Spine Rehab - Training for ADL

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Make Good Form a Habit with ADL

Learning a few basic ADL moves may help you avoid a back reinjury.
Learning a few basic ADL moves may help you avoid a back reinjury.

I'm a firm believer that "habits make the (wo)man," especially when it comes to doing well with exercise, physiotherapy, and prevention of recurring pain. To this end, I work a lot with my clients on body alignment. I believe that doing therapeutic exercise is best served by an understanding and active application of good form - as well as some basic underlying movement skill.

I have an entire program that I affectionately call "pre-exercise" that takes clients through the basics of breathing, alignment, and specific, accurate body awareness experiences before I actually start them on the exercise program. I know that quite often physiotherapists don't have as much time as I do for such a deep dive, but they usually do teach patients some basic movement constructs.

These movement constructs - rolling, getting up and down and more - pave the way for smooth, well-executed activity of daily living movements

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ADL Training - Intro

Ultrasound is one Physical Therapy Modality for Spine Rehab
Ultrasound is one Physical Therapy Modality for Spine Rehab. photographee.eu

When you're first recovering from a neck or low back injury much of your treatment may center on decreasing symptoms and learning about the positions that are safe for you to take.

Soon, though, your therapist may start teaching you some very basic moves.  Such movements include rolling,  getting up and getting down from your bed, a chair or even the floor, getting into and out of your car and more.  Becoming proficient at doing these basic actions will likely help reduce or minimize pain as you go about your daily business.

Not only that but practicing activities of daily living, as they are called (ADLs),gives you a chance to practice your neutral spine for real life situations. Neutral spine is a key component of back safe  ADLs (as well as exercises designed for therapeutic results.)

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Back Safe Rolling - Instructions

Rolling
Rolling is a basic moved used when we change sleep positions. lifeonwhite

Whether you are moving from your back to your side, your side to your front or your front to your side, rolling is a handy skill to have.  It is often used to change sleeping positions.

For this example, let's try rolling from a supine position (i.e. lying on your back) to lying on your side.

The first thing to do when rolling is to locate your neutral spine. Follow that with the drawing in maneuver. These two initial steps will likely help you establish the support necessary for transitioning to a different position while lying down.

Back Safe Rolling - Reminder

It's important to roll your trunk as one unit.  To do this, you might imagine there's a stiff pole or rod that goes down the center of your body (spinal column) from head through pelvis.  The rod image may help you keep your ribs, shoulders and/or pelvis from moving independently of one another as you roll.

Of course, it's okay to use your arms and your top leg to help you get over, so don't fret about that.

You will need your new found rolling skill for the next one - sitting to lying down or lying down to sitting.

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Move from lying down to sitting (and vise versa) without hurting your back.

How to move from sitting to lying down without hurting your back.
How to move from sitting to lying down without hurting your back. lurii Sokolov

To go from lying down to sitting.

As I mentioned on the previous page, you'll need the log roll move you just learned for the skill of going from sitting to lying on your back or vice versa.

Lie down on your back. Do the log roll such that you end up on your side. ​ As you move into this side lying position, bend your hips and knees and push yourself up with your arms. 

As with the log roll, remember to keep your trunk stiff, especially from the pelvis to the rib cage. In other words, don't allow your spine to twist and bend as you roll. Instead, let the flexion in your knees and (especially) your hips take the force. Keep the spine supported but relaxed.

To go from sitting to lying down.

Use your legs and arms to take weight and help you support your weight. If need be, place your arms in front of your body and use as a support as you lower your body down. When you get to side lying, your hip and knee joints should be bent to almost 90 degrees (i.e., they make right angles).

From the side lying position, use your log rolling skills to take yourself onto your back (or front).

Source

Kinser, C., Colby, L.A., Therapeutic Exercise: Foundations and Techniques. 4th Edition. F.A. Davis Company. Philadelphia, PA. 2002.

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