The movements belonging to this group all give work to the extensors of the hip; but they are classed with the trunk movements, because the trunk is the part of the body moved.

Their common effects are : -

(a) Exercise and development of the extensors of the hip and back.

(b) Diminished supply of blood in (i.e., depleting from) the abdominal and pelvic organs.

(c) Most of them also aid respiration, through the alternate stoop and upright position of the trunk (see further Trunk-falling-forw. and -raising).

According to the muscle action they are divided into two large groups: -

(A) Exercises with static work for the back muscles.

(B) Exercises with chiefly concert tric work for the back muscles.

A. Exercises with Static Work for the Back Muscles. (Back is held straight throughout.)

Here belong all movements done in Stoop-standing, Stoop-sitting, or Leg-forward-lying starting position.

Wing-fall-standing Neck-rest-fall-standing Stretch-fall-standing

Raising (Fig. 96).

Two gymnasts, standing behind the patient, lay their outer hands in front of his shoulders; the inner ones are placed so that the hands support the back of the head and the forearms the upper part of the back. The patient now falls back to fall position, when the gymnasts raise him again while he gives slight resistance. Repeated four to six times. (N.B. - Patient's heels must not leave the ground while coming up.)

In Neck-rest-fall-standing Raising the outer hands of the gymnast grasp the patient's elbows.

In Stretch-fall-standing Raising they grasp the wrists.

The movement takes place in the ankle joints and the calf muscles work eccentrically and to some extent concentrically, but it is described here because its effects are due to the work of the extensors of the neck, trunk, and hip, which keep the body in a straight line.

Used as a gentle back exercise.

Wing-standing Neck-rest-standing Stretch-stan ding

Trunk-failing-forward and -raising.

Free exercise. The patient lets the trunk fall forward in the hip joints as far as he can, without bending the spinal column, then raises himself and bends the back somewhat backward, so that slight "Arch position" arises. Repeated three to five times in time with breathing. Expiration while falling forward, inspiration while raising.

The working muscles are: -

(a) Extensors of the hip joint (eccentrically and concentrically).

(b) Extensors of the back statically, but also concentrically at the end of raising. Also the abdominal muscles work, as long as the line of gravity for the head and trunk falls behind the joints of the spine.

Effects And Uses

Beside the effects common to all back exercises, this movement specially helps expiration as well as inspiration. Expiration is assisted because in bending forward the abdominal cavity is compressed, so that the viscera are pressed up against the diaphragm; inspiration is assisted by the strong extension of the dorsal part of the spinal column and by the enlargement of the abdomen in raising.

By the alternate lengthening and shortening of the blood vessels in the abdomen, and by the alterations of pressure (increased in forward flexion, diminished in extension), the portal circulation is also assisted.

This movement can also be combined with Trunk-brnding-for-ward-downward. The back muscles then work eccentrically and concentrically, and the abdominal muscles are brought into action (concentrically) at the end of the forward bending. The effect of the movement is then in every way stronger. Used mostly as a between exercise.

Fig. 96.

Wing-high-ride-sitting

Neck-rest-high-ride-sitting

Stretch-high-ride-sitting

Trunk-bending-backward.

Usually two gymnasts, whose position and grasp is the same as in Fall-standing Raising. The patient bends the trunk backward in the hip joint against the resistance of the gymnast, and resists when the gymnast again raises him to the starting position. May also be given by one gymnast who then places himself back to back with the patient (Fig. 97). (N.B. - There must be no gliding against each other during the exercise.) The working muscles are: -

Fig. 97.

Fig. 98.

(a) Extensors of the hip, especially the Glutei (concentrically and eccentrically).

(b) Extensors of the neck and back (statically).

Effects And Uses

Principally as the preceding exercise, but it can be moderated at will, and is more comfortable for the patient.

Yard-stoop-stride-sitting Yard-stoop-lean-standing

Back-raising (Fig. 98).

Two gymnasts, one on each side standing behind the patient, grasp his wrists with their outer hands and lay their inner hands on his back between the upper part of the shoulder blades, one hand on the other. The patient raises himself with straight back and the arms in good yard position, while the gymnasts resist both at the wrist and in the back. The raising is finished by the gymnasts drawing the patient's arms backward, while pressing slightly in the back, so that the front of the chest is expanded. The patient then resists slightly while they push him down again to the starting position. Repeated four to six times, and concluded with the stretching described above.

The working muscles are chiefly the same as in the preceding exercise, but the back shoulder muscles must also work strongly to fix the position of the arms.

Has a strongly depleting effect on the abdominal and pelvic organs. Used especially in treatment of kyphosis combined with round shoulders.

Wing-leg-forward-lying Wing-arch-leg-forward-lying Holding.

After taking up the starting position, and after careful correction, the patient holds himself for a time in the position, then lowers the trunk and relaxes the muscles for a minute to rest, and takes the position again. Repeated two to three times.