nari
19-09-2004, 04:04 AM
I have been asked by Bernard to post some movements which can be used for patients with spontaneous/persistent pain, or, for anyone who is a bit stiff and hates boring exercise routines:
All of these movements place some tension on the long nerves, but it is quite intermittent, and they should not be regarded as stretches; that implies prolonged static postures, and most of our patients do not need that. So they might be called 'neurodynamic movements' or whatever seems appropriate.
First, remember where the large nerves are (check your anatomy if needed!) and respect them - if the movements are overdone with too many repetitions, a flare will occur; although this does no harm, it is best to avoid, if possible.
Start with 4-5 repetitions for each movement, and 2-3x day. I have no idea what is best, and I hate recipes anyway; so all we can do is try, and warn about flares. Each person will be different in their pain experience, so each set of movements should be tailored to individual needs.
Upper Limb:
Skiing - slalom movements, bend the knees and sweep both arms full range through flex/extend. Holding something employs the radial nerve better eg stocks.
PNF patterns: Move along the PNF diagonals, unilaterally or bilat.
Flex or extend the neck according to what degree of tension you want.
(Does everyone know their PNF????)
Waiter's tray - balance a tray (or virtual tray) on your hand and sweep from high on one side down to the 'table' on the contralteral side. Maintain the extended wrist and fingers. Make up fancy variations.
Place both hands behind the neck, and close over the ears with the fingers downwards. (ULNT4) Apply a bit of traction through the arms to the neck, and have a fiddle with OC1C2 if you like. Patients love this one once they get the hang of it. Hold for only a few moments, then relax arms down.
Egyptian dancing: For the more flexible ones. Remember the poses on the ancient Egyptian tombs, walls of crypts? Turn them into dynamic movements, remember where the median n. is, and improvise!
General spinal:
"wringing" - I like to call it spinal Tai Chi:
Lie on the floor in crook lying, arms comfortably at the side, or in abduction/ER -(tension, watch for flare). Roll both hips to one side, slowly, and simultaneously, turn the head to the contralateral side. Breathe normally, avoid any breath holding. Pause for a few seconds at the limit of movement, then reverse to the opposite pattern.
Note that if the neck is flexed foward, the neural tension will increase.
Have to go - lower limb next post.
Nari :wink:
All of these movements place some tension on the long nerves, but it is quite intermittent, and they should not be regarded as stretches; that implies prolonged static postures, and most of our patients do not need that. So they might be called 'neurodynamic movements' or whatever seems appropriate.
First, remember where the large nerves are (check your anatomy if needed!) and respect them - if the movements are overdone with too many repetitions, a flare will occur; although this does no harm, it is best to avoid, if possible.
Start with 4-5 repetitions for each movement, and 2-3x day. I have no idea what is best, and I hate recipes anyway; so all we can do is try, and warn about flares. Each person will be different in their pain experience, so each set of movements should be tailored to individual needs.
Upper Limb:
Skiing - slalom movements, bend the knees and sweep both arms full range through flex/extend. Holding something employs the radial nerve better eg stocks.
PNF patterns: Move along the PNF diagonals, unilaterally or bilat.
Flex or extend the neck according to what degree of tension you want.
(Does everyone know their PNF????)
Waiter's tray - balance a tray (or virtual tray) on your hand and sweep from high on one side down to the 'table' on the contralteral side. Maintain the extended wrist and fingers. Make up fancy variations.
Place both hands behind the neck, and close over the ears with the fingers downwards. (ULNT4) Apply a bit of traction through the arms to the neck, and have a fiddle with OC1C2 if you like. Patients love this one once they get the hang of it. Hold for only a few moments, then relax arms down.
Egyptian dancing: For the more flexible ones. Remember the poses on the ancient Egyptian tombs, walls of crypts? Turn them into dynamic movements, remember where the median n. is, and improvise!
General spinal:
"wringing" - I like to call it spinal Tai Chi:
Lie on the floor in crook lying, arms comfortably at the side, or in abduction/ER -(tension, watch for flare). Roll both hips to one side, slowly, and simultaneously, turn the head to the contralateral side. Breathe normally, avoid any breath holding. Pause for a few seconds at the limit of movement, then reverse to the opposite pattern.
Note that if the neck is flexed foward, the neural tension will increase.
Have to go - lower limb next post.
Nari :wink: