Cervical (Neck) Range of Motion (ROM)

If you have experienced neck pain or had a neck surgery–and have been cleared by your surgeon and physical therapist–please check out the following gentle neck movement exercises and isometric (no movement) strengthening exercises.

Gentle neck movement exercises

For all exercises, please spend time finding neutral spine. The position of neutral is slightly different for each person, but the concept is the same. In backlying (supine) neutral spine is a position where the neck muscles are able to be relaxed and the chin is perpendicular to the floor. Depending on the position of your upper back and neck, you may need to use a towel to support the back of the head to ensure that you can achieve neutral spine without strain to the neck muscles.

Active assisted range of motion (AAROM) for the cervical (neck) spine:

1. AAROM cervical rotation – Begin by placing your right hand gently on the opposite side of your forehead, then start turning your head with both your neck muscles and your hand toward the right.  At the end of the motion, return to the start position. Repeat 5-10 times.

Start Position
Start Position
Begin Movement
Begin Movement
Stop when you encounter any resistance or if you are unable to maintain rotation without sidebending the neck.
Stop when you encounter any resistance or if you are unable to maintain rotation without side-bending the neck.

Repeat for rotation to the left side.

 

2. AAROM cervical side-bending – Begin by placing your right hand on the opposite side of the top of your head. Gently begin moving your right ear toward your right shoulder. Again, stop when you encounter resistance. Perform 5-10 repetitions.

Right side-bending
Right side-bending

Repeat for side-bending to the left side.

Left side-bending
Left side-bending

 

Isometric (no movement) neck strengthening exercises

1. Isometric cervical flexion (nodding the chin down toward the chest) – Place your fist gently against the bottom of your chin and simultaneously, against the front of your neck at your throat. Without creating any movement, nod your chin into your fist (while your fist resists this motion). This exercise works the deep neck flexor muscles (longus colli). Looking down with your eyes helps to facilitate proper muscle activation. Effort for an isometric exercise is sub-maximal, nod your chin down with 10-20% effort. Hold this for 10 seconds. Repeat 10 times.

Deep neck flexor isometric/Longus colli activation
Deep neck flexor isometric/Longus colli activation

*If your shoulders pop up off the ground as you activate your deep neck flexors, try using less effort. When your shoulders come off the ground, your body is recruiting compensatory muscles.

 

2. Isometric neck rotation – Place the right hand on the right side of the forehead. Gently apply pressure through the hand as you activate your muscles against your hand turning your head to right. Remember that no motion occurs because this is an isometric exercise. Use your eyes to facilitate proper muscle activation by looking toward the right. The amount of effort is 10-20%. Hold for 10 seconds, complete 10 repetitions.

Isometric Right Cervical Rotation
Isometric right cervical rotation

Repeat for the left.

Isometric left cervical rotation
Isometric left cervical rotation

*Attempt to not actually rotate the head and neck for this exercise. It is more difficult than it appears.

 

3. Isometric cervical side-bending –  Place your right hand on the right side top of your head. Imagine bringing your right ear to your right shoulder but resist this motion with your hand to maintain the isometric component. Use 10-20% effort. Hold for 10 seconds, complete 10 repetitions.

Isometric right side-bending of the cervical spine
Isometric right side-bending of the cervical spine

Repeat on the left.

Isometric left side-bending of the cervical spine
Isometric left side-bending of the cervical spine

Then smile, you just took care of your neck!

Improve your Driving Posture & Reduce Pain & Stress!

The position you assume in your car makes a significant difference as to how you perceive the stress of driving, both emotionally and physically!

9:310:2

 

 

 

 

Positioning your arms at “10 and 2”  (as drivers used to learn in driving school) will  not only cause your arms to quickly fatigue, but will cause your shoulders  to pull forward. Then your forward shoulders pull your neck and head forward too! This posture also encourages you to grip the wheel and is also associated with feeling more stressed about the drive.

Positioning your arms on the steering wheel at “9 and 3”, or even “8 and 4” are  recommended now. From a posture perspective we find that holding the steering wheel at “8 and 4” allows your shoulders to relax and is much less stressful on the arms, shoulders and neck. And leaning back in the seat with a relaxed shoulder and head posture allows you to feel much less stressed about your drive.

 

Give the lower arm positions a try. And let us know how you feel!

 

Blog post written by Amy Selinger, PT, DPT, OCS

Maya Abdominal Therapy and Bryn Truett-Chavez

We’re so pleased to announce that Bryn Truett-Chavez is now practicing massage and particularly The Arvigo Techniques of Maya Abdominal Therapy at Back to Life every other Thursday!10330400_10204143341722738_4597536769502733695_n

Bryn is an amazing massage therapist who has been practicing for almost 40 years using bodywork techniques such as Swedish, Shiatsu, Thai, Deep Tissue, Trigger Point and The Arvigo Techniques of Maya Abdominal Massage (ATMAT). She teaches ATMAT to massage therapists, physical therapists, acupuncturists, chiropractors and physicians through The Arvigo Institute.

 

Check Bryn out at: http://www.bryntruettchavez.abmp.com/about-bryn

The Arvigo Techniques of Maya Abdominal Therapy are being practiced in the United States due to the work of Rosita Arvigo, a Naprapathic physician who moved from the United States to Central America. She settled in Belize and met one of the most revered of the traditional Mayan healers, Don Elijio Panti.  Dr. Arvigo learned from him much of traditional Mayan medicine including Mayan abdominal massage.

The Arvigo Techniques of Maya Abdominal Therapy are a gentle massage technique that focuses on supporting, repositioning and improving the flow around the abdominal organs. This technique has been used by healers for thousands of years but had been all but abandoned by modern medicine.       Dr. Arvigo and those she has trained are bringing this nourishing, traditional healing technique back into common practice and we are lucky to have wonderful practitioners of this ancient healing technique in the Bay Area.

Find out more about Rosita Arvigo, ATMAT, Don Elijio Panti and find practitioners of ATMAT at: https://arvigotherapy.com/

Blog post written by Amy Selinger, PT, DPT, OCS

Light Therapy, Phototherapy, and LASER Therapy

What is light therapy? Under the umbrella term of either “light therapy” or “phototherapy,” there are many modalities using the properties of light (as both a wave and particle, known as a photon) to influence physiological processes. Some examples include LASER, infrared, red light, and blue light. Light is a form of energy that is measured in wavelength. Therapeutic wavelengths for physical therapy purposes are between 600nm-1000nm.

What is it supposed to do? Light therapy, as it will be referred to in the remainder of this article, proposes to affect tissue repair and pain control. By adding energy to the body in the form of light, cells absorb this energy and increase their activity.

Chukuka Enwemeka wrote an article in 2004 stating: “Evidence indicates that cells absorb photons and transform their energy into adenosine triphosphate (ATP), the form of energy that cells utilize. The resulting ATP is then used to power metabolic processes; synthesize DNA, RNA, proteins, enzymes, and other products needed to repair or regenerate cell components; foster mitosis or cell proliferation; and restore homeostasis.”

Thus, by using light therapy inflammation is accelerated to resolution, blood flow is increased, which allows for improved availability of nutrients to tissues, fibroblasts are encouraged to proliferate (to aid in healing damaged tissues), collagen fibers are synthesized more quickly and alignment of these fibers improves, nerve cells can be stimulated to initiate healing and repair of axonal damage, enzymatic activity is increased to reduce pain, and nerve conduction is modulated to reduce pain.

What are the risks? Before undergoing a session of light therapy, it is important to consider the following contraindications for this type of treatment:

Cancer, direct treatment over the eyes, direct treatment over a fetus or uterus during pregnancy, direct treatment of the thyroid gland, patients with high sensitivity to light (idiopathic photophobia), and patients undergoing other treatments of taking other medications that significantly increase light sensitivity. The following is a list of medication classes that increase photosensitivity.

Antibiotics, nonsteroidal Anti-inflammatories (NSAIDs), diuretics (hydrochlorothiazide, furosemide, etc), retinoids, HMG-CoA (statins), neuroleptic drugs (phenothiazines), tricyclic antidepressants (amitriptyline, etc), oral contraceptives, anti-hypertensives (atenolol, captopril), corticosteroids, antifungals, sildenafil, and barbituates

References:

Enwemeka, C. (2012). Light Therapy: A Handbook For Practitioners. Milwaukee: University of Wisconsin-Milwaukee.

Enwemeka, C. (2004). Therapeutic Light. Disciplinary Journal of Rehabilitation, 17(1), 1-10.

Smith, K. (1991). The Photobiological Basis Of Low Level Laser Radiation Therapy. 19-24. Retrieved January 27, 2015.

 

Blog post written by Jessica Manley, DPT

Our New Therapist at Back to Life!

Bay Area Physical Therapist
Jessica Manley

Have you met our new PT?  Welcome to Back to Life, Jessica!

San Francisco Physical Therapist Jessica Manley, PT, DPT has experienced injury and physical rehabilitation first hand and knows the value of movement without pain. She believes this simple aspect of life should be within reach for all individuals who seek it.Her experience with Functional Manual Therapy (FMT) is a central part of her holistic approach, addressing overall postural and strength imbalances in the body. Drawing upon compassion and commitment to living a healthy life free of pain, she encourages patients to heal the body beyond its condition prior to injury.

Her passion is in treating pelvic health issues including chronic pelvic pain, incontinence, pain with sex, post partum/perinatal pain, and associated hip and/or low back pain. In addition, she has a talent in working with foot issues, including plantar fasciitis and shin splints.

Jessica is thrilled to be working at Back to Life and returning to San Francisco after spending time in the Midwest. When not in the clinic, Jessica enjoys cycling adventures, baking endeavors, and exploring new and challenging yoga postures.

“I’ve been to chiropractors, acupuncturists, yogis, shaman, pain specialists, and other physical therapists in the past, but this was an entirely different experience for me. Dr Manley found the cause of my back pain, taught me how to manage it, protect my back and get back to a healthy state after years of messing it up. Instead of a printout of exercises and a pat on the back like others have given me, she made sure I had everything I need to heal.

She is encouraging, smart, intuitive, understanding, insightful and a good human being. You can tell she loves what she does.”

Carl B