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7th Inning Stretch Demonstration

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7th Inning Stretch Demonstration Powered By Docstoc
					         7th Inning Stretch
   Demonstration of Exercises to
Improve Mobility, Balance, &Strength

                 Chad Shinabery MS ATC CPT
                 Owner of Atlantis Personal
                 Training LLC
                 Denver, Colorado
Purpose of Talk

   Goals of Exercise Program
   Behavioral Changes to Improve Overall
    Quality of Life
   Safe Progression of Exercise Routine
   Demonstrate a Sample Workout to Include
    Warm-up, Strength, and Balance Exercises
Goals of an Exercise Program and
Peripheral Neuropathy

   Maintain or Improve Muscle Strength
   Safely Challenge Proprioception and Body
    Position Awareness
   Prevent or Slow Down Neurological
    Degeneration
   Implement Exercises Into Daily Life
Lifestyle changes that could improve
Peripheral Neuropathy (PN)

   Get Physical Exercise           Balanced Nutrition Plan
    –   Explain this later
                                    Decrease Weight, If
   If you Smoke, STOP               Overweight or Obese
    –   Decreases circulation
    –   Increase Heart Disease


   Carefully Limit Alcohol
Before Starting an Exercise Program

   Discuss Conditions and Plan of Care with
    your Physician involved in your PN
    Treatment
   Remember, Take it slow.
    –   Rome wasn’t built in a day!!
Progression of Exercise

   Be done with caution
   First, increase frequency
    –   From 4 days to 5 days to 6 days to everyday
   Then, increase duration
    –   20 minutes to 30 minutes
   Lastly, increase intensity
    –   Small increases to reduce the risk of harmful cardiovascular
        events, muscle soreness and relapses
   Advance slowly and with careful monitoring
Lets talk about Pain

   Level I - Intial Discomfort (established, minimal)
   Level II - Moderate Discomfort (attention can
    be diverted)
   Level III – Intense Pain (attention can not be
    diverted
   Level IV – Excruciating and unbearable pain
Pain, cont.

                 Keep Pain at Level II or
                  below
                 Exercise selection
                  should reflect your pain
                  level
                 Take caution before
                  progression
                 Not a Wise Exercise
                  choice for PN
Factors that may assist in maintaining
a physical activity program:

   Take measures to            Include a partner
    avoid injury: warm-up,       –   Motivation
    cool-down, & stretches       –   Encouragement
   Set objective goals         Identify alternative
    rather than hopeful          exercises.
    outcomes                     –   Reduces boredom
   Set an exercise              –   Opens the door for more
    schedule in advance.             options
Exercise Routine Format

   Warm-up
   Stretches
   Cardiovascular exercises
   Strength Exercises
   Balance Exercises
   Cool-down
Warm up Exercises, Arm Circles

   Instructions:
    1. Start by holding your
    arms out to the side at
    shoulder height.
    2. Swing your arms in a
    small circular rotation.
    3. Continue for the
    recommended time and
    then repeat going the
    opposite direction.
Across Body Arm Swings

   Instructions:
    1. Stand tall and hold arms
    out to your side.
    2. Slowly swing your arms
    back and forth across the
    front of your body.
    3. Repeat this continuous
    motion until warm or until
    recommended time is met.
Lateral Side Bend

   Instructions:
    1. Stand with your feet parallel
    and shoulder width apart.
    2. Keeping your body in a
    straight line bend to the side
    and reach for the floor with your
    hand.
    3. Bend only until you reach a
    comfortable range of motion.
    4. Make sure to not bend
    forward or backward while
    completing this movement.
    5. Repeat for the desired
    repetitions
Forward Backward Leg Swing
   Instructions:
    1. Start by standing with your
    feet shoulder width apart. You
    can stand on a small step or on
    the ground.
    2. Keeping your upper body
    perpendicular to the ground
    swing one leg forward and
    backward.
    3. Do not swing your leg so
    hard that you can not keep your
    upper body from moving.
    4. Repeat for the recommended
    repetitions and repeat with the
    other side.
Lateral Leg Swings
                    Instructions:
                     1. Start by holding onto a
                     secure object and raise your
                     outside leg out to the side.
                     2. In a smooth and continuous
                     motion swing your leg back and
                     forth across the front of your
                     body.
                     3. Swing through your full range
                     of motion but keep your upper
                     body stable throughout the
                     movement.
                     4. Repeat for the recommended
                     repetitions and then flip sides
                     and repeat with the other leg.
Goals of Cardiovascular Exercise

   Start Slow and Progress
    –   5 minutes to start, progress to 10 and so forth
   AMA recommends 20-30 minutes of daily CV
    Exercise
   Monitor Heart Rate
    –   Target Heart Rate (220-age) x .7-.85
    –   Pulse method (radial, carotid)
    –   Heart Rate Monitors
Aerobic Exercise Choices

   Swimming
    –   Preferably without your
        shoes and fully clothed
        like the picture
        encourages you!
Cardio, Elliptical

                        Elliptical
                        Instructions:
                         Place your feet on the foot
                         plates and grab the arm
                         handles.
                         Set your resistance so that it is
                         challenging and start the
                         elliptical motion by pulling
                         machine arm with one arm and
                         push the other machine arm.
                         Pick a pace that will elevate
                         your heart rate yet let you stay
                         on the machine for a while.
Cardio Exercise, Bike Progression
Cardio

            Advanced Bike
             Progression
Cardio

            Walking
Goals of a Strength Routine

   Work Large Muscle Groups
   Start slow and Progress as tolerated
   Repetitions of 15-20
   Set of 1-3
   Non-weight bearing exercises
   Partial-weight bearing exercises
   Full weight bearing exercises
Lower Body Exercises NWB
                  Single Leg Kickbacks

                  Instructions:
                   1. Start in a four point position with
                   your hands and knees on the
                   ground.
                   2. Proceed to kick your leg back
                   and up until you reach full
                   extension.
                   3. Squeeze your glute muscle while
                   performing this movement.
                   4. Repeat with the other leg.
                   5. For a more advanced movement
                   you can attach an ankle weight
                   around your leg.
Lower Body Exercises NWB

                  Hip Hikes
                   Instructions:
                   1. Start by lying face down
                   with your legs straight.
                   2. Slowly raise one leg
                   keeping it straight using just
                   your glute muscles.
                   3. Return to the starting
                   position and repeat for the
                   desired repetitions. Repeat
                   with the other leg.
Lower Body Exercises PWB
                  Partial WB Leg Swings
                  Instructions:
                   1. Start by standing on the
                   platform and placing a foot in
                   the foot harness. Step to the
                   side so that your foot hangs off
                   the edge of the platform.
                   2. Proceed to curl your foot
                   back and up keeping your knee
                   stabilized next to your other
                   knee and bringing your foot all
                   the way to your butt.
                   3. Return to the starting position
                   and repeat according to the
                   prescribed repetitions. Repeat
                   with the other leg.
Lower Body Exercises FWB
                 Bodyweight Squats
                  Instructions:
                   1. Start by placing feet shoulder width
                   apart and holding your arms out in front
                   of you.
                   2. Proceed to squat down like you are
                   going to sit in a chair. Your upper body
                   will lean forward slightly and your hips
                   will shift backwards while going down.
                   3. Remember to keep your knees from
                   going out in front of your toes while
                   squatting.
                   4. Repeat according to your required
                   repetitions. If you want to make the
                   exercise more challenging hold your
                   arms at your sides or behind your head.
Lower Body Exercises FWB
                  Bodyweight Lateral Squat

                  Instructions:
                   1. Stand with your feet shoulder
                   width apart.
                   2. Start by stepping to the right with
                   your right foot and proceed into a
                   squat.
                   3. Return to the standing position
                   with your feet shoulder width apart.
                   4. Now step to your left with your
                   left foot and proceed into a squat.
                   5. Return to the starting position
                   and repeat.
Chest Exercises NWB

                  Instructions:
                   1. Start by lying on the floor
                   on your back holding a
                   dumbbell in each hand.
                   2. Proceed to bend your
                   arms until the back of your
                   arms touch the floor.
                   3. Push the dumbbells back
                   up to full extension.
                   4. Repeat for the desired
                   repetitions.
Chest Exercises PWB

   Instructions:
    1. Start by placing your hands
    on the wall at shoulder level
    with your feet approximately 2
    feet away from the wall.
    2. Bend your elbows so that
    your chest gets closer to the
    wall.
    3. Once your elbows are bent to
    about 90 degrees then press
    back out to the starting position.
    4. Repeat according to the
    required repetitions.
Chest Exercises FWB
                  Instructions:
                   1) Sit in upright position on ball with feet
                   flat on floor and DB in each hand. (You
                   may rest each DB on the corresponding
                   thigh.)
                   2) Walk feet forward allowing ball to roll
                   underneath body until it is positioned on
                   mid to upper back region (you may rest
                   head on ball). Raise hips to create a
                   “table top” position parallel to floor.
                   3) Start position: Maintaining stability,
                   bring DB’s to shoulders and press up
                   positioning DB’s above the chest with
                   palms facing forward.
                   4) Lower the DB’s keeping your forearms
                   perpendicular to the floor and your hands
                   aligned at the nipple line.
Low Back, NWB
                   Alternating Superman

                   Instructions:
                    1) Lie face down on floor with arms
                    extended overhead. You may place
                    a rolled towel under forehead to
                    clear face from floor.
                    2) Raise right arm and left leg 4-8
                    inches off floor.
                    3) Lower and raise alternate
                    opposite arm and leg.
                    Remember to keep head and back
                    in a neutral position. Shoulders and
                    hips should remain squared
                    throughout movement.
Low Back, NWB

   Cobra on Floor
   Instructions:
    1. Start by lying on your
    stomach with your arms at
    your sides.
    2. Slowly raise your
    shoulders up off the ground
    by contracting your low
    back.
    3. Return to the starting
    position and repeat.
Low Back, PWB
                   Bridging
                   Instructions:
                    1. Begin by lying on your back,
                    knees bent, and feet on the floor.
                    Extend your arms out to steady
                    yourself.
                    2. Squeeze buttocks and raise your
                    hips and lower back off the floor to
                    form a straight line from your knees
                    to your chest. Do not arch your
                    back.
                    3. Hold for 5-10 seconds and slowly
                    return to starting position. Relax for
                    5 seconds.
                    4. Repeat for required number of
                    repetitions.
Low Back, FWB
                   Bodyweight Good Mornings

                   Instructions:
                    1. Start by placing your hands
                    behind your head and your feet
                    shoulder width apart.
                    2. Keeping your low back flat and
                    your legs semi-straight bend
                    forward until your individual range
                    of motion is reached.
                    3. Return to the starting position
                    and repeat.
                    4. Make sure to keep good
                    technique and bend from the hips
                    keeping your lower back relatively
                    flat.
Shoulder, NWB/PWB

                 Seated DB Shoulder Press
                 Instructions:
                  1. Sit in upright position or
                  stand with feet shoulder width
                  apart and knees slightly bent.
                  2. Start position: Position DB’s
                  to ear level with an overhand
                  grip (palms facing forward).
                  3. Press hands up above head
                  keeping wrists over the elbows
                  and arms moving parallel to
                  body at all times.
                  4. Return to start position.
Shoulder, FWB
                   DB shoulder press

                   Instructions:
                    1. Starting position: Dumbbells
                    are at shoulder level with your
                    palms facing your head.
                    2. Press the dumbbells over
                    your head keeping your palms
                    facing each other.
                    3. Return to the starting position
                    and repeat. Remember to not
                    arch your lower back as your
                    press the dumbbells over your
                    head.
Biceps, NWB/PWB
   Seated Dumbbell Bicep Curl

   Instructions:
    1) Sit in upright position on stability
    ball.
    2) Start position: Grasp DB’s with
    underhand grip (palms facing
    forward) and allow arms to hang
    down at sides. Elbows should be
    close to sides.
    3) Flex at the elbows and curl DB’s
    up to approximately shoulder level.
    Keep elbows close to sides
    throughout movement.
    4) Return to start position.
Biceps, FWB
                 Dumbbell Curl

                 Instructions:
                  1) Stand with feet shoulder width
                  apart and knees slightly bent or sit
                  in upright position.
                  2) Start position: Grasp DB’s with
                  underhand grip and allow arms to
                  hang down at sides. Elbows should
                  be close to sides.
                  3) Flex at the elbows and curl DB’s
                  one at a time up to approximately
                  shoulder level. Keep elbows close
                  to sides throughout movement.
                  Return to start position.
Triceps, NWB/PWB
   Overhead tricep extension

   Instructions:
    1) Sit on ball with feet shoulder
    width apart in upright position.
    2) Start position: Grasp DB and
    place palms on inner side of weight
    plate as shown. Press DB directly
    overhead (now palms are up).
    3) Stabilize shoulders and lower
    weight moving only at the elbow
    joint until forearm is parallel to floor.
    Keep elbows pointing forward
    throughout movement.
    4) Return to start position.
Triceps, FWB
                  Standard Pushup

                  Instructions:
                   1. Lie face down on the floor with
                   hands palm down, fingers pointing
                   straight ahead, and aligned at the
                   nipple line.
                   2. Place hands slightly wider than
                   shoulder width, and feet should be
                   at hip width with toes on floor.
                   3. Start position: Extend the elbows
                   and raise the body off the floor.
                   4. Lower your entire body (legs,
                   hips, trunk, and head) 4-8 inches
                   from the floor.
                   5. Return to the start position
Goals of a Balance Routine

   Select exercises that safely challenges
    stabilization.
   Repititions of 15-20
   Set 1-3
   Can be Done Daily if Tolerated
   Progress with caution
Balance, Beginner
                   Seated Reverse Wood Chop

                   Instructions:
                    1. Sit on a stability ball with
                    your knees bent at 90 degrees.
                    2. Hold a medicine ball and
                    start at your right hip.
                    3. Rotate your trunk and arms
                    to lift the ball above your left
                    shoulder.
                    4. You should rotate at your
                    trunk first and then lift and twist
                    your arms.
                    5. Return to the starting position
                    and repeat to the other side.
Balance, Intermediate

                    Same Side Superman

                    Instructions:
                     1. Start position: Lie face
                     down on ball with hands
                     down at sides. Raise left
                     arm and left leg off floor.
                     2. Return to start position
                     and repeat with the other
                     side.
Balance Exercise, Intermediate

   1 Leg Balance Squat

   Instructions:
    1. Start by standing on one leg
    with the other leg elevated.
    2. Bend forward keeping your
    planted leg semi straight and
    reach for the ground.
    3. Keep your back relatively flat
    during the exercise.
    4. Repeat for the prescribed
    repetitions and then repeat with
    the other leg.
Balance, advanced

                   Leg ext/Tricep Ext with band

                   Instructions:
                    1. Start by placing the band
                    underneath your foot and
                    holding it with one hand over
                    your head.
                    2. With your knee bent and
                    elbow bent simultaneously
                    straighten the limbs until both
                    are in full extension.
                    3. Return to the starting position
                    and repeat with the other leg.
Balance, Not a good idea!!!

                    Kneeling Balance

                    Instructions:
                     Start Position: Position yourself
                     on the ball by placing your
                     shins on top of the ball and
                     balancing in this position.
                     Use the tops of your feet to help
                     control the movement of the
                     ball by placing them against the
                     ball.
                     Hold for the prescribed number
                     of seconds.
Cool Down

   Repeat Warm-up Exercises
   Stretch any Muscles That May Have
    Bothered You during the Workout
Conclusion

   Check with your doctor before starting any
    exercises program
   Progress slowly and with caution
   Pain at a Level II or below
   Have Fun and Enjoy your Workouts
Thank you For your Time

   Any Questions?

				
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