Upper limb Muscle stretches

 

Manual and Self-Stretching Exercises for Specific Muscles

Manual stretching of specific multijoint muscles that affect alignment of the shoulder girdle are presented in this section along with self-stretching techniques for these muscles.

Upprr limb stretches


To Stretch the Latissimus Dorsi Muscle

Manual Stretch

Patient position and procedure: Supine, with hips and knees flexed so the pelvis is stabilized in a posterior pelvic tilt. Provide additional stabilization to the pelvis with one hand, if necessary. With the other hand grasp the distal humerus and flex, laterally rotate, and partially abduct the shoulder to the end of the available range. Instruct the patient to contract into extension, adduction, and medial rotation while providing resistance for a hold–relax maneuver. During the relaxation phase, elongate the muscle .

Self-Stretch

Patient position and procedure: Hook-lying with the pelvis stabilized in a posterior pelvic tilt and the arms flexed, laterally rotated, and slightly abducted overhead as far as possible (thumbs pointing toward floor). Allow gravity to provide the stretch force. Instruct the patient to not allow the back to arch.

Patient position and procedure: Standing with back to a wall and feet forward enough to allow the hips and knees to partially flex and flatten the low back against the wall, with the arms in a “hold-up” position (abducted 90_ and laterally rotated 90_ if possible). Tell the patient to slide the back of the hands up the wall as far as possible without allowing the back to arch.

To Stretch the Pectoralis Major Muscle

Manual Stretch

Patient position and procedure: Sitting on a treatment table or mat, with the hands behind the head. Kneel behind the patient and grasp the patient’s elbows . Have the patient breathe in as he or she brings the elbows out to the side (horizontal abduction and scapular adduction). Hold the elbows at this end-point as the patient breathes out. No forceful stretch is needed against the elbows, because the rib cage is elongating the proximal attachment of the pectoralis major muscles bilaterally. As the patient  repeats the inhalation, again move the elbows up and out to the end of the available range and hold as the patient breathes out. Repeat only three times in succession to avoid hyperventilation.

Self-Stretch

Patient position and procedure: Standing, facing a corner or open door, with the arms in a reverse T or a V against the wall . Have the patient lean the entire body forward from the ankles (knees slightly flexed). The degree of stretch can be adjusted by the amount of forward movement.

Patient position and procedure: Sitting or standing and grasping the wand with the forearms pronated and elbows flexed 90_. Have the patient then elevate the shoulders and bring the wand behind the head and shoulders . The scapulae are adducted, and the elbows are brought out to the side. Combine with breathing by having the patient inhale as he or she brings the wand into position behind the shoulders; then exhale while holding this stretched position.

 

To Stretch the Pectoralis Minor Muscle

Patient position and procedure: Sitting, place one hand posterior on the scapula and the other hand anterior on the shoulder just above the coracoid process As the patient breathes in, tip the scapula posteriorly by pressing up and back against the coracoid process while pressing downward against the inferior angle of the scapula; then hold it at the end-position while the patient breathes out. Repeat, readjusting the endposition with each inhalation and stabilizing as the patient exhales.

To Stretch the Levator Scapulae Muscle

Manual Stretch

Patient position and procedure: Sitting with the head rotated opposite to side of tightness (looking away from the tight side) and forward bent until a slight pull is felt in the posterolateral aspect of the neck (in the levator muscle). The arm on the side of tightness is abducted, and the hand is placed behind the head to help stabilize it in the rotated position. Stand behind the patient and stabilize with one arm; place the other hand (same side as the tight muscle) over the superior angle of the scapula . With the muscle now in its stretched position, have the patient breathe in, then out. Hold the shoulder and scapula down to maintain the stretch as the patient breathes in again (he or she contracts the muscle against the resistance of the fixating hand). To increase the stretch, press down against the superior angle of the scapula. This is not a forceful stretch but a gentle hold–relax maneuver. Do not stretch the muscle by forcing rotation on the head and neck.

Self-Stretch

Patient position and procedure: Standing with the head side bent and rotated away from the tight side and bent elbow against a wall. The other hand can be placed across the forehead to stabilize the rotated head. Instruct the patient to slide the elbow up the wall as he or she takes in a breath, then hold the position while exhaling .

Patient position and procedure: Sitting with head side bent and rotated away from the tight side. To stabilize the scapula, have the patient reach down and back with the hand on the side of the tightness and hold onto the seat of the chair. The other hand is placed on the head to gently pull it forward and to the side in an oblique direction opposite the line of pull of the tight muscle.

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