10 Minute Stretching

10 Minute Stretching

We asked Dr Erin Beven (Osteopath), What are the benefits of stretching?

“Stretching has so many benefits, it relieves joint pain and stiffness, reduces muscle spasm, increases energy, reduces stress, increases range of motion, elongates and lengthens muscles, decompresses joints, improves posture, and enhances athletic performance to name a few.” 

We also asked what stretches she tends to do on a daily basis?
Dr Erin Beven (Osteopath) “Whilst I tend to do a lot of Yoga postures and sometimes some quite demanding stretches nowadays, I still come back to a number of basic stretches especially when I’m busy, it’s the basics that keep you functioning well, and they are suited to most people.”

With Erin’s help we have come up with a basic progressive stretching program that make up some of her core stretches, it takes about 10 minutes to do most of the stretches each morning.

This is a general program and remember that stretching should not hurt.

Should you feel pain instead of a gentle stretch, or if you have any injuries please stop and consult one of our team, we may be able to offer you an alternative or a more suitable stretch for your individual needs.

Each stretch is held for between 20-30 seconds.

Never bounce, hold your breath or stretch to the point of pain.

 

1 – Lateral Neck Stretch

2. Shoulder, Rib Cage, Lat Dorsi Stretch

3. Chest / Pectoral Stretch.

4. Pec Minor Stretch.

5. Gluteal Stretch.

5.b) Sitting Gluteal Stretch with Torso Rotation.

5. c) Hip Buttock Stretch.

6.a Lumbar Extension and Abdominal Stretch.

6.a (front view) Lumbar Extension and Abdominal Stretch.

7.a) Seated Hamstring Stretch.

6.a Lumbar Extension and Abdominal Stretch.

5.b) Sitting Gluteal Stretch with Torso Rotation.

8. Quadraceps Stretch – Front View

9. Hip Flexor Stretch – Front View

5.b) Sitting Gluteal Stretch with Torso Rotation.

10. Calf Stretch – Side Vieww

11.a) Lateral Torso Stretch.

5.b) Sitting Gluteal Stretch with Torso Rotation.

Poor Desk Posture? – Dr Stuart’s favourite corrective exercise.

Poor Desk Posture? – Dr Stuart’s favourite corrective exercise.

The Prone Cobra.

Many patients ask: 

“What exercises could I perform to assist or improve my posture?  We asked Dr Stuart Robbins (Osteopath) this question.

His Answer:

Whilst there are many, and that they usually need to be individualised to the patient’s specific needs, one of the more effective exercises I’ll often prescribe is The Prone Cobra.

I find the prone cobra, when performed in concert with a chest stretching routine, can have remarkable impact on improving patients posture.  Furthermore I personally perform this exercise for about 3 minutes in total every second day and have done for many years now.

It aims to reduce both thoracic kyphosis (rounded shoulders) and anterior (forward) head carriage, both of which I often see in patients suffering neck and shoulder tension and/or headaches.

The Prone Cobra when performed as I describe is not a stretch, but it is a strengthening exercise that focuses on postural muscles of the back and neck.  These postural muscles require endurance to cope with the demands of both gravity and occupational or recreational postural demands.  I find that it is especially relevant for many desk workers, students, breast-feeding mothers or even hands on fathers.

From the outset I want to say that performing this or any other exercise or routine aimed at improving your posture is almost a waste of time if you are still going to sit slumped at your desk.  For this reason I remind patients to address their ergonomics first; whilst I’m not going to go into ergonomics at length here I often refer patients to simple videos I feel tell the story on ergonomics quite well, I’ve included one here in the hope it also helps.

THE PRONE COBRA:

* Warning * If you have any specific concerns regarding your suitability to perform this or any other exercise please discuss it with your treating Osteopath in your next consultation.

1.  Gently squeeze your bottom to assist in stabilising your pelvis and low back.

2.  Slowly extend through your mid to upper back, lifting your head off the ground, keeping a neutral neck (keep your eyes down – you shouldn’t look around the room whilst performing this exercise and should have your nose approximately an iPhone width from the ground).

3.  Initially turn your palms towards the ground and then slowly away from yourself aiming your thumbs towards the sky.

Hold this final position for 5 – 30 seconds, you’ll likely feel muscles working between the shoulder blades and often at the back of your arms in your triceps.

Perform 3 – 6 times with 3-10 seconds break between sets.

* The frequency with which you’ll perform this exercise will depend upon the other demands of your life, but aiming for 6 x 30 seconds every couple of days will put you in good stead to cope with the demands of a desk based occupation.

4.  There are a number of variations and progressions with this exercise including changing the arm positions to represent letters – W’s, T’s, Y’s, L’s, and the use of resistance, all of which can be discussed with your treating practitioner.

Posterior Chain Bridging

Posterior Chain Bridging

Supine Hip Extensions (Bridging)

Supine Hip Extension Start Position

Supine Hip Extension Start Position

Supine Hip Extension End Position.

Supine Hip Extension End Position.

 

 

 

 

 

 

 

Pictured:  Dr Rebecca Rowe – (Osteopath / Pilates Instrutor)

What is one of the simplest exercises to develop your gluteal or bottom muscles?

The supine hip extension or bridge has got to be one of the most effective and simple exercises for developing the gluteal muscles.  Done well it can also provide improved tracking for the knees and lower limbs.  It can be done almost anywhere, and you don’t need any equipment.

Step 1 – Position:-  Laying on your back with a neutral curve in the lumbar spine, this is where you have a little bit of space between your low back and the ground.  You should be able to slip you hand between your low back and the ground.  Knees are bent with feet on the ground as in the above picture.  Note if the distance from you heels to your buttocks is greater then you will use more of your hamstring muscles.

Step 2 – The motion:- Gradually peel your bottom off the ground, vertebrae by vertebrae feel you low back peel off the ground also.  You want to aim for a point where your knees, hips, and shoulders are in a straight line.  Watch for a tendency to allow the thighs to splay apart, this may happen if there is a muscular imbalance in the lower limbs.  If this is the case you may wish to fold a pillow or place a ball between your knees and gently squeeze it as you perform the exercise.  It may also help to feel a sense of lengthening though your knees as you rise to the top.

* Tempo: 2 seconds to rise | Pause 2 seconds at the top | 2 seconds to return your bottom to the ground.

* Aim for 3 Sets of between 10 to 30 repetitions.

* Please note that in the case of a disc and some other injuries to the low back you may be best to avoid the peeling or segmental movement of the lower back especially in the early stages of your rehabilitation.

** Please consult your Osteopath or Rehab Pilates instructor before conducting this exercise to review your suitability to perform it.

Rotator Cuff Rehabilitation – External Rotation Exercises.

Rotator Cuff Rehabilitation – External Rotation Exercises.

We asked Dr Alastair Tehan (Osteopath) what are some common exercises he prescribes when dealing with shoulder injuries?

He responded:

There are many exercises and it really depends on the type of shoulder injury the person has sustained, but lets say someone has sustained an injury that has created some instability of the shoulder.  The shoulder is a very complex joint that enables a very large range of motion, weakness of the shoulder muscles can often put undue stress on the shoulder capsule and ligaments.  I often find due to desk based occupations with poor posture that people are often weak in their external rotators, and I feel this may predispose them to injuries in throwing sports such as cricket.

Strengthening the external rotators of the rotator cuff can not only help rehabilitate from many shoulder injuries but may also help reduce the likelihood of many injuries in the first place.  The rotator cuff consists of four muscles;- Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis muscles.  These muscles are endurance muscles and as such we often need to hold contractions, or perform repetitive actions with relatively light weights.  The risk of working with heavier weights is not only damaging to these muscles but often just sees these muscles being bypassed for larger muscles to perform an action.  With many of the rotator cuff exercises I’ll often start patients with about 3 sets of 12-15 repetitions, and build up to 5 sets of 25-30 repetitions.

towel squeeze

The towel Squeeze – Isometric Rotator Cuff Activation.

 

The towel squeeze:

This is an exercise I’ll often start my patients with, it requires no equipment or gym memberships and in itself can often alleviate a lot of their pain.

Often the first step is getting the patient used to an externally rotated position and then activating the rotator cuff muscles.  Placing a towel under the armpit, the patient will bend the elbow to 90 degrees and then turn the arm outwards with the palm facing forwards.

Be sure not to cheat and start to rotate your upper body, if you’re concerned this may be happening you may choose to put your back against the wall.  Once you’ve reached a comfortable externally rotated position gently drawing the elbow into you side and holding for about 10 seconds and repeat 3-6 times.

 

 

Dumbell External Rotations (Step 1)

Dumbell External Rotations (Step 1)

Dumbell External Rotation (Step 2)

Dumbell External Rotation (Step 2)

 

 

 

 

 

 

The Dumbell External Rotation exercise:

I’d like to stress that this exercise can also be done without purchasing equipment as I often get patient to perform it using a can of tomatoes or something to that effect.

A patient will lay on their side usually with a pillow under their head to assist with maintaining neutral alignment in their neck.  With their elbow of the top arm bent to 90 degrees they hold a weight often between 500 grams up to about 3kg.  Gently externally rotating at the shoulder and lifting the hand away from the ground.  Its really easy to feel if you are cheating with this one as when your body starts to rotate backwards you’ll feel like you want to roll onto your back.  Slowly lowering the weight again and repeating anywhere between 3-5 sets of 12 to 30 repetitions depending upon your current status.

Theraband External Rotations 

theraband external rotations start

Start Position

 

 

 

 

 

 

 

 

Theraband External Rotations

End Position

 

 

 

 

 

 

 

 

Theraband External Rotation exercise:

1. Secure Theraband to the door at approximately your own elbow height.  If you don’t have a door anchor you may wish to tie the theraband into a knot that you can close on the other side of the door.  Warning door handles can be dangerous.

2. Place a folded towel between your elbow and your torso on the side of the shoudler you are trying to strengthen, this will act as a feedback mechanism that will avoid cheating that can occur if you abduct or draw your elbow away from your side.

3. Bending the elbow to 90 degrees and grasping the theraband, stand side on to the door so that the Theraband is travelling across your upper abdomen.

4. Being mindful of your posture gently externally rotate / turn your upper arm out, once again avoiding rotation through the torso and avoiding any excessive wrist flexion or extension, try to keep the wrist neutral.

Start with about 3 sets of 12-15 repetitions, and build up to 5 sets of 25-30 repetitions.

Using a Theraband and a door anchor is a great portable way in which to train the muscles of the rotator cuff and shoulder.  I often find I give this to people who need to travel a lot.  The beauty about Theraband is not just its portability but I find it a little better than dumbbells as it is very easy for the patient to increase or decrease the load. Patients simply hold the band with more or less tension, or even doubling it over for more resistance.  A door anchor is a worthy investment as it prevents injuries that can sometimes occur if a door handle is used and is not securely attached to the door.

At our clinic we sell 2 meters of theraband for about $10 and Door anchors are about $15.

** Please note whilst this article includes some general information, shoulder injuries are quite complex and a thorough diagnosis is always necessary before determining the exercises that are the best course of action.  If you have a shoulder injury and are seeking information, the best thing to do is book with one of our Osteopaths for a more tailored exercise regime.

 

 

 

 

 

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome

Author: Dr Jessica Bowman (Osteopath)

We asked Dr Jessica Bowman if she could tell us a little about a common knee complaint, here’s what she had to say.

What is patellofemoral pain syndrome?

Patellofemoral pain syndrome is one of the most common causes of pain behind or around the kneecap. It is usually the result of abnormal tracking of the kneecap through the femoral groove as the knee flexes and extends, making it rub against the femur. This can cause joint irritation and, eventually, degeneration of the underside of the patella.

What causes it?

A number of factors can cause aberrant tracking of the patella. Usually, there exists a tightness of the Vastus Lateralis, which pulls your patella outwards, in combination with a weakness of the hip stabilisers and the Vastus Medialis, which usually pulls your patella up and inwards. This results in the kneecap being pulled to the outside of the knee.

Common reasons for a weak Vastus Medialis include overuse, injury, or disuse.

What are the symptoms?

People with patellofemoral pain syndrome tend to experience pain around or behind the kneecap. This is especially apparent with activities requiring the extremes of knee flexion, such as kneeling, squatting, running, or ascending/descending stairs.

What can my osteopath do to help?  

The aims of treatment for patellofemoral pain syndrome treatment are to ease pain and inflammation, maximise circulation for fast healing time, and to correct the causative underlying strain. With these in mind, your osteopath will:

  • Restore biomechanical balance to the lower extremity, pelvis and lumbar spine.
  • Tape the knee to support patellofemoral realignment.
  • Diagnose any weak musculature present and prescribe a range of stretching and strengthening exercises to be performed by the patient at home.
  • Provide advice on appropriate pain management, such as the use of a simple pain killer and avoidance of exacerbating activity.

From my experience approximately 90% of patients with patellafemoral pain will be pain-free within 6 weeks of beginning treatment.

What kind of self-management strengthening and stretching exercises can I expect?

Your osteopath will tailor a stretching and strengthening program to your individual needs, however some frequently prescribed exercises include:

1. Foam roller knee extension: 3x sets of 15 repetitions each side

  • Sit on the floor with your back supported against a wall.
  • Place a foam roller (or rolled up towel) underneath the lower thigh/knee.
  • Turn the toe out approx. 30⁰.
  • Squeeze the front of the thigh- focussing on the VMO- to lift the heel off the floor and push the back of the knee into the towel.
  • Return to the start position and repeat.
  • Repeat on opposite side.

2. Swiss Ball Squeeze: 3x sets of 15 repetitions each side

  • Position feet shoulder width apart, with the swiss ball behind one knee such that it creates a slight bend in it.
  • Contract your Transversus Abdominus (suck belly button in towards spine) and stand tall.
  • Gently extend the knee into the ball, focussing on squeezing the VMO.
  • Return to the start position and repeat.
  • Repeat on opposite side.

3. Toe- out lunge: 3x sets of 12 repetitions each side

  • Position one foot at a comfortable distance in front of the other. Each foot should be in front of the corresponding hip.
  • Turn the toes of the front foot 10⁰ away from the midline of the body.
  • Contract your Transversus Abdominus (suck belly button in towards spine) and stand tall.
  • Maintaining approx. 80% of the weight on the front foot, bend the front hip and knee into a lunge. Hold on to something for support if required.
  • Return to the start position and repeat.
  • Repeat on opposite side.

   

4. Clams: 3x sets of 20 repetitions each side

  • Lie on your side and bend your knees in front of you so that your thighs are perpendicular to your hips and shoulders, which should be in a straight line.
  • Rest your head on your bottom arm. Place your top arm on the floor in front of your chest for stability.
  • Raise the top knee towards the ceiling, allowing your hip to rotate in its socket. Keep the heels together, and only open the knees as far as you can go without allowing the pelvis to tilt forward or backward.
  • Slowly and with control, bring your knee back to the start position and repeat.

5. Theraband Squat: 3x sets of 12 repetitions

  • Step through the theraband loop and wrap it around or just above the knees.
  • Contract your Transversus Abdominus (suck belly button in towards spine) and stand tall.
  • Simultaneously bend at the hips and knees- being careful not to slump through the thoracic spine- and squat as if sitting into a chair. The head should remain facing straight forward, and the knees should track over, but no further than, the toes.
  • The movement should end as the angle at the knee reaches 90⁰. Rise and repeat.
  •  Stand with the feel shoulder width apart, such that all slack is taken out of the band.

6. Hamstring Stretch: Hold 30secs-1min each side

  • Standing up, place one heel on a raised surface with the knee slightly bent.
  • Contract your Transversus Abdominus (suck belly button in towards spine) and stand tall.
  • Lean forward from the hips- without slumping forward through the thoracic spine- until a slight stretch is felt in the middle of the hamstring muscle belly (if you feel it behind the knee, you’ve bent too far forward).
  • Accentuate the stretch by gently straightening the knee.
  • Rise and repeat on the opposite side.

** Please note whilst this article includes some general information, patellofemoral pain can be quite complex. A thorough diagnosis is always necessary before determining the exercises that are the best course of action.  If you have knee pain and are seeking information, the best thing to do is book with one of our Osteopaths for a more tailored treatment and exercise regime.