BRUGGER'S POSTURAL RELIEF EXERCISE

Brugger's Postural Relief Exercise strengthens your muscles. lt promotesstability and relaxes tight muscles that tighten due to postural stress (seeFigure 2). Check the tension in your upper back and shoulders in theslumped posture and then in the postural relief position. Muscle tension isdramatically reduced in the postural relief position. Another check is to turnyour head in the slumped and corrected postures. Again, a dramaticimprovement in the postural relief position should be observed.

Figure 1

FOLLOW THESE SIX STEPS:1. Sit with your buttocks at the edge of a chair.2. Spread your legs apart slightly.3. Turn your toes out slightly.4. Rest your weight on your legslfeet & relax your abdominal muscles.5. Tilt your pelvis fonryard & Iift your chest up thus increasing the curve

of your lower back to its maximum.6. Turn your palms up.

This postural exercise should be done for 10 seconds every 20 minutes. ltcan be incorporated into sit to stand, walking, and lifting. Within a fewweeks, you will experience the sensation of sitting and standing straighternaturally. When this occurs, conscious effort is not as necessary becauseyou have learned a new skill on an automatic basis. This is ideal as a newpostural habit once learned is unlikely to be broken.

Figure 2

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UPPER BAGK & NECKStretch i n g T h e rap e uti c Exercises

GENERAL INSTRUCTIONS: Do only those exercises taught to you by your therapist.Exercise twice daily, 10 of each.

Neck Flexion/Extension:With your chin tucked in andmouth closed, slowly loweryour head to your chest.Reiurn to starting position.Relax. Bring your head as farback as possible so you canlook up at the ceiling.

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Upper Trapezius: Sit in achair. Clasp your handsbehind your back. Titt androtate your head to the left,looking toward your underarm.Repeat on the right.

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Levator Scapulae: Sit in achair. Place your hands behindyou head" Slowly move yourchin to your chest while turningyour head to the right. Repeaton left side,

Pectoralis: Stand in an opendoorway. Raise you hands outto your sides to shoulder level.Bend your elbows and pointyour fingers toward the ceiling.Put your forearms against thedoor frame and lean fon*rarduntil you feel a stretch acrossyour chest.

Scalleni: Sit in a chair. Claspyour hands behind your back.Lower your left shoulder andtilt your head to the right.Lower your right shoulder andtilt your head to the left.

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Suboccipitals: Lie flat on yourback, or stand against a wall.Place a pillow behind yourhead. Tuck in your chin andpush your head and neck intothe pillow.

EXERCISE GUIDELINES:Exhale on exertion. Hold position for 30 seconds and then relax.Pulling sensations may occur while exercising. Stop exercising if you experience pain, nauseaor dizziness.

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UPPER BAGK & NECKRange of Motion Therapeutic Exercises

Name Date

Flexion/Extension: Sit in a chair, keeping your neck, shoulders, and trunk straight. Tuck inyour chin and lower your head slowly, keeping your mouth closed. Return to starting positionand relax. Bring your head back as far as possible, looking up at the ceiling. Stop movementif you feel any pain.

Lateral Flexion: Sit in a chair, keeping your neck, shoulders, and trunk straight. Tilt yourhead, slowly lowering your ear to your right shoulder. Return to starting position and relax.Repeat the movement to your left shoulder. Keep your nose pointing forward and do notraise your shoulders toward your head. Stop movement if you feel any pain.

Rotation: Sit in a chair, keeping your neck, shoulders, and trunk straight. Turn your headslowly bringing your chin toward your right shoulder. Return to starting position and relax.Repeat the movement to your left shoulder. Keep your eyes level with the floor. Stopmovement if you feel any pain.

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UPPER BAGK & IIEGKI sametric The ra pe uti c Exercrses

Name Date

Flexion: Place your pdm on your forehead.Press your head into your palm and reist themovement with your palm. Hold for 5seconds, then relax. Repeat with the Iefi side,Stop movement if you feelany pain.

Extension: Place your palm on the back ofyour head- Press your head into your palm andresist the movement with your palm. Hold for 5seconds, then relax- Repeat with the left side.Stop movement if you feel any pain.

Flexion: Plaeyour right palm on the rightside of your head. Prssyour head into your palmand resist the movementwith your palm. Hold for 5seconds, then relax.Repeat with the lefi side.Stop movemer* if you feelany pain.

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LOTTER BAGI( & LEGSStretch i n g T h e ra peutic Exercises

GENERAL INSTRUCTIOI,IS: Do only those exercises taught to you by your therapist.Exercise twice daily, 10 of each,

Psoas: Place knee on chair.Bend the opposite knee sothat you can feel a sketch- Donot allow your back to arch.Hold 5 seconds. Repeat on theother side.

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Hamstrings: Sit with feetagainst the wall and handsbehind back. Allow trunk toslump (slouch with poorposture). Bend nck fonlrarduntil you feel a stretch- Hold 5seconds.

Quadriceps: Stand upstraight, near something youcan use for support. Bendyour left knee to bring yourheel up touard your buttocks.Reach back and grab your footor ankh. Pull your leg behindyou. Repeat on the right side.

Soleus: Face a wall, abouttwo paces away. Place yourhands against the wall. Stepforward wtth your right l€,keeping both heels flat on thefloor. Lean your hips towardthe wallwhile keeping your lefileg straight to stretch your calf.Repeat on the otherside.

Erector Spinae: Sit doram.Bend fonrard and rmch downto grasp your calves with bothhands. Pull your My toerardthe floor. Hold. Relax-

Erector Spine: Cat & CowS&ef6t. Get on your handsand knes. Put your handsunder your shouldes andknees under your hips. Letyour head hang down. Pullyour stomach in and arch yourback up. Hold and release.Slowly let your back sag downand raise your head up.

EXERCISE GUIDELINES:Exhale on exertion. Hold position for 30 seconds and then relax.Pulling sensations may occur while exercising. Stop exercising ff you experience pain, nauseaor dizziness.

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LOWER BAGK & LEGSI so m et ri c T h e ra p e utic Exercises

GENERAL INSTRUCTIONS: Do only those exercises taught to you by your therapist.Exercise twice daily, 10 of each.

Hamstrings: Sit with yourfoot in front of the chair.Place your heel on the floorand point your toes up. Pullyour heel down to the floor.

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Quadriceps: Sit with yourfeet flat on the floor. Lift onefoot and straighten your kneecompletely. Hold and thenreturn you foot to the floor.Repeat with the other foot.

Hip Flexors: Sit with yourfeet flat on the floor. Lift oneknee and raise your foot offthe floor. Hold and thenreturn you foot to the floor.Repeat with the other foot.

Gluteals: Sit with your kneesapart. Squeeze yourbuttocks together as tightlyas possible. Hold. Relax.

Hip Adductors: Sit with arolled-up towel between yourknees and thighs. Squeezethetowel tightly. Relax.

Hip Abductors: Place achair against a wall, or use achair with arms. Put a rolled-up towel between your thighand the wall (or chair arm).Press your leg against thetowel. Hold. Relax.

EXERCISE GUIDELINES:Exhale on exertion. Hold position for 5 seconds and then relax.Pulling sensations may occur while exercising. Stop exercising if you experience pain, nauseaor dizziness.

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Name

LOWER BAGKRange of Motion Therapeutic Exercr'ses

Date

Flexion/Extension: Stand upright with yourarms relaxed at your sides and your feetslightly apart. Bend forward and reach foryour toes, let gravity pull you towards thefloor. Straighten back up and relax, Placeyour hands on the small of your back. Applygentle forward pressure. Arch backwards,keeping your eyes level with the floor. Stopmovement if you feel any pain.

Lateral Flexion: Stand upright with your arms relaxedat your sides and your feet slightly apart. Bend slowlyto the right, sliding your hand down your leg. Keepboth heels on the floor. Straighten back up and relax.Repeat to the left side. Stop movement if you feel anypain.

Rotation: Stand upright with your arms on yourhips and feet slightly apart. Twist at the waist andlook over your right shoulder with your head andeyes. Keep both feet on the floor. Return tostarting position and relax. Repeat to the left side.Stop movement if you feel any pain.

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Stretch Exercises

' Each exercise should be held for 20 seconds, followed by a 5 second relaxation period.. Each exercise should be done at least 3 times.. Do this routine once a day or as specifled.

Gastrocnemius (calf); Soleus (cal0; Quadriceps (front of thigh)

Gastrocnemius (calf)

Lean against a wall with your backleg straight and your front legslightly bent. Keep your back heelon the floor and lean progressivelycloser to the wall until you can feelthe stretch in your calf. Repeatwith other leg.

Soleus (calf)

Lean against a wallwith both yourback leg and your front leg slightlybent. Keep your back heel on thefloor and lean progressively closerto the wall untilyou can feel thestretch in your calf. Repeat withother leg.

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Quadriceps(front ofthiqh)Lying on yourside, reachback and grabyour upperfoot and pull itup toward yourbuttocks.Repeat withother leg whileon your otherside. Keepyour kneestogether.

Hamstrinos (back ofthiqh)Sitting, bring the sole ofyour bent leg to theinner thigh of yourstraight leg. Leanfonryard and grasp theankle of your straightleg with both hands.Keeping the legstraight, pull your upperbody down towardsyour feet.

Hip Flexors (front of hip)Move your hip forward, keepingthe upper body straight up andthe back leg stretched out. Feelthe tightening in the hip and holdthe position. The stretch can beaccentuated by putting the backknee on the ground. Keep thefront knee directly above the foot.

Don't keep the front knee at suchan angle that it is in front of theankle, since this hinders the realstretch in the hip.

Gluteals and Hip

Sitting, bend one leg and cross it overthe other leg which is either straight orlying on its side bent at 90 degrees.Push the opposite elbow against yourbent knee and force buttocks to table.

Gluteus Maximus(bpttocksl

Lying on your back with bothknees bent, cross the leftleg over the right. Usingboth hands pull your rightknee toward your chest.You should feel a stretch inthe buttocks on your leftside. Repeat on oppositeside.

Hip Adductors (qroin)

Sitting, bend both legs and putthe soles of your feet together.Grab your feet with both hands.\Mth your elbows, push outagainst the insides of your knees.

Erector Spinae (Iowback)

Bring both knees tothe chest by firstraising one and thenholding the knee withboth hands. Thenraise the other knee.Grasping both knees,pullthem down to thechest. Relax.

Spinal Extension(prone press-ups)

Lie on stomach withpalms by shouldersup while keepingpelvis on the surface;back and stomachsagging. Slowly lowershoulders. Repeat 10times, sustaining theup position for severalseconds during thelast few repetitions.

Supraspinatus (superiorshoulder)

Place involved hand behind your backand grasp hand with other hand. Pulldiagonally down and across back. Tilthead toward the uninvolved shoulder.You should feelthe stretch across thetop and front of your shoulder.

Rotator Cuff (internal rotation)

Place a towel in both hands. Positionyour involved arm behind your back atwaist height and your uninvolved armup and overhead. Slowly pull the towelupward. You should feelthe stretch inthe front and back of your shoulder.

Triceps and Teres Major(shoulder girdle)

Raise one arm up and behind yourhead. With the opposite arm grasp yourelbow and pullthe arm further behindyour head.

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lnfraspinatus and Teres Minor(shoulder rotator cuff)

Lying on your back or sitting, reach armacross chest toward opposite shoulderas far as possible. With opposite hand,grasp the elbow and pullthe arm acrosseven further. Externally rotating thearm during this stretch emphasizes theteres minor.

Pectoralis Major (chest)

Stand with your forearms againstthe wall in a corner of the room.Gently lean forward untilyou feel astretch in the front of your shoulderand chest. This can be done onearm at a time by placing oneforearm up against a wall andturning your chest away from thewall untilyou feela stretch.

Shoulder and Neck(tension relievers)

Roll shoulders slowly backward.Do it 4 times.