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Open Books - Self-administered Spine Rotational Mobilizations
Open Books - Self-administered Spine Rotational Mobilizations is an innovative program designed to improve spine health, flexibility and movement. It combines spinal mobilization, rotational exercises, and muscle release techniques to improve the range of motion and strength throughout the spine. Open Books helps improve posture, reduce back pain and stiffness, enhance flexibility, and prevent stiffening of the spine. This program is suitable for all levels of fitness and activity and is easy to perform at home. It takes only minutes
Transcript
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This is Brent of the Brookbush
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...blank
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Institute and in this video we're going over
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a very commonly used exercise for lumbar
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mobilization- the open book. We're also
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going to discuss how it could be used
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for thoracic and sacroiliac joint
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mobility and maybe a great active
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stretch for the pectoralis major,
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pectoralis minor, posterior deltoid, and
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potentially even the piriformis. I'm
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going to have my friend, Melissa, come out and
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she's going to help me demonstrate. Now, I
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think you guys will quickly find that
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setup is the most complicated portion of
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this exercise, and it's going to take
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some time for you to teach, and remind,
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and reinforce your patients and clients
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to be able to do this with good form. Go
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ahead and lay on your side. This is where
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we're going to start. I'm going to go
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through these form cues from bottom up
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here. So, we're going to start by
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straightening out the bottom leg, so her
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bottom leg becomes kind of this pivot
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point. It should be in line with her
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torso and her head, so we should see a
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nice straight line from the top of her
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head through her spine, through her hip,
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knee, and ankle. She's then going to take
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the foot of her top leg and put it
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behind that bottom knee. We're then going
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to use some sort of space, or foam roll, or
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Hypersphere- something about this size to
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get the top knee level with her hip. That
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is, with her pelvis in a position that is
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kind of perfectly vertical here. Now
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she's going to take this bottom hand, and
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this bottom hand is going to be
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responsible for maintaining her knee
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position. Alright, so she's going to
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hook the bottom of that leg and keep it up
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in flexion, which is going to keep us a
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little bit posteriorly tilted which is
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going to help us with the lumbar
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mobility portion of this. She's then
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going to take this hand, and I want her
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to really tuck it behind her head. So,
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she's going to wrap those fingers all the
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way behind her occiput, maybe grab her
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ponytail with her web space here. Alright,
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so all the way around. I don't want to
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see any cheating with with fingers
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barely touching the head.
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This is the setup. This is how we get
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started. Now, the fun part is to see how much
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mobility Melissa actually has. She's
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going to start by trying to put this
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elbow down on the floor. This isn't so
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easy for a lot of people. This takes a
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lot of extensibility of her posterior
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deltoids, of her scapular muscles, and
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even some mobility of her thoracic spine,
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rib cage, and lumbar spine. But then, the
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really hard part for most people is
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trying to lay this arm flat down on the
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floor. Melissa, here, has pretty good
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mobility, but you can see she still has
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about an inch to go there. So, if she
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starts again, we're going to hold for two
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and then open up, hold for two, and I try
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to get my patients doing 10 to 20 reps
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with those two second holds. Don't let
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them rush through. I think you guys are
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going to find that a lot of your
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patients get stuck. They end up right
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about here- that's as far as they can get.
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You want them putting a little bit of
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effort here, holding that position, making
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sure they are trying to put an effort to
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go further. And then have them go back.
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Same thing on this side. Put some effort
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forth. Now, let's think through some of
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our kinesiology and where this may
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benefit our patients from a mobility
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perspective outside of just the lumbar
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spine. As I mentioned, when Melissa comes
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this way, that is a lot of horizontal
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adduction which is going to require a
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ton of mobility from her posterior delt.
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She's also protracting and upwardly
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rotating her scapula, which means she's
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going to need some extensibility from
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potentially her lower traps here as she
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protracts her mid traps, as she protracts
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her rhomboids, as she
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upwardly rotates and protracts. All of
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that's going to help as an active
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stretch here. Go ahead and open up. And
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then if she gets into this position, we
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see a ton of horizontal abduction,
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abduction, and external rotation of the
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shoulder, which is basically pectoralis
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major stretching.
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Let's try that one more time. You guys
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can see that she comes back, she also has
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to upwardly rotate this way.
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Upwardly rotate and posteriorly tip
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her scapula, which is going to be a pec
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minor active stretch. So, now we have
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something that's great for both
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posterior shoulder mobility as well as
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pec mobility. Now, just the posterior
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tipping thing- alright, the posterior
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tipping of her scapula against her
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rib cage is going to help to create a
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posterior to anterior force on that rib
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cage and mobilize those ribs. Your
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ribs have a lot to do with thoracic
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mobility, and we're adding that posterior
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to anterior rib mobilization to thoracic
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rotation. Now, something to keep in mind
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is all of this is happening as an aside
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to the main goal of this exercise, which
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is generally lumbar mobility.
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So this is all of the additional benefit
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we get from an open book. But, let's talk
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about this area right here, as this is
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generally why we
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use this exercise. This is the focus. As
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she's going back and forth, she's causing
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a ton of rotation at the spine, as
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well as this position is slightly flexed and
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this position is slightly extended. We
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have her locked into a posterior tilt,
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some flexion here, and I'm not allowing
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her to get any adduction at the hip. In
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this position, she can't internally and
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externally rotate at the hip, so we know
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that the motion is primarily coming from
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her lumbar spine. As you go back
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through here, you just can see that the
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position she's put in here- go ahead and
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open up- prevents her getting any
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mobility from her hip or pelvis. Maybe we
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get a little SI joint mobility as lumbar
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rotation this way would actually force a
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little posterior to anterior mobility on
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the bottom SI joint, and anterior to
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posterior mobility on
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top SI joint. But, almost all that
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rotation has to come from this lumbar
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segment. If I want to get really,
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really tricky, I can even put on
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my physical therapy hat, remember how I
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do lumbar manipulations or lumbar
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physiological mobilizations for rotation,
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and I could actually lock in what
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segment I want to rotate by using- sorry
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let me have you back in this position- by
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using how high her knee is to get a
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ligamentous lock from bottom up. If you
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know how to do that, if you've taken
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manual mobilization, manual manipulation,
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lumbar spine courses, you know what I'm
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talking about. I can do my little piano
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grip on her lumbar spine, and let's say I
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wanted her to focus more on- we'll call
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it mid lumbar spine, although I'd love to
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say that I could target L2 L3 segment,
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we'll call it mid lumbar spine. We'll get
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her right up to about here. I'll give her
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some cue like, "Hey, I need you to grab all
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the way up to second knuckle on that
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hamstring." So, I'll give her some
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cue that she can remember as far as
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where to bring this leg, and now when she
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opens up, she should feel that a little
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higher in her lumbar spine. If I wanted a
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little lower in her lumbar spine, of
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course, I could go maybe, "Alright, I just
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want your first knuckle on your
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hamstring tendon here," which is her
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biceps femoris tendon. If I wanted to get
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up even higher, maybe I can get up into
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that upper lumbar spine, maybe I go with
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whole hand and really get her up high, and
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again, have her do this exercise there. So
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there you guys have it. We have a ton
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going on in this exercise. It's primarily
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a lumbar rotation mobilization, because
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of the way we have the pelvis locked down,
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but we have some sacroiliac joint
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mobility. We also have a ton going on in the
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upper body from
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pectoralis major and minor, posterior
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delt active stretching, and we have rib and
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thoracic mobilization going on. This
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becomes a very dynamic, very versatile
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exercise to throw in somebody's
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program. It's something I use all the
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time in self-administered lumbar spine
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home exercise programs. It also ends
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up in a ton of my integrated warm-ups
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for the athletes that I train, as well as
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the recreational fitness member who we
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know sits at a desk all day. All of
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this stuff has a propensity towards
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either restriction or overactivity. I
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hope you guys enjoyed this video. I look
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forward to seeing your questions in the
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comments section. Feel free to post any
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question you have.
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