Spine

1
Spine
2
Soft Tissue Mobilization

• Used for pain referral patterns of motion
• Will focus on myofascial release and trigger
  points

3
Upper Trapezius
4
Levator Scapulae
5
Sternocleidomastoid
6
Scalenes
7
Spleni Muscles
8
Posterior Cervical Muscles Pain Referral Sites
9
Posterior Cervical Muscles
10
Paraspinal Referral Points
11
Paraspinals
12
Quadratus Lumborum
13
Serratus Posterior
14
Joint Mobilization
15
Cervical Spine
16
Longitudinal Movement
17
Cervical Rotation Oscillations
18
Cervical Lateral Bending
19
Central Posterior-Anterior (PAs)
20
Unilateral PAs
21
Thoracic Spine
22
Central PAs
23
Unilateral PAs
24
Unilateral Costovertebral PAs
25
Lumbar Sacroiliac
26
Central PA
27
Unilateral PA
28
Rotation
29
Sacroiliac PA Pressures
30
Flexibility Exercises
31
Cervical Spine
32
Axial Extension

• Restore cervical alignment
• Common substitution
• Extends cervical spine and presses head backward
  rather than extending C-spine

33
Retraction

• Posterior cervical muscles
• Substitution motion
• Cervical extension and lifting the chin during
  retraction

34
Cervical Flexion

• Posterior cervical muscles
• Common substitution
• Not curling the c-spine but use the lower c-spine
  as a fulcrum as upper c-spine stays straight

35
Upper Trapezius

• Common substitutions
• Allowing shoulder to shrug
• Neck rotation
• Forward head bend

36
Scalene
posterior
anterior
middle
37
Thoracolumbar Spine
38
Spinal Twist

• Middle, low back and gluteal areas
• Common substitutions
• Hips rotate with the stretch

39
Quadratus Lumborum Stretch

• Also Latissimus Dorsi
• Common substitution
• Pelvis leaves neutral position
• Flexion of the trunk

40
Prolonged Lateral Bend

• Lateral trunk
• Opens facet joints
• Common substitutions
• Trunk flexion

41
Lumbar Rock

• Posterior low back and hips
• Common substitutions
• Moving hands

42
Seated Bent Over Stretch

• Lumbar and thoracic regions
• Common subsitutions
• Bending from the hips

43
Knees to Chest Stretch

• Low back and hips
• Done single or double
• Double
• Lower one leg at time to prevent arching of
  lumbar spine

44
Lateral Trunk Stretch

• Lateral lumbar area
• Common substitution
• Ipsilateral shoulder leaves table

45
Hip flexor stretch

• Common substitution
• Hyperextension of lumber spine

46
Straight Leg Raise

• Hamstrings
• Common substitution
• Flexing opposite hip off table

47
Piriformis Stretch

• Lateral hip rotators
• Common substitution
• Provide less rotation of the stretched hip

48
IT Band Stretch

• Common substitution
• Lifting opposite shoulder off table

49
Lateral Shift

• Common substitution
• Tilting shoulders away from wall
• Leaning of hips into the wall

50
Standing Extension Stretch

• Increases trunk extension
• Common substitution
• Moving hips posteriorly
• Bending knees

51
McKenzie Exercises
52
Strengthening Exercises
53
Cervical
54
Cervical Isometrics

• Flexion
• Extension
• Lateral Flexion
• Rotation

55
Cervical Isotonic

• Manually
• Theraband
• Machine

56
Upper back muscles
57
Upper Back Muscles

• Prone Fly
• Upright Row
• Military Press
• Others?

58
Lumbar, Abdominal and Pelvic Region
59
Abdominal Crunch

• Hold at top for 10 sec

60
Oblique Abdominal Crunch
61
Supine Leg Exercises
62
Bridging
63
Side-lying Sit-up
64
Lateral Trunk Rotation
65
Lunges
66
Posture and Pelvic Stabilization Exercises

• Transverse Abdominus
• BP cuff to 40 mmHg
• Pelvic neutral position
• Pull navel to spine
• Watch for change in neutral spinal position
  dont want
• If BP cuff changes drastically then lost position

67
Posture and Pelvic Stabilization Exercises

• Multifidus Recruitment
• Pelvic floor muscles
• Tighten muscles as though stopping from urinating
  at mid flow
• Use the BP cuff again to monitor neutral spinal
  position

68
Core Stabilization
69
Level 1 (Stabilization) Supine

• Lower drawing maneuver
• Bridging
• Supine w arm movement
• Supine w/ leg movement
• Supine w/ arm/leg movment
• Supine w/ arms/ unsupported legs
• Diagonal crunch

70
Level 1 (Stabilization) Quadruped

• Quadriped arm raise
• Quadriped w/ leg raise
• Quadriped opposite arm opposite leg raise

71
Level 1 (Stabilization) Prone

• Prone Cobra
• Human arrow

72
Level 1 (Stabilization) Side-lying

• Side-lying isoabdominal

73
Level 1 (Stabilization) Standing

• Lateral shuffle w/ tubing
• Lunges
• Single leg lunge w/ abdominal bracing

74
Level 2 (Stabilization Strength)
75
Level 2 (Stabilization Strength)
76
Level 2 (Stabilization Strength)
77
Level 2 (Stabilization Strength)
78
Level 2 (Stabilization Strength)
79
Level 3 (integrated stabilization strength)
80
Level 3 (integrated stabilization strength)
81
Level 3 (integrated stabilization strength)
82
Level 3 (integrated stabilization strength)
83
Level 4 (Explosive Stabilization)
84
Level 4 (Explosive Stabilization)
85
Level 4 (Explosive Stabilization)