00:00:0000:00:03
This is Brent coming at you with yet
00:00:0300:00:07
we're going to go over progressions for deep cervical flexor activation. Those
00:00:0700:00:11
commonly under active muscles of the cervical spine related to both the upper
00:00:1100:00:17
body and cervical dysfunction, the longus colli, longus capitis and rectus
00:00:1700:00:21
capitis anterior. I'm going to have my friend Rob come out and show some of
00:00:2100:00:26
these progressions. Now at the end of our previous cervical flexor
00:00:2600:00:31
activation video we kind of ended with this idea of putting somebody against
00:00:3100:00:36
the wall them working on their retraction their cervical retraction, and
00:00:3600:00:42
then starting to integrate some of our other upper body activation exercises,
00:00:4200:00:49
for example bilateral external rotation. This looks pretty good, it's pretty tough
00:00:4900:00:53
just to maintain that position. What we're going to do in this video is we're
00:00:5300:01:00
going to find ways of progressing this. So if I have Rob stand a little forward
00:01:0000:01:05
from the wall I can get this, this is just one of those smaller stability
00:01:0500:01:10
balls guys, I can have him put his head against that stability ball, walk his
00:01:1000:01:15
speed out a little bit so that now he's leaning and now he actually has to
00:01:1500:01:21
actively retract, and there's resistance against those deep cervical flexors. I
00:01:2100:01:26
would probably start just trying to maintain this position, pull out a
00:01:2600:01:32
stopwatch 15 seconds, 30 seconds. Can he hold this position for 60 seconds, but
00:01:3200:01:36
then of course we can start integrating those upper body motions once again. We
00:01:3600:01:42
can go back to our bilateral external rotation.
00:01:4300:01:47
One thing you should I should mention too that I'm starting to notice with
00:01:4700:01:52
Rob as we're doing this, is this ball is actually a much more instable
00:01:5200:01:56
environment right than the wall. So not only his his deep cervical flexors
00:01:5600:02:00
having to work harder against the resistance, they're having to also work
00:02:0000:02:05
harder just to maintain optimal alignment of his cervical spine an
00:02:0500:02:11
interesting progression to think about. Now another exercise maybe we could work
00:02:1100:02:17
on is scaption, so Rob knows scaption and we'll keep cueing him to try to keep
00:02:1700:02:23
his scapula depressed, keep working on that upward rotation. Maybe I could go in
00:02:2300:02:28
a couple different directions here, I might add some light resistance, I could
00:02:2800:02:33
maybe work on his mobility and see if he could maintain retraction both of his
00:02:3300:02:38
cervical spine, as well as retraction and depression of his scapula. See if you can
00:02:3800:02:41
go all the way up,
00:02:4100:02:45
and then I could get really really tough have him put both hands on his
00:02:4500:02:51
hips to start, and then have him see if he can work on just one side while
00:02:5100:02:58
still maintaining this perfectly center line from nose down to sternum, because
00:02:5800:03:03
every time he lifts an arm, realized now we've created an unbalanced force that
00:03:0300:03:09
these muscles have to work against to keep him center. Pretty tough, bit of a
00:03:0900:03:12
challenge. Alright i can see Rob straining actually a little bit and of
00:03:1200:03:16
course we've been going on here for a couple minutes. Now if Rob could do that
00:03:1600:03:21
well, I might progress even further. We're going to have him go ahead and get into
00:03:2100:03:26
quadruped position. Now the nice thing about quadruped position is I can actually
00:03:2600:03:33
now place a little bit of load right, via gravity to his deep cervical flexors. Now
00:03:3300:03:37
to retract is against gravity and although this is going to look a little
00:03:3700:03:42
silly, the resistance I'm going to use is actually a stability ball. You can move
00:03:4200:03:46
forward just a little bit, takes a second to kind of get somebody aligned on
00:03:4600:03:50
this, but if I let them go into flexion, just let him relax, let him go into the
00:03:5000:03:54
forward head posture that maybe I'm trying to correct, and then I have him go
00:03:5400:04:00
protraction at his scapula, retraction of his chin right, that chin tuck. Now he has
00:04:0000:04:05
to lift this ball against the force of gravity as well as just the resistance
00:04:0500:04:12
of pushing into the ball, is a little bit of further resistance. How's that feel?
00:04:1200:04:16
Yeah it's a pretty tough exercise. It doesn't take a whole lot of weight, the
00:04:1600:04:19
weight of these stability balls is actually significant for these muscles.
00:04:1900:04:24
If I was to go to larger stability balls that's actually a significant increase.
00:04:2400:04:29
If he happened to master that, once again I can go back to this idea of
00:04:2900:04:33
integrating his upper body activation exercise, in this case maybe a little
00:04:3300:04:40
core. I'll have him activate his TVA, once again cue retraction and then he can
00:04:4000:04:45
start on his marching of his hands without rotating at all, and once again
00:04:4500:04:50
now we have a stability challenge, we have an asymmetrical load challenge.
00:04:5000:04:55
We're starting to integrate some other stuff like his TVA, this is all wonderful
00:04:5500:04:59
ways of challenging and progressing these muscles. He could go into scaption,
00:05:0400:05:07
that's great, and actually fairly impressive. Guys I think you're going to
00:05:0700:05:11
find this to be a wonderful challenge for your patients. I know some of you
00:05:1100:05:14
guys have been working on those deep cervical flexor exercises for a long
00:05:1400:05:18
time, and wondering where to go with them. I hope if you guys progress to these
00:05:1800:05:23
exercises, you see some long-term change. You see some increase in strength, and
00:05:2300:05:27
hopefully people stay with this better posture for a little longer in between