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Standing Pelvic Clocks

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, Hip ABD Firing Pattern, Pelvic Clocks, Self-mobilization

Standing Pelvic Clocks

Standing Pelvic Clocks

The patient is standing facing a wall with their hands on the wall at about shoulder height and their feet hip width apart. Instruct the patient to imagine that they are standing on a clock on the floor such that when dropping the hips towards the wall they are moving towards 12 o’clock. Moving the hips forward and to the right is movement towards 1-2 o’clock and moving the hips forward and to the left is movement towards 10-11 o’clock.

They are instructed to drop their hips toward the wall then circle around from 12 to 3 and from 12 to 9.

They move in both a clockwise and counterclockwise direction, maintaining extension of their spine. They can focus on movement towards 1-2 o’clock to self mobilize for an FRS R or towards 10-11 o’clock to self mobilize for an FRS L.

They repeat the prescribed movement 10 times.

Shoulder Abduction with Hip Hiking

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Functional Integration, Hip ABD Firing Pattern, Scapular Depression, Scapular Stabilization, Shoulder Abduction

Shoulder Abduction with Hip Hiking

Elongation exercise in sitting:

  • This exercise helps to normalize shoulder abduction by asking the patient to hike up/lift the opposite hip to actively recruit the contralateral quadratus lumborum muscle.
  • The patient is sitting on a firm surface with the feet on the floor and is instructed to lift one arm out to side and up toward the ceiling.
  • At the same time as they are lifting the arm ask them to lift the opposite hip off the table/chair so that they lengthen the spine on the same side as the arm that is being raised. All of their weight should shift to the side of the pelvis that is directly underneath the raised arm.
  • Then they slowly lower their arm and repeat to the opposite side, alternating sides for 6-8 repetitions.
  • Tell the patient to try to coordinate raising the arm with lifting the opposite hip so that they occur simultaneously.

Robbery with or without Resistance Bands

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Functional Integration, Hip EXT Firing Pattern, Scapular Depression, Scapular Stabilization, Shoulder Abduction, Supine Hip ABD and ER

Robbery with or without Resistance Bands

  • The patient is standing with their hips and knees slightly bent, elbows straight and hands holding onto resistive bands.
  • Instruct the patient to keep their elbows close to their body as they straighten the knees and hips and move their arms so that their elbows and shoulder blades are pulled down and back towards the opposite back pockets with the palms ultimately facing forward.
  • Their neck should be relaxed and they should not hold their breath during this movement.
  • Ask them to repeat the exercise 3-5 times initially then increase the number of repetitions as their strength improves.

Kettle Bell Shoulder Integration – Sidelying

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Functional Integration, Scapular Depression, Scapular Stabilization, Shoulder Abduction

Kettle Bell Shoulder Integration – Sidelying

To promote stability of the R shoulder:

  • Have the patient lie on their L side with their R arm abducted to 90 degrees, their R leg is bent and their L leg is straight.
  • Place a kettle bell into the patient’s R hand and instruct the patient to hold their wrist in a neutral position.
  • Instruct the patient to find the sweet spot for stabilization of their R shoulder by drawing the humeral head back down into the glenoid fossa to “pack” the shoulder.
  • With the shoulder packed have the patient perform the following movements for 3-5 reps each:
    Turn their head to the R and L
    Internally and externally rotate the R arm
    Bend and straighten the R leg
    Rotate the R hip/pelvis forward and backward
  • They should keep their neck relaxed and avoid holding their breath during the exercise.
  • Once they have completed this exercise for the R shoulder you remove the kettle bell from the patient’s hand and have them roll onto their R side to repeat the exercise with the L shoulder.

Self-Stretch of the Pectorals

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Pectoralis Minor/Posterior Capsule, Scapular Depression, Scapular Stabilization, Self Stretch, Shoulder Abduction, Shoulder Circle, Supine Shoulder Flexion

Self-Stretch of the Pectorals

To stretch the right pectorals:

  • Initially the patient stands facing the wall and places their outstretched right hand on the wall at shoulder height.
  • Ask them to turn their trunk to the left so that their feet are parallel to the wall.
  • Have them bend their right elbow as they bring the right shoulder blade down and back.
  • Instruct the patient to place their left hand on the wall to help turn the trunk further to the left.
  • Make sure they hold the right shoulder down and back so that the right shoulder is no higher than the left.
  • Instruct the patient to lean into the wall to increase the stretch.
  • They should feel a stretch through the front of the chest and right shoulder.
  • Have them hold for 30 seconds and repeat 2-3 times.
  • Then have them repeat on the opposite side.

Posterior Capsule Self Stretch

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Pectoralis Minor/Posterior Capsule, Self Stretch

Posterior Capsule Self Stretch

In comparing the sleeper stretch with the cross body stretch in a group of asymptomatic recreational athletes the cross body stretch improved IR ROM better and the results lasted longer (McClure et al., 2007). However, they performed the cross body stretch with the shoulder internally rotated which we believe can lead to impingement and therefore we prefer to have the patient perform the stretch with ER of the shoulder and emphasize contralateral upper thoracic spinal rotation instead. We believe that it is the mobilization of the thoracic spine for contralateral rotation that explains the superior results with the cross body stretch.

To stretch the left posterior capsule:

  • The patient is seated and is instructed to bring their left arm up until parallel to the floor with their fingers pointing up towards the ceiling and the left elbow bent to 90 degrees.
  • They place their right hand on the outside of the left elbow.
  • Instruct the patient to use their right hand to pull their left elbow across in front of them keeping the left elbow bent and their left palm facing behind them.
  • Have the patient rotate their trunk as far as they can to the right to enhance the stretch and increase upper thoracic spinal rotation to the right.
  • The patient is instructed to hold for 30 seconds and repeat 2-3 times.
  • It’s important that you watch to make sure that the patient does not slump as they rotate to the right.

Shoulder Circles

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Rolling, Self-mobilization, Shoulder Circle

Shoulder Circles

To restore thoracic rotation to the left:

The patient is lying on their right side with their hips flexed between 45-60º and their hands out in front of them.

  • Instruct the patient to take their left arm and sweep their hand up over the head with the hand remaining in contact with the floor and the elbow straight.
  • The patient is encouraged to rotate their trunk and rib cage back as they circle around, but keep the knees together. They only circle around as far as they can while keeping the hand touching the floor.
  • Instruct the patient to follow their hand with their eyes as they circle around with an emphasis on opening the chest.
  • If the hand comes off the floor the patient is instructed to reverse directions and circle around the opposite way.
  • Have the patient repeat the exercise 5-6 times in a clockwise and counterclockwise direction on each side.

Egyptian Self-Mobs

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Pectoralis Minor/Posterior Capsule, Scapular Stabilization, Self-mobilization, Shoulder Circle, Supine Shoulder Flexion

Egyptian Self-Mobs

  • The patient is lying on their back with their legs straight and their arms straight out to the sides with their elbows bent to a right angle.
  • Instruct the patient to bring the palm of one hand towards the floor while the back of the other hand reaches back to touch the floor. As the arms are rotating tell the patient to turn their head to face the palm that is facing up toward the ceiling.
  • Instruct the patient to reverse directions with their arms and head rotation so that their eyes always look towards the palm that is turned up facing the ceiling.
  • The patient repeats this alternating rotation of their arms and head 8 to 10 times.
  • Tell the patient not to force their neck to turn any further than is comfortable, but that they can push further rotation thru their arms to increase the rotation of the neck.
  • Make sure that the patient maintains 90 degrees of shoulder abduction and 90 degrees of elbow flexion throughout the exercise.

Side Lying Reach and Roll

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Pectoralis Minor/Posterior Capsule, Rolling, Self Stretch, Self-mobilization, Shoulder Circle

Side Lying Reach and Roll

To restore thoracic rotation to the left:

  • The patient is lying on their right side with both hands out in front of them at arms length.
  • Ask the patient to reach forward with their left hand past their right hand and turn the thumb down to internally rotate the arm.
  • Instruct the patient to initiate the movement from the shoulder then shoulder blade, upper ribs, segmentally down to the lower ribs and finally move the left hip and knee forward.
  • To reverse this movement ask the patient to rotate back from below up so that the hip and knee move back first, then they bring the lower ribs back segmentally to the upper ribs and finally the shoulder blade and arm until the left elbow touches the floor behind them.
  • The goal is for the patient to be able to extend their elbow and lie the back of their hand on the floor with the palm of the hand facing the ceiling. If the patient is unable to fully extend their elbow initially they can just touch the elbow to the floor then reverse direction.
  • Instruct the patient to repeat the whole sequence 5-6 times then switch and repeat lying on their L side.
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