Self Stretch

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Stretch the Left Iliopsoas

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, 5 Home Exercise Strategy, Active Trunk Rotation, All Home Exercises, All Manual Therapy, Manual Stretching, Self Stretch, Supine Heel slide

Stretch the Left Iliopsoas

To Stretch the Left Iliopsoas:

  • The patient starts in half kneeling with the left knee placed on a towel or pillow on the floor with the hip internally rotated and the right hip and knee flexed to 90º. Their right hand may be placed on a chair or against the wall for support.
  • Have them place their left hand on their left buttocks. They are instructed to tighten the left buttocks muscle and tuck the hips under (12:00). They draw the belly button in and keep the shoulders centered over the hips so that they don’t arch the back.
  • Instruct the patient to use their right leg to pull the pelvis forward leading with the front of the left hip. They should feel a stretch in the front of the left leg/thigh. Further stretch can be obtained by maintaining this stretch position and side bending the trunk away (toward the right).
  • They are instructed to hold the stretch for 30 seconds 2-3 times or perform a series of isometric contractions attempting to pull the left hip forward for 5-7 seconds then relaxing and stretching further.
  • Then have the patient switch sides and repeat with the right leg.

Scalene Self-Stretch

in 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Upper Quarter, Self Stretch

Scalene Self-Stretch

To stretch the right scalenes:

  • Instruct the patient to sit up tall and place their left hand over the right first rib and clavicle to stabilize. The patient’s right hand grasps the bench or chair to further stabilize the neck.
  • Keeping their chin down, ask the patient to bring their head straight back into extension, side bend the head to the left and rotate back to the right.
  • They should feel a stretch through the front of their neck on the right side.
  • They hold for 30 seconds and repeat 2-3 times.
  • Then have the patient repeat the stretch on the L side.

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.

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.

Side Lying Thoracic Rotation

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 Thoracic Rotation

To increase thoracic spinal rotation to the left:

  • The patient is side lying on their right side with both hips flexed below 90º.
  • Have the patient place their left hand behind the head with their right arm straight out in front of them.
  • Instruct the patient to rotate back to the left as far as they can then return to midline and repeat again 5 times.
  • Then have them flex both hips to 90º and rotate back again 5 times.
  • Finally, have the patient flex both hips above 90º and rotate back 5 times.
  • As they flex their hips higher they move the focus of the rotation higher up their spine.
  • They repeat the exercise 5 times in each position to the opposite side, with the hips flexed below, at and above 90º.

Quadratus Lumborum Self Stretch

in 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Upper Quarter, Self Stretch, Shoulder Abduction, Supine Shoulder Flexion

Quadratus Lumborum Self Stretch

To stretch the left quadratus lumborum:

  • The patient is supine with hips and knees flexed and feet flat on the floor.
  • Instruct the patient to cross the right leg over the left and drop both legs to the right.
  • Ask the patient to push the legs 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 then repeat on the R side.
  • Goal – for the patient to try to touch the inside of the left knee to the floor while keeping the left shoulder on the floor.

Latissimus Dorsi Self Stretch

in 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Upper Quarter, Scapular Depression, Self Stretch, Supine Shoulder Flexion

Latissimus Dorsi Self Stretch

  • The patient is kneeling with their elbows on top of a bench or chair and their hips and knees flexed to approximately 90º.
  • Instruct the patient to place their hands and forearms together and rest their head on their upper arms.
  • Ask the patient to press the inner borders of their arms together to separate the shoulder blades in back.
  • Ask the patient to drop their chest toward the floor as much as possible, then perform a posterior tilt (12:00) of the pelvis without lifting up the chest. They should feel a good stretch along the sides, around their shoulder blades.
  • Have the patient hold the stretch for 30 seconds, then relax and sag the chest further toward the floor. They repeat the stretch 2-3 times.

Self-Stretching of the Upper Trapezius and Sternocleidomastoid

in 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Upper Quarter, Cervical Flexion Stability/Motor Control, Self Stretch

Self-Stretching of the Upper Trapezius and Sternocleidomastoid

Upper Trapezius and SCM Stretch

  • These muscles extend the upper cervical spine, side bend toward the ipsilateral side and rotate the head to the opposite side
  • When tight these muscles may serve as long restrictors for mobility at C0-C1

To stretch the right upper trapezius and sternocleidomastoid:

  • Instruct the patient to position their head in flexion, side bending to the left and rotation to the right.
  • Their left hand is placed on top and around their head for support. Instruct the patient not to pull on the head with the left hand.
  • The right hand grasps the chair or bench behind the right hip.
  • The stretch is introduced by asking the patient to slowly lean forward and away and not by pulling on the head. They should feel a stretch over the top of the right shoulder and behind the ear.
  • Then instruct the patient to tuck the chin down (nod the chin) to add to the stretch which should be felt at the attachment behind the right ear.
  • Ask the patient to pull their right shoulder blade down and back to further increase the stretch.
  • They hold for 20 seconds and repeat 2-3 times. Have the patient alternate sides and stretch to symmetry as much as possible.
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