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Home Exercise Programs ELITE PAIN MANAGEMENT AND RECOVERY CENTERS HOME EXERCISE PROGRAMS Springfield, MO Osage Beach, MO Galena, KS Las Vegas, NV Myrtle Beach, SC THANK YOU Thank you for choosing Elite Pain Management and Recovery Centers. The following booklet describes various stretches and exercises to help improve your functionality and alleviate pain. Additionally, this booklet contains a calendar to record days that you performed the stretches and exercises that your provider instructs. CONTENTS CERVICAL EXERCISES ................................................................................................. 3 CERVICAL ISOMETRIC EXERCISES ......................................................................... 3 CERVICAL SPINE EXERCISES ................................................................................... 4 THORACIC SPINE & POSTURAL STRETCHES ...................................................... 4 MID-BACK STABILIZATION ......................................................................................... 5-6 LUMBAR EXERCISES .................................................................................................... 7 LUMBAR SPINE AND RELATED HIP STRETCHES ............................................... 7-8 ACTIVE BALANCED POSTURE .................................................................................. 9 CORE STABILIZATION EXERCISES .......................................................................... 10-11 PROPER BODY MECHANICS WITH HOUSEHOLD ACTIVITIES ........................ 11 PAIN MANAGEMENT - FLARE UP CONTROL ........................................................ 12 MUSCLE RELEASE TECHNIQUE ............................................................................... 13 THERAPEUTIC BREATHING AND RELAXATION ................................................. 13 SITTING POSTURE AND COMPUTER ERGONOMICS .......................................... 14 CALENDAR ....................................................................................................................... 15 PROVIDER NOTES CERVICAL EXERCISES REPEAT: 10X HOLD: 1 SECOND COMPLETE: 2 SETS PERFORM: 2X /DAY RETRACTION/CHIN TUCK CERVICAL SIDE BEND CERVICAL ROTATION Slowly draw your head back so Tilt your head towards the side, then Turn your head towards the that your ears line up with your return back to looking straight ahead. side, then return back to looking shoulders. Be sure to keep your eyes and nose straight ahead. pointed straight ahead the entire time. UPPER TRAP STRETCH DOORWAY STRETCH LEVATOR SCAPULAE (Hand behind back and top of head) While standing in a doorway, place your STRETCH arms up on the door jam and place one Begin by retracting your head back foot forward through the doorway. Next, into a chin tuck position. Next, Place the arm of the affected bend the front knee until a stretch is place one hand behind your back side behind your back and use felt along the front of your chest and/or and gently draw your head towards your other hand to draw your shoulders. Your upper arms should be the opposite side with the help of head downward and towards the horizontal to the ground and forearms your other arm. opposite side. You should be should line up along the door frame. looking towards your opposite *NOTE: Your legs should control pocket of the affected side. how much you stretch by bending or straightening your knee through the doorway. * CERVICAL ISOMETRIC EXERCISES BALL ISOMETRICS- EXTENSION HAND ISOMETRICS - BALL ISOMETRICS- EXTENSION EXTENSION SIDE BEND Clasp both Cradle ball Place the ball on your hands behind at base of right shoulder. Push head your head, skull. Push in and down against use a towel, head back the ball as if toward your sling, or into the ball shoulder. furniture then tip your headrest. head back as if ROTATION Attempt to tip your head back to trying to look at the ceiling. Place ball at the right side of forehead. look up at the ceiling while resisting Push cheek into ball and turn your head with your hands. in the direction of the ball. Do not turn your body. 3 CERVICAL SPINE STRETCHES SCALENE LEVATOR SCAPULAE Sit with your right hand holding the edge of a chair. Sit with right hand holding the edge of a chair. Tip Place your left hand over your right collarbone to chin towards chest, tilt left ear toward your left stabilize. Pull chin back, tip ear toward left shoulder, shoulder and nose toward your left armpit. Left turn to look over left shoulder and hold. Repeat on right hand can be used for gentle overpressure-DO NOT side. PULL. Alternate. MODIFICATION: Begin in the same position, but now tip FOR A DEEPER STRETCH: Lift right arm up and left ear to left shoulder, and tip head back as if drinking place behind neck. Avoid shrugging. Tilt left ear out of a cup. toward left shoulder, turn head to left, and bend chin down. Alternate. FLEXION/ EXTENSION SIDE BENDING ROTATION UPPER TRAPEZIUS Bring your chin toward your Bend your ear Turn to look over Sit with right hand holding chest; hold. Return to upright, toward your right your right shoulder; edge of chair. Move chin then bring your head back; shoulder while hold, then switch towards chest, tilt your left hold. Hold the back of your looking straight sides. Add gentle ear toward your left shoulder neck with your hands if you ahead; hold, then hand pressure at the turn right to look up towards need more support. alternate. chin as tolerated for the ceiling. Left hand can be more stretch. used for overpressure-DO NOT PULL. Repeat to right side. LEVEL 2: SUPINE HEAD NOD LEVEL 3: SUPINE HEAD LIFT Lie on your back with your head on a firm surface and Lie on your back with your head on a firm surface a towel roll under your neck. Gently nod your head by and a towel roll supporting your neck. Gently nod bringing your chin towards your chest. Do not lift your your chin toward your chest and lift your head up head off of the table, and maintain contact with the slightly. Do not lose contact with the towel roll. Feel towel roll. Feel the back of your neck lengthen and the the back of your neck lengthen and the front of your front of your neck tighten. neck tighten. THORACIC SPINE & POSTURAL STRETCHES HEAD AND SCAPULAR THORACIC TOWEL ROLL STRETCH RETRACTION Lie on your back with knees bent, and place a towel roll across shoulder Pull chin straight back (without blades. Relax for as long as tolerated up to 5 minutes, 1-3 times per day. As tucking it down). Squeeze this becomes more tolerable, raise arms above head and tuck chin for a better shoulder blades down and stretch. To stretch chest muscles, tuck chin and place arms at sides, elbows together, then rotate palms bent and positioned at 90 degrees. outward and hold. ALTERNATE: Place towel vertically. LOWER TRAPEZIUS MOBILIZATION Step 1: Sit, stand or lie on your back. Place your elbows, forearms and palms together in front of your chest. Step 2: Keep your elbows as close together as possible while you raise your elbows over your head. Step 3: Turn your palms up then out. If lying, try to lower your arms to the floor. Step 4: Lower your elbows down the sides of your body. If lying, continue to keep your elbows in contact with the floor. Keep palms turned out as if you’re opening curtains. Step 5: Straighten your elbows and pull your hands down along your sides. Pause and relax while breathing slowly. Repeat the stretch 2-3 times. 1 2 3 4 5 4 MID BACK STABILIZATION These exercises will strengthen the mid-back (between and underneath the shoulder blades) which will contribute to improved posture and decreased pain by decreasing strain on the spine. INSTRUCTIONS 1. Do only the exercises indicated and instructed by your provider. 2. Maintain the DLC (Deep Layer Contraction). See page 9 for DLC instructions. 3. Do not allow your shoulders to shrug up while doing the exercises. 4. Exercise 3x/week, not 2 days in a row. 5. Stop if pain symptoms significantly worsen. 6. Complete 20 slow repetitions of each exercise or a maximum of 2 minutes with good control. 7. Progress to the next level when able to complete 20 repetitions or 2 minutes without high fatigue. STRAIGHT ARM PUSH-UPS: MAINTAIN DLC LEVEL 1 Place your hands on the wall and feet away from the wall enough that you are leaning forward slightly. Keep elbows straight but not locked. By moving only the shoulder blades, allow your chest to move toward the wall, pause, and then push your chest as far away from the wall as you can. Do not allow shoulders to shrug up. 20 reps. MODIFICATION: Keep your hands fisted and wrists neutral if you have wrist/thumbs pain or carpal tunnel syndrome pain. LEVEL 2 Use Level 1 positioning but place hands on a Swiss ball against the wall at shoulder level. Keep elbows straight but not locked. By moving only the shoulder blades, allow your chest to move toward the wall, pause, and then push your chest as far away from the wall as you can. Do not allow shoulders to shrug up. 20 reps. MODIFICATION: Hold your hands with palms flat on the sides of the ball so that wrists are neutral if you have wrist/thumb pain or carpal tunnel syndrome pain. LEVEL 3 Position yourself on your hands and knees. Keep your spine in a neutral position. Keep elbows straight, but not locked. Allow your chest to move toward the floor, pause, and then push your chest as far away from the floor as you can. 20 reps. LEVEL 4 Place your hands on the floor directly beneath your shoulders, Keep your spine in a neutral position. Keep elbows straight, but not locked. Allow your chest to move toward the floor, pause, and then push your chest as far away from the floor as you can. 20 reps. Advance by adding a full push-up with each rep. 5 MID BACK STABILIZATION These exercises will strengthen the mid-back (between and underneath the shoulder blades) which will contribute to improved posture and decreased pain by decreasing strain on the spine. REVERSE WALL PUSH-UPS: MAINTAIN DLC LEVEL 1 LEVEL 2 Stand with your head and Begin in the same position, back against the wall and your now push your body feet 8-12 inches away from the forward by pushing your wall (or further away for more elbows into the wall. Your challenge) and your knees hips should be in line slightly bent.
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