2 Movement Tests Lower Quarter

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Prone Press Ups

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

Prone Press Ups

Prone Press Ups

To mobilize an FRS dysfunction and increase lumbar extension:

The patient is lying on their stomach with their hands placed under their shoulders. The patient is instructed to attempt to press up using only their arms and not their back muscles.

They try to keep their hips resting on the table as they straighten their elbows as far as possible. Instruct them to bring their shoulders down and back as they press up.

Repeat 10 times.

Side Gliding in Standing Facing the Wall

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Side Gliding in Standing Facing the Wall

Side Gliding in Standing Facing the Wall

For treatment of an FRS Right:

The patient is standing facing the wall with the feet approximately three feet away from the wall. Instruct the patient to shift their hips to the right and hold this shift as they drop their hips straight forward towards the wall on and off 10 times.

Make sure that the patient introduces the side shift first before extending their spine and that they maintain this shift throughout the exercise.

Side Gliding in Standing Against the Wall

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

Side Gliding in Standing Against the Wall

Side Gliding in Standing Against the Wall

For treatment of an FRS Right:

Have the patient place their feet 2 to 3 feet away from the wall with their right shoulder and forearm resting against the wall. Make sure that their forearm blocks the rib cage.

Instruct them to place their left hand on their left hip and push their hips towards the wall as far as they can. Have them hold for 5 seconds then release.

Repeat 8 to 10 times.

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

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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

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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

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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

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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

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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.
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