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Supine Piriformis Self Stretch above 90 degrees

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Manual Therapy, Muscle Energy, Rolling, Self Stretch

Supine Piriformis Self Stretch above 90 degrees

To Stretch the Left Piriformis:

  • Have the patient reach under the left leg and grasp underneath the ankle with their right hand and under their left knee with the left hand.
  • Instruct the patient to draw the left and ankle towards their right shoulder using both hands.
  • A stretch should be felt in the left buttocks.
  • Then have the patient push their left knee and ankle into both hands for 5-7 seconds, when the patient relaxes have them draw their left leg further up towards the right shoulder.
  • Have them repeat 3-4 times progressively drawing the left leg further up towards the right shoulder upon each relaxation.
  • Then have them repeat this exercise on the right side.

Piriformis Self Stretch above 90 degrees

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Manual Therapy, Muscle Energy, Rolling, Self Stretch

Piriformis Self Stretch above 90 degrees

To Stretch the Left Piriformis:

  • Starting from the hands and knees position, the patient places the left foot across and underneath the trunk so that the arch of the foot is facing the ceiling with the left knee remaining outside of the trunk.
  • Have the patient stretch out the right leg straight behind them while keeping the pelvis straight.
  • Instruct the patient to gradually sink down until they feel a stretch in the left buttocks. You can have the patient either stay up with their elbows extended or have them come down to rest on their forearms.
  • Ask the patient to press their left leg straight down into the table or floor for 5-7 seconds, then relax and stretch further by sliding the right leg further back making sure that they keep the pelvis level.
  • Repeat a series of contract/relax efforts 3-4 times.
  • No pain should be felt in the left knee or low back during this exercise.

Piriformis Self Stretch below 90 degrees

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Manual Therapy, Muscle Energy, Rolling, Self Stretch

Piriformis Self Stretch below 90 degrees

To Stretch the Left Piriformis:

  • Have the patient place their left foot outside of their right knee and flat on the table.
  • The patient places their left hand over the left pelvis to stabilize and places the right hand over the lower left thigh, a towel or belt wrapped around the lower left thigh will also work.
  • Have the patient maintain an active contraction of the right leg to keep it straight.
  • Instruct the patient to slowly pull the left leg across until a stretch is felt in the left posterior hip area.
  • From this position a series of contract/relax efforts can be made for 5-7 seconds, progressively stretching into further adduction or the stretch can be maintained for 30 seconds and repeated 2-3 times.

Prone to Supine Leading with the Upper Body

in 2 Movement Tests Lower Quarter, All Lower Quarter, Rolling

Prone to Supine Leading with the Upper Body

Prone to Supine Leading with the Upper Body

Patient is lying prone with arms and legs straight and slightly abducted and head is in neutral.

Ask the patient to roll over onto her back using the right arm only.

The head and neck should extend and rotate to the right as the arm is brought back.

The lower body/legs should not contribute to the roll.

Evaluate for quality, ease of movement, respiration, synergy and ability to complete the roll without substitution by pushing off with the feet.

Repeat to the opposite side initiating the movement from the left arm and compare the two sides.

Prone to Supine Leading with the Lower Body

in 2 Movement Tests Lower Quarter, All Lower Quarter, Rolling

Prone to Supine Leading with the Lower Body

Prone to Supine Leading with the Lower Body

Patient is prone with arms and legs slightly abducted and head in neutral.

Ask patient to roll over onto her back using her right leg only.

The patient should keep the right leg straight if possible.

The upper body should not contribute to the roll.

Evaluate for quality, ease of movement, respiration, synergy and ability to complete the roll.

Repeat to the opposite side leading with the left leg

Supine to Prone Leading with the Upper Body

in 2 Movement Tests Lower Quarter, All Lower Quarter, Rolling

Supine to Prone Leading with the Upper Body

Supine to Prone Leading with the Upper Body

Patient is lying supine with legs extended and slightly abducted and arms flexed overhead and slightly abducted.

Head starts in the neutral position.

Ask patient to roll onto her stomach by reaching obliquely across with her right arm.

The patient’s head should flex and turn towards the left axilla.

The lower body should not contribute to the roll, watch for assistance by the legs.

Evaluate for the quality, ease of movement, respiration, synergy and ability to complete the roll using only the right upper body.

Repeat by rolling to the right using only the left upper body and compare the two sides.

Supine to Prone Leading with Lower Body

in 2 Movement Tests Lower Quarter, All Lower Quarter, Rolling

Supine to Prone Leading with Lower Body

How to Perform

Supine to Prone Leading with Lower Body

Patient is lying supine with arms separated overhead and legs apart, 10 and 2 and 8 and 4 positions.

Ask the patient to roll to the prone position starting with the right leg only.

The patient should lead with right hip flexion followed by adduction of the extended leg.

The upper body should not contribute to the roll.

Evaluate for the quality, ease of movement, respiration, synergy and ability to complete the roll without substitution.

Repeat with the left leg to assess for symmetry and quality of the movement.

Anterior Hip Capsule Mobilization

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, All Lower Quarter, All Manual Therapy, Mobilization, Rolling, Supine Heel slide

Anterior Hip Capsule Mobilization

Prone Hip Flexor Stretch Sequence: Anterior Hip Capsule Mobilization

  • Subject’s left foot is placed on the floor with lumbar spine side bent to the left and right leg in alignment with the trunk
  • Therapist flexes the right knee to assess free range and holds the knee flexed just short of end range
  • Therapist then applies a PA glide to the femur from medial to lateral to find the direction of the greatest restriction
  • The therapist then mobilizes the hip in a PA direction applying grade III to IV mobs for 1-2 minutes

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.
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