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Long Sitting Slump Flossing

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

Long Sitting Slump Flossing

  • The patient is sitting with a belt or towel wrapped around the balls of the feet and is instructed to pull their trunk forward as far as they can while keeping their head up.
  • Then instruct the patient to drop their head down as they point their toes down and hold momentarily.
  • Then have the patient reverse these movements by raising their head up as they pull their toes up and hold momentarily.
  • Have the patient repeat these back and forth flossing movements of the nervous system 8-10 times.
  • When finished, always remember to instruct the patient to lie on their back with their knees up and feet flat on the table and rock the pelvis toward 12:00 and 6:00, 10-12 times to release any tension across the low back.

Counter Stretch for the Hamstrings (Neural Tension Self Mobilization)

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

Counter Stretch for the Hamstrings (Neural Tension Self Mobilization)

  • The patient is standing with the feet approximately hip width apart and places both hands on top of a counter or table top with the hands shoulder width apart.
  • Have the patient bend their knees but have them keep their heels flat on the floor. The patient is instructed to lift their sit bones up and back, toward the ceiling to achieve a neutral spine.
  • Instruct the patient to push their hands against the table top to assist in extending and elongating the thoracic spine.
  • Instruct the patient to straighten their elbows and attempt to elongate the spine, dropping the chest towards the floor.
  • Finally, have the patient straighten the knees maintaining a neutral lumbar spine, while lifting the sit bones towards the ceiling.
  • They straighten and bend their knees on/off approximately 10-12 times. They should not feel pain in the low back with this stretch.
  • Do not allow the patient to hyperextend the knees or drop their head during the stretch.

Wall Stretch for the Hamstrings (Neural Tension Self Mobilization)

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

Wall Stretch for the Hamstrings (Neural Tension Self Mobilization)

  • The patient is standing with the feet approximately hip width apart and places both hands against the wall with the hands shoulder width apart.
  • Have the patient bend their knees but have them keep their heels flat on the floor. The patient is then instructed to lift their sit bones up and back, toward the ceiling to achieve a neutral spine while lengthening the back of the leg.
  • Instruct the patient to push their hands against the wall to assist in elongating the thoracic spine.
  • Instruct the patient to straighten their elbows and attempt to elongate the spine, dropping the chest towards the floor.
  • Finally, have the patient straighten their knees while maintaining a neutral lumbar spine as they try to lift the sit bones towards the ceiling.
  • They straighten and bend their knees on/off approximately 10-12 times. They should not feel pain in the low back with this stretch.
  • Do not allow the patient to hyperextend the knees or drop their head during the stretch.
  • You may have to instruct the patient to begin this exercise with their hands much higher up the wall if they are not able to achieve and maintain a neutral lumbar spine while extending the knees.
  • As their flexibility improves the patient can slowly lower the placement of their hands on the wall.
  • The goal is for the patient’s hands to be placed on the wall at the same height as the hips, maintaining a neutral lumbar spine while fully straightening both knees.

Supine Left Hamstring Stretch with a Belt with Hip Adduction and Internal Rotation

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

Supine Left Hamstring Stretch with a Belt with Hip Adduction and Internal Rotation

  • The patient is lying supine and places a belt around the ball of the left foot.
  • Starting with the L knee flexed and with the left hip flexed to 90 degrees, instruct the patient to try to straighten the L knee as much as possible while maintaining dorsiflexion at the left ankle using the belt.
  • Then instruct the patient to keep the L knee as straight as possible as they bring the leg across the body into adduction and internal rotation to put an additional stretch on the sciatic nerve and lateral hamstrings.
  • The stretch is held for only 5 seconds and then released by bringing the left leg back to the midline while still maintaining a straight knee and dorsiflexion of the L ankle.
  • Instruct the patient to repeat this on/off stretch 10 times.
  • Then have the patient repeat on the right side.

Supine Left Hamstring Stretch with a Belt

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

Supine Left Hamstring Stretch with a Belt

  • The patient is lying supine and places a belt around the ball of the left foot.
  • Starting with the L knee flexed and with the left hip flexed to 90 degrees, instruct the patient to try to straighten the L knee as much as possible while maintaining dorsiflexion at the left ankle using the belt.
  • The stretch is only held for 5 seconds and then released by bending the left knee.
  • Instruct the patient to repeat this on/off stretch 10 times while keeping the left knee pointing straight up towards the ceiling.
  • Then have the patient repeat on the right side.

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, 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, 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, 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.

Supine Quadratus Lumborum Self Stretch

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, Active Trunk Rotation, All Home Exercises, All Lower Quarter, All Upper Quarter, Hip ABD Firing Pattern, Rolling, Self Stretch, Self-mobilization, Shoulder Circle

Supine Quadratus Lumborum Self Stretch

To Stretch the Left Quadratus Lumborum

  • The patient is lying supine and crosses the right leg over the left.
  • Instruct the patient to drop both legs to the right.
  • Have the patient push their knees together for 5 to 7 seconds and then relax. Upon relaxation the right leg pulls the left leg further over to the right to increase the stretch.
  • Repeat 3-4 times progressively.
  • Goal – try to touch the inside of the left knee to the floor without raising the left shoulder off the floor.
  • Repeat on the opposite side.

Quadratus Lumborum Hands and Knees Self Stretch

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, Active Trunk Rotation, All Home Exercises, All Lower Quarter, Hip ABD Firing Pattern, Self Stretch

Quadratus Lumborum Hands and Knees Self Stretch

To Stretch the Right Quadratus Lumborum:

  • Have the patient reach forward with the right hand and grasp a solid object. From this position instruct the patient to sit back diagonally towards the right hip, elongating (stretching) the right side of the back.
  • The right arm may be internally rotated (thumb down) or externally rotated (thumb up). Since the latissimus dorsi is an internal rotator of the shoulder internal rotation of the arm places more stretch selectively on the quadratus muscle.
  • Have the patient hold the stretch position for 30 seconds and repeat 2-3 times alternating sides.
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