Standing Fundamental Position

Standing Fundamental Position (Fig. 33). - In taking this position -

1. The heels must be together in the same frontal plane (in cases of knock-knee this is not possible).

2. The. feet must form a right angle with each other. In Denmark and elsewhere the angle is given as about 70°.

3. The knees must be fully extended, or even somewhat hyper-extended.

4. The trunk must be held erect, with shoulders lowered and drawn back.

5. The head must be kept erect, with chin slightly drawn in. Eyes to the front.

6. The arms must be held close to the sides, with slightly extended elbow, wrist and finger joints, and the palms against the thighs.

The correct position is most easily taken if one attempts to raise the crown of the head as much as possible while the shoulders at the same time are lowered and drawn back.

The principal working muscles for taking and maintaining this position are : -

(a) The posterior neck muscles, because the line of gravity for the head falls in front of the cervical spine.

(b) Back muscles, because the line of gravity for the head and trunk combined falls in front of the spine.

(c) The posterior shoulder muscles (Trapezius, Lat. Dorsi, Rhomboids), to hold the shoulders down and back.

Besides these, for the balancing of the body in the joints of the spine, hips and ankles, first one and then the other of the muscles passing over these joints must work incessantly.

The line of gravity may by a slight forward movement of the pelvis be put behind the frontal axis of the hip joints, so that stretching of the ilio-femoral ligament prevents the trunk falling back and makes a great deal of muscle action unnecessary; but in a correct position this does not occur.

The knee joints are, on the other hand, so well fixed by hyper-extension and by tension of the ligaments and capsule at the back that their muscles practically need not work.

So far as the ankle joints are concerned, theoretically they ought also to be sufficiently fixed, because they are ginglymus joints, and because their axes are not parallel but form an angle of 70° to 90° with each other, but on account of the gliding in them the help of the leg muscles is necessary for balancing the body.

Fig. 33.

Effects And Uses

1. The chest is expanded (the shoulders being drawn back and the spine extended).

2. The internal organs have ample space, so that they are not hampered in their functions by undue pressure.

3. Deportment is improved.

4. The position is not steady, partly because the base is small (made by the lines drawn along the outer borders of the feet and between the big toes), partly because the centre of gravity lies so high above the base (centre of gravity lies between third and fourth sacral vertebrae).

It is used as starting position for a number of free-standing exercises. Its greatest importance, however, lies in the fact that a large number of positions are derived from it, so that a fault in the fundamental position makes all the derived positions faulty.

Knee-standing Fundamental Position

Knee-standing Fundamental Position (Fig. 34). - If this position is taken on a plinth, the feet should lie just beyond the edge, with the dorsum touching the plinth. The knees should be together, and the position of the body otherwise the same as in the preceding position.

If the position is taken on the floor, the ankle joints should preferably be plantar flexed, but may be dorsal flexed.

The working muscles are chiefly the same as in standing fundamental position, but the muscles of the knee joint, especially Quadriceps Femoris, must take rather a greater share in balancing the body.

Effects And Uses

1. Gives more support than the preceding position because: -

(a) The base is larger;

(b) The centre of gravity is nearer the base;

(c) The unsteadiness caused by the gliding of the joints becomes less, since the joints of the foot are excluded.

2. The pelvis is fixed, because the origin and insertion of Rectus Femoris are further apart, so that the muscle is more on the stretch.

On this account this position is used, or some position derived from it, as starting position in many trunk exercises, in order to give the working muscles a firm origin, e.g., Knee-stride-standing Alternate Trunk-rotation.

Fig. 34.

3. Because the muscles of the feet and leg do not take any share in maintaining the position, the effect of a movement done in this position will be more definite and purer than if done in standing position, because the pure effect of the exercise itself will be less obscured by muscle action necessary for maintenance of the starting position.

Sitting Fundamental Position

Sitting Fundamental Position (Fig. 35). - It is taken on a chair, form, or other similar apparatus In this position the body rests chiefly on the tuberosities of the ischium, but the back of the thighs should also be supported and the feet should rest upon the floor.

The hip, knee, and ankle joints should all form right angles.

The knees should be slightly apart so that the position of the legs is easy. The position of the head, trunk, and arms should be the same as in preceding positions.

The working muscles for maintaining the position are principally the neck, back, and posterior shoulder muscles.

Effects And Uses

1. General steadiness in this position is considerably greater than in the previous positions, because : -

(a) The base is larger;

(b) The centre of gravity lies nearer the base;

(c) Gliding in hip, knee, and ankle joints has no disturbing influence.

2. The pelvis is also firmer, because it rests on the supporting surface.

3. The leg muscles work little, if at all, to maintain the position, so that movements are purer. For all these reasons the sitting fundamental position and its derived positions are much used in medical gymnastics.

Lying Fundamental Position

Lying Fundamental Position (Fig. 36). - The body lies stretched out upon a horizontal surface, arms to the sides, muscles relaxed.

There is actually no real muscle work necessary for maintaining this position. It is steady and does not disturb the effects of movements and massage.

Is Used

(a) For weak patients.

(b) For small children, because they often do not understand how to maintain other starting positions.

(c) Frequently for massage.

Fig. 35.

Hanging Fundamental Position

Hanging Fundamental Position (Fig. 37). - Taken on a horizontal boom, bar, trapeze, or similar apparatus, usually placed so high as to prevent the patient's feet touching the floor.

The hands, usually pronated (= over-grasp, if they are supinated the grasp is undergrasp), grasp the apparatus at a distance from each other not less than shoulders-breadth. The arms straight, and carriage of the body otherwise similar to standing position, except that the head is carried slightly back. The body must not hang slack like a sack of flour, but the muscles of the arms and shoulders, especially at the back, must work to avoid too strong stretching of ligaments and capsules, and to prevent sinking together of the shoulders and a contracted position. The working muscles are : -

1. Flexors of fingers, to fix the body to the apparatus.

2. Most of the arm muscles, i.e., muscles which go from forearm to hand, from arm to forearm, and from shoulder girdle to arm.

3. Most of the muscles going from the trunk to the shoulder girdle and arm.

Effects And Uses

(a) Produces a passive stretching of the spine and its ligaments, especially in the lower part, and is therefore used in treating spinal curvatures.

(b) Raises the ribs by stretching the shoulder muscles, and is therefore used in the treatment of flat chest.

(c) Because the weight of the lower part of the body draws down the ribs, these are fixed, so that respiration, and consequently circulation, are impeded. On this account this position must not be used for weak patients, nor for those who suffer from heart or lung complaints.

Fig. 36.

Fig. 37.