LEVEL A: Upper Spinal Floor Twist w/ Arm Sweep
Functional Purpose
Biomechanical Outcomes:
Create a neutral and stable position of the lumbar spine with hips flexed to 90 degrees.
Eliminate influence of pelvic positioning on motion of the thoracic spine and create a top down influence on the thoracic and lumbar spine.
Enhance thoracic mobility in the frontal & transverse plane of motion with the body being in a perpendicular position relative to the vector of gravity.
Use flexion and rotation of the shoulder joint to drive scapulo-thoracic motion & create accessory lateral flexion movements of the thoracic spine.
Create extensibility and compliance to the trunk muscles that contribute to flexion and rotation.
Neurological | Physiological Outcomes:
Full breath to engage the diaphragm and expand the rib cage prior to the “open” allows for a full, intentional exhalation that reduces guarded responses and allows for better thoracic rotation.
Audible and intentional breathing for the individual to execute during the “open” provides the client/patient with an external point of focus, further reducing conscious or unconscious guarding within the movement.
Cervical rotation and visual tracking and complimentary neural coupling with the desired motion.
Psycho | Social Outcomes:
Foster an environment where the opportunity for interoception can manifest, down-regulating any anxiety sensitivity / learned fears associated to biomechanical factors and/or physiological sensations.
Modifications:
Can place unilateral emphasis in cases of asymmetrical spinal deviations.
Small pillow may be placed under head for comfort and to keep cervical spine in alignment with thoracic spine.
Uninvolved hand can be used to hold knees together if necessary, to ensure pelvis and hips remain fixed.
Contraindications:
Subacromial Impingement syndrome.
Frozen shoulder.
LEVEL B: Quadruped | Reach & Pull
Functional Purpose
Biomechanical Outcomes:
Employing principles of relative motion, facilitate a top-down environment where the thoracic spine can begin rotating faster than lumbar segments caudally / cervical segments cranially.
Utilizing the transverse plane of motion creates an opportunity for the thoracic spine to extend through the principle of coupled motion (thoracic rotation and extension).
Neurological | Physiological Outcomes
The large base-of-support and low-level stabilization requirement facilitates the opportunity for blending novel and existing motor strategies.
Promotes an increase in connective tissue adherence at gleno-humeral / hip joints, enhancing tensional-stability to safely accommodate thoracic rotation and extension.
Psycho | Social Outcomes:
Create a backdrop where the gradual successes of each repetition fosters an increase in positive affect and movement confidence.
Modifications:
Increase the lever length at the hip to increase the influence of gravity’s vector.
Contraindications:
Spondylosis/Spondylolisthesis
Challenges associated hip prosthesis / hip degenerative disease.
LEVEL C: Hip Hinge with Hands on Wall
Functional Purpose
Biomechanical Outcomes:
From bottom up = Utilizing the hip as a fulcrum (create hip flexion), this increases lumbar extension and encourages the thoracic spine to extend the more the thorax is perpendicular to gravity.
From top down = Due to the hands being fixed to the wall, the upward rotation, abduction and posterior tilting of the scapula create the demand for an increase in thoracic extension.
Enhance the osteokinematics / arthokinematics of the gleno-humeral, sternoclavicular and acromioclavicular joints within a closed chain environment as the thorax moves on a fixed humerous (via hand on wall).
Neurological | Physiological Outcomes
Increase connective tissue extensibility associated with closed-chain gleno-humeral and scapula motion necessary to enhance / accommodate thoracic extension.
Facilitate optimal motor unit recruitment associated with thoracic extension via isometric contraction of thoracic and lumbar extensors.
Psycho | Social Outcomes:
Enhance psychological resiliency, self-efficacy and movement confidence via integration of cognitive-perceptual and somatosensory mechanisms.
Modifications:
Distance to the wall.
Contraindications:
Inability to dissociate motion from the hips / pelvis and lumbar / thoracic regions.
Subacromial Impingement syndrome.
LEVEL D: Staggered Stance Backends to the Wall
Functional Purpose
Biomechanical Outcomes:
Enhance the coupled motion of hip / lumbar extension to accommodate the thoracic spine moving into extension as the arms reach overhead.
As the mass of upper body and arms reach overhead and posterior to the axis of the hip joint, this will promote necessary connective tissue adherence and extensibility through the abdominals and hip flexors of the posterior leg to control the shift in center of mass.
Due to the asymmetrical stance, this creates a relative rotation in the thoracic spine (relative to the pelvis / lumbar spine). Therefore, as the arms go overhead there is coupled motion relationship between rotation and extension in the thoracic spine.
Neurological | Physiological Outcomes
Enhance tissue elasticity and resiliency associated with thoracic extension and segmental rotation during eccentric loading.
Elicit a heightened somatosensory demand in response to cervical extension and the subsequent reduction in the visual-ocular and vestibular system contribution.
Psycho | Social Outcomes:
With its enriched, variable environment, this up-regulates the co-construction of a comprehensive appraisal (cognitive-evaluation) of the proposed task, and the subcortical, autonomic mechanisms execution of the exercise.
Modifications:
Increase somato-sensory motor demand by extending the cervival spine, influencing vestibular/visual sub-cortical responses.
Reduce motor control emphasis by maintaining neutral cervical spine and eyes gazing forward.
Pre-position feet bi-laterally so as to heighten the sagittal plane ascendency and bi-lateral dorsiflexion emphasis.
Contraindications:
Spondylosis/Spondylolisthesis.
Challenges associated with hip extension and / or ankle dorsiflexion.