Strengthening/Stretching Cases Flashcards
Your client is weak with shoulder external rotation and needs a stretch to address tightness after completing the DeLorme protocol for bench press. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Shoulder External Rotation with TheraBand
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Infraspinatus
- Attachments: infraspinous fossa, greater tubercle
- Innervation: suprascapular nerve, C5
- Other Actions: extension, adduction of shoulder
Shoulder Doorway Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Pectoralis Major
- Attachments: medial clavicle, sternum, costal cartilage, external oblique aponeurosis, intertubercular groove
- Innervation: medial pectoral nerve, lateral pectoral nerve, C6-8
- Actions: adduction, IR, flexion, extension of shoulder
Your client has difficulty standing from the floor and reports tightness near the R lateral humeral epicondyle. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Body Weight Lunges
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Rectus Femoris
- Attachments: AIIS, patellar tendon to tibial tuberosity
- Innervation: femoral nerve, L2-4
- Actions: extend leg, flex hip
Passive Wrist Extensor Stretch (Painted Nails Stretch)
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Extensor Carpi Ulnaris
- Attachments: lateral epicondyle (posterior surface of olecranon process), distal aspect of 5th metacarpal
- Innervation: deep radial nerve, C7
- Actions: extension, adduction of wrist
Your client has difficulty climbing stairs and reports tightness on the inside of the thigh. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Step Ups
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Rectus Femoris
- Attachments: AIIS, patellar tendon to tibial tuberosity
- Innervation: femoral nerve, L2-4
- Actions: extend leg, flex hip
Butterfly Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Adductor Magnus
- Attachments: inferior pubic ramus, ischial ramus, ischial tuberosity, gluteal tuberosity, linea aspera, medial supracondylar line, adductor tubercle
- Innervation: obturator nerve, L3, tibial part of sciatic nerve, L4
- Actions: adduction, flexion, extension of thigh
Your client has difficulty with the abdominal bridge hold test and tightness behind the thigh when reaching towards the floor. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Abdominal Bridge
- 2 sets to fatigue (15-20 seconds)
- 2x/day everyday
Rectus Abdominis
- Attachments: pubic crest, pubic symphysis, xiphoid process, 5th-7th costal cartilage
- Innervation: thoracoabdominal nerve T7-11
- Actions: trunk flexion, compress abdominal viscera
Standing Hamstring Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Semitendinosus
- Attachments: ischial tuberosity, tibia
- Innervation: tibial division of sciatic nerve, L5-S1
- Actions: extension of thigh, flexion of leg, IR of flexed leg
Your client is unable to complete toe walking and has tightness in the thigh with knee flexion in supine. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Toe Walking
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Gastrocnemius
- Attachments: condyles of femur, popliteal surface of femur
- Innervation: tibial nerve, S1-2
- Actions: plantar flex ankle, flex leg
Standing Quadriceps Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Rectus Femoris
- Attachments: AIIS, patellar tendon to tibial tuberosity
- Innervation: femoral nerve, L2-4
- Actions: extend leg, flex hip
Your client is weak with ankle eversion and has tightness with R cervical side bending. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Ankle Eversion with TheraBand
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Fibularis Longus
- Attachments: head and superior 1/3 of fibula, 1st metatarsal, medial cuneiform
- Innervation: superficial fibular nerve, L5-S1
- Actions: eversion, plantar flexion of ankle
Cervical Lateral Flexion Stretch to Right
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Sternocleidomastoid
- Attachments: mastoid process, manubrium, clavicle
- Innervation: spinal accessory nerve, CN XI
- Actions: bilateral flexion, ipsilateral lateral flexion, contralateral rotation of head
Your client has difficulty carrying grocery bags secondary to wrist weakness and has tightness that limits full knee extension. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Wrist Curls with Dumbbell
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Flexor Carpi Radialis
- Attachments: medial epicondyle, 2nd metacarpal
- Innervation: median nerve, C7
- Actions: flexion, abduction of wrist
Standing Hamstring Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Semitendinosus
- Attachments: ischial tuberosity, tibia
- Innervation: tibial division of sciatic nerve, L5-S1
- Actions: extension of thigh, flexion of leg, IR of flexed leg
Your client needs hip abduction strengthening and stretch for the anterior chest. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Standing Hip Abduction
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Gluteus Medius
- Attachments: ilium, greater trochanter
- Innervation: superior gluteal nerve, L5-S1
- Actions: abduction, IR of thigh; stabilize pelvis in midstance of gait
Shoulder Doorway Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Pectoralis Major
- Attachments: medial clavicle, sternum, costal cartilage, external oblique aponeurosis, intertubercular groove
- Innervation: medial pectoral nerve, lateral pectoral nerve, C6-8
- Actions: adduction, IR, flexion, extension
Your client has increased thoracic kyphosis and weakness with scapular retraction muscles as well as tightness with the hands behind back assessment. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Rows with TheraBand
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Rhomboid Major
- Attachments: spinous processes T2-5, medial border of scapula
- Innervation: dorsal scapular nerve, C5
- Actions: retraction of scapula, downward rotation of glenoid cavity
Shoulder Internal Rotation Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Teres Major
- Attachments: posterolateral surface of scapula, intertubercular sulcus
- Innervation: lower subscapular nerve, C6
- Actions: extension, adduction, medial rotation of arm
Your client needs shoulder internal rotation strengthening and has decreased ankle DF motion due to tightness behind the calf. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Shoulder Internal Rotation with TheraBand
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Teres Major
- Attachments: posterolateral surface of scapula, intertubercular sulcus
- Innervation: lower subscapular nerve, C6
- Actions: extension, adduction, medial rotation of arm
Calf Stretch on Half Foam Roll
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Gastrocnemius
- Attachments: condyles of femur, popliteal surface of femur, calcaneal tendon
- Innervation: tibial nerve, S1-2
- Actions: plantar flex ankle, flex leg
Your client needs an exercise for elbow extension strength and stretch to increase flexibility of the piriformis muscle. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Standing Dumbbell Triceps Extension
- 2 sets until fatigue (12-15 reps)
- 2x/day everyday
Triceps Brachii
- Attachments: infraglenoid tubercle, posterior humerus
- Innervation: radial nerve, C7-8
- Actions: extension of shoulder and arm
Supine Figure-4 Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Piriformis
- Attachments: anterior sacrum, sacrotuberous ligament, greater trochanter
- Innervation: S1-2
- Actions: ER of extended thigh, abduction of flexed thigh
Your client needs strengthening for lifting the arm to the side and has tightness near the medial epicondyle. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Shoulder Abduction with TheraBand
- 2 sets until fatigue (12-15 reps)
- 2x/day everyday
Deltoid
- Attachments: clavicle, acromion process, spine of scapula, deltoid tuberosity
- Innervation: axillary nerve, C5
- Actions: extension/lateral rotation, flexion/medial rotation of shoulder, shoulder abduction
Passive Wrist Flexor Stretch (Upside-Down High-Five)
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Flexor Carpi Radialis
- Attachments: medial epicondyle, 2nd metacarpal
- Innervation: median nerve, C7
- Actions: flexion, abduction of wrist
Your client is unable to complete a single push up and has tightness in the hip flexors. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Wall Push-Ups
- 2 sets until fatigue (12-15 reps)
- 2x/day everyday
Pectoralis Major
- Attachments: medial clavicle, sternum, costal cartilage, external oblique aponeurosis, intertubercular groove
- Innervation: medial pectoral nerve, lateral pectoral nerve, C6-8
- Actions: adduction, IR, flexion, extension
Kneeling Hip Flexor Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Iliacus
- Attachments: ala, iliac crest, iliac fossa, anterior sacroiliac ligaments, tendon of psoas major, lesser trochanter
- Innervation: femoral nerve, L2
- Actions: flexion of thigh
Your client has difficulty carrying groceries due to elbow flexor weakness and needs a stretching exercise to isolate the soleus. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Bicep Curl with Dumbbell
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Biceps Brachii
- Attachments: supraglenoid tubercle, coracoid process, tuberosity of radius, bicipital aponeurosis
- Innervation: musculocutaneous nerve, C6
- Actions: flexion, supination of forearm; flexion of arm
Bent-Knee Calf Stretch on Half Foam Roll
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Soleus
- Attachments: head of fibula, superior fibula, posterior tibia above soleal line, calcaneal tendon
- Innervation: tibial nerve, S1-2
- Action: plantar flexion of ankle
Your client has difficulty with heel walking and has tightness in the back of the neck with cervical flexion. What strength and stretch would you prescribe? What are the muscles involved and their action, innervation, and attachments?
Ankle Dorsiflexion with TheraBand
- 2 sets to fatigue (12-15 reps)
- 2x/day everyday
Tibialis Anterior
- Attachments: lateral condyle, superolateral tibia, interosseous membrane, medial cuneiform, 1st metatarsal
- Innervation: deep fibular nerve, L4
- Actions: dorsiflexion, inversion of ankle
Cervical Flexion Stretch
- 2 sets, hold each 30-60 seconds
- 2x/day everyday
Rectus Capitis Posterior Major
- Attachments: spinous process C2, inferior nuchal line
- Innervation: suboccipital nerve, posterior ramus C1
- Actions: extension, ipsilateral rotation of neck
