Therapeutic Exercise Assignment
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... Wait for Dr's permission to begin running and jumping
--Lauren Mulsow
Home Exercises for Ad…
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Wait for Dr's permission to begin running and jumping
--Lauren Mulsow
Home Exercises for Adhesive Capsulitis
Pendulum Exercise
Bend over at the waist so that the arm falls away from the body and dangles in a relaxed way. Use your body to initiate a circular motion. Make small circles while keeping the shoulder relaxed. Do this for 2 to 3 minutes at a time.
Table-top Arm Slides
Sit in a chair adjacent to a smooth table top. Lift the involved arm with the uninvolved arm and place the hand and forearm on the table. Bend forward at the waist allowing the hand and arm to slide forward. Do 10 repetitions.
Supine Passive Forward Flexion
Lie on your back. Using the strength of the uninvolved arm. Raise the involved arm up and then backward (as if to reach overhead) Do 10 repetitions.
Wall Climb Stretch
Stand facing a wall; place the hand of the affected arm on the wall. Slide the hand up the wall, allowing the hand and arm to go upward. As you are able to stretch the hand and arm higher, you should move your body closer to the wall. Hold the stretch for 15 to 20 seconds. Do 10 repetitions.
Internal Rotation: Behind-the-Back Stretch
Sitting in a chair or standing, place the hand of the affected arm behind your back at the waistline. Use your opposite hand to help the other hand higher toward the shoulder blade of the opposite shoulder. Do 10 repetitions.
Horizontal Adduction Stretch
Lying on your back, hold the elbow of the affected arm with your opposite hand. Gently stretch the, elbow toward the opposite shoulder. Do 10 repetitions.
Standing Neutral External Rotation
Hold a door frame with the hand of the involved arm. While keeping the involved arm firmly against your side and the elbow at a right (90 degree) angle, rotate your body away from the door to produce outward rotation at the shoulder. Do 10 repetitions.
External Rotation in Corner
Standing facing a corner, position the arms with the elbows at shoulder level. Lean your body gently forward toward the comer until a stretch is felt. Hold this position gently for15 to 20 seconds. Repeat 10 times.
Shoulder Shrugs and Scapular Retraction
Shrug shoulders upward and pinch shoulder blades backward and together. Do 10 repetitions.
-Andrew Towell
Elbow
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... Positive Elbow Flexion Test (elbow is fully flexed, wrist is neutral, shoulder girdle abductio…
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Positive Elbow Flexion Test (elbow is fully flexed, wrist is neutral, shoulder girdle abduction and depression, patient holds position for 3-5 minutes)
Positive response is tingling/paresthesia in ulnar nerve distribution (6)
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Sign (assesses abductoradductor pollicis weakness
Positive Wartenberg’s Sign (examine for clawing/abduction of the small finger with extension) (11)
Evaluate sensation, vibratory perception and light touch, and 2-point discrimination
Therapeutic Exercise Assignment
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... You can increase the intensity of the exercise by having the pt increase the speed of movement…
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You can increase the intensity of the exercise by having the pt increase the speed of movement and/or the range that they are reaching.
You can also add external forces such as resistance band and free weight to progress the exercises.
Adam Mathers - Transient Brachial Plexopathy/Stinger/Burner
Brachial plexus injury that is common when tackling in football
MOI
brachial plexus stretch most often involving C5 and C6 nerve roots
direct blow causing contralateral neck flexion and ipsilateral shoulder depression
Temoporary burning sensation radiates from the shoulder to the hand. May last hours, days, weeks. No complaints of neck pain associated.
Symptoms typically resolve without intervention
Occurs in 65% of collegiate players during a 4 year career
Exam findings – weakness of shoulder abductors, external rotators, and biceps
Differential Diagnosis
cervical cord neuropraxia (transient quadriparesis), stable cervical sprain, nerve root - brachial plexus axonotmesis, intervertebral disk herniation, unstable / stable cervical fractures,
clavicle fracture, AC separation, peripheral nerve injury, scapula fracture, rotator cuff tear
Referenced from Wheeless’ online textbook. http://www.wheelessonline.com/ortho/172
Therapeutic Exercise Assignment
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... Lunge with reach for back, gluts
Lunge with arms overhead works abs, quads
Balance Exercise…
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Lunge with reach for back, gluts
Lunge with arms overhead works abs, quads
Balance Exercises from April 6th - Brandon Walker
A few useful definitions:
Points of balance - The number of body parts that are in contact with a stable surface. (e.g. standing on one leg with both hands on the wall equals 3 points of contact).
Driver - Anything that is use to achieve a desired motion. (e.g. reaching horizontally with the arms to achieve IR and ER at the hip)
Balance exercises can be established and modified by changing the drivers, points of balance, range, speed, and angulation of the movements to achieve the desired movement.
How changing the movement of different drivers affects the hip. (All of these exercises are in single leg stance with no UE support)
LE driver
Moving foot straight anterior and posterior - hip flexion and extension
Moving foot straight lateral and medial - hip abduction and adduction
Moving foot from anterior/medial to posterior lateral and back (allowing pelvis to move with swinging leg) - hip IR and ER
UE drivers
Reaching horizontally left and right - hip IR and ER
Reaching straight down anteriorly and straight overhead - hip flexion and extension
Reaching left and right keeping arms straight overhead - hip abduction and adduction
Techniques can be combined to facilitate more complex motions
You can increase the intensity of the exercise by having the pt increase the speed of movement and/or the range that they are reaching.
You can also add external forces such as resistance band and free weight to progress the exercises.
Therapeutic Exercise Assignment
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... Pulleys are now considered active-assisted.
You can do thoracic movements if shoulder is immo…
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Pulleys are now considered active-assisted.
You can do thoracic movements if shoulder is immobilized. Have them relax shoulder when they are moving other body parts. It's a simple concept but a lot of people are very guarded no matter how they are moving.
balance: your ability to keep upright in your personal environment
stability: when something acts on you, ability to maintain position
Squatting Specifics- Amanda Young
There are 27 common stances for squats in ther ex
Therapeutic Exercise Assignment
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During each joint lab, we will be designing a therapeutic exercise program for various cases. Y…
During each joint lab, we will be designing a therapeutic exercise program for various cases. You will need to collect these exercise programs and post them here. Students will work in a group of 5-6. This assignment must be completed by April 16. However, you are welcome to add more exercises to this document to make a comprehensive exercise program that you can use during your clinical internships.
Ankle Lab
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Instruct patient how to maintain/increase strength through their HEP
Patient must be instructed on how to progress the exercises in their program
Shoulder Dislocation Exercises
Brandon Smith
Shoulder Flexion
You can do this exercise laying down and using a broomstick or plastic pipe. 1. Lie on your back, holding a broom with your hands. Your palms face down as you hold the broom. Place your hands slightly wider than your shoulders.
Keeping your elbows straight, slowly raise your arms over your head until you feel a stretch in your shoulders, upper back, and chest
Hold 15-30 seconds
Reapeat 2-4 times
Shoulder Blade Squeeze
While standing with your arms at your sides, squeeze your shoulders blades together. Do not raise your shoulders as you are squeezing.
Hold for 6 seconds
Repeat 8-12 times
Internal Rotator Strengthening Exercises
Using a piece of thera-band or thera-tube tye a piece to doorknob
Stand or sit with your shoulder relaxed and your elbow bent 90 degrees. Your upper arm should rest comfortably against your side. Squeeze a rolled towel between your elbow and your body for comfort and to help keep your arm at your side.
Hold one end of the elastic band in the hand of the affected arm.
Rotate your forearm toward your body until it touches your stomach
Keep your elbow and upper arm firmly tucked against the towel roll or the side of your body during this movement. Repeat 8-12 times
Isometric Shoulder External Rotation
Stand with your affected arm close to a wall.
Bend your arm up so your elbow is at a 90 degree angle and turn your palm as if you are about to shake someone's hand.
Hold our forearm and elbow close to the wall Press the back of your hand in to the wall with moderate pressure.
Hold for 6 seconds. Repeat 8-12 times.
Isometric Shoulder Abduction
Stand with your affected arm close to a wall
Bend your arm up so your shoulder is at a 90 degree angle and turn your palm as if you are about to shake someone's hand
Hold your forearm and elbow close to the wall. Press your elbow in the the wall with moderate pressure.
Hold for 6 seconds. Repeat 8-12 times.
Wall Push-ups
Stand against a wall with your feet about 12-24 inches away. If any pain is felt when exercise is performed, then stand close to wall
Place your hands on the wall slightly wider apart than your shoulders, and lean forward.
Gently lean your body toward the wall. Then push back to your starting position. Keep the motion smooth and controlled.
Repeat 8-12 times
Wrist Lab (March 7th)
Group 1: Demonstrate PT intervention for someone with Carpal tunnel syndrome
Literature Presentation
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... Reference:
Drake, M., Bittenbender, C., & Boyles, R. E. (2011). The short-term effects of…
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Reference:
Drake, M., Bittenbender, C., & Boyles, R. E. (2011). The short-term effects of treating plantar fasciitis with a temporary custom foot orthosis and stretching. The Journal of orthopaedic and sports physical therapy, 41(4), 221-31. doi:10.2519/jospt.2011.3348
Open Versus Closed Chain Kinetic Exercises After Anterior Cruciate Ligament Reconstruction A Prospective Randomized Study
Accelerated therapy after an ACL reconstructive surgery is known to be beneficial, but there is still debate as to whether a closed chain exercise program is better than an open chain one. A closed chain exercise is one where the body is moving on a fixed foot. They are usually performed near full extension, which compresses the joint and provides stability. This is also a more functional position that can help develop proprioception. This is compared to open chain activities. These include exercises where the lower extremity is free and moving on a fixed body, for example, seated knee extension machine. These exercises are normally done in 30-90 degrees of flexion. This position has little to no compressive forces on the joint; however, the shear forces are increased.
This study found 100 patients who underwent ACL reconstruction with a patellar tendon autograft. All knees were put in a 0-90 degree motion brace after surgery, and performed continuous passive motion from 0-60 degrees for 12 hours a day until discharge. The exercise protocols for each group are seen below. The closed chain group used the Sport Cord to add resistance.
Time
Open Chain Exercises
Time
Closed Chain Exercises
0-3 weeks
Isometrics and hamstring concentric and eccentric isotonics
0-8 weeks
Two leg 1/3 knee bends, seated leg press, hamstring curl
3 weeks
30⁰ of flexion straight leg raises
6 weeks
Stationary bike, proprioception
6 weeks
Light quadriceps isotonics, stationary bike, proprioception training
8 weeks
One leg 1/3 knee bends, forward and backward walking against resistance, jog against resistance
8 weeks
Isokinetic hamstrings
12 weeks
Slow, deep lateral jumping against resistance, previous exercises with added resistance
12 weeks
Unrestricted quadricep eccentric and concentric activity
16 weeks
Free weight leg press, squats, sport specific exercises
16 weeks
Treadmill jogging, forward and backward running, single-leg deep knee bends
24 weeks
Progressive running and sport specific
24 weeks
Isokinetic quad training; progressive resistance training
9 months
Noncutting sport activities
7-8 months
Progressive running and sport specific training
12 months
Unrestricted sports
9 months
Noncutting sport activities
12 months
Unrestricted sports
At the final follow up the mean deficits were 1 degree of extension, and 2 degrees of flexion between both groups. The functional outcome measures increased as well. The Lysholm score improved from 67 to 87, and the Tegner activity level went from 4 to 6. There were no significant differences between groups in the pivot shift, Lachman, KT side to side differences, or extension or flexion deficits. However, patellofemoral pain that restricted activity was significantly higher in the open chain group (38%), compared to 15% in closed chain group nine months post-op. The closed chain group rated their therapy as good or excellent 97% of the time, compared to 80% in the open chain. Also, 72% of the closed chain group reported that they returned to sport sooner than expected, compared to 33% of the open chain group. This study supports the statement that closed chain exercises in an accelerated therapy program are safe and effective for post-op ACL reconstructions.
Reference
Bynum, E.B., Barrack, R.L, & Alexander, A.H. (1995). Open versus closed chain kinetic exercises after anterior cruciate ligament reconstruction: a prospective randomized study. American Journal of Sports Medicine, 23(4), 401-406.
