Ultrasound guided procedures

Trochanteric Bursitis Rehabilitation Exercises

You can begin stretching the muscles that run along the outside of your hip using the first 3 exercises. You can do the strengthening exercises when the sharp pain lessens.

Stretching exercises

Gluteal stretch: Lying on your back with both knees bent, rest the ankle of one leg over the knee of your other leg. Grasp the thigh of the bottom leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the top leg. Hold this for 15 to 30 seconds. Repeat 3 times.
Iliotibial band stretch: Standing: Cross one leg in front of the other leg and bend down and touch your toes. You can move your hands across the floor toward the front leg and you will feel more stretch on the outside of your thigh on the other side. Hold this position for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Reverse the positions of your legs and repeat.
Iliotibial band stretch: Side-leaning: Stand sideways near a wall. Place one hand on the wall for support. Cross the leg farthest from the wall over the other leg, keeping the foot closest to the wall flat on the floor. Lean your hips into the wall. Hold the stretch for 15 seconds, repeat 3 times, and then switch legs and repeat the exercise another 3 times.

Strengthening exercises

Straight leg raise: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle of the other leg and lift it about 8 inches off the floor, keeping the thigh muscle tight throughout. Slowly lower your leg back down to the floor. Do 3 sets of 10.
Prone hip extension: Lie on your stomach with your legs straight out behind you. Tighten the buttocks and thigh muscles of your injured leg and lift it off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10.
Side-lying leg lift: Lying on your uninjured side, tighten the front thigh muscles on your top leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight and lower slowly. Do 3 sets of 10.
Wall squat with a ball: Stand with your back, shoulders, and head against a wall and look straight ahead. Keep your shoulders relaxed and your feet 2 feet away from the wall and a shoulder’s width apart. Place a soccer or basketball-sized ball behind your back. Keeping your back upright, slowly squat down to a 45-degree angle. Your thighs will not yet be parallel to the floor. Hold this position for 10 seconds and then slowly slide back up the wall. Repeat 10 times. Build up to 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Wrist Sprain Rehabilitation Exercises

The first 5 exercises are stretching exercises. You may do these when the sharp wrist pain goes away. The last 3 exercises are strengthening exercises. You may do these exercises when stretching is nearly painless.

Stretching exercises

Wrist Range of Motion

Flexion: Gently bend your wrist forward. Hold for 5 seconds. Do 3 sets of 10.
Extension: Gently bend your wrist backward. Hold this position 5 seconds. Do 3 sets of 10.
Side to side: Gently move your wrist from side to side (a handshake motion). Hold for 5 seconds at each end. Do 3 sets of 10.

Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Wrist extension stretch: Stand at a table with your palms down, fingers flat, and elbows straight. Lean your body weight forward. Hold this position for 15 seconds. Repeat 3 times.
Wrist flexion stretch: Stand with the back of your hands on a table, palms facing up, fingers pointing toward your body, and elbows straight. Lean away from the table. Hold this position for 15 to 30 seconds. Repeat 3 times.
Forearm pronation and supination: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10.

When this exercise becomes pain free, do it with some weight in your hand such as a soup can or hammer handle.

Strengthening exercises

Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.

Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the

starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.

Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Triangular Fibrocartilage Complex Injuries Rehabilitation Exercises

You may do the stretching exercises when the sharp wrist pain goes away. You may do the strengthening exercises when stretching is nearly painless.

Stretching exercises

Wrist Range of Motion

Flexion: Gently bend your wrist forward. Hold for 5 seconds. Do 3 sets of 10.
Extension: Gently bend your wrist backward. Hold this position 5 seconds. Do 3 sets of 10.
Side to side: Gently move your wrist from side to side (a handshake motion). Hold for 5 seconds at each end. Do 3 sets of 10.

Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Wrist extension stretch: Stand at a table with your palms down, fingers flat, and elbows straight. Lean your body weight forward. Hold this position for 15 seconds. Repeat 3 times.
Wrist flexion stretch: Stand with the back of your hands on a table, palms facing up, fingers pointing toward your body, and elbows straight. Lean away from the table. Hold this position for 15 to 30 seconds. Repeat 3 times.
Forearm pronation and supination: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10.

Strengthening exercises

Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.
Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.

Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

DeQuervain’s Tenosynovitis Rehabilitation Exercises

You may do all of these exercises when the initial pain is gone.

Opposition stretch: Rest your hand on a table, palm up. Touch the tip of your thumb to the tip of your little finger. Hold this position for 6 seconds. Repeat 10 times.
Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.
Wrist radial deviation strengthening: Put your wrist in the sideways position with your thumb up. Hold a can of soup or a hammer handle and gently bend your wrist up, with the thumb reaching toward the ceiling. Slowly lower to the starting position. Do not move your forearm throughout this exercise. Do 3 sets of 10.
Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.
Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10.
Finger spring: Place a large rubber band around the outside of your thumb and the rest of your fingers. Open your fingers to stretch the rubber band. Do 3 sets of 10.

Written by Scott Coleman, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

© 2009 RelayHealth and/or its affiliates. All Rights Reserve

Spondylolysis and Spondylolisthesis Rehabilitation Exercises

It is important to have strong abdominal muscles when the structures of your spine are weakened. These exercises help build strong stomach muscles.

Pelvic tilt: Lie on your back with your knees bent and your feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. Hold this position for 5 seconds, then relax. Do 3 sets of 10.

As the pelvic tilt becomes easier, you can progress to an exercise called the dead bug.

Dead bug exercise: Lie on your back with your knees bent, arms at your sides, and feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. While keeping your abdominals tight, lift up one leg several inches off the floor, hold for 5 seconds, then lower it. Repeat this exercise with the opposite leg. Then lift your arm over your head, hold for 5 seconds, then lower it. Repeat with the opposite arm. Do 5 repetitions with each leg and arm. Once this exercise becomes easy, raise one leg and the opposite arm together. Hold for 5 seconds. Lower your arm and leg and raise the opposite arm and leg up and hold for 5 seconds. Do 3 sets of 5.
Gluteal stretch: Lying on your back with both knees bent, rest the ankle of one leg over the knee of your other leg. Grasp the thigh of the bottom leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the top leg. Hold this for 15 to 30 seconds. Repeat 3 times.
Quadruped arm/leg raise: Get down on your hands and knees. Tighten your abdominal muscles to stiffen your spine. While keeping your abdominals tight, raise one arm and the opposite leg away from you. Hold this position for 5 seconds. Lower your arm and leg slowly and alternate sides. Do this 10 times on each side.
Partial curl: Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles. Tuck your chin to your chest. With your hands stretched out in front of you, curl your upper body forward until your shoulders clear the floor. Hold this position for 3 seconds. Don’t hold your breath. It helps to breathe out as you lift your shoulders up. Relax. Repeat 10 times. Build to 3 sets of 10. To challenge yourself, clasp your hands behind your head and keep your elbows out to the side.
Double knee to chest: Lie on your back with your knees bent and your feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. Pull both knees up to your chest. Hold for 5 seconds and repeat 10 to 20 times.
Side Plank: Lie on your side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm so your elbow is directly under your shoulder. Lift your hips off the floor and balance on your forearm and the outside of your foot. Try to hold this position for 15 seconds, then slowly lower your hip to the ground. Switch sides and repeat. Work up to holding for 1 minute or longer. This exercise can be made easier by starting with your knees and hips flexed to 45 degree angles.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Low Back Pain Exercises

Standing hamstring stretch: Place the heel of your injured leg on a stool about 15 inches high. Keep your knee straight. Lean forward, bending at the hips until you feel a mild stretch in the back of your thigh. Make sure you do not roll your shoulders and bend at the waist when doing this or you will stretch your lower back instead of your leg. Hold the stretch for 15 to 30 seconds. Repeat 3 times.
Cat and camel: Get down on your hands and knees. Let your stomach sag, allowing your back to curve downward. Hold this position for 5 seconds. Then arch your back and hold for 5 seconds. Do 3 sets of 10.
Quadruped arm/leg raise: Get down on your hands and knees. Tighten your abdominal muscles to stiffen your spine. While keeping your abdominals tight, raise one arm and the opposite leg away from you. Hold this position for 5 seconds. Lower your arm and leg slowly and alternate sides. Do this 10 times on each side.
Pelvic tilt: Lie on your back with your knees bent and your feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. Hold this position for 5 seconds, then relax. Do 3 sets of 10.
Partial curl: Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles. Tuck your chin to your chest. With your hands stretched out in front of you, curl your upper body forward until your shoulders clear the floor. Hold this position for 3 seconds. Don’t hold your breath. It helps to breathe out as you lift your shoulders up. Relax. Repeat 10 times. Build to 3 sets of 10. To challenge yourself, clasp your hands behind your head and keep your elbows out to the side.
Gluteal stretch: Lying on your back with both knees bent, rest the ankle of one leg over the knee of your other leg. Grasp the thigh of the bottom leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the top leg. Hold this for 15 to 30 seconds. Repeat 3 times.
Extension exercise: Lie face down on the floor for 5 minutes. If this hurts too much, lie face down with a pillow under your stomach. This should relieve your leg or back pain. When you can lie on your stomach for 5 minutes without a pillow, then you can continue with the rest of this exercise.

After lying on your stomach for 5 minutes, prop yourself up on your elbows for another 5 minutes. Lie flat again for 1 minute, then press down on your hands and extend your elbows while keeping your hips flat on the floor. Hold for 1 second and lower yourself to the floor. Repeat 10 times. Do 4 sets. Rest for 2 minutes between sets. You should have no pain in your legs when you do this, but it is normal to feel pain in your lower back. Do this several times a day.

Side Plank: Lie on your side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm so your elbow is directly under your shoulder. Lift your hips off the floor and balance on your forearm and the outside of your foot. Try to hold this position for 15 seconds, then slowly lower your hip to the ground. Switch sides and repeat. Work up to holding for 1 minute or longer. This exercise can be made easier by starting with your knees and hips flexed to 45 degree angles.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Herniated Disk Rehabilitation Exercises

Side Plank: Lie on your side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm so your elbow is directly under your shoulder. Lift your hips off the floor and balance on your forearm and the outside of your foot. Try to hold this position for 15 seconds, then slowly lower your hip to the ground. Switch sides and repeat. Work up to holding for 1 minute or longer. This exercise can be made easier by starting with your knees and hips flexed to 45 degree angles.
Gluteal stretch: Lying on your back with both knees bent, rest the ankle of one leg over the knee of your other leg. Grasp the thigh of the bottom leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the top leg. Hold this for 15 to 30 seconds. Repeat 3 times.
Quadruped arm/leg raise: Get down on your hands and knees. Tighten your abdominal muscles to stiffen your spine. While keeping your abdominals tight, raise one arm and the opposite leg away from you. Hold this position for 5 seconds. Lower your arm and leg slowly and alternate sides. Do this 10 times on each side.
Extension exercise: Lie face down on the floor for 5 minutes. If this hurts too much, lie face down with a pillow under your stomach. This should relieve your leg or back pain. When you can lie on your stomach for 5 minutes without a pillow, then you can continue with the rest of this exercise.

After lying on your stomach for 5 minutes, prop yourself up on your elbows for another 5 minutes. Lie flat again for 1 minute, then press down on your hands and extend your elbows while keeping your hips flat on the floor. Hold for 1 second and lower yourself to the floor. Repeat 10 times. Do 4 sets. Rest for 2 minutes between sets. You should have no pain in your legs when you do this, but it is normal to feel pain in your lower back. Do this several times a day.

Dead bug exercise: Lie on your back with your knees bent, arms at your sides, and feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. While keeping your abdominals tight, lift up one leg several inches off the floor, hold for 5 seconds, then lower it. Repeat this exercise with the opposite leg. Then lift your arm over your head, hold for 5 seconds, then lower it. Repeat with the opposite arm. Do 5 repetitions with each leg and arm. Once this exercise becomes easy, raise one leg and the opposite arm together. Hold for 5 seconds. Lower your arm and leg and raise the opposite arm and leg up and hold for 5 seconds. Do 3 sets of 5.

Do the following, partial curl exercise only when you no longer have pain in your buttocks or legs.

Partial curl: Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles. Tuck your chin to your chest. With your hands stretched out in front of you, curl your upper body forward until your shoulders clear the floor. Hold this position for 3 seconds. Don’t hold your breath. It helps to breathe out as you lift your shoulders up. Relax. Repeat 10 times. Build to 3 sets of 10. To challenge yourself, clasp your hands behind your head and keep your elbows out to the side.

If you have a herniated disk, you should limit driving and other sitting activities to no more than 30 minutes at a time. Walking is also good exercise for you.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Wrist Sprain Rehabilitation Exercises

The first 5 exercises are stretching exercises. You may do these when the sharp wrist pain goes away. The last 3 exercises are strengthening exercises. You may do these exercises when stretching is nearly painless.

Stretching exercises

Wrist Range of Motion

Flexion: Gently bend your wrist forward. Hold for 5 seconds. Do 3 sets of 10.
Extension: Gently bend your wrist backward. Hold this position 5 seconds. Do 3 sets of 10.
Side to side: Gently move your wrist from side to side (a handshake motion). Hold for 5 seconds at each end. Do 3 sets of 10.

Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Wrist extension stretch: Stand at a table with your palms down, fingers flat, and elbows straight. Lean your body weight forward. Hold this position for 15 seconds. Repeat 3 times.
Wrist flexion stretch: Stand with the back of your hands on a table, palms facing up, fingers pointing toward your body, and elbows straight. Lean away from the table. Hold this position for 15 to 30 seconds. Repeat 3 times.
Forearm pronation and supination: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10.

When this exercise becomes pain free, do it with some weight in your hand such as a soup can or hammer handle.

Strengthening exercises

Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.

Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the

starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.

Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Triangular Fibrocartilage Complex Injuries Rehabilitation Exercises

You may do the stretching exercises when the sharp wrist pain goes away. You may do the strengthening exercises when stretching is nearly painless.

Stretching exercises

Wrist Range of Motion

Flexion: Gently bend your wrist forward. Hold for 5 seconds. Do 3 sets of 10.
Extension: Gently bend your wrist backward. Hold this position 5 seconds. Do 3 sets of 10.
Side to side: Gently move your wrist from side to side (a handshake motion). Hold for 5 seconds at each end. Do 3 sets of 10.

Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Wrist extension stretch: Stand at a table with your palms down, fingers flat, and elbows straight. Lean your body weight forward. Hold this position for 15 seconds. Repeat 3 times.
Wrist flexion stretch: Stand with the back of your hands on a table, palms facing up, fingers pointing toward your body, and elbows straight. Lean away from the table. Hold this position for 15 to 30 seconds. Repeat 3 times.
Forearm pronation and supination: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10.

Strengthening exercises

Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.
Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.
Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

DeQuervain’s Tenosynovitis Rehabilitation Exercises

You may do all of these exercises when the initial pain is gone.

Opposition stretch: Rest your hand on a table, palm up. Touch the tip of your thumb to the tip of your little finger. Hold this position for 6 seconds. Repeat 10 times.
Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.
Wrist radial deviation strengthening: Put your wrist in the sideways position with your thumb up. Hold a can of soup or a hammer handle and gently bend your wrist up, with the thumb reaching toward the ceiling. Slowly lower to the starting position. Do not move your forearm throughout this exercise. Do 3 sets of 10.
Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.
Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10.
Finger spring: Place a large rubber band around the outside of your thumb and the rest of your fingers. Open your fingers to stretch the rubber band. Do 3 sets of 10.

Written by Scott Coleman, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

© 2009 RelayHealth and/or its affiliates. All Rights Reserve

Lateral Epicondylitis (Tennis Elbow) Rehabilitation Exercises

You may do the stretching exercises right away. You may do the strengthening exercises when stretching is nearly painless.

Stretching exercises

Wrist active range of motion: Flexion and extension: Bend your wrist forward and backward as far as you can. Do 3 sets of 10.
Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Forearm pronation and supination: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10.
Active elbow flexion and extension: Gently bring your palm up toward your shoulder and bend your elbow as far as you can. Then straighten your elbow as far as you can 10 times. Do 3 sets of 10.

Strengthening exercises

Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.
Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.
Wrist radial deviation strengthening: Put your wrist in the sideways position with your thumb up. Hold a can of soup or a hammer handle and gently bend your wrist up, with the thumb reaching toward the ceiling. Slowly lower to the starting position. Do not move your forearm throughout this exercise. Do 3 sets of 10.
Forearm pronation and supination strengthening: Hold a soup can or hammer handle in your hand and bend your elbow 90°. Slowly rotate your hand with your palm upward and then palm down. Do 3 sets of 10.
Wrist extension (with broom handle): Stand up and hold a broom handle in both hands. With your arms at shoulder level, elbows straight and palms down, roll the broom handle backward in your hand. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Medial Apophysitis (Little Leaguer’s Elbow) Rehabilitation Exercises

You may do the stretching exercises right away. You may do the strengthening exercises when stretching is nearly painless.

Stretching exercises

Wrist active range of motion: Flexion and extension: Bend your wrist forward and backward as far as you can. Do 3 sets of 10.
Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Forearm pronation and supination: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10.

Strengthening exercises

Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.
Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.
Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.
Forearm pronation and supination strengthening: Hold a soup can or hammer handle in your hand and bend your elbow 90°. Slowly rotate your hand with your palm upward and then palm down. Do 3 sets of 10.
Resisted elbow flexion and extension: Hold a can of soup with your palm face up. Slowly bend your elbow so that your hand is approaching your shoulder. Then lower it slowly so your elbow is completely straight. Do 3 sets of 10. Slowly increase the weight you are using.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Lateral Epicondylitis (Tennis Elbow) Rehabilitation Exercises

You may do the stretching exercises right away. You may do the strengthening exercises when stretching is nearly painless.

Stretching exercises

Wrist active range of motion: Flexion and extension: Bend your wrist forward and backward as far as you can. Do 3 sets of 10.
Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Forearm pronation and supination: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10.
Active elbow flexion and extension: Gently bring your palm up toward your shoulder and bend your elbow as far as you can. Then straighten your elbow as far as you can 10 times. Do 3 sets of 10.

Strengthening exercises

Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.
Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.
Wrist radial deviation strengthening: Put your wrist in the sideways position with your thumb up. Hold a can of soup or a hammer handle and gently bend your wrist up, with the thumb reaching toward the ceiling. Slowly lower to the starting position. Do not move your forearm throughout this exercise. Do 3 sets of 10.
Forearm pronation and supination strengthening: Hold a soup can or hammer handle in your hand and bend your elbow 90°. Slowly rotate your hand with your palm upward and then palm down. Do 3 sets of 10.
Wrist extension (with broom handle): Stand up and hold a broom handle in both hands. With your arms at shoulder level, elbows straight and palms down, roll the broom handle backward in your hand. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Medial Epicondylitis (Golfer’s Elbow) Rehabilitation Exercises

You may do the stretching exercises right away. You may do the strengthening exercises when stretching is nearly painless.

Stretching exercises

Wrist active range of motion: Flexion and extension: Bend your wrist forward and backward as far as you can. Do 3 sets of 10.
Wrist stretch: With one hand, help to bend the opposite wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets on each hand.
Forearm pronation and supination: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10.

Strengthening exercises

Wrist flexion: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding.
Wrist extension: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding.
Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10.
Forearm pronation and supination strengthening: Hold a soup can or hammer handle in your hand and bend your elbow 90°. Slowly rotate your hand with your palm upward and then palm down. Do 3 sets of 10.
Resisted elbow flexion and extension: Hold a can of soup with your palm face up. Slowly bend your elbow so that your hand is approaching your shoulder. Then lower it slowly so your elbow is completely straight. Do 3 sets of 10. Slowly increase the weight you are using.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Sternoclavicular Joint Separation Rehabilitation Exercises

Chest stretch: Grasp your hands behind your back and lift your arms away from your body. Hold 15 to 30 seconds. Repeat 3 times.
Shoulder flexion: Stand with your arms hanging down at your side. Keep your elbow straight and lift your arms up over your head as far as you can reach. Hold the end position for 5 seconds. Do 3 sets of 10.
Scaption: Stand with your arms at your sides and with your elbows straight. Slowly raise your arms to eye level. As you raise your arms, they should be spread apart so that they are only slightly in front of your body (at about a 30 degree angle to the front of your body). Point your thumbs toward the ceiling. Hold for 2 seconds and lower your arms slowly. Do 3 sets of 10. Hold a soup can or light weight when doing the exercise and increase the weight as the exercise gets easier.
Single-arm shoulder abduction: Stand with your arms at your sides with your palms resting against your sides. With your elbow straight, lift one arm out to the side and toward the ceiling. Hold the position for 5 seconds. Repeat 10 times. Add a weight to your hand as this exercise becomes easier.
Shoulder horizontal abduction (single arm): Standing with your arm out in front of you, elbow straight and at shoulder level, move your arm in a horizontal direction out to the side. Return to the starting position. Repeat 10 times.
Scapular squeeze: While sitting or standing with your arms by your sides, squeeze your shoulder blades together and hold for 5 seconds. Do 3 sets of 10.
Supine shoulder flexion: Lie on your back, hold your arm out straight, and move your arm up until your hand is toward the ceiling. Return your arm to the starting position. Do 3 sets of 10. As you get stronger, hold a weight in your hand as you do this exercise.
Prone shoulder extension: Lie on your stomach on a table or a bed with one arm hanging down over the edge. With your elbow straight, slowly lift your arm straight back and toward the ceiling. Return to the starting position. Do 3 sets of 10. As this becomes easier, hold a weight in your hand.
Horizontal abduction: Lie on a table or the edge of a bed face down with one arm hanging down straight to the floor. Raise your arm out to the side, with your thumbs pointed toward the ceiling until your arms are parallel to the floor. Hold for 2 seconds and then lower it slowly. Start this exercise with no weight. As you get stronger add a light weight or hold a soup can. Do 3 sets of 10.
Supine Chest Fly: Hold a small dumbbell in each hand and lie on your back with your knees bent, arms out to your sides and elbows slightly bent. Slowly bring both arms across your chest

until the dumbbells touch. Lower slowly back to the starting position. Do 3 sets of 10. Gradually increase the amount of weight in your hands.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Shoulder Subluxation Rehabilitation Exercises

Do these exercises as soon as your healthcare provider says you can.

Isometric shoulder external rotation: Standing in a doorway with your elbow bent 90° and the back of your wrist pressing against the door frame, try to press your hand outward into the door frame. Hold for 5 seconds. Do 3 sets of 10.
Isometric shoulder internal rotation: Standing in a doorway with your elbow bent 90° and the front of your wrist pressing against the door frame, try to press your palm into the door frame. Hold for 5 seconds. Do 3 sets of 10.
Isometric shoulder adduction: With a pillow between your chest and your arms, squeeze the pillow with your arms and hold 5 seconds. Do 3 sets of 10.
Isometric shoulder flexion: Stand facing a wall with your elbow bent at a right angle and held close to your body. Press your fist forward against the wall, hold this for 5 seconds, then rest. Do 3 sets of 10.
Isometric shoulder extension: Standing facing away from the wall with your elbow touching the wall, press the back of your elbow into the wall and hold for 5 seconds. Rest. Do 3 sets of 10.
Isometric shoulder abduction: Standing with one side towards the wall and your elbow bent at a 90-degree angle, press the side of your arm into the wall as if attempting to lift it. Hold for 5 seconds. Rest. Do 3 sets of 10.
Shoulder flexion: Stand with your arms hanging down at your side. Keep your elbow straight and lift your arms up over your head as far as you can reach. Hold the end position for 5 seconds. Do 3 sets of 10.
Shoulder extension: Stand with your arms at your sides. Move the arm on one side back, keeping your elbow straight. Hold this position for 5 seconds. Return to the starting position and repeat 10 times.
Shoulder abduction: Stand with your arms at your sides. Bring your arms up, out to the side, and toward the ceiling. Hold for 5 seconds. Return to the starting position. Repeat 10 times.
Active elbow flexion and extension: Gently bring your palm up toward your shoulder and bend your elbow as far as you can. Then straighten your elbow as far as you can 10 times. Do 3 sets of 10.

As these exercises become easier, add a weight to your hand to give you some resistance

Resisted shoulder internal rotation: Holding tubing connected to a door knob at waist level, keep your elbow in at your side and rotate your arm inward across your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 10.
Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.
Latissimus dorsi strengthening: Sit on a firm chair. Place your hands on the seat on either side of you. Lift your buttocks off the chair. Hold this position for 5 seconds and then relax. Repeat 10 times. Do 3 sets of 10.
Rowing exercise: Tie a piece of elastic tubing around an immovable object and grasp the ends in each hand. Keep your forearms vertical and your elbows at shoulder level and bent to 90 degrees. Pull backward on the band and squeeze your shoulder blades together. Repeat 10 times. Do 3 sets.
Horizontal abduction: Lie on a table or the edge of a bed face down with one arm hanging down straight to the floor. Raise your arm out to the side, with your thumbs pointed toward the ceiling until your arms are parallel to the floor. Hold for 2 seconds and then lower it slowly. Start this exercise with no weight. As you get stronger add a light weight or hold a soup can. Do 3 sets of 10.
Scaption: Stand with your arms at your sides and with your elbows straight. Slowly raise your arms to eye level. As you raise your arms, they should be spread apart so that they are only slightly in front of your body (at about a 30 degree angle to the front of your body). Point your thumbs toward the ceiling. Hold for 2 seconds and lower your arms slowly. Do 3 sets of 10. Hold a soup can or light weight when doing the exercise and increase the weight as the exercise gets easier.
Push-up with a plus: Begin on the floor on your hands and knees. Keep your arms a shoulder width apart and lift your feet off the floor. Arch your back as high as possible and round your shoulders (this is the “plus” part or the exercise). Bend your elbows and lower your body to the floor. Return to the starting position and arch your back again. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Shoulder Separation Rehabilitation Exercises

Wand exercise: Flexion: Stand upright and hold a stick in both hands, palms down. Stretch your arms by lifting them over your head, keeping your elbows straight. Hold for 5 seconds and return to the starting position. Repeat 10 times.
Wand exercise: Extension: Stand upright and hold a stick in both hands behind your back. Move the stick away from your back. Hold the end position for 5 seconds. Relax and return to the starting position. Repeat 10 times.
Wand exercise: External rotation: Lie on your back and hold a stick in both hands, palms up. Your upper arms should be resting on the floor, your elbows at your sides and bent 90°. Using one arm, push your other arm out away from your body while keeping the elbow of the arm being pushed at your side. Hold the stretch for 5 seconds. Repeat 10 times.
Wand exercise: Internal rotation: Stand with one arm behind your head holding the end of a stick. Put your other arm behind your back at waist level and grab the stick. Move the stick up and down your back by bending your elbows. Hold the bent position for 5 seconds and then return to the starting position. Repeat 10 times.
Wand exercise: Shoulder abduction and adduction: Stand upright and hold a stick with both hands, palms facing away from your body. Rest the stick against the front of your thighs. While keeping your elbows straight, use one arm to push your other arm out to the side and up as high as possible. Hold for 5 seconds. Repeat 10 times.
Wand exercise: Horizontal abduction and adduction: Stand upright and hold a stick in both hands. Place your arms straight out in front of you at shoulder level. Keep your arms straight and swing the stick to one side, feel the stretch, and hold for 5 seconds. Then swing the stick to the other side, feel the stretch, and hold for 5 seconds. Repeat 10 times.
Shoulder flexion: Stand with your arms hanging down at your side. Keep your elbow straight and lift your arms up over your head as far as you can reach. Hold the end position for 5 seconds. Do 3 sets of 10.
Shoulder abduction: Stand with your arms at your sides. Bring your arms up, out to the side, and toward the ceiling. Hold for 5 seconds. Return to the starting position. Repeat 10 times.
Horizontal shoulder abduction: Stand with your arms held straight out in front of you at shoulder level. Pull your arms apart and out to the sides as far as possible. Hold them back for 5 seconds, then bring them back together in front of you. Repeat 10 times. Remember to keep your arms at shoulder level throughout this exercise.
Shoulder extension: Stand with your arms at your sides. Move the arm on one side back, keeping your elbow straight. Hold this position for 5 seconds. Return to the starting position and repeat 10 times.
Scapular active range of motion: Stand and shrug your shoulders up and hold for 5 seconds. Then squeeze your shoulder blades back and together and hold 5 seconds. Next, pull your shoulder blades downward as if putting them in your back pocket. Relax. Repeat this sequence 10 times.
Side-lying horizontal abduction: Lie on your side with your top arm relaxed across your chest. Slowly bring your top arm up off the floor, elbow straight, so that your hand is pointing toward the ceiling. Do 3 sets of 10. Hold a weight in your hand as the exercise becomes easier.
Prone shoulder extension: Lie on your stomach on a table or a bed with one arm hanging down over the edge. With your elbow straight, slowly lift your arm straight back and toward the ceiling. Return to the starting position. Do 3 sets of 10. As this becomes easier, hold a weight in your hand.
Single-arm shoulder abduction: Stand with your arms at your sides with your palms resting against your sides. With your elbow straight, lift one arm out to the side and toward the ceiling. Hold the position for 5 seconds. Repeat 10 times. Add a weight to your hand as this exercise becomes easier.
Resisted shoulder internal rotation: Holding tubing connected to a door knob at waist level, keep your elbow in at your side and rotate your arm inward across your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 10.
Resisted shoulder adduction: Stand sideways next to a door. With the hand closest to the door, hold tubing connected to a door knob at waist level. Stand away from the door approximately 8 to 10 inches. Slowly bring your arm with tubing next to your body. Do 3 sets of 10.
Resisted shoulder flexion: Holding tubing connected to a door knob at waist level, face away from the door, keep your elbow straight and pull your arm forward. Do 3 sets of 10.
Resisted shoulder extension: Face a door holding tubing connected to the door knob at waist level, pull your arm back. Be sure to keep your elbow straight. Do 3 sets of 10.
Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Shoulder Bursitis Rehabilitation Exercises

You may do these exercises when your pain has improved.

Scapular active range of motion: Stand and shrug your shoulders up and hold for 5 seconds. Then squeeze your shoulder blades back and together and hold 5 seconds. Next, pull your shoulder blades downward as if putting them in your back pocket. Relax. Repeat this sequence 10 times.
Wand exercise: Flexion: Stand upright and hold a stick in both hands, palms down. Stretch your arms by lifting them over your head, keeping your elbows straight. Hold for 5 seconds and return to the starting position. Repeat 10 times.
Wand exercise: Extension: Stand upright and hold a stick in both hands behind your back. Move the stick away from your back. Hold the end position for 5 seconds. Relax and return to the starting position. Repeat 10 times.
Wand exercise: External rotation: Lie on your back and hold a stick in both hands, palms up. Your upper arms should be resting on the floor, your elbows at your sides and bent 90°. Using one arm, push your other arm out away from your body while keeping the elbow of the arm being pushed at your side. Hold the stretch for 5 seconds. Repeat 10 times.
Isometric shoulder external rotation: Standing in a doorway with your elbow bent 90° and the back of your wrist pressing against the door frame, try to press your hand outward into the door frame. Hold for 5 seconds. Do 3 sets of 10.
Isometric shoulder internal rotation: Standing in a doorway with your elbow bent 90° and the front of your wrist pressing against the door frame, try to press your palm into the door frame. Hold for 5 seconds. Do 3 sets of 10.
Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.
Scaption: Stand with your arms at your sides and with your elbows straight. Slowly raise your arms to eye level. As you raise your arms, they should be spread apart so that they are only slightly in front of your body (at about a 30 degree angle to the front of your body). Point your thumbs toward the ceiling. Hold for 2 seconds and lower your arms slowly. Do 3 sets of 10. Hold a soup can or light weight when doing the exercise and increase the weight as the exercise gets easier.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Rotator Cuff Strain Rehabilitation Exercises

You may do all of these exercises right away.

Isometric shoulder external rotation: Standing in a doorway with your elbow bent 90° and the back of your wrist pressing against the door frame, try to press your hand outward into the door frame. Hold for 5 seconds. Do 3 sets of 10.
Isometric shoulder internal rotation: Standing in a doorway with your elbow bent 90° and the front of your wrist pressing against the door frame, try to press your palm into the door frame. Hold for 5 seconds. Do 3 sets of 10.
Wand exercise: Flexion: Stand upright and hold a stick in both hands, palms down. Stretch your arms by lifting them over your head, keeping your elbows straight. Hold for 5 seconds and return to the starting position. Repeat 10 times.
Wand exercise: Extension: Stand upright and hold a stick in both hands behind your back. Move the stick away from your back. Hold the end position for 5 seconds. Relax and return to the starting position. Repeat 10 times.
Wand exercise: External rotation: Lie on your back and hold a stick in both hands, palms up. Your upper arms should be resting on the floor, your elbows at your sides and bent 90°. Using one arm, push your other arm out away from your body while keeping the elbow of the arm being pushed at your side. Hold the stretch for 5 seconds. Repeat 10 times.
Wand exercise: Shoulder abduction and adduction: Stand upright and hold a stick with both hands, palms facing away from your body. Rest the stick against the front of your thighs. While keeping your elbows straight, use one arm to push your other arm out to the side and up as high as possible. Hold for 5 seconds. Repeat 10 times.
Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.
Resisted shoulder internal rotation: Holding tubing connected to a door knob at waist level, keep your elbow in at your side and rotate your arm inward across your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 10.
Scaption: Stand with your arms at your sides and with your elbows straight. Slowly raise your arms to eye level. As you raise your arms, they should be spread apart so that they are only slightly in front of your body (at about a 30 degree angle to the front of your body). Point your thumbs toward the ceiling. Hold for 2 seconds and lower your arms slowly. Do 3 sets of 10. Hold a soup can or light weight when doing the exercise and increase the weight as the exercise gets easier.
Side-lying external rotation: Lie on your one side with your top arm at your side and your elbow bent to 90°. Keep your elbow against your side, raise your forearm and hold for 2 seconds. Slowly lower your arm. Do 3 sets of 10. You can start doing this exercise holding a soup can or light weight and gradually increase the weight as long as there is no pain.
Horizontal abduction: Lie on a table or the edge of a bed face down with one arm hanging down straight to the floor. Raise your arm out to the side, with your thumbs pointed toward the ceiling until your arms are parallel to the floor. Hold for 2 seconds and then lower it slowly. Start this exercise with no weight. As you get stronger add a light weight or hold a soup can. Do 3 sets of 10.
Push-up with a plus: Begin on the floor on your hands and knees. Keep your arms a shoulder width apart and lift your feet off the floor. Arch your back as high as possible and round your shoulders (this is the “plus” part or the exercise). Bend your elbows and lower your body to the floor. Return to the starting position and arch your back again. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Frozen Shoulder Rehabilitation Exercise

Wand exercise: Flexion: Stand upright and hold a stick in both hands, palms down. Stretch your arms by lifting them over your head, keeping your elbows straight. Hold for 5 seconds and return to the starting position. Repeat 10 times.
Wand exercise: Extension: Stand upright and hold a stick in both hands behind your back. Move the stick away from your back. Hold the end position for 5 seconds. Relax and return to the starting position. Repeat 10 times.
Wand exercise: External rotation: Lie on your back and hold a stick in both hands, palms up. Your upper arms should be resting on the floor, your elbows at your sides and bent 90°. Using one arm, push your other arm out away from your body while keeping the elbow of the arm being pushed at your side. Hold the stretch for 5 seconds. Repeat 10 times.
Wand exercise: Internal rotation: Stand with one arm behind your head holding the end of a stick. Put your other arm behind your back at waist level and grab the stick. Move the stick up and down your back by bending your elbows. Hold the bent position for 5 seconds and then return to the starting position. Repeat 10 times.
Wand exercise: Shoulder abduction and adduction: Stand upright and hold a stick with both hands, palms facing away from your body. Rest the stick against the front of your thighs. While keeping your elbows straight, use one arm to push your other arm out to the side and up as high as possible. Hold for 5 seconds. Repeat 10 times.
Scapular active range of motion: Stand and shrug your shoulders up and hold for 5 seconds. Then squeeze your shoulder blades back and together and hold 5 seconds. Next, pull your shoulder blades downward as if putting them in your back pocket. Relax. Repeat this sequence 10 times.
Pectoralis stretch: Stand in a doorway or corner with both arms on the wall slightly above your head. Slowly lean forward until you feel a stretch in the front of your shoulders. Hold 15 to 30 seconds. Repeat 3 times.
Biceps stretch: Stand facing a wall (about 6 inches away from the wall). Raise your arm out to your side and place the thumb side of your hand against the wall (palm down). Keep your elbow straight. Rotate your body in the opposite direction of the raised arm until you feel a stretch in your biceps. Hold 15 seconds, repeat 3 times.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Dislocated Shoulder Rehabilitation Exercises

Do these exercises as soon as your healthcare provider says you can.

Isometric shoulder external rotation: Standing in a doorway with your elbow bent 90° and the back of your wrist pressing against the door frame, try to press your hand outward into the door frame. Hold for 5 seconds. Do 3 sets of 10.
Isometric shoulder internal rotation: Standing in a doorway with your elbow bent 90° and the front of your wrist pressing against the door frame, try to press your palm into the door frame. Hold for 5 seconds. Do 3 sets of 10.
Isometric shoulder adduction: With a pillow between your chest and your arms, squeeze the pillow with your arms and hold 5 seconds. Do 3 sets of 10.
Isometric shoulder flexion: Stand facing a wall with your elbow bent at a right angle and held close to your body. Press your fist forward against the wall, hold this for 5 seconds, then rest. Do 3 sets of 10.
Isometric shoulder extension: Standing facing away from the wall with your elbow touching the wall, press the back of your elbow into the wall and hold for 5 seconds. Rest. Do 3 sets of 10.
Isometric shoulder abduction: Standing with one side towards the wall and your elbow bent at a 90-degree angle, press the side of your arm into the wall as if attempting to lift it. Hold for 5 seconds. Rest. Do 3 sets of 10.
Shoulder flexion: Stand with your arms hanging down at your side. Keep your elbow straight and lift your arms up over your head as far as you can reach. Hold the end position for 5 seconds. Do this 10 times.
Shoulder extension: Stand with your arms at your sides. Move the arm on one side back, keeping your elbow straight. Hold this position for 5 seconds. Return to the starting position and repeat 10 times.
Shoulder abduction: Stand with your arms at your sides. Bring your arms up, out to the side, and toward the ceiling. Hold for 5 seconds. Return to the starting position. Repeat 10 times.
Active elbow flexion and extension: Gently bring your palm up toward your shoulder and bend your elbow as far as you can. Then straighten your elbow as far as you can 10 times. Do 3 sets of 10.

As these exercises become easier, add a weight to your hand to give you some resistance.

Resisted shoulder internal rotation: Holding tubing connected to a door knob at waist level, keep your elbow in at your side and rotate your arm inward across your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 10.
Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.
Resisted shoulder adduction: Stand sideways next to a door. With the hand closest to the door, hold tubing connected to a door knob at waist level. Stand away from the door approximately 8 to 10 inches. Slowly bring your arm with tubing next to your body. Do 3 sets of 10.
Resisted shoulder flexion: Holding tubing connected to a door knob at waist level, face away from the door, keep your elbow straight and pull your arm forward. Do 3 sets of 10.
Resisted shoulder extension: Face a door holding tubing connected to the door knob at waist level, pull your arm back. Be sure to keep your elbow straight. Do 3 sets of 10.
Latissimus dorsi strengthening: Sit on a firm chair. Place your hands on the seat on either side of you. Lift your buttocks off the chair. Hold this position for 5 seconds and then relax. Repeat 10 times. Do 3 sets of 10.
Scaption: Stand with your arms at your sides and with your elbows straight. Slowly raise your arms to eye level. As you raise your arms, they should be spread apart so that they are only slightly in front of your body (at about a 30 degree angle to the front of your body). Point your thumbs toward the ceiling. Hold for 2 seconds and lower your arms slowly. Do 3 sets of 10. Hold a soup can or light weight when doing the exercise and increase the weight as the exercise gets easier.
Push-up with a plus: Begin on the floor on your hands and knees. Keep your arms a shoulder width apart and lift your feet off the floor. Arch your back as high as possible and round your shoulders (this is the “plus” part or the exercise). Bend your elbows and lower your body to the floor. Return to the starting position and arch your back again. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Broken Collarbone Rehabilitation Exercises

Wand exercise: Flexion: Stand upright and hold a stick in both hands, palms down. Stretch your arms by lifting them over your head, keeping your elbows straight. Hold for 5 seconds and return to the starting position. Repeat 10 times.
Wand exercise: Extension: Stand upright and hold a stick in both hands behind your back. Move the stick away from your back. Hold the end position for 5 seconds. Relax and return to the starting position. Repeat 10 times.
Wand exercise: External rotation: Lie on your back and hold a stick in both hands, palms up. Your upper arms should be resting on the floor, your elbows at your sides and bent 90°. Using one arm, push your other arm out away from your body while keeping the elbow of the arm being pushed at your side. Hold the stretch for 5 seconds. Repeat 10 times.
Wand exercise: Internal rotation: Stand with one arm behind your head holding the end of a stick. Put your other arm behind your back at waist level and grab the stick. Move the stick up and down your back by bending your elbows. Hold the bent position for 5 seconds and then return to the starting position. Repeat 10 times.
Wand exercise: Shoulder abduction and adduction: Stand upright and hold a stick with both hands, palms facing away from your body. Rest the stick against the front of your thighs. While keeping your elbows straight, use one arm to push your other arm out to the side and up as high as possible. Hold for 5 seconds. Repeat 10 times.
Wand exercise: Horizontal abduction and adduction: Stand upright and hold a stick in both hands. Place your arms straight out in front of you at shoulder level. Keep your arms straight and swing the stick to one side, feel the stretch, and hold for 5 seconds. Then swing the stick to the other side, feel the stretch, and hold for 5 seconds. Repeat 10 times.
Shoulder flexion: Stand with your arms hanging down at your side. Keep your elbow straight and lift your arms up over your head as far as you can reach. Hold the end position for 5 seconds. Do 3 sets of 10.
Shoulder abduction: Stand with your arms at your sides. Bring your arms up, out to the side, and toward the ceiling. Hold for 5 seconds. Return to the starting position. Repeat 10 times.
Horizontal shoulder abduction: Stand with your arms held straight out in front of you at shoulder level. Pull your arms apart and out to the sides as far as possible. Hold them back for 5 seconds, then bring them back together in front of you. Repeat 10 times. Remember to keep your arms at shoulder level throughout this exercise.
Shoulder extension: Stand with your arms at your sides. Move the arm on one side back, keeping your elbow straight. Hold this position for 5 seconds. Return to the starting position and repeat 10 times.
Scapular active range of motion: Stand and shrug your shoulders up and hold for 5 seconds. Then squeeze your shoulder blades back and together and hold 5 seconds. Next, pull your shoulder blades downward as if putting them in your back pocket. Relax. Repeat this sequence 10 times.
Side-lying horizontal abduction: Lie on your side with your top arm relaxed across your chest. Slowly bring your top arm up off the floor, elbow straight, so that your hand is pointing toward the ceiling. Do 3 sets of 10. Hold a weight in your hand as the exercise becomes easier.
Prone shoulder extension: Lie on your stomach on a table or a bed with one arm hanging down over the edge. With your elbow straight, slowly lift your arm straight back and toward the ceiling. Return to the starting position. Do 3 sets of 10. As this becomes easier, hold a weight in your hand.
Single-arm shoulder abduction: Stand with your arms at your sides with your palms resting against your sides. With your elbow straight, lift one arm out to the side and toward the ceiling. Hold the position for 5 seconds. Repeat 10 times. Add a weight to your hand as this exercise becomes easier.
Resisted shoulder internal rotation: Holding tubing connected to a door knob at waist level, keep your elbow in at your side and rotate your arm inward across your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 10.
Resisted shoulder adduction: Stand sideways next to a door. With the hand closest to the door, hold tubing connected to a door knob at waist level. Stand away from the door approximately 8 to 10 inches. Slowly bring your arm with tubing next to your body. Do 3 sets of 10.
Resisted shoulder flexion: Holding tubing connected to a door knob at waist level, face away from the door, keep your elbow straight and pull your arm forward. Do 3 sets of 10.
Resisted shoulder extension: Face a door holding tubing connected to the door knob at waist level, pull your arm back. Be sure to keep your elbow straight. Do 3 sets of 10.
Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Brachial Plexus Injury (Stinger/Burner) Rehabilitation Exercises

You can begin these exercises when moving your neck in all directions (up, down, right, left) does not cause numbness or tingling down your arm or into your hand. Do not do any exercises that make your neck pain worse.

Isometric neck flexion: Sit tall, eyes straight ahead, and chin level. Place your palm against your forehead and gently push your forehead into your palm. Hold for 5 seconds and release. Do 3 sets of 5.
Isometric neck extension: Sit tall, eyes straight ahead, and chin level. Clasp your hands together and place them behind your head. Press the back of your head into your palms. Hold 5 seconds and release. Do 3 sets of 5.
Isometric neck side bend: Sit tall, eyes straight ahead, and chin level. Place the palm of your hand at the side of your temple and press your temple into the palm of your hand. Hold 5 seconds and release. Do 3 sets of 5 on each side.
Head lift: Neck curl: Lie on your back with your knees bent and your feet flat on the floor. Tuck your chin and lift your head toward your chest, keeping your shoulders on the floor. Hold for 5 seconds. Repeat 10 times.
Head lift: Neck side bend: Lie on your right side with your right arm lying straight out. Rest your head on your arm, then lift your head slowly toward your left shoulder. Hold for 5 seconds. Repeat 10 times. Switch to your left side and repeat the exercise, lifting your head toward your right shoulder.
Neck extension on hands and knees: Get on your hands and knees and look down at the floor. Keep your back straight and let your head slowly drop toward your chest. Then tuck your chin slightly and lift your head up until your neck is level with your back. Hold this position for 5 seconds. Repeat 10 times.
Shoulder shrug: Stand with your head directly over your shoulders, with your spine straight. Shrug your shoulders up and then relax. Do 3 sets of 10.
Shoulder abduction: Stand with your arms at your sides. Bring your arms up, out to the side, and toward the ceiling. Hold for 5 seconds. Return to the starting position. Repeat 10 times.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Biceps Tendonitis Rehabilitation Exercises

Active elbow flexion and extension: Gently bring your palm up toward your shoulder and bend your elbow as far as you can. Then straighten your elbow as far as you can 10 times. Do 3 sets of 10.
Biceps stretch: Stand facing a wall (about 6 inches away from the wall). Raise your arm out to your side and place the thumb side of your hand against the wall (palm down). Keep your elbow straight. Rotate your body in the opposite direction of the raised arm until you feel a stretch in your biceps. Hold 15 seconds, repeat 3 times.
Biceps curls: Stand and hold some kind of weight (soup can or hammer) in your hand. Bend your elbow and bring your hand (palm up) toward your shoulder. Hold 5 seconds. Slowly return to your starting position and straighten your elbow. Do 3 sets of 10.
Single-arm shoulder flexion: Stand with one arm hanging down at your side. Keeping your elbow straight, bring your arm forward and up toward the ceiling. Hold this position for 5 seconds. Do 3 sets of 10. As this exercise becomes easier, add a weight.
Resisted shoulder internal rotation: Holding tubing connected to a door knob at waist level, keep your elbow in at your side and rotate your arm inward across your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 10.
Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.
Side-lying external rotation: Lie on your one side with your top arm at your side and your elbow bent to 90°. Keep your elbow against your side, raise your forearm and hold for 2 seconds. Slowly lower your arm. Do 3 sets of 10. You can start doing this exercise holding a soup can or light weight and gradually increase the weight as long as there is no pain.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth.

Published by RelayHealth.

Thoracic Outlet Syndrome Rehabilitation Exercises

Scalene stretch: This stretches the neck muscles that attach to your ribs. Sitting in an upright position, clasp both hands behind your back, lower your left shoulder, and tilt your head toward the right. Hold this position for 15 to 30 seconds and then come back to the starting position. Lower your right shoulder and tilt your head toward the left until you feel a stretch. Hold for 15 to 30 seconds. Repeat 3 times on each side.
Pectoralis stretch: Stand in a doorway or corner with both arms on the wall slightly above your head. Slowly lean forward until you feel a stretch in the front of your shoulders. Hold 15 to 30 seconds. Repeat 3 times.
Scapular squeeze: While sitting or standing with your arms by your sides, squeeze your shoulder blades together and hold for 5 seconds. Do 3 sets of 10.
Arm slide on wall: Sit or stand with your back against a wall and your elbows and wrists against the wall. Slowly slide your arms upward as high as you can while keeping your elbows and wrists against the wall. Do 3 sets of 10.
Thoracic extension: While sitting in a chair, clasp both arms behind your head. Gently arch backward and look up toward the ceiling. Repeat 10 times. Do this several times per day.
Rowing exercise: Tie a piece of elastic tubing around an immovable object and grasp the ends in each hand. Keep your forearms vertical and your elbows at shoulder level and bent to 90 degrees. Pull backward on the band and squeeze your shoulder blades together. Repeat 10 times. Do 3 sets.
Mid-trap exercise: Lie on your stomach on a firm surface and place a folded pillow underneath your chest. Place your arms out straight to your sides with your elbows straight and thumbs toward the ceiling. Slowly raise your arms toward the ceiling as you squeeze your shoulder blades together. Lower slowly. Do 3 sets of 15. Progress to holding soup cans or small weights in your hands.

Written by Phyllis Clapis, PT, DHSc, OCS, and Pierre Rouzier, MD.

Published by RelayHealth.

Neck Strain Rehabilitation Exercises

Do these exercises only if you do not have pain or numbness running down your arm or into your hand. The first 6 exercises are meant to help your neck remain flexible. Do not do any exercises that make your neck pain worse.

Active neck rotation: Sit in a chair, keeping your neck, shoulders, and trunk straight. First, turn your head slowly to the right. Move it gently to the point of pain. Move it back to the forward position. Relax. Then move it to the left. Repeat 10 times.
Active neck side bend: Sit in a chair, keeping your neck, shoulders, and trunk straight. Tilt your head so that your right ear moves toward your right shoulder. Move it to the point of pain. Then tilt your head so your left ear moves toward your left shoulder. Make sure you do not rotate your head while tilting or raise your shoulder toward your head. Repeat this exercise 10 times in each direction.
Neck flexion: Sit in a chair, keeping your neck, shoulders, and trunk straight. Bend your head forward, reaching your chin toward your chest. Hold for 5 seconds. Repeat 10 times.
Neck extension: Sit in a chair, keeping your neck, shoulders, and trunk straight. Bring your head back so that your chin is pointing toward the ceiling. Repeat 10 times.
Chin tuck: Place your fingertips on your chin and gently push your head straight back as if you are trying to make a double chin. Keep looking forward as your head moves back. Hold 5 seconds and repeat 5 times.
Scalene stretch: This stretches the neck muscles that attach to your ribs. Sitting in an upright position, clasp both hands behind your back, lower your left shoulder, and tilt your head toward the right. Hold this position for 15 to 30 seconds and then come back to the starting position. Lower your right shoulder and tilt your head toward the left until you feel a stretch. Hold for 15 to 30 seconds. Repeat 3 times on each side.
Isometric neck flexion: Sit tall, eyes straight ahead, and chin level. Place your palm against your forehead and gently push your forehead into your palm. Hold for 5 seconds and release. Do 3 sets of 5.
Isometric neck extension: Sit tall, eyes straight ahead, and chin level. Clasp your hands together and place them behind your head. Press the back of your head into your palms. Hold 5 seconds and release. Do 3 sets of 5.
Isometric neck side bend: Sit tall, eyes straight ahead, and chin level. Place the palm of your hand at the side of your temple and press your temple into the palm of your hand. Hold 5 seconds and release. Do 3 sets of 5 on each side.
Head lift: Neck curl: Lie on your back with your knees bent and your feet flat on the floor. Tuck your chin and lift your head toward your chest, keeping your shoulders on the floor. Hold for 5 seconds. Repeat 10 times.
Head lift: Neck side bend: Lie on your right side with your right arm lying straight out. Rest your head on your arm, then lift your head slowly toward your left shoulder. Hold for 5 seconds. Repeat 10 times. Switch to your left side and repeat the exercise, lifting your head toward your right shoulder.
Neck extension on hands and knees: Get on your hands and knees and look down at the floor. Keep your back straight and let your head slowly drop toward your chest. Then tuck your chin slightly and lift your head up until your neck is level with your back. Hold this position for 5 seconds. Repeat 10 times.
Scapular squeeze: While sitting or standing with your arms by your sides, squeeze your shoulder blades together and hold for 5 seconds. Do 3 sets of 10.

Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth. Published by RelayHealth.

Neck Spasm Rehabilitation Exercises

You may do all of these exercises right away but avoid any movements that increase your pain.

Neck rotation with flexion:

Right: Turn your head to the right and clasp your hands behind your head. Let the weight of your arms pull your chin to the right side of your chest. Relax. Hold for a count of 15. Do this 3 times.

Left: Turn your head to the left and clasp your hands behind your head. Let the weight of your arms pull your chin to the left side of your chest. Relax. Hold for a count of 15. Do this 3 times.

Chin tuck: Place your fingertips on your chin and gently push your head straight back as if you are trying to make a double chin. Keep looking forward as your head moves back. Hold 5 seconds and repeat 5 times.
Scalene stretch: This stretches the neck muscles that attach to your ribs. Sitting in an upright position, clasp both hands behind your back, lower your left shoulder, and tilt your head toward the right. Hold this position for 15 to 30 seconds and then come back to the starting position. Lower your right shoulder and tilt your head toward the left until you feel a stretch. Hold for 15 to 30 seconds. Repeat 3 times on each side.
Neck rotation stretch

Right side: Rotate your neck by looking over your right shoulder. Lift your right hand and place your palm on the left side of your chin. Push your chin with your palm toward your right shoulder. Hold for a count of 10. Do this 3 times.

Left side: Rotate your neck by looking over your left shoulder. Lift your left hand and place your palm on the right side of your chin. Push your chin with your palm toward your left shoulder. Hold for a count of 10. Do this 3 times.

Scapular squeeze: While sitting or standing with your arms by your sides, squeeze your shoulder blades together and hold for 5 seconds. Do 3 sets of 10.
Thoracic extension: While sitting in a chair, clasp both arms behind your head. Gently arch backward and look up toward the ceiling. Repeat 10 times. Do this several times per day.

Written by Pierre Rouzier, MD, and Phyllis Clapis, PT, DHSc, OCS, for RelayHealth. Published by RelayHealth.

The Science of Wellness: How Lifestyle Practices Influence Human Physiology

Introduction

Wellness isn’t just a buzzword; it’s a holistic approach to health that encompasses physical, mental, and emotional well-being. While genetics play a role in determining our health outcomes, lifestyle factors such as diet, exercise, sleep, stress management, and social connections exert profound effects on our physiology. In this comprehensive guide, we’ll explore the intricate relationship between wellness practices and human physiology, shedding light on the underlying mechanisms through which lifestyle choices impact our bodies at the molecular, cellular, and systemic levels.

Nutrition and Metabolism

The food we eat serves as fuel for our bodies, providing the essential nutrients needed for energy production, cellular function, and tissue repair. A balanced diet rich in whole foods, fruits, vegetables, lean proteins, and healthy fats supports optimal physiological functioning while reducing the risk of chronic diseases such as obesity, diabetes, and cardiovascular disorders. Carbohydrates, proteins, and fats are macronutrients that undergo digestion and metabolism to generate ATP (adenosine triphosphate), the body’s primary energy currency. Macronutrient balance, along with micronutrient intake (vitamins, minerals, antioxidants), influences metabolic processes, hormone regulation, and immune function.

Exercise and Physical Fitness

Regular exercise is not only essential for maintaining a healthy weight and cardiovascular health but also exerts profound effects on physiological systems throughout the body. Aerobic exercise, such as running, cycling, and swimming, improves cardiovascular fitness, enhances oxygen delivery to tissues, and stimulates the release of endorphins, neurotransmitters that promote mood elevation and stress reduction. Strength training exercises, meanwhile, increase muscle mass, bone density, and metabolic rate, contributing to overall strength, mobility, and metabolic health. Exercise-induced adaptations include improvements in insulin sensitivity, lipid profile, blood pressure, and inflammatory markers, reducing the risk of metabolic syndrome and chronic inflammation.

Sleep and Circadian Rhythms

Quality sleep is essential for physical and mental well-being, serving as a time for rest, repair, and rejuvenation. During sleep, the body undergoes essential physiological processes, including tissue regeneration, hormone regulation, memory consolidation, and immune system modulation. Disruptions to the sleep-wake cycle, such as sleep deprivation or irregular sleep patterns, can impair cognitive function, mood stability, and metabolic health. Chronic sleep disturbances have been linked to an increased risk of obesity, insulin resistance, hypertension, and mood disorders.

Stress Management and Hormonal Balance

Chronic stress triggers a cascade of physiological responses, including the release of stress hormones such as cortisol and adrenaline, activation of the sympathetic nervous system (fight-or-flight response), and suppression of the parasympathetic nervous system (rest-and-digest response). Prolonged stress exposure can dysregulate hormone levels, suppress immune function, and contribute to systemic inflammation, increasing the risk of stress-related disorders such as anxiety, depression, insomnia, and gastrointestinal problems. Mind-body practices such as meditation, deep breathing, yoga, and progressive muscle relaxation promote relaxation, activate the parasympathetic nervous system, and mitigate the detrimental effects of chronic stress on physiology.

Social Connections and Emotional Well-being

Human beings are social creatures wired for connection, and interpersonal relationships play a crucial role in shaping our physiological responses to stress, adversity, and life events. Strong social support networks have been associated with better mental health, immune function, and longevity, while social isolation and loneliness are risk factors for poor health outcomes and mortality. Positive social interactions release feel-good neurotransmitters such as oxytocin and dopamine, which promote bonding, trust, and emotional resilience. Cultivating meaningful relationships, engaging in social activities, and seeking support from friends, family, and community networks are essential for nurturing emotional well-being and maintaining physiological equilibrium.

The practice of wellness encompasses a range of lifestyle choices and behaviors that profoundly influence human physiology at multiple levels. From nutrition and exercise to sleep, stress management, and social connections, each aspect of wellness plays a unique role in promoting optimal health and vitality. By adopting healthy habits and prioritizing self-care, individuals can harness the power of lifestyle medicine to optimize physiological function, prevent chronic disease, and enhance overall quality of life. Remember, wellness is not a destination but a journey, and each positive choice brings us closer to achieving our full potential for health and well-being.

The Road to Recovery: The Vital Role of Physical Therapy After Injury

Introduction

Suffering an injury can be a challenging and often disheartening experience, impacting not only physical health but also emotional well-being and overall quality of life. Whether it’s a sprained ankle, a torn ligament, or a post-surgery rehabilitation, the journey to recovery can feel daunting. However, with the guidance and expertise of physical therapists, individuals can navigate this journey with confidence and resilience. In this comprehensive guide, we’ll explore the critical role of physical therapy in the rehabilitation process, from reducing pain and restoring mobility to enhancing strength and preventing future injuries.

Understanding Physical Therapy

Physical therapy is a branch of rehabilitative health focused on restoring movement and function following injury, illness, or surgery. Physical therapists are highly trained healthcare professionals who assess, diagnose, and treat musculoskeletal and movement disorders using evidence-based techniques and interventions.

The primary goals of physical therapy include:

Pain Management: Physical therapists employ various modalities such as manual therapy, therapeutic exercises, electrical stimulation, and ultrasound to alleviate pain and discomfort associated with injury or surgery.

Restoring Mobility and Function: Through targeted exercises, stretches, and manual techniques, physical therapists work to improve joint range of motion, flexibility, and functional abilities, enabling individuals to perform activities of daily living with greater ease and confidence.

Strengthening and Conditioning: Physical therapy programs often include strength training exercises to rebuild weakened muscles, improve muscle balance, and enhance overall physical fitness, reducing the risk of reinjury.

Improving Balance and Coordination: Balance and coordination are essential for safe movement and injury prevention. Physical therapists incorporate balance exercises, proprioceptive training, and coordination drills to enhance motor control and reduce the risk of falls.

Education and Empowerment: Physical therapists educate patients about their condition, treatment options, and injury prevention strategies, empowering them to take an active role in their recovery and long-term health.

The Role of Physical Therapy After Injury

After sustaining an injury, whether acute or chronic, seeking prompt physical therapy intervention is crucial for optimal recovery and long-term outcomes. Here’s how physical therapy can benefit individuals at different stages of the rehabilitation process:

Acute Phase

During the acute phase of injury, immediate goals focus on reducing pain, swelling, and inflammation while protecting the injured area from further damage. Physical therapists may employ modalities such as ice, compression, and elevation (R.I.C.E), along with gentle range-of-motion exercises to maintain joint mobility and prevent stiffness.

Subacute Phase

As the acute symptoms subside, physical therapy interventions become more focused on restoring function and mobility. Physical therapists develop personalized treatment plans tailored to the individual’s specific needs, incorporating a combination of manual therapy techniques, therapeutic exercises, and functional activities to promote healing and rehabilitation.

Recovery and Rehabilitation

In the later stages of rehabilitation, the emphasis shifts towards rebuilding strength, improving flexibility, and enhancing overall physical performance. Physical therapists prescribe progressive exercise programs designed to address muscle imbalances, restore functional movement patterns, and optimize biomechanics, facilitating a safe return to pre-injury activities and sports.

Maintenance and Injury Prevention

Even after completing formal physical therapy, maintaining an active lifestyle and adhering to a personalized home exercise program are essential for preventing re-injury and promoting long-term musculoskeletal health. Physical therapists provide education on proper body mechanics, ergonomics, and injury prevention strategies to empower individuals to stay healthy and active.

Physical therapy plays a vital role in the rehabilitation journey following injury, providing individuals with the support, guidance, and expertise needed to recover safely and effectively. By addressing pain, restoring mobility, enhancing strength, and promoting overall wellness, physical therapists empower individuals to overcome adversity, reclaim their independence, and live life to the fullest. Remember, the road to recovery may be challenging, but with perseverance, determination, and the right team by your side, healing and renewal are possible.

Chukwuemeka Nnabuife MD, DO CAQ

A Comprehensive Guide to Sustainable Weight Loss: Science-Backed Strategies for Success

Introduction

In a world where fad diets and quick fixes dominate headlines, achieving sustainable weight loss can feel like an elusive goal. However, by understanding the science behind weight loss and adopting evidence-based strategies, you can embark on a journey towards a healthier lifestyle that lasts a lifetime. In this comprehensive guide, we’ll delve into the intricacies of weight loss, exploring the physiological factors at play, debunking common myths, and providing actionable tips to help you achieve your goals.

Understanding Weight Loss

At its core, weight loss is a simple equation: calories consumed versus calories expended. To lose weight, you need to create a calorie deficit, which means consuming fewer calories than your body uses for energy. However, the human body is a complex system influenced by various factors, including metabolism, hormones, genetics, and behavior.

Metabolism, often misunderstood, refers to the process by which your body converts food and drink into energy. Basal metabolic rate (BMR) accounts for the majority of calories burned at rest, while physical activity and the thermic effect of food also contribute to energy expenditure.

Hormones play a crucial role in regulating appetite, metabolism, and fat storage. Hormones like insulin, leptin, ghrelin, and cortisol influence hunger, satiety, and fat metabolism, making hormonal balance essential for weight management.

Genetics can predispose individuals to certain body types and metabolic rates, but they do not dictate destiny. While genetics may influence weight loss outcomes to some extent, lifestyle factors like diet and exercise play a more significant role in determining success.

Dispelling Myths

Before diving into effective weight loss strategies, it’s essential to dispel common myths that often derail progress:

Myth 1: Crash diets lead to sustainable weight loss. Reality: Crash diets may result in rapid initial weight loss, but they are unsustainable and often lead to rebound weight gain.

Myth 2: Carbohydrates are the enemy. Reality: Carbohydrates are a vital source of energy and essential for overall health. The key is to choose complex carbohydrates like whole grains, fruits, and vegetables while moderating intake of refined sugars and processed foods.

Myth 3: You have to exercise excessively to lose weight. Reality: While exercise is beneficial for weight loss and overall health, it’s not necessary to spend hours at the gym every day. Consistent, moderate exercise combined with dietary changes yields the best results.

Effective Strategies for Sustainable Weight Loss

Now that we’ve laid the foundation, let’s explore science-backed strategies for achieving sustainable weight loss.

Set Realistic Goals: Instead of fixating on a specific number on the scale, focus on adopting healthier habits that promote long-term success. Set realistic, achievable goals based on behavior changes rather than strict weight targets.

Prioritize Nutrition: Opt for a balanced diet rich in whole foods, including lean proteins, fruits, vegetables, whole grains, and healthy fats. Practice portion control, mindful eating, and moderation rather than restrictive dieting.

Monitor Caloric Intake: Keep track of your food intake using a food diary or mobile app to gain insight into your eating habits and calorie consumption. Aim for a moderate calorie deficit of 500 to 750 calories per day to promote steady weight loss.

Stay Hydrated: Drink plenty of water throughout the day to stay hydrated and support metabolism. Sometimes thirst can be mistaken for hunger, leading to unnecessary calorie consumption.

Incorporate Physical Activity: Find enjoyable forms of exercise that suit your lifestyle and preferences, whether it’s walking, cycling, swimming, or dancing. Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week, along with muscle-strengthening exercises on two or more days.

Get Adequate Sleep: Prioritize quality sleep, aiming for 7-9 hours per night. Lack of sleep can disrupt hormone levels, increase appetite, and hinder weight loss efforts.

Manage Stress: Practice stress-reducing techniques such as mindfulness, meditation, deep breathing, or yoga to minimize emotional eating and cortisol levels, which can promote abdominal fat storage.

Seek Support: Surround yourself with a supportive network of friends, family, or professionals who can offer encouragement, accountability, and guidance on your weight loss journey.

In conclusion, achieving sustainable weight loss requires a holistic approach that addresses diet, exercise, mindset, and lifestyle factors. By understanding the science behind weight loss, dispelling common myths, and implementing evidence-based strategies, you can embark on a journey towards improved health, vitality, and well-being. Remember, small, consistent changes over time can lead to significant and lasting results.

– By Dr. Nnabuife

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Arthritis

Arthritis refers to a group of inflammatory joint disorders characterized by pain, swelling, stiffness, and decreased range of motion. There are many types of arthritis, but the two most common forms are osteoarthritis (OA) and rheumatoid arthritis (RA).

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Arthritis Q & A

What are the causes of Arthritis?

Osteoarthritis (OA):

- OA is the most common form of arthritis, typically affecting older adults.
- It occurs when the protective cartilage that cushions the ends of bones wears down over time, leading to bone-on-bone friction, inflammation, and joint damage.
- Risk factors include age, genetics, obesity, joint injury, and repetitive stress on the joints.

Rheumatoid Arthritis (RA):

- RA is an autoimmune disease in which the body’s immune system mistakenly attacks the synovium (the lining of the membranes that surround the joints), causing inflammation and joint damage.
- The exact cause of RA is unknown, but genetics and environmental factors may play a role.
- RA typically affects multiple joints symmetrically and can lead to systemic symptoms such as fatigue, fever, and weight loss.

When do Seek Medical Help for Arthritis?

You should seek medical attention if you experience:

Persistent joint pain, swelling, or stiffness that lasts for more than a few weeks.
Joint redness, warmth, or tenderness.
Difficulty performing daily activities due to joint symptoms.
Joint deformity or instability.
Systemic symptoms such as fever, fatigue, or unexplained weight loss.

What are the treatment Options for Arthritis?

Medications:

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce pain and inflammation.

Disease-modifying antirheumatic drugs (DMARDs) are often prescribed for RA to suppress the immune system and slow disease progression.

Corticosteroids may be used to provide short-term relief of severe arthritis symptoms.

Analgesics such as acetaminophen can help alleviate pain but do not reduce inflammation.

Lifestyle Modifications:

Regular exercise, including low-impact activities like swimming or cycling, can help improve joint function and mobility.

Maintaining a healthy weight can reduce stress on weight-bearing joints and slow the progression of OA.

Physical therapy can provide exercises to strengthen muscles around the affected joints and improve flexibility.

Assistive devices such as braces, splints, or orthotic shoe inserts can help support the joints and alleviate pain.

Joint Protection:

Avoiding activities that exacerbate joint pain or cause further damage, such as high-impact sports or repetitive movements.

Using ergonomic tools and techniques to reduce joint stress during daily tasks.

Surgery:

Joint replacement surgery may be considered for severe OA or RA that does not respond to other treatments, particularly in the hips or knees.

Other surgical options include arthroscopy, synovectomy, or joint fusion to alleviate pain and improve joint function.

It’s important to work with a healthcare provider, such as a rheumatologist or orthopedic specialist, to develop a comprehensive treatment plan tailored to your specific type and severity of arthritis. Early intervention and appropriate management can help alleviate symptoms, preserve joint function, and improve quality of life for individuals with arthritis.

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Concussion

A concussion is a type of traumatic brain injury (TBI) caused by a sudden jolt, blow, or bump to the head or body that results in the brain’s rapid movement within the skull. This movement can cause stretching and damage to brain cells and disrupt normal brain function temporarily. Concussions are often referred to as mild TBIs because they are usually not life-threatening, but they can have serious short-term and long-term effects on cognitive, physical, and emotional health. Our sports medicine program includes specialized care for athletes who have sustained concussions or head injuries. Our sports medicine physicians are trained in concussion evaluation and management protocols, including sideline assessment, symptom monitoring, neurocognitive testing, and gradual return-to-play protocols. We prioritize the safety and well-being of athletes with concussions, providing comprehensive care to support their recovery and minimize the long-term effects of head injuries.

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Concussion Q & A

What are the symptoms of concussion?

Symptoms of Concussion:

Headache or Pressure in the Head: The most common symptom of concussion is a headache, which may vary in intensity.

Dizziness or Balance Problems: Feeling dizzy, lightheaded, or unsteady on your feet is common after a concussion.

Nausea or Vomiting: Some individuals may experience nausea or vomiting after sustaining a concussion.

Confusion or Disorientation: Difficulty concentrating, feeling mentally foggy, or having trouble remembering events before or after the injury.

Sensitivity to Light or Noise: Increased sensitivity to light or noise, known as photophobia and phonophobia, respectively.

Visual Disturbances: Blurred or double vision, seeing stars, or difficulty focusing on objects.

Fatigue or Drowsiness: Feeling unusually tired, lethargic, or sleepy even after getting adequate rest.

Sleep Disturbances: Changes in sleep patterns, such as difficulty falling asleep, excessive sleepiness, or disrupted sleep.

Mood Changes: Irritability, mood swings, anxiety, depression, or emotional instability may occur following a concussion.

Memory Problems: Difficulty recalling recent events, difficulty concentrating, or feeling mentally sluggish.

When do seek medical Attention?

It’s essential to seek medical attention if you or someone else experiences any of the following symptoms after a head injury:

Deteriorating mental status (confusion, agitation, difficulty waking up) Loss of consciousness: Although not all concussions involve loss of consciousness, if it does occur, especially for an extended period, it can indicate a more severe brain injury.

Worsening symptoms: If symptoms such as headache, dizziness, confusion, or nausea worsen over time rather than improving, it could suggest an evolving brain injury.

Seizures: Seizures following a head injury can be a sign of a more severe brain injury and require immediate medical attention.

Persistent vomiting: Vomiting that continues or worsens after the initial injury may indicate increased intracranial pressure and should be evaluated promptly.

Unequal pupil size: Also known as anisocoria, a significant difference in the size of the pupils can be a sign of serious brain injury or other neurological problems.

Severe or worsening headache: While headaches are common after a concussion if they are severe, persistent, or getting worse, it may indicate a more serious issue.

Weakness or numbness: Weakness or numbness, especially on one side of the body, can indicate damage to the brain or spinal cord and should be evaluated immediately.

Difficulty waking up: If someone has difficulty waking up or appears excessively drowsy after a head injury, it could indicate a more severe brain injury.

Confusion or agitation: Severe confusion, unusual behavior, or agitation following a head injury may be signs of a more severe brain injury.

Slurred speech: Difficulty speaking clearly, or slurred speech can be a sign of neurological impairment and should be evaluated promptly.

What are the treatment and Management of concussion:

The primary treatment for concussion involves rest and avoiding activities that may exacerbate symptoms. Physical and cognitive rest is crucial in the acute phase of injury to allow the brain to heal. Depending on the severity of symptoms and individual circumstances, healthcare providers may recommend gradually resuming activities once symptoms improve.

In some cases, medication may be prescribed to manage specific symptoms such as headache, nausea, or sleep disturbances. Cognitive rehabilitation therapy, vestibular rehabilitation, and other forms of specialized therapy may also be recommended to address persistent symptoms and facilitate recovery.

It’s essential to follow the guidance of healthcare professionals and gradually return to normal activities, including work, school, and physical exercise, to minimize the risk of complications and ensure a safe and full recovery. If symptoms persist or worsen over time, further evaluation and monitoring may be necessary to address any underlying issues and support long-term recovery.

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Knee Pain

The knee is a complex joint that plays a crucial role in supporting the body’s weight and facilitating movement. Knee pain can be a common complaint and may arise from various causes, ranging from acute injuries to chronic conditions. Understanding the potential causes of knee pain, when to seek medical help, and available treatment options is essential for effective management.

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Knee pain Q & A

What are the causes of knee pain? Causes of knee pain include

Acute Injuries: These include ligament sprains or tears (such as ACL or MCL injuries), meniscus tears, fractures, dislocations, or patellar (kneecap) injuries. These injuries often occur due to sudden trauma or overuse during sports activities or accidents.

Osteoarthritis: This degenerative joint disease occurs when the cartilage that cushions the ends of the bones within the knee joint gradually wears away. Osteoarthritis can lead to pain, stiffness, swelling, and decreased mobility in the knee.

Rheumatoid Arthritis: An autoimmune condition that causes chronic inflammation of the joints, including the knee. Rheumatoid arthritis can result in pain, swelling, warmth, and deformity of the knee joint.

Patellofemoral Pain Syndrome (Runner’s Knee): This condition involves pain around or behind the kneecap, often aggravated by activities that involve bending the knee, such as running, squatting, or climbing stairs.

Bursitis: Inflammation of the bursae, small fluid-filled sacs that cushion the knee joint, can lead to pain, swelling, and tenderness around the knee.

Tendonitis: Inflammation of the tendons surrounding the knee, such as patellar tendonitis (jumper’s knee) or quadriceps tendonitis, can cause pain, stiffness, and difficulty with movement.

Overuse or Repetitive Strain: Activities that involve repetitive bending, kneeling, or squatting can strain the structures of the knee joint, leading to pain and discomfort.

When do you Seek Medical Help for Knee Pain?

You should seek medical attention for knee pain if:

The pain is severe or persistent.
You are unable to bear weight on the affected knee.
The knee looks deformed or misshapen.
You have signs of infection, such as redness, warmth, swelling, or fever.
The knee pain is accompanied by locking, popping, or clicking sensations.
You have a history of knee injury or underlying medical conditions that may affect joint health.

What are the treatment Options for Knee Pain?

Treatment for knee pain depends on the underlying cause and severity of the condition. It may include:

Rest and Activity Modification: Avoid activities that exacerbate knee pain and allow the joint to rest and heal.

Physical Therapy: Exercises to strengthen the muscles around the knee, improve flexibility, and restore range of motion.

Pain Management: Over-the-counter pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), can help alleviate pain and inflammation.

RICE Therapy: Rest, ice, compression, and elevation can reduce swelling and pain associated with acute knee injuries.

Bracing or Splinting: Supportive braces or splints may be used to stabilize the knee joint and provide pain relief.

Corticosteroid Injections: Injections of corticosteroids into the knee joint can help reduce inflammation and relieve pain, especially for conditions like arthritis or bursitis.

Surgery: In severe cases or when conservative treatments fail, surgical interventions such as arthroscopy, ligament reconstruction, meniscus repair, or knee replacement may be necessary.

It’s essential to consult with a healthcare professional, such as an orthopedic specialist or sports medicine physician, for a thorough evaluation and personalized treatment plan tailored to your specific needs. Early intervention and appropriate management can help alleviate knee pain and prevent further complications, allowing you to maintain an active and healthy lifestyle.

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Concussion

A concussion is a type of traumatic brain injury (TBI) caused by a sudden jolt, blow, or bump to the head or body that results in the brain’s rapid movement within the skull. This movement can cause stretching and damage to brain cells and disrupt normal brain function temporarily. Concussions are often referred to as mild TBIs because they are usually not life-threatening, but they can have serious short-term and long-term effects on cognitive, physical, and emotional health. Our sports medicine program includes specialized care for athletes who have sustained concussions or head injuries. Our sports medicine physicians are trained in concussion evaluation and management protocols, including sideline assessment, symptom monitoring, neurocognitive testing, and gradual return-to-play protocols. We prioritize the safety and well-being of athletes with concussions, providing comprehensive care to support their recovery and minimize the long-term effects of head injuries.

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281-256-8685

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Concussion Q & A

What are the symptoms of concussion?