Stretch 4-6 times per day and hold each stretch for a minimum of 30 seconds. Perform the stretch gently without bouncing. Discuss any problems with your Chiropractor. Sit upright with your head and shoulder fully relaxed. Lightly hold on to the side of your chair with one hand, turn your head away from this side at a 45 angle and tilt your chin down towards your chest. Do the same as above, but turn your head TOWARDS the side that you re holding on to the chair. Lie on your side with your head over a rolled up towel. Allow the action of gravity to let your head stretch your head under its own weight. DO NOT pull it any more forcefully than this Whilst sitting, tuck your chin in and hold this with one of your hands. Lift the other hand up and grip under the back of your head. Gently traction your head up with this hand while ensuring the chin is still tucked in with the other hand. Stand up with your arms out straight, placing one hand on top of the other. Let your head drop forward while you try and push your shoulders and arms further forward. Stand in a doorway or against a wall. Put your arm up, holding it straight against the doorway, above the level of your own shoulder. Turn your body away from the arm and feel a stretch over the front of your chest. Lift one arm above your head, allowing it to bend behind your neck. Hold the elbow of this arm with your other hand. Pull with your hand to feel the stretch under the shoulder of the first arm at the back of your upper arm. Reach the affected arm across your chest towards the opposite hip. Hold on to the elbow with the opposite hand and traction the arm across your chest towards the opposite hip to feel a stretch at the back of the affected arm and shoulder.
Stretch 4-6 times per day and hold each for a minimum of 30 seconds. Perform the stretch gently without bouncing. Discuss any problems with your Chiropractor. Stand with your feet wide apart. Stretch one arm over the head. Bend away from that side at the same time as the elevated shoulder is brought slightly forwards. Make sure that your feet stay on the floor and that your hips are lined up with your feet. The stretch should be felt in the waist and lower back. Lie on your back with both knees bent. Cross one leg over the other one, putting your heel/shin on top of the leg. Then reach through and pull up the uncrossed leg towards your chest. The stretch should be felt in the buttock. This stretch can also be done seated at the edge of a chair leaning forward over the crossed legs. Lie on your back with both knees bent. Hold the top of each one in turn and pull it up to your chest, towards the opposite shoulder. This will create a stretch in the buttock and outer hip. For a more intense stretch keep one leg stretched out along the floor. Stand side-on, 1 foot away from a wall. Place the leg closest to the wall behind the other one with the foot turned out. Lean against the wall, and tilt your upper body away from the wall. The stretch should be felt on the leg closest to the wall. Kneel down with one leg in front of the other one. Perform a back tilt of the pelvis. Shift your weight forwards until you feel your back leg stretch at the front of the thigh. Kneel down with one leg stretched out in front of you. You might find it easier to support yourself against a chair or the bed. Keeping your back straight, lower yourself forwards to feel a pull behind the outstretched leg. If you are suffering from knee problems this stretch is best done sitting on a chair instead of kneeling. Kneel on all fours and try to raise your back up towards the ceiling. Then place your arms as far forwards as you can reach and kneel back onto your heels. Alternatively lie on your back and hug one or both knees to your chest. The stretch should be felt in the lower back.
Always perform your recommended stretches before and after these exercises. Build up the number of repetitions over a period of time. If an exercises is causing exacerbation of your symptoms STOP the exercise, stretch and discuss any problems with your Chiropractor. Stand or sit upright with elbows flexed, forearms turned in and wrists extended. Depress the shoulder blades and then slowly rotate the shoulders/arms outwards until you can feel a strong contraction of the muscles between your shoulder blades. Hold for 10 seconds and do 10 reps twice daily. Lie on your back with your head in neutral or slightly flexed (you can support the back of your head on a ½ inch book or block). Tuck your chin in and hold this position for 10 seconds. When this exercise can be performed 10 consecutive times, without fatigue, progress to step two. Lie in the same position as above. Tuck your chin in and curl your neck up segmentally as if to look at your feet. Then lower back down maintaining the chin tucked in. Repeat a maximum of 10 reps. Rapid fatigue is common initially. Stand or sit with back to a wall, with arms overhead. If standing keep knees slightly flexed. Press your shoulder blade against the wall, and maintain this pressure while sliding your arms down until the shoulder blades are pressed together. Hold position for 4 seconds. Do 10 reps twice daily. Lie on your front with your weight on your knees and elbows. Your elbows should be straight under your shoulders, and your forearms turned in as far as possible. Keep your tummy muscles tight and look towards the floor. Round your upper back without shrugging your shoulders. Hold position for 4 seconds. Repeat 10 reps twice daily. Sit or stand with your back straight. Place your hands on your forehead. Gently push your head forwards into your hands. Your hands should resist any movement of your head. Start with light pressure, build to maximum pressure, then return to light pressure. Repeat the same exercise pressing your head back and sideways. Hold for 5 seconds, repeat 5 times twice daily.
Your spinal rehabilitation exercises should be done at least once per day. The exercises should not be painful. If you experience pain while doing the exercise please stop and discuss any problems with your Chiropractor. It is recommended that you follow these exercises with previously advised stretches. The first exercise for the patient after co-contraction is achieved is just sitting on the ball. The ball should be pumped up to a reasonable pressure the firmer it is the more labile. Lie on your back with your knees bent. Push the small of the back down towards the floor This is the back pelvic tilt and is best done whilst breathing out. Arching just the small of your back is a front pelvic tilt and should be done whilst breathing in. Finding the mid-point between the two and holding this position helps protect the lower back. Practice this exercise sitting, standing and on all fours. Perform the back pelvic tilt. Next, concentrate on pulling your navel in towards your spine and then up under your ribs. You should be able to breath during the whole of this exercise. If your ribs flare out or your superficial stomach muscles show, the contraction is too forceful. Hold for 10 seconds and work up to 10 reps. After these steps have been achieved you are ready to progress into the spinal TRACKS recommended to you by your doctor. Although not a real track abdominal strength and lumbar range is often lacking in the chronic low back pain patient. Consequently, focusing on these areas is a good starting point. To perform curl downs push yourself to a sitting position using your hands. Make sure that you keep your knees bent while slowly, with arms out straight, curl down. The heels should not come off the floor. If they do, reduce the bending of the legs. Repeat this action 10 times and do 2 reps. To progress: 1. Pull the heels in to increase the bending of the legs. 2. Bend the arms across the chest. 4. Progress to perform a sit-up. 5. Perform a sit-up using a chest weight. 1. Find the mid/neutral range, perform co-contraction and simply sit on the ball for periods instead of a chair. 2. It is common to part the feet to achieve greater stability, so the first progression is to sit with the feet closer together. 3. Next march on the spot whilst maintaining the cocontraction After you have progressed well with the previous exercises you can proceed to anterior pelvic movements. These involve the maintenance of the co-contraction position with hips bent to 90 whilst the pelvis is lifted upwards. Repeat this action 10 times and do 2 reps. 4. Finally, raise one leg off the ground and hold for 15 seconds.
1. Lie on the floor, explore the full pelvic tilt range and find the neutral position. Then perform co-contraction, and hold this for 30 seconds and remember to breathe!! 3. The exercise is advanced by straightening the legs and arms, and also by moving the feet closer together. 2. Next raise your pelvis off the floor to form the bridge whilst maintaining the neutral co-contraction of the pelvis. Repeat this action 10 times and do 2 reps. 3. To progress with the exercise first keep the position described above while gently marching on the spot. Later straighten alternate leg to add further difficulty to the exercise. 1. Start kneeling on all fours and perform co-contraction in the neutral position. Make sure that head, neck and back are all in one straight line. 2. Maintain this position as you slowly raise one arm to horizontal, or the opposite leg. 4. Perform step 2 and 3 whilst the head and shoulders are supported on a gym ball. 3. Progression of this exercise is to combine arm and leg movement. Do not lift above horizontal as this will put unnecessary tension on the back. Hold position for 10 seconds. Repeat this action 10 times and do 2 reps. 1. Slump over the gym ball with your feet against the wall/ or held under the edge of a bar/bed. 2. Next with your hands behind your neck, perform cocontraction in the neutral range, and lift your back up to 90. Work up to 10 lifts and do 2 reps.
Core stability exercise programme Before commencing the following exercise programme, ensure you are able to contract your core muscles correctly whilst continuing to breathe normally. It is important to contract the core muscles before carrying out each exercise and to ensure each movement is performed slowly, steady and in control, whilst keeping everything else relaxed. If you experience any pain or pulling sensation whilst carrying out the exercises, speak to your Sports Therapist or Chiropractor who can advise you on an alternative to the exercise. Never work through the pain as you may be causing harm and injury. 1) Lie on your back knees raised with your feet and palms flat on the floor. Slowly and steadily slide your right leg out keeping the foot as close to the floor as possible, then slide your leg back to its starting position. Repeat the movement with your left leg. Reps = 10-15 N.B. to advance this movement, aim to keep the foot a few inches off the floor as you slide the leg out. 2) Lie on your back, knees raised and feet flat on the floor. Using a controlled movement let the right knee fall slowly to the side about 45 then bring it back to the starting position. Repeat on the left side. Reps = 10-15 3) Lie on your back, knees raised and palms flat on the floor. Slowly raise your hips off the floor to a bridge then lower back down, ensuring the core muscles are contracted throughout the exercise. Reps= 8-12 N.B. to advance this movement, when in the bridge position extend your leg at the knee, ensuring there is no movement through the hip joint. 4) Lie on your back with your feet on a swiss ball. As you extend your legs and roll the ball out, keeping your feet still, raise your hips off the floor. As you lower your hips down, bring your knees in towards you. Reps = 10-15 5) Lie on your back with legs raised into table top position. Keeping the lower back pressed into the floor and core contracted, slowly lower one leg keeping the knee at a 90 to tap the toe on the floor then raise back to meet the other leg in table top. Reps = 8-12 6) On all fours, ensuring there is no swaying or rotation of the pelvis, slide your right foot out directly behind you, keeping the foot in contact with the floor. Bring the leg back to its starting position and repeat with the left side. Reps = 8-12 N.B. to advance this movement, keep the foot raised off the floor so your leg is in line with your back.
7) On all fours, raise your right arm up to your ear then lower back to its starting position. Repeat with your left arm. Reps = 8-12 8) On all fours, slide your right leg out behind you and raise your left arm up to your ear, ensuring no swaying or rotation of the pelvis occurs. Repeat with the opposite arm and leg. Reps 10-15. N.B. to advance this movement, instead of placing the hand and leg back on the floor between movements, bring the elbow and knee to touch under the body and extend back out again - perform all reps on one side before repeating on the other side. 9) On all fours, extend opposite arm and leg as in exercise previous, keeping the torso still, windmill the arm and leg out to the side, aiming for them to be on a diagonal. Bring back to centre and relax arm and leg down, repeat on opposite side. Reps = 10-15 10) Sitting up straight with legs extended out in front of you, and hands placed on the lap, roll down to lie flat on your back. Ensure you roll down as slow as possible, vertebra by vertebra. From the lying position, using only your core muscles, sit yourself up straight. Reps = 8-12 N.B. to advance this move keep the arms by the ears throughout. 11) Lying face down, place the arms bent in front of you. Keeping the neck and shoulders relaxed, and eyes looking down to the floor, raise your torso off the floor slightly. Ensure you keep your core muscles contracted throughout and to not allow the back to arch. Reps = 10-15 N.B. to advance this move, place the hands lightly by the ears and keeping the eyes looking down to the floor raise the torso (you will have a little more range of movement in this position). 12) Lie down so your resting on your forearms and knees, lower your back so you in the plank position. Aim to hold it for up to 2minutes. Reps = 3-6 N.B. to advance this move, come off the knees so you re just resting on your toes in full plank. To advance further, army walk forward for 6 and back for 6. 13) Go down into full plank position. Keeping the ankles pressed together, roll the right arm up in the air into side plank. Hold for 30seconds, lower and repeat immediately on opposite side. Reps = 3-6 14) Sitting on the Swiss Ball raise each foot off the floor. This can be progressed to straightening the leg out in front of you and then bring the knee out to the side. Reps = 15-20 15) Sitting on the Swiss Ball, walk your feet out so your shoulders and upper back are on the ball (in bridge). Walking your feet back in, use your core muscles to sit yourself back up. Reps = 6-10 N.B. to advance this move, when in bridge position, extend your right leg out straight, hold for 3 seconds and place back on the floor, repeat with left leg then sit yourself back up.
16) On knees with hands on Swiss Ball, keeping back straight lower yourself towards Swiss Ball then extend your arms. Ensure you are only on your knee caps and not on your shins. Your weight should be unbalanced, so your arms are taking the weight. Reps = 6-10 17) Sitting on the Swiss Ball, walk your feet out so your back is resting on the Swiss Ball. Perform standard sit-ups, and then twisting sit-ups, ensure not to pull on the neck, hands should just be placed at the side of the head. Reps = 15-20 18) On hands and knees over the Swiss Ball, walk hands out until you re in press up position, with your shins/feet on the Swiss Ball. Hold for 3 seconds then walk your hands back in to the starting position. Reps = 6-10 N.B. to advance this exercise, try to do a press up whilst your holding the press up position. 19) Perform the move as above in number 18, once in the press up position, roll the Swiss Ball in towards your hands with your feet and the roll back out. Reps = 6-10 On completing the exercise programme, ensure you stretch your back out well. Your sports therapist and Chiropractor can advise you on these stretches and provide you with any others that may be of benefit.