer 33

Place the contralateral arm down on the floor in front between the knees, with the ipsilateral hand behind the head or internally rotated behind the back. Lead with the head and rotate to the ipsilateral side.

Question 34

What position is used for the T-Spine Rotation (Close/Open Book) exercise, and what does it aim to improve?

Answer 34

In a sidelying position with hips stacked at a 90/90 angle, T-Spine Rotation is used to increase and encourage thoracic spine rotation, improving motor control and providing a stretch at the end range of motion.

Question 35

Describe the movement for the T-Spine Rotation (Close/Open Book) exercise.

Answer 35

With the ipsilateral side on top, arms outstretched in front, lead with the head, then the arm/shoulder into ipsilateral rotation. Maintain stacked hips, progressing to laying both scapulae on the ground if possible.

Question 36

How do you stretch the lumbar erector spinae in the supine position?

Answer 36

Flex the lumbar spine by assisting in bilateral hip and knee flexion toward the chest, applying slight overpressure. Place hands under the knees to avoid knee joint compression.

Question 37

Describe a movement to stretch the lumbar erector spinae, quadratus lumborum (QL), and obliques in a supine/hooklying position.

Answer 37

Slowly rock the client’s knees from side to side, holding the stretch where appropriate. Increase sustained stretch by extending the top leg.

Question 38

What is the Banana Stretch for the QL, and how is it performed?

Answer 38

In a supine position, the client stabilizes by holding the edge of the table. The therapist slides both legs to one side of the table. Stretch can be increased by asking the client to reach the ipsilateral arm above the head.

Question 39

How do you stretch the QL in the sidelying position?

Answer 39

Place a towel roll under the waist. With the stretch side as the uppermost, extend the upper leg off the table behind the body while the client reaches the uppermost hand upwards and forward. The therapist can increase the stretch by applying cross-hand pressure at the ribs and hips.

Question 40

What is the primary movement to stretch in Child’s Pose for lumbar erector spinae, QL, obliques, and latissimus dorsi?

Answer 40

Flexion of the lumbar spine, with optional sidebending.

Question 41

Describe the sequence to perform Child’s Pose in a quadruped position.

Answer 41

Begin in a neutral position, then slowly lean back so the buttocks rest on the heels and the chest moves toward the floor.

Question 42

How can pillows or bolsters be used in Child’s Pose for self-stretching?

Answer 42

Place pillows/bolsters between the chest and thighs, under the buttocks, or under the ankles for added support.

Question 43

How can arm positioning enhance the stretch in Child’s Pose?

Answer 43

Arms can be placed above the head or along the sides of the body. For increased stretch on one side (targeting QL, obliques, and latissimus dorsi), reach the arms above the head and move them contralaterally.