1. 3-Dimensional Stretching Benjamin L. Kolly DPT, OMPT, ATC Xcel Physical Therapy, PLC

2. Bring spine • roll • Wedges, towels • belts

3. Objectives • Review Basic Concepts of Stretching • Identify purpose for 3-Dimensional Stretching • Describe two 3-D stretches for immediate use

4. 6 Principles • Force vs Time • Prepositioning • Avoid torque through stiff joint • Follow up with AROM or activity

5. Tissues • Muscles • Manual stretching, Hold-Relax, Reciprical inhibition • Joints • Mobilizations, traction

6. Why 3-D • Tissues do not move in 1 plane • Avoid aberrant stresses on painful, restricted joints • Maximize the lengthening of muscles • Maximally open foramen • Protect spinal segments

7. Mechanisms • Traction joints • Pre-position joints • Stretch through 2 or more joints • Glide (slow mobilization) through stretch

8. Thoracic Spine Stretch • SDLY with SB over roll and knees bent up • With top arm reach backwards causing a rotation opposite of side bending • Add weight to arm as needed • Vary amount of trunk flexion

9. Piriformis • Roll under L/S promote anterior tilt = L/S extension • Flex greater than 90 degrees, ER hip, glide hip posteriorly • Flex to approximately 60 degrees, IR hip and stabilize ipsi ASIS (p237)

10. Hip Extensors • Roll under L/S promote anterior tilt = L/S extension • Flex hip and posterior gliding of hip joint • Gluteus Medius & Minimus • Abduction and ER • Gluteus Maximus • adduction and IR

11. Ilipsoas • Prone on table, folded towel under abdomen to protect, wedge under foot • Extend thigh, IR hip, apply ventral glide

12. Rectus Femoris • Prone on table, folded towel under abdomen to protect, wedge under foot • Extend the hip, flex the knee, apply ventral glide

13. Short Adductors • Supine, stabilize straight leg • Abduct thigh and traction force • Prone, stabilize pelvis with belt • Ventral glide femur

14. Long Adductors • Posterior tilt with contra leg over table • Extend knee and abduct hip • (amt hip flexion or knee flexion )

15. LatissimusDorsi • Maximally flex the lumbar spine, flex shoulder, ER • Also SB away and cranially glide humerus

16. Disc Traction • Seated, prone, supine, SDLY options • Preposition varying amount flexion, SB • Stabilize caudal and pull cranial or vise versa • (pg 28-29 notebook)

17. Facet Stretching (Glide) • Creates extension at 1 segment and flexion at others • Mobilize cranial segment ventral cranial to create flexion moment on that segment and extension above

18. Coupling in the Spine • Coupled movements • Non-coupled movements • Example:

19. Review • 3-D stretches can be used on muscles and joints • 3-D concept is useful to: • replicate normal movement patterns • Reduce painful, compressive loads • Maximize elongation • Protect the spine

20. Questions • Ben can be reached at bkolly@xceltherapy.com