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3-Dimensional Stretching. Benjamin L. Kolly DPT, OMPT, ATC Xcel Physical Therapy, PLC. Bring spine roll Wedges, towels belts. Objectives. Review Basic Concepts of Stretching Identify purpose for 3-Dimensional Stretching Describe two 3-D stretches for immediate use. 6 Principles .

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3 dimensional stretching

3-Dimensional Stretching

Benjamin L. Kolly DPT, OMPT, ATC

Xcel Physical Therapy, PLC

slide2

Bring spine

  • roll
  • Wedges, towels
  • belts
objectives
Objectives
  • Review Basic Concepts of Stretching
  • Identify purpose for 3-Dimensional Stretching
  • Describe two 3-D stretches for immediate use
6 principles
6 Principles
  • Force vs Time
  • Prepositioning
  • Avoid torque through stiff joint
  • Follow up with AROM or activity
tissues
Tissues
  • Muscles
    • Manual stretching, Hold-Relax, Reciprical inhibition
  • Joints
    • Mobilizations, traction
why 3 d
Why 3-D
  • Tissues do not move in 1 plane
  • Avoid aberrant stresses on painful, restricted joints
  • Maximize the lengthening of muscles
  • Maximally open foramen
  • Protect spinal segments
mechanisms
Mechanisms
  • Traction joints
  • Pre-position joints
  • Stretch through 2 or more joints
  • Glide (slow mobilization) through stretch
thoracic spine stretch
Thoracic Spine Stretch
  • SDLY with SB over roll and knees bent up
  • With top arm reach backwards causing a rotation opposite of side bending
  • Add weight to arm as needed
  • Vary amount of trunk flexion
piriformis
Piriformis
  • Roll under L/S promote anterior tilt = L/S extension
  • Flex greater than 90 degrees, ER hip, glide hip posteriorly
  • Flex to approximately 60 degrees, IR hip and stabilize ipsi ASIS (p237)
hip extensors
Hip Extensors
  • Roll under L/S promote anterior tilt = L/S extension
  • Flex hip and posterior gliding of hip joint
  • Gluteus Medius & Minimus
    • Abduction and ER
  • Gluteus Maximus
    • adduction and IR
ilipsoas
Ilipsoas
  • Prone on table, folded towel under abdomen to protect, wedge under foot
  • Extend thigh, IR hip, apply ventral glide
rectus femoris
Rectus Femoris
  • Prone on table, folded towel under abdomen to protect, wedge under foot
  • Extend the hip, flex the knee, apply ventral glide
short adductors
Short Adductors
  • Supine, stabilize straight leg
  • Abduct thigh and traction force
  • Prone, stabilize pelvis with belt
  • Ventral glide femur
long adductors
Long Adductors
  • Posterior tilt with contra leg over table
  • Extend knee and abduct hip
  • (amt hip flexion or knee flexion )
latissimus dorsi
LatissimusDorsi
  • Maximally flex the lumbar spine, flex shoulder, ER
  • Also SB away and cranially glide humerus
disc traction
Disc Traction
  • Seated, prone, supine, SDLY options
  • Preposition varying amount flexion, SB
  • Stabilize caudal and pull cranial or vise versa
  • (pg 28-29 notebook)
facet stretching glide
Facet Stretching (Glide)
  • Creates extension at 1 segment and flexion at others
  • Mobilize cranial segment ventral cranial to create flexion moment on that segment and extension above
coupling in the spine
Coupling in the Spine
  • Coupled movements
  • Non-coupled movements
  • Example:
review
Review
  • 3-D stretches can be used on muscles and joints
  • 3-D concept is useful to:
    • replicate normal movement patterns
    • Reduce painful, compressive loads
    • Maximize elongation
    • Protect the spine
questions
Questions
  • Ben can be reached at bkolly@xceltherapy.com