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