Half-lying Stretch-grasp-arch-half-crook-standing

Leg-rolling.

Half-lying Leg-rolling (Fig. 71). - Is a passive movement. The gymnast stands in stride-standing position, obliquely in front of the patient, and grasps the sole of the foot with one hand (on the inner side), the other hand under the knee or just below. The knee is carried in as large circles as possible (really semi-circles) upward, outward and downward, while the foot goes straight forward and backward in the sagittal and horizontal plane about the level of the support.

In carrying upward one must avoid letting the knee go over the middle line, and at least with women patients the movement is given only in one direction, as described above, to avoid irritation of the genital organs (Brandt). Repeated ten to twelve times.

Sometimes given with vigorous upward swinging of the knee towards the axilla (avoid pushing against the breast), so that the thigh each time exercises pressure on the abdominal wall. In this way it helps peristalsis.

If it is used for stiffness in the hip joint the knee is made to describe small circles in and around the largest circle which can be made. The movement is then practised in both directions.

Fig. 71.

Effects And Uses

Besides the special effects spoken of above, leg-rolling aids circulation in the veins of the leg, and has a strongly repleting effect on the pelvis (Brandt). This last is important to remember, as the movement is largely used in general gymnastic treatment, and may easily cause inconvenience to women patients with a tendency to profuse menstruation.

Stretch-Grasp-Arch-Half-Crook-Standing Leg - Rolling

Given by two gymnasts standing one on each side of the patient, on whose sacrum they each lay a hand, whilst they grasp his knee with the other. The leg is carried in circles in the same way as in the preceding. The foot hangs down loosely. Repeated eight to ten times, first with one, then with the other leg. Usually finished by single knee adduction concentrically and eccentrically and knee-updrawing and -downpressing in the same position.

Used by Thure Brandt as a strongly repleting movement to the pelvis.

Arm Movements.

Besides the general effects of active movements, arm movements as a rule deplete the internal organs. Many of them directly aid respiration, and consequently circulation. Most movements in the shoulder joints also develop the thorax and correct the position of the shoulders. If they are given with strong resistance, as a rule they somewhat impede respiration, because the thorax is contracted to give the working muscles firm origin.

Movements in the Finger Joints.

Sitting (or Half-lying) Finger-bending And -Stretching (Fig. 72). - The patient's elbow is supported on the gymnast's knee, or on a high plinth or other suitable apparatus. The gymnast fixes the patient's wrist with one hand and with the other gives resistance to the movement, while the patient alternately bends and stretches the fingers. (N.B. - In flexion the last phalanx must be bent first; in extension the first phalanx must be extended first. Repeated six to eight times.)

Fig. 72.

If not otherwise stated, the movement is always done as described, i.e., so that the muscles only work concentrically. Also given passively.

The working muscles are : -

(a) Interossei and Lumbricales.

(b) The flexors and extensors of the fingers on the forearm.

Effects And Uses

(a) Supply of blood, metabolism, and production of heat in the forearm and hand increased, so that the movement is used for cold hands and after massage of the hand or forearm.

(b) Innervation to muscles of fingers is exercised. Used, therefore, in treatment of writer's cramp and similar trade neuroses and other disturbances of innervation.

(c) Loosens the joints, and on this account is largely used in after-treatment of fractures of forearm, teno-synovitis, joint diseases, etc.

Standing Sitting

Finger-stretching.

Free Movement. While the fingers are alternately stretched and bent they are at the same time separated and closed.

Takes places in the same joints as the preceding; almost the same muscles work; effects and uses similar.

Sitting Half-lying

Finger-rolling.

Passive Movement. The gymnast fixes the patient's metacarpal bones (not the thumb) with one hand, and with the other grasps the four fingers, which are rolled (circumducted) in both directions in the metacarpophalangeal joints.

Used for stiffness in the fingers.

Movements of Thumb.

Flexion-extension, Abduction-adduction, Opposition, and Rolling are specially given.

Movements in Wrist Joint.

Sitting Half-lying

Wrist-bending and -stretching (Fig. 73).

The patient's forearm is supported on the gymnast's knee, on a plinth, or in some other way.

Fig. 73.

The gymnast fixes the patient's forearm with one hand immediately above the wrist, and with the other grasps the hand at the metacarpophalangeal joints, and gives resistance to the movement, while the patient alternately bends and stretches the hand. Repeated four to six times.

The working muscles are: - For palmar flexion (= bending), most of the muscles on the front of the forearm (concentrically); for dorsal flexion (= stretching), most muscles on the back of the forearm. Effects and Uses. - Like those of Finger-bending and -stretching.

Sitting Radial And Ulnar Flexion(Ab- And Adduction)

The position and grasp are similar to the preceding exercises. The patient bends the hand alternately towards the radial and ulnar sides against the resistance of the gymnast.

The working muscles are: -

For abduction, Flex. Carpi. Rad. and Ext. Carpi Rad.; for adduction, Flex. Carpi Uln. and Ext. Carpi Uln. Effects and Uses. - Like the preceding. Sitting Wrist-rolling (Fig. 74). - Passive movement. Position and grasp as in Wrist-bending-stretching. The gymnast rolls (circumducts) the patient's hand in as large circles as possible both ways. Repeated ten to twenty times. Can be done actively. Effects and Uses (like all rollings). - (a) Aids circulation. (b) Loosens joints.

Movements in Radio-Ulnar Joints.

Sitting Forearm-rotation (Fig. 75). - (Inward = pronation, outward = supination.)

The patient's elbow is bent to a right angle and supported. The gymnast grasps the patient's hand, and with the other hand presses the elbow against the supporting surface to give steadiness to the movement. The patient rotates the forearm alternately outward and inward against the resistance of the gymnast. Wrist kept well extended. Repeated four to six times.

Fig. 74.

Fig. 75.

The working muscles are: -

For pronation, Pron. Teres and Pron. Quad. (concentrically); for supination, Supin. Brevis and Biceps, and a little at the beginning of the movement Brachio-radialis (Supin. Longus) (concentrically).

No special effect besides exercise of muscles and joints.

Movements in the Elbow Joint.

Sitting Forearm-bending and -stretching (Fig. 76). - One of the gymnast's hands grasps and supports the patient's elbow, the other resists at the wrist, whilst the patient alternately bends and stretches the elbow joint. Resistance may also be given at the middle of the hand, in which case the flexors and extensors of the wrist also take part in the movement (statically to fix wrist). Repeated four to six times.

The working muscles are : -

In flexion, Biceps, Brachialis In-ternus (Anticus), and Brachio-radialis (Supin. Longus); in extension, Triceps.

Effects And Uses

No special effect, except exercise of muscles and joints. It is used in general gymnastic treatment as an easy arm exercise and after massage of elbow or arm.

Used often as a passive movement to increase mobility in the elbow joint.

Back-Lean-Standing 2 (Double) Forearm-Bending And -Stretching

The gymnast stands in front of the patient and resists at the wrist. The patient holds the arms close to the body.

Movements in the Joints of the Shoulder Girdle.

Movements in these joints are very seldom isolated from each other, but usually take place at the same time in all three joints (humero-scapular, aeromio-clavicular, and sterno-clavicular), but for convenience and clearness the various exercises following are referred to the joint in which they chiefly take place.