The BioMechanics Method
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1 The BioMechanics Method EXERCISE SOLUTIONS FOR CHRONIC PAIN The Fundamentals of Corrective Exercise
2 End of Section Self-Check #1 In order for an exercise program to be successful, the exercises you recommend and the amount of time a client must spend performing those exercises should be compatible with that person s activity preferences and schedule. The exercises must also specifically address the muscles and imbalances you want to target. Use the S.I.M.P.L.E. exercise evaluation procedure on two exercises from the corrective exercise examples detailed in Section 4 of this manual to help you start thinking smarter about exercise recommendations for a particular client or person. (A blank copy of this form can be found in Appendix A of this manual and on the Assessment Tools CD- ROM included with your course materials.) Recommended Exercise S.I.M.P.L.E. Exercise Evaluation Structures addressed (e.g., muscles, fascia, areas, etc.) Imbalance(s) addressed (e.g., pronated feet, medial knee, excessive lordosis or kyphosis, etc.) Mechanics (can the client correctly perform the exercise using the right muscles) Practical to perform (including amount of time needed and equipment requirements) Level (identify an exercise progression or regression based on client s ability) Exercise alternatives (based on client preferences and exercise effectiveness) Recommended Exercise S.I.M.P.L.E. Exercise Evaluation Structures addressed (e.g., muscles, fascia, areas, etc.) Imbalance(s) addressed (e.g., pronated feet, medial knee, excessive lordosis or kyphosis, etc.) Mechanics (can the client correctly perform the exercise using the right muscles) Practical to perform (including amount of time needed and equipment requirements) Level (identify an exercise progression or regression based on client s ability) Exercise alternatives (based on client preferences and exercise effectiveness) 10 Section 1 Corrective Exercise Programs 2010 The BioMechanics. All Rights Reserved.
3 End of Section Self-Check #2 When choosing corrective exercises for your clients, it is important to make sure that the exercises you give them can be performed successfully. However, you must also explain the rationale for incorporating a specific exercise into a program so your clients understand why they are performing that particular exercise. Doing so will make your clients more likely to perform the exercise regularly. Think about a client you are currently helping. For each of the following exercises listed below (details on these exercises can be found in Section 4 of this manual) identify whether the level of the exercise is beginner, intermediate or advanced based on the baseline skills of your client. Once you have determined the exercise level, write a brief, jargon-free description that you could use to highlight the benefits of that exercise for your client. Use the example provided to help you get started. Calf Stretch NAME OF EXERCISE LEVEL OF EXERCISE Beginner REASON FOR PERFORMING EXERICSE When the calf muscles are tight it makes it difficult for the leg to come forward over the foot when you walk. If the leg cannot come forward over the foot then the hips may shift backward. This incorrect position of the hips affects the function of the lower back and is contributing to your back pain, so it is important to stretch your calves. Golf Ball Roll Foam Roller IT Band Hip Flexor Stretch Butt Lift 2010 The BioMechanics. All Rights Reserved. Section 1 Corrective Exercise Programs 11
4 End of Section Self-Check #1 In this section you learned about several types of myofascial, stretching, and strengthening exercises. Take a few minutes to consider the unique aspects of each type. In the space below, you will find the various exercise types discussed in this section listed on the left side of the page. Draw a line from each exercise type to the sample exercise (taken from Section 4 of this manual) that matches it on the right. There is one exercise match per exercise type. Self-Myofascial Release The Pivot Kinetic Chain Strengthening The Wave Goodbye (with position held) Active Stretch Lower Back Stretch (seated without opposing contraction) Isometric Strengthening Extension Crunch Passive Stretch Tennis Ball Shoulder Complex Eccentric Multi-Joint Strengthening Hip Flexor Stretch (with Glute activation) Dynamic Stretch Foot Stretch (while rotating the tibia inward and outward) Trigger Point Massage Foam Roller IT Band 40 Section 2 Types of Corrective Exercises 2010 The BioMechanics. All Rights Reserved.
5 End of Section Self-Check #2 When designing corrective exercise programs for clients, it is extremely important to know how to regress an exercise to ensure they succeed at each level of the program. It is equally as important to know how to progress an exercise to ensure you help clients reach their goals. To help you practice your exercise adjustment skills, list an appropriate regression and progression for each of the following exercises. (These exercises can all be found in Section 4 of this manual.) NAME OF EXERCISE Foam Roller Gluteal Complex POSSIBLE REGRESSION POSSIBLE PROGRESSION Tennis Ball Shoulder Complex Hamstring Stretch (standing) Calf Stretch Butt Lift The Pivot Extension Crunch 2010 The BioMechanics. All Rights Reserved. Section 2 Types of Corrective Exercises 41
6 End of Section Self-Check #1 There are many postural habits that your clients may have adapted over their lifetimes that likely contribute to both musculoskeletal and neuromuscular compensation patterns. To help you become aware of some of the most common patterns you may encounter, perform the following movements with your own body and make a note of the sensations you experience. Movement On which side of the body is it easier to perform the movement? What areas on the difficult side do you feel are restricted? Crossing Your Arms First cross your right arm over left Now cross your left arm over right Crossing Your Legs While Seated First cross your right leg over left Now cross your left leg over right Propping Weight On One Leg First shift your body weight onto your left leg Then shift your body weight onto your right leg Reaching Behind You To Touch Opposite Glute While Standing First use your left arm to touch your right butt cheek (with palm down on butt) Then use your right hand to touch your left butt cheek (with palm down on butt) 52 Section 3 Postural Considerations 2010 The BioMechanics. All Rights Reserved.
7 End of Section Self-Check #2 Consider all the muscles, soft tissue structures, and fascia that can be adversely affected by prolonged postures. Next to each activity below, list two possible musculoskeletal issues that could be caused (or exacerbated by) that activity and determine one myofascial, one stretching, and one strengthening exercise that could be used to address the resultant problems. PROLONGED ACTIVITY PROBLEMS CAUSED EXERCISE USED TO ADDRESS PROBLEM Driving long distance Standing over an operating table Sleeping on one side of the body Entering data on a desktop PC Drawing plans at a drafting table Dancing in 3-inch high heels 2010 The BioMechanics. All Rights Reserved. Section 3 Postural Considerations 53
8 Fundamentals of Corrective Exercise Exercise Skills Test As a specialist in The BioMechanics Method, you will likely design corrective exercise programs on a regular basis. The best way to learn how to select appropriate exercises and create effective programs is to practice thinking about which exercises would help real-life people who are in pain. The activities in this manual have provided you with an opportunity to practice your skills with regard to identifying and evaluating different kinds of exercises. As a test of your assessment, anatomy, and corrective exercise skills, use the following questionnaire to guide you through the process of choosing an effective corrective exercise that you could use with a specific person. You might want to make several copies of this questionnaire before you use it in the event that you would like to practice this skill on a number of people. Who is the person that has asked for my help? What specific imbalance does this person have that I want to address? What muscles and soft tissue structures are located in that area of the body? What is each muscle in that area supposed to do from a functional anatomy perspective? Is each muscle doing what it is supposed to be doing? If not, what is actually happening? Which muscles and/or soft tissue structures are being adversely affected by this imbalance? What kind of action would help reverse the stress to that muscle/soft tissue? What specific exercise (myofascial, stretching, or strengthening) would accomplish this goal? How will this exercise do that (e.g., what is the outcome from a functional anatomy perspective)? What real-life activity will be improved by this exercise? Do I want or need equipment for this exercise? If so, what? 2010 The BioMechanics. All Rights Reserved. 87
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