Exercise Booklet
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Cat stretch
Therapist`s aim
To stretch or maintain range in the spine.
Client`s aim
To stretch or maintain range in your spine.
Therapist`s instructions
Position the patient in four-point kneeling. Instruct the patient to flex
their spine and head then extend their spine and head.
Client`s instructions
Position yourself on your hands and knees. Practice arching
(rounding) your back up as you bend your head down, then drop your
back down to the opposite position and lift your head up.
Precautions
1. Avoid hyperextended spinal positions.
Spinal rotation stretch in sitting
Therapist`s aim
To stretch or maintain range in the spine.
Client`s aim
To stretch or maintain range in your spine.
Therapist`s instructions
Position the patient in sitting. Instruct the patient to rotate their head
and trunk to one side and reach behind them with both hands.
Client`s instructions
Position yourself sitting with your thighs supported on a bed. Rotate
your head and trunk to one side and reach behind you with both
hands.
Precautions
1. Impaired or absent sensation of stretch.
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Spinal rotation stretch in sitting with the arms crossed
Therapist`s aim
To stretch or maintain range in the spine.
Client`s aim
To stretch or maintain range in your spine.
Therapist`s instructions
Position the patient in sitting with their hands folded across their
chest. Instruct the patient to rotate their head and trunk to one side.
Client`s instructions
Position yourself sitting with your hands folded across your chest.
Rotate your head and trunk to one side.
Precautions
1. Impaired or absent sensation of stretch.
Side flexion over a ball
Therapist`s aim
To stretch tight tissue over the flank and axilla.
Client`s aim
To stretch tight tissue over your trunk and armpit.
Therapist`s instructions
Instruct the patient to lie sideways over the ball with the ball centred
under the thoracic spine and their feet on the floor. Instruct the
patient to raise their upper arm over their head to increase the stretch
through their upper arm, axilla and trunk. Ensure that hips, trunk,
shoulders and ankles are in alignment. The patient might need to
adjust their position to find the maximal area of stretch. This will be
individual to each patient and their area of tight tissue.
Client`s instructions
Lie sideways over the ball with their feet on the floor and the ball
centred under the middle of your spine. Raise your upper arm over
your head to increase the stretch through your upper arm, axilla and
trunk. Ensure that your hips, trunk, shoulders and ankles are in
alignment. You may need to adjust your position to find the maximal
area of stretch as instructed by your physiotherapist.
Precautions
1. Be aware that the ball is an unstable surface. 2. Ensure that the
environment is safe for this exercise. 3. Ensure that you dismount with
care.
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Thoracic spine and upper-chest stretch
Therapist`s aim
To stretch or maintain length of the trunk and upper chest muscles.
Client`s aim
To stretch or maintain range in your trunk and chest muscles.
Therapist`s instructions
Position the patient in supine with a rolled-up towel underneath the
length of their thoracic spine.
Client`s instructions
Position yourself lying on your back with a rolled-up towel underneath
the length of your upper spine.
Progressions and variations
Less advanced: 1. Use a smaller towel. More advanced: 1. Use a
larger towel. 2. Place the arms up behind the head. 3. Remove the
pillow.
Precautions
1. Impaired or absent sensation of stretch.
Hand behind head
Therapist`s aim
To maintain or improve range of motion and stretch tight tissue over
the lateral trunk, axilla and upper arm.
Client`s aim
To stretch tight skin and scarring over your trunk, axilla and upper
arm.
Therapist`s instructions
Instruct the patient to reach one arm behind their head and down their
spine as far as possible. Instruct the patient to use the contralateral
hand to increase the stretch by pulling on the elbow. Ensure that the
patient sits upright. The patient might need to adjust their arm position
to find the maximal area of stretch. This will be individual to each
patient and their area of tightness.
Client`s instructions
Reach one arm behind your head and down your spine as far as
possible. Use your other hand to increase the stretch by pulling on the
elbow. You may need to adjust your arm position to find the maximal
area of stretch as instructed by your physiotherapist.
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Neck flexion in 4-point kneeling
Therapist`s aim
To improve the ability to bend the neck.
Client`s aim
To improve your ability to bend your neck.
Therapist`s instructions
Position the patient in 4-point kneeling. Ensure that the patient has
their knees under their hips and their hands under their shoulders.
Instruct the patient to gently draw their belly button towards their
spine, push gently through their shoulder blades and lift their head up
so that it is level with their shoulders. Ensure that the patient keeps
their chin tucked in. Instruct the patient to slowly bend their neck
towards their chest and then return to the neutral position.
Client`s instructions
Position yourself in 4-point kneeling. Ensure that you have your knees
under your hips and your hands under your shoulders. Gently draw
your belly button towards your spine, push gently through your
shoulder blades and lift your head up so that it is level with your
shoulders. Ensure that your chin remains tucked in. Slowly take your
chin towards your chest. Return to the neutral position.
Progressions and variations
Less advanced: 1. Decrease the amount of flexion. More advanced:
1. Increase the amount of flexion.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner. 3. Maintain and hold a safe four point kneeling position while
doing the exercise.
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