Free-standing

Stretch-half-lying

Stretch-stride-sitting

Stretch-stoop-stride-sitting

Stretch-lying, or stretch-sit-lying

Stretch-leg-forward-lying

2 (double) Arm-bending and -stretching.

Free-st. 2 Arm-bending and -stretching. - Free exercise. Usually the arms are stretched in various directions (forward, upward, outward, backward and downward). Between each stretching the arms are taken to "bend" position.

Fig. 84.

Fig. 85.

Stretch-Half-Lying 2 Arm-Bending-Stretching

The gymnast's position and holding as in 2 Arm-rolling. The patient bends and stretches the arms against the resistance of the gymnast, who at the end of the extension draws strongly upwards without jerking, so that the ribs are raised and the patient compelled to take a deep inspiration. At the end of the downdrawing the gymnast, by suitable pressure on the hands, can press the patient's arms against the sides of the chest, so that expiration becomes more complete. The patient should breathe in during stretching, out during down-drawing. Elbows throughout are carried in the frontal plane. Repeated four to eight times.

Str.-std.-sitting 2 Arm-bending-stretching (Fig. 84). - The gymnast's position and holding as in 2 Arm-rolling. Given as the preceding exercise.

Str.-stp.-std.-sitting 2 Arm-bending-stretching (Fig. 85). - The gymnast stands on a stool in front of the patient. They grasp each other's wrists (the gymnast's hands are supinated, the patient's pronated). It is given like the preceding, except that the stretching upwards is not given so strongly. (N.B. - The patient must not change the stoop position and other holding during the exercise.)

Str.-lying and Str.-sit-lying 2 Arm-bending-stretching. - Given as Str.-std.-sitting 2 Arm-bending and stretching.

Str.-leg-forw.-lying 2 Arm-bending-stretching (Fig. 86). - The gymnast stands in front of the patient. They grasp each other's wrists. Otherwise the exercise is performed in the same way as the exercises already described.

Fig. 86.

The working muscles are: -

For flexion = Arm downdrawing. - (a) Flexors of the elbow = Biceps, Brach. Intern. (Ant.), Brachio-Radialis (Supinator Long.), and those muscles of the forearm which arise from the lowest part of the humerus.

(b) Adductors of the humero-scapular joint = Pect. Maj., Lat. Dorsi, and Teres Major.

(c) Inward rotators of the acromioclavicular joint (or scapula) = Rhomboids.

(d) Muscles which draw the shoulder-blade down (in the sternoclavicular joint) = Pectoralis Minor and lower fibres of Trapezius. All these muscles work concentrically.

(e) Flexors of the fingers work statically to grasp the gymnast's hands.

(f) All the muscles which go from the forearm to the hand work statically to prevent too strong stretching of the ligaments of the wrist.

For Upward Stretching Of The Arms

(a) Extensors of the elbow = Triceps.

(b) Abductors of humero-scapular joint = Deltoid and Supra-spinatus.

(c) Outward rotators of the acromioclavicular joint (scapula) = Serr. Magnus and lower fibres of Trapezius.

(d) Muscles which raise the shoulder (in sterno-clavicular joint) = upper part of Trapezius.

(e) Also the extensors of the back must work statically and on both sides to prevent the spine being bent to either side.

N.B. - Because the elbows are to move in the frontal plane, Lat. Dorsi and the back shoulder muscles must be innervated more strongly than in ordinary stretching and downdrawing of the arms, which helps to improve the carriage of the shoulders.

In this movement nearly all the arm and shoulder muscles are thus brought into action as well as the back muscles.

Effects And Uses

(a) Because of the large number of working muscles the movement is strongly depleting from the internal organs.

(b) It is used in general gymnastic treatment as a good arm exercise.

(C) Aids Both Inspiration And Expiration (For The Effects Of Respiratory Exercises See 2 Arm-Carry

outw.-upw.-outw.-downw.).

(d) Through the stretching of the spine which arises in down-drawing the back is passively stretched, and by the work of the extensors in upstretching it is actively corrected.

On this account the movement is used in the treatment of spinal curvatures, but it must be carefully noticed that the patient really holds the back stretched and straight. Also that patients with severe curves and weak patients only do arm downdrawing and updrawing (concentric and eccentric work for the muscles which draw down the arms).

Contra-indications to the movement are heart disease and severe lung trouble, because a strong expansion of the chest impedes the heart's action, and may also produce severe injury of the lung tissue itself or its surroundings.

The Effects Of The Various Starting Positions

Free-st. - Movement is less strong. Used mostly as a between movement, it is much used as a home exercise and in educational gymnastics.

Str.-half-lying. - Makes the effect pure, is most comfortable and most used, but not in treatment of scoliosis.

Str.-std.-sitting. - Used specially in treatment of scoliosis, because the holding of the back and work of the back muscles can be more easily controlled. It is also used in treatment in the patient's home and where plinths are not obtainable.

Str.-stp.-std.-sitting. - Increases the depleting effect on the internal organs, but does away with its effect as a respiratory exercise.

Str.-lying and Str.-sit-lying. - Used for children : Str.-sit-lying especially when a strong arm -downdrawing is to be given.

Str.-leg-forw.-lying. - Used in treatment of spinal curvature.

(Half-Wg.-half-bend-) stoop-stride-sitting

(Half-Wg.-half-bend-) stoop-leg-lean-standing

Single Arm-upstretching and -downpressing (Fig. 87).

The gymnast stands in front of the patient (on a stool if necessary). They grasp each other's wrists : the patient's free hand in wing position, the gymnast's free hand laid on the upper part of the patient's back. The patient stretches up the arm against the resistance of the gymnast, who presses it down against the resistance of the patient. Repeated four to six times. (N.B. - In order to obtain the greatest possible effect of the exercise the arm must be stretched as high as possible.)

The working muscles are: -

(a) Same muscles as in Arm-upstretching (concentrically and eccentrically).

(b) Extensors of the back, on the opposite side to the stretched arm.

Used in one-sided curvatures in the dorsal region of spine (stretch the arm on the opposite side to the convexity).

Arch-hanging

Fall-hanging

Stretch-hanging

Heaving and Sinking.

From the respective starting position the patient raises himself, with the help of the gymnast if necessary, to "heave position" (see Heave-hanging starting position) and lowers himself slowly.

Fig. 87.

The working muscles are the same as in Arm-downdrawing, but with origin and insertion reversed.

Because the resistance is the weight of the patient's own body, the heaving cannot be moderated in any other way than by the gymnast helping the patient, or by lessening the range of movement.

Effects And Uses

Are chiefly the same as in Hanging and Heave-hanging position. Good active arm exercise in educational gymnastics; corrects carriage of head and shoulders, expands chest, stretches spine, but is hard work and impedes respiration, so can only be used for strong patients.

The Effect Of The Various Starting Positions

Arch-hanging helps to correct kyphosis, and as well as Fall-hanging helps to facilitate the movement because the patient has not to raise his whole body weight. Str.-hanging is the most difficult.