Tag Archives: physio

Joint mobilising series

This collection of movements is a multi-purpose series designed to:

  • warm up some of the major muscles of the body
  • warm up some of the major joints of the body
  • develop your physical awareness of some of the major muscles and joints in your body
  • help transition from the stresses and strains of the day towards a calming Yoga practice

It is also a very useful sequence to do if you are confined to bed, or the sofa, but are feeling achy and in need of doing something.

1. Shoulder mobilising sequence from this post

2. Leg stretch

Have your knees bent and feet on the floor/bed. Draw your right knee in towards your belly and hold the back of your right thigh with both hands. As you breathe in (inhale) straighten your leg as much as you can and as you breathe out (exhale) bend your knee back to the starting position.

Draw your left knee in towards your belly and hold the back of your  left thigh  with both hands. As you breathe in (inhale) straighten your leg as much as you can and as you breathe out (exhale) bend your knee back to the starting position.

Recommendation: repeat up to five times, building up to ten times.

Extension 1: Extend your leg, and hold the stretch for up to 10 breaths.

Extension 2: repeat the movement using both legs

Extension 3:extend both legs and hold the stretch for up to 10 breaths

3. Ankle twirls

Have your knees bent and feet on the floor/bed. Draw your right knee in towards your belly and hold the back of your right thigh with both hands. As you breathe in (inhale) straighten your leg as much as you can. Twirl your ankle around one way and then twirl your ankle around in the opposite direction. As you breathe out (exhale) bend your knee back to the starting position.

Have your knees bent and feet on the floor/bed. Draw your left knee in towards your belly and hold the back of your left thigh with both hands. As you breathe in (inhale) straighten your leg as much as you can. Twirl your ankle around one way and then twirl your ankle around in the opposite direction. As you breathe out (exhale) bend your knee back to the starting position.

Recommendation: repeat up to five times, building up to ten times.

4. Hip openers

Gently rest both hands on your right knee and move your knee in a circle by pulling it towards you. opening to the side, pushing it away from you and then taking your knee over your left hip.

Repeat with your left knee.

Recommendation: repeat up to five times, building up to ten times.

5. Reclining cobblers pose

Start with knees bent and feet on the bed / floor. when you are ready, drop your left knee out to the left side, and then drop your right knee out to the right.. Bring your soles together. If you want to you can place cushions underneath your thighs to help support your legs. You may wish to put your hands on your thighs to help increase the stretch. Just do what feels right.

Recommendation: hold for between 5 and 10 breaths.

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3 gentle moves to alleviate discomfort from being in bed – mobilising your shoulders

This series of movements focusses on the shoulders. These movements can be done lying in bed or sitting up. See which position your prefer by trying them both. If you decide to practice these lying down in bed, scoot down the bed a little and make sure you have plenty of space above your head – you’ll need to freely be able to move your arms above your head.

 

Make sure your read the guidelines first.

1. Shoulder mobilising A

Start in the lying on your back, knees bent position with your arms by the side of your body, palms down. This is your neutral position.

a) Slowly bring your right arm up over your head as you breathe in.

b) As you breathe out, return your arm back to the neutral position.

c) Slowly bring your left arm up over your head as you breathe in.

d) As you breathe out, return your arm back to the neutral position.

Recommendation – repeat five times, building up to ten times on each side.

2. Shoulder mobilising B

Start in the lying on your back, knees bent position with your arms by the side of your body, palms down. This is your neutral position.

a) Slowly bring your both arms up over your head as you breathe in.

b) As you breathe out, return both arms back to the neutral position.

Recommendation – repeat five times, building up to ten times on each side.

3. Shoulder mobilising C

Start in the lying on your back, knees bent position with your arms by the side of your body, palms down. This is your neutral position.

a) Bring your right hand across to your left shoulder and try to pull your arm across as far as you can, feeling a stretch at the upper back.

b) Release and return to neutral

c) Bring your left hand across to your right shoulder and try to pull your arm across as far as you can, feeling a stretch at the upper back.

b) Release and return to neutral

Recommendation – repeat five times, building up to ten times on each side.

Round off the routine by stretching both hands up over your head and having a good stretch.

3 gentle moves to alleviate discomfort from being in bed – mobilising your neck

This series of movements is all about mobilising your neck muscles. These movements can be done lying in bed or sitting up. See which position your prefer by trying them both.If you decide to practice these lying down in bed, scoot down the bed a little and make sure you have plenty of space above your head. Remember to read the guidelines first!

1. Mobilising your neck A

Start by tucking your chin into your neck and then:

a) Roll your head towards your right shoulder

b) Roll your head back to centre

c) Roll your head towards your left shoulder

d) Roll your head back to centre

Recommendation: Repeat between 5 and 10 times to each side.

2. Mobilising your neck B

Start in a neutral position and then:

a) Drop your head to your left, as if you are trying to bring your left ear towards your left shoulder

b) Keeping your chin tucked in, roll your head to centre and then towards the right, finishing with your right ear towards your right shoulder

c) Keeping your chin tucked in, roll your head to centre and then towards the left, finishing with your left ear towards your left shoulder.

Recommendation: Repeat between 5 and 10 times to each side.

3. Mobilising your neck C

Start in a neutral position and then:

a) Keeping your chin level, turn your head to the left

b) Return to neutral

c) Keeping your chin level, turn your head to the right

d) Return to neutral

Recommendation: Repeat between 5 and 10 times to each side.

3 gentle moves to alleviate discomfort from being in bed – lower body

Sooner or later after surgery, the novelty of a morphine pump will wear off, and horror (@.@) you realise that the nursing staff will actually take it away from you so you will have to retire from your career as an opium eater. You aren’t quite ready to get out of bed let alone go for a walk, but you are starting to want to move about a bit. As you are weaned off pain relief, aches and pains related to being immobile and in bed will present themselves to you.

This sequence of movements is aimed at mobilising the lower body and back, and you should be able to do them whilst in bed.

This series of movements is fantastic to do at any time, at any point. I use them all the time as warm up or cool down before my Yoga practice and also if I have back ache, it’s an excellent first aid treatment for getting rid of aches and pains.

Check out the guidelines first!

1. Pelvic tilt

In addition to helping you to engage with your abdominal muscles, this practice has the added benefit of stretching your lower back as well as activating your abdominal muscles.

a) Start by lying on your back and if possible come to a position where your knees are bent and your feet are on the floor or the bed. Put your hands on your hips and begin by pressing the back of your waist into the bed. When you first start doing this, this might be as much as you can do, and that is absolutely fine.

b) To move on, as you press the back of your waist into the bed, try to draw your navel in towards your spine.

c) For the third stage try to tilt your pelvis towards you as your press the back of your waist into the bed.

d) Finally you press down through your feet in order to lift your hips slightly off the bed.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions

2. Hug knees to belly

This is a movement which complements the pelvic tilt very well. This stretches out the back of the body and can be very helpful in starting to restore your mobility. The action of bringing your knees up on to your belly helps you to get to know your insides again after your surgery.

a) Begin with your knees bent and feet on the floor / your bed. If you can, use your hands to draw your right knee towards your belly and hold this position for a few breaths and then release.

b) Keeping your knees bent and feet on the floor / your bed. If you can, use your hands to draw your left knee towards your belly and hold this position for a few breaths and then release. notice if this side feels different to the first side.

c) If you want to you could repeat this movement on each side, but this time pull your knee in closer to your belly. You should feel a stretch in your lower back and the back of your hips along with gentle pressure on your abdomen.

d) Once you have become familiar with the movement on each side, try bringing both knees on to your belly, one at a time. Hold for a few breaths and then release.

e) If you want to you could repeat this movement with both knees on your belly, but this time pull your knees in closer to your belly. You should feel a stretch in your lower back and the back of your hips along with gentle pressure on your abdomen.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions

3. Supine Twist

a) Come to knees bent and feet on the bed or the floor, if you are doing this on the floor. Have your knees and feet together. Use your folded towel and both hands to apply gently pressure on your abdomen. Very gently drop your left knee to the left until it is resting on the bed / floor. If your knee won’t go that far, then use a pillow to support the knee at whatever height is comfortable for you. Then drop your right knee to the left knee so that the right knee and ankle are resting on the left knee and ankle.

b) Rest here for a few breaths feeling the stretch along the right side of your body.

c) Come back to the starting position. Have your knees and feet together. Use your folded towel and both hands to apply gently pressure on your abdomen. Very gently drop your right knee to the right until it is resting on the bed / floor. If your knee won’t go that far, then use a pillow to support the knee at whatever height is comfortable for you. Then drop your left knee to the right knee so that the left knee and ankle are resting on the right knee and ankle.

d) Rest here for a few breaths feeling the stretch along the left side of your body.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions

Finish the sequence with a couple of repetitions or the pelvic tilt or the knees to chest.

Safe stretching after surgery

The following two techniques aim to help you stretch your body safely after your operation.  You have complete control over how far your stretch and how long you hold the stretches. Together the techniques make a nice sequence which you can flow through if you wish.

1. Cat Stretch

Come to a ‘table’ position, kneeling position with your hips over your knees and your shoulders over your wrists – like a table. As you exhale (breathe out), pull in your navel towards your spine, rounding your back and as you inhale lift your tailbone and your head. Repeat.

Continue the movement, aligning the arching of your spine with your breath. take the opportunity to find a speed of movement that suits you. When you are ready you can return to neutral.

Recommended number of repetitions: start with 5 and build up to 20

2. Child Stretch

From the same starting position bring your big toes together and experiment with sitting your hips back towards your heels, resting your forehead on the floor. You might be more comfortable with your knees together or knees apart.

An alternative is to stack your fists one on top of the other and then rest your forehead on them. Try lengthening your back through your tailbone, Hold for a breath or two and come back to table.

Recommended number of repetitions: start with 5 and build up to 20

The sequence

You can put both movements together to form a sequence

  • Come to table – perform one cat stretch
  • Come to table – perform once child stretch
  • Come to table – perform one cat stretch
  • Come to table – perform once child stretch

Getting more ambitious, post surgery abdominal (diaphragmatic) breathing

This breathing technique will seem like madness just after your abdominal surgery. You’ll feel very bruised and deep breathing will be painful. However this technique has a number of benefits that make it worthwhile persevering with. Firstly your physiotherapist will want you to breathe deeply into the bottom part of your lungs to help prevent infection; second it is a very calming breathing technique and third it is a fantastic breathing technique to practice so that you can use it in very day life.

1. Place one hand on your chest and the other on your abdomen. Take a deep breath in and try to make the hand on your abdomen rise higher than the one on the chest (to help ensure that the diaphragm is pulling air into the bases of the lungs).

2. Breath out slowly.

3. Take a deep breath in and try to make the hand on your abdomen rise higher than the one on the chest again, hold your breath in for a count of 2.

4. Slowly exhale through your mouth and gently contract your abdominal muscles as if you were trying to squeeze all the air from your lungs.

5. Repeat steps 3 and 4 for a minimum of five breaths building up to 20 breaths.

Tip: If you are practising this technique in bed after surgery, place a folded towel on your tummy to help your belly feel ‘secure’.

Placing your hands on your chest and abdomen is to help you train your breathing and get to know the technique. Once you feel comfortable with your ability to breathe into the abdomen, you don;t need to use your hands.

The more your practice this technique, the more natural it will become to you.

Guidelines for post-op physical recovery exercises

At the moment I am posting a series of articles aimed at post-op recovery. I thought it would be a good idea to supply you with some common sense guidelines and checks for you to go through before embarking on any of the techniques described.

Make sure:

  • There is no reason why you should not practice the techniques – check with your nurse or doctor
  • Your bed-rails are up
  • Your drips and tubes are tidy, and that they won’t fall out, pulled or tangled
  • Your alarm button is somewhere safe and easily accessible – make sure it won’t get knocked on the floor
  • Your clothes and bed covers will adequately cover you

 

2 gentle moves to gently discover your abdominal muscles again

Post surgery, you might be thinking that you will never be able to use your abdominal muscles again. Turning over or getting out of bed might seem impossible now, but these two practices will help you to find you abdominal muscles after surgery and build your confidence in them. Try to practice them every day.

1. Pelvic tilt

In addition to helping you to engage with your abdominal muscles, this practice has the added benefit of stretching your lower back as well as activating your abdominal muscles.

a) Start by lying on your back and if possible come to a position where your knees are bent and your feet are on the floor or the bed. Put your hands on your hips and begin by pressing the back of your waist into the bed. When you first start doing this, this might be as much as you can do, and that is absolutely fine.

b) To move on, as you press the back of your waist into the bed, try to draw your navel in towards your spine.

c) For the third stage try to tolt your pelvis towards you as your press the back of your waist into the bed.

d) Finally you press down through your feet in order to lift your hips slightly off the bed.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions

2. Uddiyana Bandha

In Yoga ‘Bandha’ means ‘lock’ and this Uddiyana bandha is also known as the abdominal lock. It is a brace position for the abdominal muscles which has three subtle stages and as such is an excellent practice to use to get to know your abdominals again.

a) As before, start by lying on your back with your knees bent and feet on the floor or the bed. Put one hand below your navel (belly button) and one hand above. The emphasis here is on trying to do something rather than doing it – so it doesn’t matter if you have dressing in the way.

b) Focus on your lower hand. Try to draw in your abdomen, only pulling in your lower hand. The reality is that nothing will move, or the whole abdomen will move slightly. Remember, we are focussing on trying to do the right movement rather than actually doing it!

c) Focus on your upper hand. Try to draw in your abdomen, only pulling in your upper hand. The reality is that nothing will move, or the whole abdomen will move slightly. Remember, we are focussing on trying to do the right movement rather than actually doing it!

d) Now bring together both sensations – of drawing in both the upper and lower abdominals.

Hold for a moment.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions. You can also increase the length on of the ‘lock’ up to a maximum of 5 breaths but don’t try to hold for more than five breaths until you have fully recovered.

The first thing after surgery – breathe….

The first thing after surgery – breathe….

After major abdominal surgery I was surprised to experience lots of problems breathing. This is exacerbated by the physiotherapist’s insistence that you take deep breaths and cough a lot – even when the merest whisper of a breath makes you feel like you might explode.

Here are two breathing techniques. You can use the first one as soon as you come round from your anaesthetic, and the second one a few days later. If you are visiting someone in hospital after surgery you could print this out and guide them through the techniques – a real luxury.

1. Breathing focus

  1. Tune inwards, notice the body
  2. Tune into your breath
  3. Without changing the breath count the breath in and count the breath out
  4. Now try to equalise the breath
  5. Now make the out breath longer
  6. Now try to breathe more deeply, some areas of the lungs will feel sore, others won’t just experiment.
  7. Try breathing down towards your belly button
  8. Try breathing into your ribs, as if you are trying to push them to the sides
  9. Try breathing into your back
  10. As you focus your breath into your belly, ribs or back, repeat the mantra ‘I am breathing in….. I am breathing out….’ for several breaths
  11. Let go of the matra, let go of any breathing pattern, return to natural breathing.
  12. Observe how you feel.

Complete Yoga Breath

This is a stronger version of the first exercise, and will help you to get to know the new landscape of your belly after surgery. This will be a little sore, but if it hurts, then return to the first exercise.

Rest one hand on your belly below the navel, and one above the navel.

  1. Tune inwards, notice the body
  2. Tune into your breath
  3. Without changing the breath count the breath in and count the breath out
  4. Now try to equalise the breath
  5. Now make the out breath longer
  6. Now try to breathe more deeply, some areas of the lungs will feel sore, others won’t just experiment.
  7. Try breathing down towards your belly button, pushing your hand below the navel out a little
  8. Then in the same in-breath try breathing into your ribs, as if you are trying to push them to the sides
  9. Then still in the same in breath, try breathing into your back and up towards your collar bones.
  10. Once you have got a breathing rhythm, repeat the mantra ‘I am breathing in….. I am breathing out….’
  11. After about 12 breaths Let go of the matra, let go of any breathing pattern, return to natural breathing.
  12. You can increase the number of breaths as you recover, until you are doing the complete Yoga breath for 5 minutes.

If you have any questions, please do post them.

Cat x