Spine Rehabilitation

Question 1

foam roller for thoracic extension

Answer 1

1. client should be in a position where they can comfortably shift from a sitting position to a lying position, place foam roller perpendicular to their spine behind them as they sit with knees bent
2. client will hug their shoulders and lean back over the foam roller, using their heels to push the roller to the part of the spine they wish to extend
3. to progress, client can hold their arms up overhead

Question 2

cow for spinal extension

Answer 2

1. modified cow; sitting up tall with arms crossed, hands on shoulders, lift head and upper spine up through the elbows, keeping lower spine tall to get thoracic extension
2. cow; hands and knees stacked below shoulders and hips, bring stomach towards the group while retracting shoulders and extending the neck

Question 3

cobra for spinal extension

Answer 3

1. low cobra: lying prone on the ground, elbows bent and tucked by sides in push up pos, lift only chest above the ground while neck extends to emphasize thoracic
2. high cobra: like low cobra but lift stomach and chest off the ground with elbows fully extended to emphasize lumbar

Question 4

cat for spinal flexion

Answer 4

1. modified cat; can use if have knee inj, sitting tall hugging shoulders and lean forward bringing shoulders into abdomen without flexing the hip
2. cat; on hands and knees, bringing chest towards the celing with some shoulder protraction

Question 5

child’s pose for spinal flexion

Answer 5

1. sitting on heels, knees pointed forwards, slide hands as far away from body as possible as you press chest to ground
2. for those with lower extremity pathology, hip flexion may be limited, therefore point knees outwards for greater lumbar flexion

Question 6

spine rotation

Answer 6

1. seated spinal twist, sitting upright, hugging self, rotate through the spine without moving hips; progress by sitting with one knee up, opp hand holding ankle of bent knee and twist spine towards bent knee without twisting hips
2. modified archer; lying on side, stack legs together arms out to side, arm on top will cross chest to open up the spine as neck rotates to follow it
3. archer; lying on side, opp side knee bent, same side straight, same side arm holding bent knee, other arm cross chest to open up the spine as neck rotates to follow it

Question 7

spine lat flexion

Answer 7

1. seated lat flexion; sit up with one arm raised, other holds opp ribcage to prevent flare, use overhead arm as guide to bring ear to hip
2. lat flexion lunge; in lunge postition, lat flex towards back knee
3. banana stretch; lying supine, optional cross legs, arms overhead, bend arms towards one side as legs follow to open up opposite side, lifting ribcage away from iliac crest

Question 8

cervical lat flexion

Answer 8

1. independent; sit on one hand and bend neck towards opp side, use other hand to help pull ear towards shoulder
2. therapist assisted; client lying supine, one hand on client’s occipital bone, other on their shoulder, gently flex neck towards other side until they feel stretch
3. watch for dizziness or headache

Question 9

dead bug variations

Answer 9

1. used train abdominal brace (abdominal strength and stabilty); start by lying supine and bracing core by making sure low back is pressed into ground, begin with shoulders, knees and hips flexed 90 deg, start with single limb extension with heel taps
2. progression into single limb heel slide > opposite leg and arm > same leg and arm > both legs and arms

Question 10

chin tuck variations

Answer 10

1. trains upper cervical flexion and lower cervical extension; sit with spine straight, can use a dowel at sacrum, upper thoracic spine, and back of skull to maintain straight spine, make double chin
2. to regress do this supine, to progress do this in table top pos (hands and knees)

Question 11

tall sitting

Answer 11

1. train anti-flexion abdominal extensors; sit on chair, can use dowel for guidance, chin tucked, sternum lifted up, keep ribs tucked, and shoulders relaxed
2. progression: criss crossed legs on the ground > legs straight on the ground

Question 12

bird dog variations

Answer 12

1. train anti-flexion and anti-rotation; start braced in table top postion, can use dowel for guidance, start with single limb
2. progression: opp leg and arm > feet up opp leg and arm > same side leg and arm > feet up same side leg and arm

Question 13

front plank variations

Answer 13

1. abdominal strength; high plank on knees; bear plank is adj to plank; start in tabletop position, protract shoulders and lift knees up with toes to hover, can use dowel for guidance; progression by incorporating movement (bear crawl)
2. progression: low plank on knees > incline high or low incline planks, the greater the incline, the easier > full high plank > full forearm plank

Question 14

side plank variations

Answer 14

1. train anti-lat flexion; side lying start with arm outstretched in high plank with legs stacked togther with knees bent, lifting the hips and thighs off the ground with knees as support; watch for rotation, maintain body in one plane
2. progression: low plank with legs stacked > high plank with legs extended, one foot in front of the other > high plank with extended stacked legs > low plank with extended legs