The first step for achieving joint stability after an injury is to assess the joints for misalignment or structural defects caused by the injury. Your physician or therapist will check the joint alignment and tests for weakness or deficits in soft-tissues (tendons, ligaments, and cartilage). Correcting these deficits may require taping, bracing, chiropractic adjustments or possibly surgery. Once the joints are returned to proper alignment, joint stability is addressed. Specific exercises are prescribed to help restore function.
These exercises target balance, proprioception, range of motion, flexibility, strength and endurance. In order to make a full recovery from an injury the individual must fully participate in their rehab program.
Neuromuscular training and proprioception is key to joint stability. Neuromuscular control is an unconscious response to joint motions that occurs without awareness. (ie.. shifting your weight to stay balanced in an incline) Proprioceptive information includes an ability to detect joint position, movement, direction, amplitude and speed of motion.
***Always warm up before exercises. Five minutes of walking, or exercise bike, elliptical trainer, or even marching on the spot is enough. Not warming up before stretching leaves your back susceptible to injuries causing back pain. Warm muscles are more flexible than cold muscles and are less likely to tear.
***Check with your physician before doing exercises that involve twisting or arching the back if you have a back condition.
Pelvic Tilt: lower back stretching exercise (also strengthens abs)- Lie on back, knees bent, feet flat on floor. Tighten buttocks and abdomen, flattening small of back against the floor. Hold for a count of five. Slowly relax. Repeat five - fifteen times.
Knee to Chest: Gluteal stretching exercise- Lie on back, knees bent, feet flat on floor. Grasp left leg behind the knee/back of thigh and pull knee towards left shoulder. Hold for a count of five. Switch sides. Repeat 5 times.
Piriformis Stretch: (Stretches Muscles that lie beneath gluteal muscles)-Sit on chair, Place your left ankle over your right leg, just above the knee and lean forward. Hold for 30 seconds. Repeat on other side.
Basic Twist: lower back stretching exercise- Lie on back, arms stretched out to the sides. Bend knees and bring knees up close to your chest. Take a deep breath. Exhale as you slowly lower knees (keep knees together) to floor to the right or as close to the floor as is comfortable. Pause. Inhale as you slowly return your knees to chest. Exhale as you slowly lower knees to left side. Inhale as you return your knees to chest.
Repeat about 5 times.
The Cat: back stretching exercise- Begin on all fours, hands directly under your shoulders and knees directly under your hips. Inhale as you drop tummy towards the floor and look up over your head.
Exhale as you bring your tummy back up, rounding your back as you tuck your chin in and tuck your tailbone in. Move slowly back and forth between these two positions pausing on each pose. Repeat about 5 times.
Shoulder, Back, Arms Stretch: Stand with knees slightly bent. Interlace fingers, extend arms forward at shoulder level. Turn palms out and reach your arms further until you feel a stretch. Hold 10 - 20 seconds. Repeat.
Chest Stretch: Stand with knees slightly bent. Hands behind the back, fingers interlaced. Turn palms up extend arms backward. Do not arch the back. Hold 10 - 20 seconds.
Sides, Waist Stretch: Stand with knees slightly flexed. (Can also be done sitting down) Place your right hand behind your head. Grab your right elbow with your left hand and pull gently. Bend slowly to the left until you feel a gentle stretch. Hold 10 - 20 seconds. Switch sides. Repeat.
*************Shortened hamstrings can contribute to sway back
Hamstring (back of thigh) Stretch: Sitting on floor, extend right leg, place left foot against right knee. Lean forward (keeping back straight), reaching for foot until you feel a slight pull on you hamstring. Hold for 10 - 20 seconds. Switch sides. Repeat
Hamstring (back of thigh) Stretch: Lying flat on back. Raise left leg up. Grab leg and pull up further until you feel a gentle pull in the hamstring Hold for 10 - 20 seconds. Switch sides. Repeat.
*************Shortened quadriceps can contribute to sway back
Quadriceps (front of thigh) Stretch: Stand up. Bend your knee behind you, grab your ankle and gently pull your heel toward you buttocks until you feel a gentle pull on the front of your thigh. Hold for 10 - 20 seconds. Switch sides. Repeat.
Wall Back Stretch: back / neck stretching exercise- Stand up with your back against the wall. Try to press the small of your back and the back of your neck toward the wall. Hold for 10 - 30 seconds. Do not overstretch!
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