Would you like to view this video?

Deep Cervical Flexor Progression for Range of Motion (ROM)

Deep Cervical Flexor Progression for Range of Motion (ROM) is a physical therapy program used to improve full range of motion of the cervical spine. This program includes a combination of strengthening, stretching and mobilization exercises targeted to the cervical spine. The exercises involve targeted strengthening and stretching of the deep cervical flexor muscles, which are responsible for head and cervical spine movement. Performance of these exercises progresses from unloaded and low-resistance exercises to higher-resistance, weight-bearing exercises

Transcript

00:00:0000:00:03
This is Brent coming at you with another progressions video for the deep
00:00:0300:00:07
cervical flexors. Now we've been through isolated activation exercise, we've been
00:00:0700:00:11
through two progressions videos for stabilization exercise, now if we've
00:00:1100:00:16
managed to activate the deep cervical flexors and then increase endurance and
00:00:1600:00:20
stabilization so that an individual is able to maintain, good, cervical posture,
00:00:2000:00:25
it's time for us to start working on that range of motion that was lost. Now I
00:00:2500:00:28
have to thank Doctor of Physical Therapy Michelle Petrowski, over at Dynamic
00:00:2800:00:33
Sports Physical Therapy for giving me the idea for these progressions, they all
00:00:3300:00:37
start the same way. They're all going to start with one of our upper body
00:00:3700:00:42
activation exercises to stabilize the scapula and help to inhibit those
00:00:4200:00:48
overactive synergists in the cervical spine, followed by retraction to activate
00:00:4800:00:52
the deep cervical flexors, and then we're going to work in to whatever range of
00:00:5200:00:56
motion that we've lost. I have my friend Leanne to come help me out. She's going
00:00:5600:01:00
to demonstrate these exercises. The first thing we're going to do is a very common
00:01:0000:01:03
exercise you have seen, which is that bilateral, external rotator
00:01:0300:01:07
activation up against this wall. I think you will see the advantage of
00:01:0700:01:12
having this wall here really quickly. This is definitely an exercise that I choose to
00:01:1200:01:19
use initially, when I'm just starting to work on range of motion. So, Leanne is
00:01:1900:01:23
going to get into her external rotator activation position, she's going to go
00:01:2300:01:28
ahead and rotate out, that's the "chest out thumbs out" position, scapula are
00:01:2800:01:32
stabilized, she's going to retract against the wall, that's going to
00:01:3200:01:38
activate those deep cervical flexors, and then from here, I can go in any range of
00:01:3800:01:42
motion that I've lost. Let's say Leanne's lost some flexion, so I can have her try
00:01:4200:01:50
to touch her sternum and then come back up. If she's lost lateral flexion, having
00:01:5000:01:53
the wall here is really nice for this one, I can have her go into a
00:01:5300:01:58
little bit of retraction, and then maintain that retraction as she goes
00:01:5800:02:03
into lateral flexion, and back. Good. I could do rotation. This is
00:02:0300:02:07
actually one of my favorite exercises regardless of if somebody is starting, or
00:02:0700:02:14
has progressed quite a bit, having this wall here to queue somebody into rotation, is
00:02:1400:02:19
extremely helpful! Now, with whatever range of motion you have lost,
00:02:1900:02:23
it would seem just from from my experience, you want to get somebody to
00:02:2300:02:29
activate first, retract, they're going to go into whatever range of motion they
00:02:2900:02:34
lost, they're going to try to maintain that for two to four seconds, come back
00:02:3400:02:39
to neutral, and start over. This is what I found to work best from a practical
00:02:3900:02:43
perspective, and then we can go back to those 12 to 20 repetitions that we
00:02:4300:02:47
normally do for activation exercise. Now, other than this exercise we could do
00:02:4700:02:54
cobras. Cobras are great because they they resist depression.
00:02:5400:02:59
The resistance is pulling upward, so as she pulls down and back we get a lot of
00:02:5900:03:04
depression in the scapula, we get a lot of inhibition of our lateral flexors of
00:03:0400:03:09
the cervical spine, which is why I love to use this one to work on lateral
00:03:0900:03:16
flexion. So, if I have her retract and then move this way, I'm sure Leanne can feel
00:03:1600:03:21
it. This is a great exercise for working on that active flexibility
00:03:2100:03:25
of these structures in here, and then she can go back up. If she had only lost
00:03:2500:03:28
range of motion on that side, I would only go to that side. If she's lost range
00:03:2800:03:31
of motion in both directions I could have her then go to lateral flexion to
00:03:3100:03:36
the other side, work on getting all the active flexibility in these structures,
00:03:3600:03:41
and then back, and then of course she can start over.
00:03:4100:03:46
Down, she's nice and stabilized here, she's retracted, and then once again go
00:03:4600:03:54
back into lateral flexion. The next exercise that I really enjoy using for
00:03:5400:03:59
this deep cervical flexor activation and range of motion, is, I don't know if you
00:03:5900:04:03
saw that serratus anterior progressions video we did, where we did
00:04:0300:04:11
this modification of this Sarmon serratus anterior activation, but
00:04:1100:04:19
if we start with that, here's what happens. As Leanne moves her arms up, and
00:04:1900:04:27
focuses on scapular depression, she forces her scapula into upward rotation.
00:04:2700:04:33
That upward rotation already starts to lengthen the levator scapulae, and
00:04:3300:04:41
lengthening that levator scapulae I can start working on that flexion and
00:04:4100:04:45
rotation combination that so often becomes a problem for people with
00:04:4500:04:53
cervical dysfunction. Then she can go into the other direction, and then
00:04:5300:04:58
relax for a second. Alright, good. Draw-in. Let's do one more rep.
00:04:5800:05:05
So she can draw-in, squeeze up, make sure she's focusing on scapular
00:05:0500:05:14
depression, so we forced upward rotation, and she can go here. Now I know I've
00:05:1400:05:17
thrown out a lot of words, a lot of queues, a lot of information in this video, but I
00:05:1700:05:22
want to show you guys how easy it is to incorporate all of these exercises in
00:05:2200:05:27
to an activation sequence, or an upper body warm up for somebody with
00:05:2700:05:32
cervical spine and upper body dysfunction. So, if Leanne starts off with
00:05:3200:05:37
her isolated cervical flexor activation, and it works to do this much
00:05:3700:05:41
better in front of a mirror, but we'll make do with what we've got right now, so
00:05:4100:05:46
she can start off with her 15 repetitions just doing her deep cervical
00:05:4600:05:49
flexor activation, so this is getting her prepared to work on those
00:05:4900:05:56
range of motion exercises. Relax, and back. Now we're going to say that
00:05:5600:06:01
most of Leanne's problems were on her right side. So I'm going to go ahead, and
00:06:0100:06:05
after she's done 12 to 20 repetitions of this, have her flip around use
00:06:0500:06:07
the same wall,
00:06:1000:06:16
and we're going to have her do her bilateral external rotator
00:06:1600:06:22
activation, keep her scapula depressed, and now I can have her work on right
00:06:2200:06:31
lateral flexion, or right rotation. Good. I'll have her do 12 to 20 reps of that, then I
00:06:3100:06:38
can have her jump over to her cobras.
00:06:3900:06:43
Same thing here. If I did right rotation here, maybe I want to do right lateral
00:06:4300:06:48
flexion here, or work on some range of motion she's lost, have her do her 12 to
00:06:4800:06:55
20 repetitions. Good. Then I can go ahead and have her do her Sarmon exercise.
00:06:5800:07:03
And now, maybe I worked on rotation here, lateral flexion here, I can work on that
00:07:0300:07:09
rotation lateral flexion and flexion on this one, going to the levator scapulae
00:07:0900:07:15
active stretch, and cervical spine range of motion, making sure the whole time I'm
00:07:1500:07:19
queueing retraction. Now, I realized if I did 12 to 20 reps of that, and I had
00:07:1900:07:23
it set up in a nice tight area like this, it might take five minutes to get
00:07:2300:07:27
through this, and I've also activated her external rotators her serratus anterior,
00:07:2700:07:33
and her lower traps. All of this has been done so that she can go into whatever
00:07:3300:07:38
upper body exercise, or whatever functional task for her upper body you
00:07:3800:07:42
want her to be able to do with better form, and of course better motor unit
00:07:4200:07:46
recruitment. I hope you have enjoyed these exercises, I hope you enjoy