Home Exercise Treatment
Dr Robert C Slater BA, MSc, DC, CME, CN, DACO
Healing Hands Wellness Center
631 South Cleveland Ave.
St Paul, MN 55116
Six- Part Self-treatment protocol for alleviation of pain and muscle spasms in acute conditions or secondary to chronic muscle tension and myofascial trigger point in the neck, middle or lower back.
1-Applying ice: cold packs can be applied to all muscles of the spine: cervical/thoracic and lumbar regions to reduce pain and swelling in affected tissues.
Apply cold for 15-20 minutes for the 3-4 consecutive hours to reduce spasms, pain and inflammation. Ice/cold has an important neurologic effect by helping to interrupt the vicious cycle of muscle pain and spasms.
Ice can also be applied to a spinal area as one applied PIS techniques noted below.
2-Application of Heat: aspects of home therapy which will increase effectiveness of treatments
Applying heat at the start of home treatment allows increase in ranges of motion as well as decreased pain. Heat softens tense muscle fibers as well as promoting healing of these tissues by increasing circulation.
Ex: hot shower: moist heat seems to be the best for getting warmth into the deep muscle tissues. Directing hot water [safe heat and not damaging to the skin] onto the neck and shoulder for 10-15 minutes to increase circulation and to soften the muscle and tendons before any other exercises are performed.
Ex: heating pads: these are good if your applying the heat away from home and need maximal convenience with minimal cleanup
3-Range of Motion Exercises: allow enough time so that you can move in each direction for 20-100 repetitions.
Spinal Flexion: start by bringing the chin, torso or lower back downward by 55, 30, 15 degrees respectively. Return to neutral and sequentially repeat.
Spinal Extension: from the neutral position, gently tilt your head, torso or lower back backward by 45, 30 and 15 degrees respectively. Return to neutral and sequentially repeat.
Spinal rotation: from the neutral position, turn your head, torso or lower back to the right and then left, by 45, 30 and 15 degrees respectively. Return to neutral and sequentially repeat.
Spinal lateral flexion: from the neutral position, lean your head, torso or lower back to the right and then left, by 45, 30 and 15 degrees respectively. Return to neutral and sequentially repeat.
How much and how often: three times per day for 2-4 sets of 20 repetitions with better results associated with more repetitions [3-4 sets as opposed to 2] giving faster and more complete relief of spinal pain/soreness.
3-Gentle Stretching: gentle is the key to stretching exercise, combined with range of motion after a minimum of 1 week of prior range of motions exercise.
Once you have reached the end range of any range of motion, apply a bit of end range pressure with your hands will stretch the muscles. To minimize occurrence of a new injury or exacerbation of a current one, do not put any stretching pressure at the end of any range of motion is you experience any degree of pain.
4-Post-Isometric Stretching [PIS]: pis..provides immediate relief of pain in 94% of patients, lasting relief in 63% as well as lasting relief of ‘point tenderness’ in 23% of patients.
Follow these five steps for PIS. 1-stretch, 2-contract, 3-stretch, 4-relax and 5-repeat
4a-position yourself with target muscle in stretched position, just sort of pain or the position you begin to feel resistance to move any further.
4b-while in this tolerably stretched position, contract the target muscle against slight resistance as with your hands for 10-30 seconds.
4c-now take a deep breath and then exhale, relax for 10 seconds, then gently increase the degree of stretching, allowing the muscle to continue to lengthen with slight pressure. Alternate period of relation with [3 cycles] breathing center periods of inhalation/exhalation followed by gentle 15-20 seconds of increased stretching to whatever degree tolerable.
5-Relax back into a neutral position..then repeat steps 1 to 3 for 5 -6 repetitions.
Be specific: efforts to stretch and contract must be specific to the direction along which the muscle is aligned from its origin to insertion. Learn to locate and effect specific muscle fibers for efficient treatment.
Effectiveness: restoring full stretch length to a muscle will reduce tension in muscles affected by pain and dysfunction. PIS is a simple and harmless, noninvasive and effective way of restoring full muscle length and relieve pain in muscles affected by adverse strain or repetitive stresses.
6- Complete cycles 1 to 5 above with application of a natural analgesic cream: A cream with a combination of capsaicin, belladonna and arnica or menthol will help the spine feel better between home exercise treatment sessions.