In diseases like backache or cervical spondylitis, if you do not advise correct exercises, and stress the need, you are doing half a job. An NSAID tablet will give relief for 6hrs only. For a long lasting relief, exercises to strengthen the right muscles are essential.
A proper advise and guidance about the exercises is as important as the medicines given. Study and understand the basic exercises given in this chapter. Explain them neatly to your patient. Bring out your hidden drawing skills and give a separate ‘Exercise Prescription’ with simple line diagrams, as given below. Cervical Spondylitis:
Neck Exercises –
1. Perform 6 movements 2-5 times each
- Flexion-Extension
- Lateral Flexions: Right-Left,
- Lateral Bending (Turning):
Right-Left.
1. Now repeat these 6 movements with assistance from the hands pressing the head to bend further. 2. Next perform these 6 movements against resistance provided by the fists.
Relaxation position – Sit cross – legged on floor in front of a chair with cushion or pillow on the seat. Bend forwards, to rest the head on the chair with arms folded in front – 5 minutes. Low Backache: Back Exercises –
1. Leg raising: Lie flat on the stomach, with hands by the side. Lift one leg to 30 hold for 5 seconds, keep it down. Repeat with other leg. Repeat with both legs together. Repeat 5 times. If painful, start by rsising leg with knee flexed.
1. Leg straightening: Lie on the back with legs folded, feet on the floor. Straighten each leg (in air) in turn, hold for 30 seconds & keep down.
1. Leg swings for sciatic pain: Lie lateral on your good side, Keep lower (normal) hip slightly flexed. Lift & Move affected leg backwards and forwards gently.
Relaxation positions –
• Sit in Padmasan or Vajrasan and bend forwards fully. Take a pillow under the chest if needed.
Knee squeezes: Lie on your back on a firm floor, and bring the knees to chest over the abdomen. Right leg, then left, then both together.
Lie on the floor next to a chair; Place the calves on chair; Relax for 5 minutes. Knee exercises:
Aim: To strengthen the quadriceps. Sit on a tall chair or table with legs freely hanging. Extend the knees – flex again 10 times. Gradually, repeat this with small weight or pillow tied to the ankle. Cramps in calf:
Stand upright, Raise the body to stand on the toes, lower back to heels. Repeat 10-20 times. Headache:
1. Firm pressure with thumbs with slight rotatory movements at the Supra-or-bital ridge, at the root of the nose, at the Temporal point about 1” above and in front of the ears, and at the sub-occipital ridge on both sides. 2. Massage of the Head, Neck, Forehead and Temple.
Exercises to increase height:
1. Pull ups – gradually increase to 10-20 per day. 2. Hang on a horizontal bar for 2-5 min 3. Posture: practice erect sittig and standing posture. 4. Leg ups. Stand 2’ from a table whose height is at you hip level. Keep one leg on the table edge with knee straight and hip at 90degree. Maintain for 2 minutes.
Deep Breathing exercises:
Useful for patients of Asthma, COPD, Sinusitis and nasal obstructions.
1. Take deep breath through the nose, exhale slowly and fully through the mouth. Practice 5 times x 3 times a day. 2. Pranayam: Take deep breath slowly through one nostril, hold breath for 2 seconds, exhale slowly through other nostril. Repeat the other way. Repeat 10 times.
Note: if there is nasal obstruction (non-physical), Practice the exercise 10 minutes after instilling Otrivin nasal droops. Cardiac Patients – CCF:
1. Exercise: In supine position, Flex an dextend all joints ie. Hand, wrist, elbow, shoulder, foot, knee & hip, each joint 3 times, 3 times daily. Increase gradually. 2. Relaxation: lie in cardiac relaxation position with 2 or 3 pillows under the head and back, to make a comfortable slant. Keep a small pillow under the knee. Relax and take slow relaxed breaths for 10 minutes.
Fir leg edema:
1. foot exercise: Dorsiflex and plantarflex the foot 15 times, every 2-3 hrs. 2. Keep the legs elevated on two pillows in lying down position. Take pillow under the head & chest if breathless. 3. while sitting on a chair, keep legs elevated on a small stool or pillow. Avoid hanging of the legls.
Chronic Constipation, Gases:
Aim – To increase the tone of abdominal wall muscles and stimulate peristalsis
1. Straight Leg raising: lie flat on the back with hands by the side lift on leg to 30-40 degrees, Hold it there for 3 seconds. Keep it down slowly. Repeat with other leg, then with both legs together. Repast 5 times. 2. lie flat on the back. Lift your legs in air and do scissor kicks in the air –as if pedaling a bicycle. 3. Lie on your back, Flex your legs over the abdomen and straighten them back – 10 times 4. Sit ups – lie flat on the back. Lift the head and chest to sit and then bend forwards. Lie back flat. 5. Also suggested – Walking, Jogging.
Prenatal Exercises:
Aim: To strengthen and tone inner and outer thigh muscles, Abdominal wall muscles and Pelvic muscles.
For Pelvic floor muscles –
1. Pelvic floor Tensing: Tense and Relax your anal muscles (as if trying to hold stools back) and vulval muscles (as if trying to stop urinating midflow) 30-50 times. 2. Pelvic lift: Lie supine, Bend the knees drawing the feet to the buttocks. Lift the pelvis – constricting your anus, Ten lower the pelvis slowly and relax the anus.
For thigh muscles –
1. Leg rolls: Lie supine with legs straight. Roll the legs inwards, then outwards, 50-100 times. 2. sit on a chair with knee one foot apart. Bring the knees together against resistance provided by hands or against a pillow between them. 3. Sideways Leg Raising: Lie on left side with left arm under the head. Lift the upper ie right leg up (Straight or bent), breath in, lower it but not to touch the lower leg, repeat 5 times, then turn to right and repeat 5 times with left leg. Gradually increase. Standing position – 4. Knee lift: Stand with feet 10” apart, take support of chairback or wall. Lift Right knee to 90°, then lower 4-8 times, then lift left knee 4-8 times. 5. Foot Circling: Raise the foot off the ground, and turn it around in circle 4-8 times. Then repeat with the other foot.
Post natal Exercises: increase.
1. Pelvic Floor exercise as above: Pelvic floor tensing, Pelvic Lift. 2. Sideways Leg Raising: Lie on left side with left arm under the head. Lift the upper ie right leg up (straight or bent), breath n, lower it but not to touch the lower leg, repeat 5 times, then turn to right and repeat 5 times with left leg. Gradually increase. 3. Knee squeezes: lie supine with legs flexed. Press the knees against each other as hard as possible, raising the pelvis slightly. Then relax the thighs and lower the pelvis.
For Abdomen:
1. Bent knee leg raising: Lie on the back. Raise one leg with knee bent, Then lower it. Then the other leg. Repeat 10-20 times. After 1 month, raise the leg with straight knee. 2. Scissor kicks: Lie flat on the back. Lift your legs in air and do scissor kicks in the air – as if pedaling a bicycle 3. Bent knee sit ups: lie supine with knees bent. Raise the head with hand under the occiput for support, then lower. After some practice, do sit-ups with arms by the side.
Computer syndrome:
For Eye strain:
1. Blink often to moisten dry eyes. 2. Eye splashing every 2 hrs. – close the eyes splash them with cold water eyes and splash them with cold water 20-25 times. If available, splash with hot and cold water alternately. If you are using glasses, wash them twice a day as particles or stains on glasses increase eye strain. 3. Take frequent breaks from the computer. Rest and relax your ye by palming: Sit on a chair with elbows resting on the table. Place the palms over your closed eyes with fingers crossing over the center of the forehead. The hollow of the palms prevents direct pressure on the eyes. Hold the hands firmly over the eyes making a firm contact with the skin around and blocking all the light. 4. Apply firm pressure with your thumbs ovr th supra-orbital notches-(indentation in the middle third of the upper edge of the eye sockets) – for 15-30 seconds. Then apply pressure in the midline where forehead meets the roots of the nose. 5. Eye exercises:
Near-far focusing: hold a pencil or finger vertically at a distance of 1*. Focus once on the finger, then at a far object alternately 10 times.
Clock watching: sit with your back straight. Without moving the neck, look up, to right, to down to left and up (Clockwise) 3 times. Then in opposite direction (Anticlockwise) 3 times.
For Back strain:
Sitting near the edge of the chair, keep feet firmly flat on the floor.
Straighten the arms upwards with fingers interlaced. Straighten the back for 10sec, Breath in & out deeply.
Holding the back of the chair with right hand, turn to right for 10 seconds, then similarly turn to left, Bend fully forwards on your thighs, with hands on lumbar region, for 30 sec.
Perform neck exercises against resistance.
Lift your shoulders hold up for 10 seconds, bring them down for 10 seconds.
