SHOULDER PULL DOWNS. To learn efficient use of the shoulder blades and arms while maintaining a neutral spine position.

Transcription

1 SHOULDER INTRODUCT ION Welcome to your shoulder exercise program The exercises in the program are designed to improve your shoulder mobility, posture and the control of the muscles in your neck and shoulder girdle. The stretch based exercises have been included specifically to relieve posture-related neck pain, tension headaches and pain or tension in the neck and shoulders. The exercises are in order of progression, commencing with awareness exercises and finishing with whole body movement. It is important that you start at the beginning and work your way through to the end. As a routine you should aim to complete 6-8 repetitions of each exercise, unless otherwise stated. Once per day is sufficient but more often is better S Every exercise has a name and a purpose, so that you can understand what you are trying to achieve. The starting position describes the position you need to adopt before commencing there is usually an image to help you understand. The exercise describes the action required and again, the images will help. Progressions and variations are made available for when you are performing the exercise well and are ready for new challenges. The self check identifies the commonly made mistakes and what you need to notice to ensure they don t occur to you. SAFETY Should you experience pain with any of the prescribed exercises, stop, re-read the instructions and carefully try again. If pain persists consult your physiotherapist.

2 SHOULDER PULL DOWNS To learn efficient use of the shoulder blades and arms while maintaining a neutral spine position. Lay on front with forehead resting on hands, legs outstretched. Shrug both shoulders up toward ears, and then slide shoulder blades down toward the buttocks. PROGRESSION 1 PROTRACTION/RETRACTION: As for shoulder Pull Downs, maintain distance between your ear and shoulder. Roll your shoulders forward as through trying to curl them to touch. Then slides the shoulder blades back along your back as though trying to crack a walnut between the blades. VARIATION: Can be performed in sitting, standing and quadruped. Shoulder blades should move slowly and smoothly along your back. Concentrate on the downward pull of the shoulders. Let the shoulder blades float upwards with little effort.

3 PRONE LOWER TRAPS To increase lower trapezius function and control. Lay face down with arms by your sides, palms down. Rest the forehead comfortably on the floor. Lift the shoulders off the floor, sliding the scapulas down the back. Then lift the hands about 5cm off the floor. Ensure the head stays on the floor, and shoulders continue in a gliding movement down the back away from your ears. 1 LOADED LOWER TRAP: As above, add hand weights. Use a weight reasonably light, ½ -1kg should be adequate. Lead movement with the little finger side of the hand. Maintain length through the spine and connection to centre to avoid sinking through the abdomen.

4 STOP SIGN WRIST LIFT To learn efficient use of the shoulder blades and arms, while maintaining a neutral spine position/ strong centre. Lay on front, with forehead resting on a small pillow. Arms in stop sign position. Gently glide the shoulder blades down the back. Keep the forearm and wrist straight imagining that there is a metal rod from your elbow to the tips of your fingers. Exhale gently as you lift your left wrist off the floor, pivoting at your elbow. Inhale as you relax. Repeat on the opposite side. 1 DOUBLE ARM WRIST LIFT: As for Stop Sign Wrist Lift. Lift both right and left forearms simultaneously. Inhale to lift, exhale to return. Lengthen the forearm as it is lifted from the floor. Feel the muscles work under and around the shoulder blades.

5 STOP SIGN ARM LIFT To learn efficient use of the shoulder blades and arms, while maintaining a neutral spine position. Lay on front, with forehead resting on a small pillow. Arms in stop sign position. Keep the forearm and wrist straight imagining that there is a metal rod from your elbow to the tips of your fingers. Gently glide the shoulder blades down the back away from your ears. Exhale gently as you lift your left wrist, then elbow off the floor, pivoting at your elbow first, then lifting the elbow off the floor. Inhale as you relax, placing the elbow down first, followed by the wrist. Repeat on the opposite side. 1 CONTINUOUS ARM LIFT: As for Stop Sign Arm Lift. Lift the wrist and elbow simultaneously pivoting at the shoulder joint and ensuring that the shoulder blades glide in and downward toward the spine. 2 DOUBLE ARM WRIST LIFT: As for Stop Sign Arm Lift. Inhale, lifting both right and left arms simultaneously. Exhale to relax. 3 REACH: As for Stop Sign Arm Lift. Pause in the lifted position and take a breath in. Exhale, reach the arm straight overhead, keeping the space between the ear and shoulder. Inhale to draw them back to stop sign position. Exhale lower to the floor Lengthen the arm through the fingertips, as the elbow lifts from the floor. Feel the muscles work under and around the shoulder

6 DIAMOND PRESS To mobilise the upper back into extension. To learn to isolate the activity of the upper back muscles from the lower back. To work appropriately with the shoulder blades and the neck. Lay on front, with forehead resting on hands and fingers making diamond shape. Glide the shoulder blades gently down the back to create space between the ear and shoulder. Lift the head slightly, and reach the crown of the head forward to the edge of the mat. Reach the elbows wide and press the forearms into the floor as you segmentally extend the upper back from the floor. As you lift the upper back, keep the lower ribs in contact with the floor, and the lower back relaxed and open. Maintain your gaze to your fingers. Slowly lower, keeping the length in the spine, then relax completely. Maintain a long neck and spine throughout the exercise, keeping your chin connected to the throat. Do not lift your head too high and keep looking down to your fingers as you lift your head. You should not feel any activation or fatigue in the lower back.

7 ARM ARCS To challenge the control of your trunk and ribs, with arm movements. Lay in the rest position (on back with knees bent), hands resting by side. Gently glide the shoulder blades down the back. Float the arms up to shoulder height, lengthening the fingers to the ceiling, while maintaining a neutral shoulder position. Slowly lower hands back to your side. 1 ARM FLOATS 180 o : As for Arm Floats 90, lift arms to ceiling, and continue reaching the arms overhead. Allow the shoulder blades to glide up the back towards the ears. Stop if you feel your ribs beginning to lift. Slowly lower hands back to your side. 2 ALTERNATING ARMS: Arms start lifted to shoulder height, fingers pointing up to ceiling. Lift one arm overhead and lower the other down to the floor, like scissors. Slowly return arms to shoulder height and switch over. Ensure that your ribs stay soft and your back does not arch up. Maintain neutral spine and easy breathing.

8 QUAD KNEELING ARM REACH To challenge your awareness and control of neutral spine, and the strength of your upper body. Kneel on hands and knees, with spine neutral and shoulders level. Slide fingertips out along the floor then lift your hand, gliding your fingers up to shoulder height. Maintain a lifted position over your weight bearing arm, keeping the collar bones wide. 1 ELEVATION/DEPRESSION:. Maintaining neutral spine position, lift the shoulders up toward the ears, feeling the shoulder blades separate. Gently, slide them back down toward your toes. 2 PROTRACTION/RETRACTION:. Maintaining neutral spine position, press the chest up from the floor as you lift the breast bone through the shoulder blades. Then slide the shoulder blades back and toward the spine, as though trying to crack a walnut in the shoulder blades. Lengthen from the crown of your head to the tailbone. Maintain equal weight through remaining points on floor, keeping shoulders level and spine neutral. Maintain a neutral shoulder blade position. Do not 'sag' between the shoulders. Keep the chin gently connected to the throat ensuring length at the back of the neck.

9 SNAKE ARMS To stretch the chest muscles, open the chest and improve ribcage mobility. To enhance awareness of the shoulder blades. Lay in the sidelying rest position, with knees bent. Find your neutral sidelying position and maintain. Reach top hand past bottom hand as far as you can, to release the muscles between the spine and the shoulder blade. Glide the shoulder blade back towards the spine, keeping elbow straight. Bend elbow and slide hand along bottom arm, across chest and stretch out on other side of body. Rotate the chest as you do so, keeping the pelvis in neutral. Follow hand with eyes, and allow the head to gently rotate. Return hand to starting position by sliding hand back across chest and bottom arm. 1 CHEST OPENER: Stretch top hand past bottom hand as far as you can. Lift arm up, reach up and over, like your arms are a giant clam. Feel the stretch across the front of your chest as you open out the clam. Follow hand with eyes. Return hand to starting position by bringing your arm back to rest on your other hand. Keep the head and neck soft and relaxed. Maintain the length through the arm.

10 CHALK CIRCLES To improve chest and shoulder mobility. Lay on side with knees bent, hips stacked and arms stretched out in front at shoulder height with palms together. Find your side lying neutral spine position and maintain. Reach top hand forward as you pick up your imaginary piece of chalk. Draw the biggest possible circle up around you with your head as the centre. As your arm reaches your ear, turn the palm up and reach as long through the fingertips as possible, to lengthen the arm. Repeat in the opposite direction. Allow the hand to lift from the floor as you need, as it will be more comfortable fro the shoulder and you will get a better stretch. Maintain a neutral pelvic position as you reach your hand around the circle.

11 ROLLER ARM SERIES An advanced exercise to challenge the control of your trunk and shoulder blades. Will strengthen the arms and shoulders. Lay on back with head and tailbone on the roller, knees bent and feet hip width apart. Hold weights in hands above shoulders. Choose hand weights which are reasonably light as the purpose is to challenge stability not to promote muscle bulk. 1-2kg hand weights should be adequate. Follow the exercise progressions below. 1 HUG A TREE: Begin with weights in hands, arms lifted to shoulder height and elbows soft. Slowly lower both hands toward the floor, stop where you feel comfortable, maintaining the banana-like shape of the arms. Return to the start position. VARIATION: Single Arm Hugs: as above, keep one arm stationary while lowering the other toward the floor. Maintain body position. 2 BALLERINA ARMS: To begin change to holding one weight end to end with both hands. Keeping elbows soft and a neutral spine position take both hands overhead as far as is comfortable before the ribcage starts to lift or the back arch. VARIATION: Scissors: holding a weight in each hand, with hands in line with shoulders, lower one hand toward the floor the other overhead. Limit range of movement to maintain neutral spine and rib position. 3 ARM STIRS: Begin with a weight in each hand and arms lifted to shoulder height. Trace small circles on the ceiling. Repeat the other direction. Maintain a neutral spine, rib and shoulder position. Keep spine long, shoulders relaxed and ribs soft. Movement should be slow and controlled.