Key Points for Success:

Transcription

1 SELF NECK 1

2 2

3 All of the stretches described in this chapter are detailed to stretch the right side. Key Points for Success: Recommended seating: Your chair should be firm enough to allow you to easily keep your pelvis in a neutral position. It should also have a back to help you monitor and maintain good posture. Keep both of your shoulder blades touching the back of the chair. Keep your pelvis in a neutral position. Keep your movements slow and precise. Breathe in before you move and breathe out while you move. Body Awareness: Alternately focus on the muscles moving the joint and the muscles being stretched. Check for tension during the movement. Use a mirror whenever possible to be aware of how your body is actually moving. Remember to move your head first and then assist yourself. Never force your assist. Never strain with your movement. If your muscles are shaking, you are working too hard; breathe and relax. 3

4 Movement Tips Correct: Keep your shoulders back and down. Correct: Keep your breastbone up towards the ceiling.. Correct: Tuck your chin. Correct: Roll your chin towards the floor. Maintain your tucked position throughout the movement. Correct: Keep your chin tucked on the return. Incorrect: Jutting your chin forward. Dropping your chin without tucking. Incorrect: Shrugging your shoulders. Incorrect: Extending your chin on the return. Extending your neck when you tuck your chin. Incorrect: Leaning forward Incorrect: 4 Leaning Backward

5 Sitting/Standing vs. Lying Down The consideration here is the effect of gravity. Remember; gravity is always pulling down. The moment your head and/or neck move away from a neutral plane, the muscles that are stretching are also contracting. They must maintain some tone to work against the pull of gravity otherwise your head would fall; uncontrolled, in the direction you are stretching. Asking your muscles to work against gravity creates a superior result every time. However, it is not always possible, that is why there are the seated and/or standing options. Sitting/Standing: The effects of gravity in the sitting or standing position create compression on the spine. If you are suffering from degenerative disc issues, the spaces between vertebrae and possibly the bones themselves are already compromised. Further compressive forces may lead to aggravation instead of relief. If you are weak or suffer from hypermobility, you may suffer pain from poor articulation of the joint as the compressive forces of gravity, combined with joint instability, make it difficult for the muscles to sequence properly for pain-free joint movement. Some of the table stretches are not done seated due to the unavoidable compression that occurs in this position. Lying Down: Working against gravity accomplishes everything you would like for your healing without any of the potential problems that can arise when you are sitting or standing. In this position, every stretch is equal to one repetition of strengthening as well. With the average head weighing in at about 15 lbs., it will not take long to develop true stability in your neck. Working against gravity gives your muscles the neurological stimulus they require to function differently by creating appropriate sequencing for smooth joint movement and retraining proprioception. With compressive forces reduced, you can safely apply this work to disc conditions. 5

6 Neck Semi-Circles; Seated Area Stretched: Entire Neck Muscles Emphasized: General warm up for all muscles, ligaments and discs. 1. Sit with your arms at your sides. 2. Turn your head to your R. 3. Drop your chin towards your R shoulder. 4. Keeping your chin tucked, slowly follow your collar bone to your breast bone and then up your other collar bone, making a smiley face with the movement of your chin. 5. Keep your chin tucked as you return to the starting position. Repetitions: 10 times. Be sure to keep your chin tucked. If you cannot keep your chin tucked, you are flexing your neck too far. You may need to keep your finger on your chin as reminder. If you are leaning forward, you are moving too far, keep your back straight. Keep your shoulder blades against the chair. Keep your breastbone up towards the ceiling. Do not let your chest collapse during the movement. Keep your shoulder blades down and back. Keep your spine straight. 6

7 Neck Flexion 1; Seated Area Stretched: Back of Neck Muscles Emphasized: Neck Erectors 1. Sit with your arms at your sides. 2. Place both hands over the top of your head with your elbows pointing towards your chest. 3. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 4. Bring your nose towards your breastbone. 5. When you cannot move farther on your own, assist yourself gently with your hands. 6. Hold for 2 seconds. 7. Keep your chin tucked as you return to the starting position. Precautions: This stretch may be contraindicated if you have a posterior disc bulge. Keep your breastbone up towards the ceiling. Do not let your chest collapse during the movement. Be sure to keep your chin tucked. If you cannot keep your chin tucked, you are flexing your neck too far. You may need to keep your finger on your chin as reminder. If you are leaning forward, you are moving too far. Keep your shoulder blades against the chair. Keep your shoulder blades down and back. Keep your spine straight. 7

8 Neck Flexion 2; Seated Area Stretched: Back of Neck Muscle Emphasized: Levator Scapula 1. Sit with your arms at your sides. 2. Turn your head halfway or 45 degrees to your L. 3. Place your L hand over the top of your head with your elbow pointing towards the center of your L breast. 4. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 5. Bring your nose to the center of your L breast and reach your R hand towards the floor. 6. When you cannot move farther on your own, assist yourself gently with your L hand. 7. Hold for 2 seconds. 8. Keep your chin tucked as you return to the starting position. Precautions: This stretch may be contraindicated if you have a posterior disc bulge. Keep your breastbone up towards the ceiling. Do not let your chest collapse during the movement. Keep your shoulder blades down and back. Be sure to keep your chin tucked. If you cannot keep your chin tucked, you are flexing your neck too far. You may need to keep your finger on your chin as reminder. If you are leaning forward, you are moving too far. Keep your shoulder blades against the chair. Keep your spine straight. 8

9 Neck Flexion 3; Seated Area Stretched: Back of Neck Muscle Emphasized: Trapezius 1. Sit with your arms at your sides. 2. Turn your head halfway or 45 degrees to your R. 3. Place your L hand over the top of your head above your R ear. 4. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 5. Bring your L ear to the center of your L breast and reach your R hand towards the floor. 6. When you cannot move farther on your own, assist yourself gently with your L hand. 7. Hold for 2 seconds 8. Keep your chin tucked as you return to the starting position. Precautions: This stretch may be contraindicated if you have a posterior disc bulge. Keep your breastbone up towards the ceiling. Do not let your chest collapse during the movement. Focus on an object or point straight ahead of you. Do not lean your torso forward, backward or sideways. Keep your shoulder blades against the chair. Keep your shoulder blades down and back. Keep your spine straight. 9

10 Neck Lateral Flexion; Seated Area Stretched: Side of Neck Muscles Emphasized: Trapezius, Levator Scapula, and Scalenes 1. Sit with your arms at your sides. 2. Reaching your L arm over your head, place your L hand on top of your head above your R ear. 3. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 4. Bring your L ear to your L shoulder and reach your R hand towards the floor. 5. When you cannot move farther on your own, assist yourself gently with your L hand. 6. Hold for 2 seconds 7. Keep your chin tucked as you return to the starting position. Precautions: This stretch may be contraindicated if you have a lateral disc bulge. Keep your breastbone up towards the ceiling. Focus on an object or point straight ahead of you. Do not lean your torso forward, backward or sideways. Keep your shoulder blades against the chair. Do not let your chest collapse during the movement. Keep your shoulder blades down and back. Keep your spine straight. Mr. Stretchy: Remember to bring your ear to your shoulder, not your shoulder to your ear! 10

11 Neck Rotation; Seated Area Stretched: Back and Side of Neck Muscle Emphasized: Sternocleidomastoid 1. Sit with your arms at your sides. 2. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 3. Turn your head to the R. 4. As you turn your head, place your R hand on your L cheek bone and your L hand behind your head just behind your R ear. 5. When you cannot move farther on your own, assist yourself gently with your both hands. 6. Hold for 2 seconds 7. Keep your chin tucked as you return to the starting position. Keep your breastbone up towards the ceiling. Do not let your chest collapse during the movement. Keep your shoulder blades down and back. Keep your spine straight. Only rotate your head; do not move it forward or backward. Lead with your eyes, looking as far behind you as possible. Even after your head has stopped, continue to look behind you with your eyes. Keep your L shoulder down and back. Hold onto the bottom of the chair to help stabilize your torso. Keep your torso and shoulders facing forward at all times. Keep your shoulder blades against the chair. 11

12 Neck Extension 1; Seated Area Stretched: Front of Neck Muscles Emphasized: Scalenes and Platysma 1. Cross your arms over your chest with your fingertips gently holding your collar bones. 2. Lean forward until your elbows rest on your thighs. 3. Keep your back straight. 4. Jut your chin forward as you extend your head and neck, and look up towards the ceiling. 5. Hold for 2 seconds 6. Return to the starting position. Precautions: This stretch may be contraindicated if you have an anterior disc bulge. Keep your abdominals tight. Lean forward the whole time. Do not sit up. Keep your shoulder blades down and back. Keep your spine straight. Lead with your eyes, looking as far behind you as possible. Even after your head has stopped, continue to look behind you with your eyes. Place your tongue on the roof of your mouth to intensify the stretch. 12

13 Neck Extension 2; Seated Area Stretched: Front of Neck Muscles Emphasized: Scalenes 1. Cross your arms over your chest with your fingertips gently holding your collar bones. 2. Lean forward until your elbows rest on your thighs. 3. Keep your back straight. 4. Turn your head halfway or 45 degrees to your L. 5. Bring your L ear up and back towards your L shoulder blade. 6. Hold for 2 seconds 7. Return to the starting position. Precautions: This stretch may be contraindicated if you have an anterior disc bulge. Keep your abdominals tight. Lead with your eyes, looking as far behind you as possible. Even after your head has stopped, continue to look behind you with your eyes. Remember to keep your head turned to a 45 degree angle throughout the movement. Lean forward the whole time. Do not sit up. Keep your shoulder blades down and back. Keep your spine straight. 13

14 Neck Extension 3; Seated Area Stretched: Front of Neck and Jaw Muscle Emphasized: Scalenes and Platysma 1. Cross your arms over your chest with your fingertips gently holding your collar bones. 2. Lean forward until your elbows rest on your thighs. 3. Keep your back straight. 4. Turn your head halfway or 45 degrees to your R. 5. Jut your jaw. 6. Look up towards the ceiling, bringing the back of your head towards your L shoulder blade. 7. Hold for 2 seconds 8. Return to the starting position. Precautions: This stretch may be contraindicated if you have an anterior disc bulge. Keep your shoulder blades down and back. Keep your lower body relaxed. Keep your spine straight. Lead with your eyes, looking as far behind you as possible. Even after your head has stopped, continue to look behind you with your eyes. Place your tongue on the roof of your mouth to intensify the stretch. Remember to keep your head turned to a 45 degree angle throughout the movement. 14

15 Neck Flexion 1; Table Area Being Stretched: Back of Neck Muscles Emphasized: Neck Erectors 1. Lie on your back with your arms at your sides. 2. Place both of your hands on the top of your head with your elbows pointing towards your chest. 3. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 4. Roll your neck, bringing your nose towards your breastbone, without lifting your shoulder blades off the surface you re lying on. 5. When you cannot move farther on your own, assist yourself gently with your both hands. 6. Hold for 2 seconds. 7. Keep your chin tucked as you return to the starting position. Advanced Movement: As your flexibility improves, reach your hands towards your feet. Precautions: If you have a TMJ disorder, be cautious of tucking your chin aggressively. Keep your chin tucked. If you cannot keep your chin tucked, you are lifting too high. Keep your shoulder blades touching the surface you are lying on. If you feel them come up, you are lifting too high. Pull your shoulder blades together and press them down into the table. Keep your body relaxed. Focus on moving your head only - do not roll your shoulders up. Be certain to keep your shoulder blades touching the surface you are lying on. Mr. Stretchy: Suffer from headaches? Cervical flexion can be an excellent stretch for relief of headaches. 15

16 Neck Flexion 2; Table Area Being Stretched: Back of Neck Muscle Emphasized: Levator Scapula 1. Lie on your back with your hands at your sides. 2. Turn your head halfway or 45 degrees to your L. 3. Place your L hand over the top of your head with your elbow pointing towards the center of your L breast. 4. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 5. Bring your nose to the center of your L breast without lifting your shoulder blades. 6. When you cannot move farther on your own, assist yourself gently with your L hand. 7. Hold for 2 seconds. 8. Keep your chin tucked as you return to the starting position. Advanced Movement: As your flexibility improves, reach your hands towards your feet. Precautions: If you have a TMJ disorder, be cautious of tucking your chin aggressively. Be sure to keep your chin tucked. If you cannot keep your chin tucked, you are lifting too high. Keep your shoulder blades touching the surface you are lying on. If you feel them come up, you are lifting too high. Pull your shoulder blades together and press them down into the table. 16 Keep your body relaxed.

17 Neck Flexion 3; Table Area Being Stretched: Back of Neck Muscle Emphasized: Trapezius 1. Lie on your back with your hands at your sides. 2. Turn your head halfway or 45 degrees to your R. 3. Place your L hand over the top of your head above your R ear. 4. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 5. Bring your L ear to the center of your L breast and reach your R hand towards the floor. 6. When you cannot move farther on your own, assist yourself gently with your L hand. 7. Hold for 2 seconds 8. Keep your chin tucked as you return to the starting position. Advanced Movement: As your flexibility improves, reach your hands towards your feet. Precautions: If you have a disc condition use a pillow to help reduce the effort required by your muscles to lift your head, Be certain to keep your shoulder blades touching the surface you are lying on. Keep your shoulder blades touching the surface you are lying on. If you feel them come up, you are lifting too high. Pull your shoulder blades together and press them down into the table. 17

18 Neck Lateral Flexion; Table Area Being Stretched: Side of Neck Muscles Emphasized: Trapezius, Levator Scapula, and Scalenes 1. Lie on your R side with your knees slightly bent for balance. 2. Reaching your L arm over your head, place your L hand on top of your head above your R ear. 3. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 4. Bring your L ear to your L shoulder, not your shoulder to your ear. 5. When you cannot move farther on your own, assist yourself gently with your L hand. 6. Hold for 2 seconds 7. Keep your chin tucked as you return to the starting position. Precautions: If you are weak, do this exercise lying on your side with your head resting on a pillow. If you have a disc condition use a pillow to help reduce the effort required by your muscles to lift your head, Keep your chin tucked. If you cannot keep your chin tucked, you are lifting too high. Focus on an object or spot in front of you. Placing a pillow between your knees helps provide comfort, balance, and support. Lengthen or extend your spine through the top of your head, then bring your ear to your shoulder, not your shoulder to your ear. Keep your hips stacked. Do not roll your body forward or back. 18 Keep your spine straight.

19 Neck Rotation; Table Area Being Stretched: Back and Side of Neck Muscle Emphasized: Sternocleidomastoid 1. Lie on your R side with your knees slightly bent for balance. 2. Gently draw your chin back, lengthening up through the top of your head, and keep it tucked. 3. Turn your head to the L. 4. As you turn your head place your L hand on your L cheek bone. 5. When you cannot move farther on your own, assist yourself gently with your L hand. 6. Hold for 2 seconds 7. Keep your chin tucked as you return to the starting position. Precautions: If you are weak, do this exercise lying on your side with your head resting on a pillow. If you have a disc condition use a pillow to help reduce the effort required by your muscles to lift your head, Lengthen or extend your spine through the top of your head, then rotate your head and neck. Do not shrug your shoulder. Only rotate your head and neck. Lead with your eyes. Start by looking down at the floor; then, turn to look behind you as far as possible. When your head cannot turn farther, continue looking with your eyes. Keep your eyes open throughout the movement. Hold onto your pants leg or reach for your feet with your non-exercising arm to help stabilize your shoulder. Placing a pillow between your knees helps provide comfort, balance, and support. Mr. Stretchy: Do not lift your head up or down. Keep your hips stacked. Do not roll your body forward or back. Keep your spine straight. When driving can you see your blind spot without turning your torso? If not this stretch is for you! 19

20 Neck Extension 1; Table Area Being Stretched: Front of Neck Muscles Emphasized: Scalenes and Platsyma 1. Lie on your stomach with your head and arms hanging over the edge of a bed or perhaps an ottoman or stool. 2. Jut your jaw and extend your head and neck looking up towards the ceiling. 3. Hold for 2 seconds 4. Return to the starting position. Precautions: This movement may be contraindicated if you have an anterior disc bulge. Begin your movement at the bottom of your neck. Do not shrug your shoulders. Keep your lower body relaxed. Lead with your eyes, looking up and back. Even after your head has stopped moving, continue looking up with your eyes. Keep your tongue on the roof of your mouth to intensify the stretch Remember to exhale as you lift your head. Place a pillow under your hips and ankles for extra comfort. Keep your chest on the table; do not extend your back. 20

21 Neck Extension 2; Table Area Being Stretched: Front of Neck Muscles Emphasized: Scalenes 1 Lie on your stomach with your head and arms hanging over the edge of a bed or perhaps an ottoman or stool. 2. Turn your head halfway or 45 degrees to your L. 3. Bring your L ear towards your L shoulder blade, looking over your shoulder with your eyes. 4. Hold for 2 seconds 5. Return to the starting position. Precautions: This movement may be contraindicated if you have an anterior disc bulge. Begin your movement at the bottom of your neck. Keep your head turned to a 45 degree angle. Keep your chest on the table; do not extend your back. Lead with your eyes, looking up and back. Even after your head has stopped moving, continue looking up with your eyes. Remember to exhale as you lift your head. Place a pillow under your hips and ankles for extra comfort. Do not shrug your shoulders. Keep your lower body relaxed. 21

22 Neck Extension 3; Table Area Being Stretched: Front of Neck and Jaw Muscles Emphasized: Scalenes and Platysma 1. Lie on your stomach with your head and arms hanging over the edge of a bed or perhaps an ottoman. 2. Turn your head halfway or 45 degrees to your L. 3. Jut your jaw. 4. Look up towards the ceiling, bringing the back of your head towards your R shoulder blade. 5. Hold for 2 seconds 6. Return to the starting position. Precautions: This movement may be contraindicated if you have an anterior disc bulge. Begin your movement at the bottom of your neck. Lead with your eyes, looking up and back. Even after your head has stopped moving, continue looking up with your eyes. Remember to exhale as you lift your head. Place a pillow under your hips and ankles for extra comfort. Keep your head turned to a 45 degree angle. Keep your chest on the table; do not extend your back. Do not shrug your shoulders. Keep your lower body relaxed. Mr. Stretchy: Cervical extensions are the most important stretch for reducing forward head posture. 22

23 Thoracic Extension; Table Area Being Stretched: Front of Torso and Ribs Muscles Emphasized: Abdominals and Intercostals 1. Lie on your stomach on the floor or on a firm bed. 2. Pull your shoulder blades together. 3. Reach your hands down towards your feet. 4. Lift your torso towards the ceiling, keeping your bottom ribs touching the floor or bed and your legs and feet relaxed. 5. Hold for 2 seconds 6. Return to the starting position. Precautions: If you have lower back muscle pain, spasms or a disc condition, use caution when doing this exercise. Keep your lower back relaxed. Begin your movement at the bra line or mid back. Do not extend your lower back. Keep your hips and legs relaxed. Lead with your eyes, looking up to the ceiling. Even after your head has stopped moving, continue looking up with your eyes. Remember to exhale as you lift your head. Turning your feet outward will help keep your hips and lower back relaxed. Place a pillow under your ankles for extra comfort. Mr. Stretchy: Thoracic extension is a key player in reversing an exaggerated kyphosis. 23

24 Key for Protocols of the Neck - Name of Stretch Muscles Stretched Seated Neck Semi-Circles; Seated 1 general neck warm up Neck Flexion; Seated 1-3 Cervical Erectors Neck Lateral Flexion; Seated 1 Trapezius, Levator Scapula, Scalenes Neck Rotation; Seated 1 Sternoclidomastoid, Trapezius, Levator Scapula, Neck Extension; Seated 1-3 Sternoclidomastoid, Scalenes, Platysma Table Neck Flexion; Table 1-3 Cervical Erectors, Sub-occipitals Neck Lateral Flexion; Table 1 Trapezius, Levator Scapula, Scalenes Neck Rotation; Table 1 Sternoclidomastoid, Scalenes Trapezius, Levator Scapula Neck Extension; Table 1-3 Sternoclidomastoid, Scalenes, Platysma Thoracic Extension; Table 1 Abdominals, Intercostals Shoulder Horizontal Abduction; Standing 1-5 Pectorals, Biceps, Deltooid Shoulder Extension; Standing 1-6 Biceps Shoulder External Rotation; Standing 1 Rotator Cuff 24

25 Complete Neck Protocol - If time allows, complete the entire cervical routine for table and chair. You can expect the entire seated protocol to take about minutes. Seated Neck Semi-Circles; Seated Page N6 Neck Flexion; Seated 1-3 N7-N9 Neck Lateral Flexion; Seated Neck Rotation; Seated N10 N11 Neck Extension; Seated 1-3 N12-N14 You can expect the entire table protocol to take about minutes. Table Page Neck Flexion; Table 1-3 N15-N17 Neck Lateral Flexion; Table Neck Rotation; Table N18 N19 Neck Extension; Table 1-3 N20-N22 Thoracic Extension; Table N23 25

26 Protocols for the Neck Forward Head Posture, Thoracic Outlet, Dowager s Hump and Military Neck The timing below considers both sides. Primary Purpose - Reverse the exaggerated hump that sometimes forms in your upper back and lower neck. Common Challenges - Being very tight in the front muscles of your shoulders and torso is a common challenge. Often, however, weakness in the muscles of the back, neck and shoulder muscles is the overriding cause. Long Term Goals - Stretch and strengthen all of the neck and shoulder muscles, with emphasis placed on strengthening the postural or anti-gravity muscles. If time is not a consideration, it is more efficient to simply do the complete neck protocol and then move on to the complete shoulder protocol. The below suggestions are taking time into account. Stretch Page Neck Extension: Table 1-3 N20-N22 Thoracic Extension: Table 1 N23 Shoulder Horizontal Abduction; Standing 1-4 S6-S10 Shoulder Extension; Standing 1-6 S11-S13 Shoulder External Rotation; Standing 1 S15 Neck Lateral Flexion; Table 1 N18 Neck Rotation; Table 1 N19 Neck Flexion; Table 1-3 N15-N17 26

27 Nerve Impingement - Nerve impingement follows the same protocols as above. Typically the impingement comes from pressure on the nerves due to overly tight muscles constantly pressing upon the joint and eventually the nerve. Spurring - Spurring may or may not be helped with manual treatment. The body has the potential to reabsorb the calcium it has laid down provided a healthy environment can be created. This requires not only stretching but a lot of strengthening. The body requires stability in order to feel confident enough to disintegrate the spur. Be careful when rotating your neck; there is increased potential for the muscles to be torn by the spur. X-rays and good communication with your doctor will usually give you the feedback you need to understand which movements are safe and which are not. In order to have the highest chance for success, it is vital that each movement is done precisely. Be very diligent to avoiding compensatory movements. Remember that most likely repetitive movements and poor posture created the conditions that have led to spurring. For example, when rotating your head, do not allow your head to tilt forward or backward. Keep your head in a neutral position in relation to your atlas and axis (the first two cervical vertebrae). Do not allow your neck to move away from neutral. Disc Conditions - In general cervical disc conditions are addressed in the same manner as described above. The tendency is for the neck to move forward and the head to tilt backwards due to forward posturing. This posture; is typically created by poor body mechanics and the accumulative effects of gravity. This often leads to a disc condition, especially after trauma such as whiplash. There is no predetermined direction a disc will bulge, herniate or rupture. It is vital to know which direction the disc is protruding in order to take best care for yourself. Be sure to discuss x-rays or MRI results and communicate with your physician before beginning any of these exercises. When working with a disc condition, it is advisable to avoid chair stretches and go right into the table protocols. This allows for building strength and flexibility at the same time. One of the biggest roadblocks to success with these conditions can be stability. Without stability the body continues the cycle of spasms. 27

28 You will usually find the muscles on the side of the bulge to be in spasm. The body adjusts to this condition by tightening muscles in order to protect the disc from further harm. Unfortunately the same tension the body uses to try to keep further pressure from aggravating the disc creates an environment of constant stress on the disc. Without any help to get out of this cycle, more and more pressure is put on your disc as your muscles begin to weaken. Under these circumstances, work very slowly and gently to avoid triggering the stretch reflex and possible muscle spasms. In order to create a more favorable environment for bringing the disc back into its appropriate position, it is important to emphasize movement in the direction of the bulge. For example, if the disc is bulging to the front, it is advisable to begin with flexion and end with flexion. You are likely to be very sensitive to this movement as some pressure will be placed on the disc. Move very slowly and gently. Listen to your body and be very careful of working into painful movements. Pain is a reminder to pay attention to what your injured body needs to heal. Be mindful of the movements you are doing and remain present to the work being done. 28

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