Top Active Range of Motion Exercises for Upper and Lower Body

Have you heard of someone complaining of tired legs, aching ankles or stiffness, while getting out of bed? These are all common symptoms of past injuries or aging. Decreased movement at a joint can cause many problems, ranging from functional disability to psychological fears. Active ranges of motion (AROM) exercises are done by the individual, by using their own muscle strength and power, without external help. These exercises are prescribed by a trained physiotherapist who helps to increase joint flexibility, and overall functionality. In this blog, we have mentioned the benefits of doing active range of motion exercises, and a few easy-to-do range of motion exercises are given below.

 

Benefits

There are many benefits of doing AROM exercises if the movement is decreased at a joint. Some of them are:

• Increases joint range of motion
• Increases the functionality
• Improves and maintains joint integrity
• Improves movement efficiency
• Increases  independence

 

Upper Body Exercises:

Starting position:

• Sit or stand in a comfortable position.
• Face forward. 
• Shoulders should be straight and relaxed.

 

Head forward and backward movement:

·    Gently bend the head and try to touch the chin to the chest.  Raise the chin back to the starting position. Tilt the head backward and look up towards the ceiling and return to the starting position.

 

Head side to side movement:

·    Tilt the head to the side, by bringing the ear towards the shoulder. Do not raise the shoulder towards the ear, return to the starting position.

 

Head turns:

·    Turn the head to look over at the shoulder. Tilt the chin down and try to touch the shoulder without raising the shoulder to the chin, return to the starting position.

 

Shoulder and elbow exercises:

Starting position:

• Stand or sit on a chair without the arms.
• Hold the arms straight down by the side
• Palms facing towards the body.

 

Shoulder up and down movement:

·    Raise the arm forward and then up over the head, such that the inner arm touches the ear. Bring the arm down to the side. Bring it back as far as possible behind the body, return to the starting position.

 

Shoulder side to side movement:

·    Raise the arm by the side and then up over the head as far as possible. Return the arm to the side. Bring the arm across the front of the body and reach for the opposite shoulder, return to the starting position.

 

Shoulder rotation:

·    Raise both shoulders up toward the ears. Bring them back to the starting position, and relax the shoulders. Pull the shoulders back. And relax them again. Roll the shoulders in a smooth circular motion and then repeat the same in the opposite direction.

 

Elbow bends:

·    With the palm facing forward, bend the elbow. Try to touch the shoulder with the fingertips and return to the starting position.

 

Arm and wrist exercises:

Starting position:

• Sit down.
• Bend the elbow and rest the forearm on a flat surface, such as a table. Make sure the wrist hangs loosely over the side.

 

Wrist bends:

·    Bend the hand back towards the wrist, so that the fingers point toward the ceiling. Then bend the hand down with fingers pointing towards the floor.

 

Wrist rotation:

·    Move the hand from side to side. Then roll the hand in a circular motion in one direction and repeat the same in the other direction.

 

Palm up and down movement:

·    Stay in the same position, but tuck the bent elbow against the side. Face your palm down. Turn the palm so that it faces up towards the ceiling. Then turn the palm so that it faces down.

 

Hand and finger exercises:

Starting position:

• Sit or stand.
• Place the hand out in front.

 

Finger bends:

·    Make a tight fist, open and relax the hand.

 

Finger spreads:

·    Open the hand and stretch the fingers as far apart as possible, bringing them together again.

 

Finger-to-thumb movement:

·    Touch each fingertip to the pad of the thumb, one at a time.

 

Thumb-to-palm movement:

·    Move the thumb and rest it across the palm. Move it out and repeat again.

 

Lower Body Exercises

Hip and knee exercises:

Starting position

·    Lie on the bed with legs extended.

 

Hip and knee bends:

·    Slowly bend the knee up as close to the chest as possible. Straighten the leg and return  to the starting position

 

 Leg lifts:

·     Raise the leg to 300. And hold it in the same position for a few seconds and then return to the bed.

 

Leg side to side movement:

·    Flex the foot with toes pointing up towards the ceiling. Move the leg out to the side as far as possible and return to the starting position.

 

Leg in and out movement:

·    Put the leg extended on the bed. Bring the leg towards the middle, so that the big toe touches the bed. Then roll the leg out and try to make the smallest toe touch the bed.

 

Knee in and out movement:

·    Lie on the back of the bed. Bend the knee so that the bottom of the foot is flat on the bed. Slide the heel towards the buttocks and then return to the starting position.

 

Ankle and foot exercises:

Starting position:

·    Sit in a chair, place your feet on the floor.

 

Ankle bends:

·    Keep the toes on the floor and raise the heel as high as you can. Lower the heel and keep it on the floor and raise the toes as high as you can.

 

Ankle rotation:

·    Raise the foot slightly off the floor. Move the ankle in a circular motion then repeat the same in the other direction.

 

Toe bends:

·    Curl the toes down toward the bottom of the foot. Straighten them. Curl them up toward the ceiling. Then straighten them again.

 

Toe spreads:

·    Spread the toes apart. Bring them together again.

 

Avoid fast or jerky movements, the movements should be smooth and gentle. In case of pain or discomfort while doing the exercises, consult your physiotherapist.

 

Returning to Sports after Back Pain: What role does Physiotherapy play?

Do you suffer from back pain while bending over and standing up? And want to get back to running? Then doing the right kind of exercises without straining your back, can help you relieve your back pain. The exercises can be done under the guidance of a well-trained physiotherapist who recommends a  tailored exercise program depending on the intensity of your pain and its causes. In this blog, we will discuss the steps that should be taken,  to safely return to running when you have back pain.

 

1: Understanding the cause

Understanding the cause is the key to recovery. Your physiotherapist tries to know the cause behind your back pain and does a physical examination to find out the structures that are involved so that it is easy for him/her to plan out the exercises that should be done. A skilled physiotherapist will be able to assess and provide you with a diagnosis and treatment plan.

 

2: Treatment plan

Plenty of different structures like muscles, ligaments, tendons, joints, discs, and nerves can injure your back by different types of injuries like overuse, compression, repetitive movement, etc. The treatment plan includes pain relief, range of motion (PROM and AROM), and strengthening exercises.

 

·    Range of motion exercises

Treatment is started with pain relief modalities like TENS, Ultrasound, Laser, Shockwave, etc followed by passive range of motion and active range of motion exercises done in pain-free ranges to maintain the joint movement. Once these are achieved the therapist starts stretching exercises are started.

 

·    Strengthening exercises:

Strengthening exercises help to improve circulation and increase the strength of the muscles to support your spine. These exercises are set at the correct level for the specific type of injuries so that these exercises do not cause any pain during or after the treatment session. There is an endless list of exercises that can be done, but your physiotherapist chooses the appropriate exercises to strengthen your back.

 

·    Moving:

Movement is encouraged for the back pain sufferers to remain active. For the patient with acute pain, short walks can be recommended. But other options like a long walk, swimming or cycling. While doing these exercises the patient might feel mild discomfort which is normal.

 

3: Time

The healing process takes time as new healthy cells are produced to replace the damaged ones. Strength and flexibility also take several weeks to increase.  An average time taken for healing can be :

• Mild sprain –  5 to 6 weeks
• Severe sprain – 8 weeks or several months
• Mild disc injury –  10 to 12 weeks
• Severe disc injury – This can vary a lot but almost from 6 months to 2 years to get back to full function.
• An injury affecting one of the nerves in the leg – This can vary a lot depending on the type of injury but can take almost from 3 months to 2 years.

 

4: Walk/Run program

Walking or running is a part of the treatment program. Walking and running allow the lower back to slowly get used to the impact forces. Short-run intervals are quite short, which might cause mild discomfort that settles quickly. Whereas long continuous running can cause an intense flare-up that may take several days to settle down.

 

The level of pain does not indicate the severity of the injury. It is often found, once a person starts doing the right things, severe pain settles down to very mild levels. We can usually predict much more effectively how long an injury will take to recover by observing how a person's pain changes within the first 2 weeks of following the treatment advice.

 

Celebrating World Physiotherapy Day 2021: Managing Long COVID Symptoms with Physical Therapy

Individuals who have suffered from COVID-19 can experience prolonged symptoms lasting for weeks to months even after the infection has gone, ultimately resulting in "LONG COVID".  One of the possibilities for LONG COVID is the overdrive of one’s immune system towards the virus resulting in harming one’s own tissues. This usually happens with people having a very strong immune system. Another possibility is the presence of the fragments of the virus in the body, usually in the dormant form, even after the recovery from the deadly infection, thus giving way to ''LONG COVID''. For the recovery from the symptoms and impairments of "Long COVID", multi-disciplinary approach assessment and management is essential.  Rehabilitation for individuals recovered from COVID-19 requires the consultation of a physiotherapist, who makes sure that the exercises are done with care to minimize the risk of overexertion. He also ensures the exercise programs are restorative and do not make an individual's symptoms worse. In this blog, we will discuss the physiotherapist's treatment for "LONG COVID" patients.

 

Symptoms of long COVID:

The severity of symptoms varies and many individuals have been left unable to perform strenuous tasks. The symptoms include fatigue, post-exertional symptom exacerbation (PESE), insomnia, breathlessness, chest pain, heart palpitations, dizziness, muscle and joint pain, depression and anxiety,  earaches, diarrhea, stomach aches, a high temperature, cough, sore throat, changes to sense of smell, or taste, problems with memory, and many more.

 

Physiotherapy treatment:

Assessment:

The physiotherapist carries out a detailed assessment and takes various tests to find the causes of symptoms to plan out a rehabilitation program.

Depending on the symptoms of each individual the physiotherapist designs a tailored rehabilitation program. The therapist uses safe, effective techniques and interventions to enhance the recovery process and increase functionality. During exercising, utmost care is taken to prevent oxygen desaturation, hyperventilation, and breathing pattern disorders.

 

Pacing:

Pacing is a self-management technique of breaking up the activity into smaller tasks, with rest intervals to make the activity less intense, this is to avoid post-exertional symptom exacerbation (PESE). The physiotherapist teaches the individual to monitor the heart rate and advice to do activities with less exertion and not to keep doing until one feels tired which in turn can worsen their symptoms. 

 

Breathing exercises:

While breathing the body has a sufficient supply of oxygen, thus the muscles have more energy stored that increases the lung endurance. Breathing exercises or Chest Physiotherapy steadily increase lung capacity and also increases the lungs' ability to maintain a sufficient supply of oxygen over time.

 

Diaphragmatic breathing:

When the diaphragm is functioning effectively as the primary muscle of inspiration, ventilation is efficient and the oxygen consumption of the muscles is very low during quiet relaxed breathing. Diaphragmatic breathing, help decrease the work of breathing, improves the efficiency of ventilation, increases the excursion of the diaphragm, and improves gas exchange

 

Pursed lip breathing:

Controlled expiration with gentle pursed-lip breathing. This mechanism keeps the airways open by creating backpressure in the airways. Pursed lip breathing increases the tidal volume decreases the respiratory rate and improves exercises tolerance.

 

Incentive Spirometry:

Incentive spirometry is a technique used for maximal inspiration. It is a form of ventilation training that focuses on sustained maximum inspiration. The spirometer provides visual or auditory feedback when the patient inhales and breathes in as deeply as possible

 

Lateral costal expansion:

The lateral costal expansion focuses on the movement of this portion of the lower rib cage (bilaterally or unilaterally) and is thought to facilitate diaphragmatic excursion.

High-intensity exercises are recommended after the symptoms improve to maintain flexibility and endurance e.g. core strengthening exercise, increase the walk time, and increase the activity levels gradually. During activities don't forget to take a rest with no mental stress.