Mid and Lower Thoracic and Lumbar Regions - Stretching Techniques
Precautions for Stretching
Monitor for any increases in peripheralization: pain, numbness, or tingling sensations should not intensify or radiate down the extremity with assisted and/or self-stretching.
Techniques to Increase Lumbar Flexion
Your K&C text provides several options for assisted and self-stretching of the lumbar musculature
Active Learning Exercise
Perform each of the lumbar stretches as instructed in your text. Ask a classmate or family member to provide the illustrated pelvic stabilization force. What do you notice? What patient-specific limitations might interfere with a comfortable stretch position?
Techniques to increase lumbar extension
Techniques to increase lateral flexibility in the spine
Note that your text emphasizes the importance of stabilizing either the pelvis or thorax in order to optimize the stretch. Family members can also be trained to assist with
lateral trunk stretching.
Be sure to integrate breathing techniques to use rib cage mechanics in adding to the stretch. Additional lateral trunk stretches are described and illustrated in K&C on p. 449-450.
Traction as a stretching technique
Use of a traction table is discussed in the PTA 104L Review for Traction Skill Check resource. Note the benefits of a split table as it relates to the coefficient of friction.
Active Learning Exercise
1. Position yourself in sidelying. Note the amount of side bending in the lumbar spine and weight bearing pressure in the contralateral shoulder and greater trochanter.
2. Repeat with hand towel rolled into a cylinder and placed under waistline
3. Repeat with standard bath towel rolled into a cylinder and placed under waistline.
What are the differences in your comfort level? If you needed to be in a sidelying position on a treatment table for greater than 5 minutes, which of the three options would you choose? Compare your findings with classmates and note differences in preferred positioning.
