CMT
review class
Introduction:
The impact of stretching, ROM and strength training on
neurology based conditions can be profound. Inactivity has a dramatic impact on future muscle function and coordination. Decreased
ROM and muscle tightness impacts total movement and leads to overstressing the body and poor movement patterns. Many current
and future problems come from these poor movement patterns.
The initial phase of corrective exercises
is to increase general joint range of motion. It is essential to increase range of motion in a bilateral sense. ROM should
be roughly equal bilaterally. Be sure to not work in any range where pain is felt. Make sure the ROM is smooth. Be sure to
start with small ranges and work until maximal ROM is attained. Initially the speed of the exercises should be comfortable.
Slowing down will increase strength and speeding up will increase more explosive capability. Focus on the exercise and be
as precise as possible. Make sure the rest of the body is stable and supported so that only the joint being exercised moves.
Corrective exercise list and basic instructions:
Ankle- The ankle and foot
can be the leading cause to many movement concerns, injuries and poor patterns.
Drags:
(these can be done sitting or standing) hook your big toe top side down on the floor or behind something; drag your foot forward.
This should stretch the top of the foot, in line with the ankle. This can be done with the foot being pulled straight forward
or angled inward and outward.
Circles: This one is easy, complete perfect circles
Abduction/adduction: move your foot at the toes to the right then left.
Knee-
The knee has very little range of motion so the focus is on circles. Try to keep the ankles and hips quiet.
Hip- The hips has significant ROM so there are many movements to be done here.
Circles: Hip circles should be done with the straight leg forward, to the side and posterior.
Hip raises: keeping one leg straight, lift the other upwards off the ground.
Hip
clocks: sit at the end of a bench with your knee bent; swing the leg laterally like a pendulum back and forth.
Hip rotations: Stand and internally and externally rotate (straight leg and turn at the foot) your leg.
Pelvic circles: Think Hula Hoop. Rotate at the pelvis.
Pelvic
tilts: tilt the hip girdle forward and back. Tuck under the tailbone and then pelvic thrust.
Spine-
The spine is made up of the lumbar, thoracic and cervical sections. Each of these sections should be worked in linear fashion
and circular fashion.
Circles: start small here and remember to not move
into pain. Try to stabilize both above and below the area you are working.
Flexion/extension/adduction/abduction:
focus on each vertebrae and try to move just above it front/back/side/side.
Glides:
We typically do glides on the cervical spine (neck). Holding everything else still, slide your head forward and back, as well
as side to side. The top of your head should not raise or lower. Many people find the glide backwards very difficult.
Egyptian: Keep your head level and slide it in a circle. Remember not to lift your chin or drop it.
Rotations: Rotations should be done in each of the three sections. Try to rotate just above the area you
are working.
Shoulder-The shoulder is often affected by the neck and can
be affected by the elbow and wrist.
Flexion/extension/abduction: Stabilize
the shoulder at the scapula and keep the neck straight. Move the arm forward, backward and sideways to the end of the ROM.
Rotations: Straighter your arm, rotate inward from the shoulder then extend from the shoulder.
Circles: Just like the hip, do circles starting forward, to the side and backward.
Scapula-The scapula or shoulder blade has the capacity for movement in all directions,
so it is essential to move it upwards, downward, outward and inward. Keep the arm straight when you move the shoulder blade.
What happens at the arm is happening at the shoulder blade.
Scapula circles: Take
one arm (horizontal to the shoulder) forward. Create a circle at the shoulder starting forward and moving down back up and
forward again.
Elbow-The elbow has very little range of motion and rarely does
anybody struggle with flexion and extension.
Rotations: Flex the elbows and move the
hands in a circular pattern. Be sure to rotate both ways.
Wrist-
The wrist flexes, extends, moves medially and laterally as well as circles.
Circles:
Flex the wrist toward the ceiling with palms facing your. Leading with your thumbs rotate the hand inward and down then completing
the circle.
Fingers- Flex/extend/ and circles are needed to maximize the
finger ROM.
Balance & Core Strength Balance exercises are a key in maintaining appropriate
movement patterns. Proper balance requires core strength and endurance. The core’s function is to hold posture at rest
and during function. Balance and core exercises go hand and hand and can be easily combined.
Try
these exercises, make sure you are in a safe place and use a chair or bed to provide safety.
Close
eye stand: Use a chair or something for stability, stand tall and close your eyes.
Small
step lunge: Step forward with one leg and lower straight down. Adjust the depth as needed. To add difficulty angle the
front step then close your eyes.
Single leg lift: Lift one leg while maintaining
level hips. Increase difficulty by closing your eyes.
Single leg squat: Use
a bench, step or table to add support. Bring one leg backwards and in the air, then squat on the remaining leg. Increase the
depth to increase difficulty.
Horizontal axe chop: Place both hands in front
of your body just above the belly button. Rotate at the waist as if you were swinging an axe. Add weight to make it more difficult.
Diagonal axe chop: Same as the above exercise but angle upward and downward.
Bent
knee crunch: lie down on the floor with feet flat and knees bent. Lift your shoulders upward towards the ceiling. You
can also lift your knees and keep your back and head flat on the floor.
Bicycles: Lie on the
floor with your back flat on the ground. Bend knees and begin to air peddle the legs. Focus on keeping your back flat.