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.