0:00 This is Brent coming at you with another progressions video for the deep 0:03 cervical flexors. Now we've been through isolated activation exercise, we've been 0:07 through two progressions videos for stabilization exercise, now if we've 0:11 managed to activate the deep cervical flexors and then increase endurance and 0:16 stabilization so that an individual is able to maintain, good, cervical posture, 0:20 it's time for us to start working on that range of motion that was lost. Now I 0:25 have to thank Doctor of Physical Therapy Michelle Petrowski, over at Dynamic 0:28 Sports Physical Therapy for giving me the idea for these progressions, they all 0:33 start the same way. They're all going to start with one of our upper body 0:37 activation exercises to stabilize the scapula and help to inhibit those 0:42 overactive synergists in the cervical spine, followed by retraction to activate 0:48 the deep cervical flexors, and then we're going to work in to whatever range of 0:52 motion that we've lost. I have my friend Leanne to come help me out. She's going 0:56 to demonstrate these exercises. The first thing we're going to do is a very common 1:00 exercise you have seen, which is that bilateral, external rotator 1:03 activation up against this wall. I think you will see the advantage of 1:07 having this wall here really quickly. This is definitely an exercise that I choose to 1:12 use initially, when I'm just starting to work on range of motion. So, Leanne is 1:19 going to get into her external rotator activation position, she's going to go 1:23 ahead and rotate out, that's the "chest out thumbs out" position, scapula are 1:28 stabilized, she's going to retract against the wall, that's going to 1:32 activate those deep cervical flexors, and then from here, I can go in any range of 1:38 motion that I've lost. Let's say Leanne's lost some flexion, so I can have her try 1:42 to touch her sternum and then come back up. If she's lost lateral flexion, having 1:50 the wall here is really nice for this one, I can have her go into a 1:53 little bit of retraction, and then maintain that retraction as she goes 1:58 into lateral flexion, and back. Good. I could do rotation. This is 2:03 actually one of my favorite exercises regardless of if somebody is starting, or 2:07 has progressed quite a bit, having this wall here to queue somebody into rotation, is 2:14 extremely helpful! Now, with whatever range of motion you have lost, 2:19 it would seem just from from my experience, you want to get somebody to 2:23 activate first, retract, they're going to go into whatever range of motion they 2:29 lost, they're going to try to maintain that for two to four seconds, come back 2:34 to neutral, and start over. This is what I found to work best from a practical 2:39 perspective, and then we can go back to those 12 to 20 repetitions that we 2:43 normally do for activation exercise. Now, other than this exercise we could do 2:47 cobras. Cobras are great because they they resist depression. 2:54 The resistance is pulling upward, so as she pulls down and back we get a lot of 2:59 depression in the scapula, we get a lot of inhibition of our lateral flexors of 3:04 the cervical spine, which is why I love to use this one to work on lateral 3:09 flexion. So, if I have her retract and then move this way, I'm sure Leanne can feel 3:16 it. This is a great exercise for working on that active flexibility 3:21 of these structures in here, and then she can go back up. If she had only lost 3:25 range of motion on that side, I would only go to that side. If she's lost range 3:28 of motion in both directions I could have her then go to lateral flexion to 3:31 the other side, work on getting all the active flexibility in these structures, 3:36 and then back, and then of course she can start over. 3:41 Down, she's nice and stabilized here, she's retracted, and then once again go 3:46 back into lateral flexion. The next exercise that I really enjoy using for 3:54 this deep cervical flexor activation and range of motion, is, I don't know if you 3:59 saw that serratus anterior progressions video we did, where we did 4:03 this modification of this Sarmon serratus anterior activation, but 4:11 if we start with that, here's what happens. As Leanne moves her arms up, and 4:19 focuses on scapular depression, she forces her scapula into upward rotation. 4:27 That upward rotation already starts to lengthen the levator scapulae, and 4:33 lengthening that levator scapulae I can start working on that flexion and 4:41 rotation combination that so often becomes a problem for people with 4:45 cervical dysfunction. Then she can go into the other direction, and then 4:53 relax for a second. Alright, good. Draw-in. Let's do one more rep. 4:58 So she can draw-in, squeeze up, make sure she's focusing on scapular 5:05 depression, so we forced upward rotation, and she can go here. Now I know I've 5:14 thrown out a lot of words, a lot of queues, a lot of information in this video, but I 5:17 want to show you guys how easy it is to incorporate all of these exercises in 5:22 to an activation sequence, or an upper body warm up for somebody with 5:27 cervical spine and upper body dysfunction. So, if Leanne starts off with 5:32 her isolated cervical flexor activation, and it works to do this much 5:37 better in front of a mirror, but we'll make do with what we've got right now, so 5:41 she can start off with her 15 repetitions just doing her deep cervical 5:46 flexor activation, so this is getting her prepared to work on those 5:49 range of motion exercises. Relax, and back. Now we're going to say that 5:56 most of Leanne's problems were on her right side. So I'm going to go ahead, and 6:01 after she's done 12 to 20 repetitions of this, have her flip around use 6:05 the same wall, 6:10 and we're going to have her do her bilateral external rotator 6:16 activation, keep her scapula depressed, and now I can have her work on right 6:22 lateral flexion, or right rotation. Good. I'll have her do 12 to 20 reps of that, then I 6:31 can have her jump over to her cobras. 6:39 Same thing here. If I did right rotation here, maybe I want to do right lateral 6:43 flexion here, or work on some range of motion she's lost, have her do her 12 to 6:48 20 repetitions. Good. Then I can go ahead and have her do her Sarmon exercise. 6:58 And now, maybe I worked on rotation here, lateral flexion here, I can work on that 7:03 rotation lateral flexion and flexion on this one, going to the levator scapulae 7:09 active stretch, and cervical spine range of motion, making sure the whole time I'm 7:15 queueing retraction. Now, I realized if I did 12 to 20 reps of that, and I had 7:19 it set up in a nice tight area like this, it might take five minutes to get 7:23 through this, and I've also activated her external rotators her serratus anterior, 7:27 and her lower traps. All of this has been done so that she can go into whatever 7:33 upper body exercise, or whatever functional task for her upper body you 7:38 want her to be able to do with better form, and of course better motor unit 7:42 recruitment. I hope you have enjoyed these exercises, I hope you enjoy 7:46 these progressions, I hope you get great outcomes!
