Reach-standing

7. Reach-standing. - Arises from the fundamental position by bringing the arms forward to the horizontal plane. The shoulders are lowered and drawn back; they must not be raised or pushed forward. The elbow, hand and finger joints are extended, the fingers closed; hands the width of the shoulders apart, palms facing each other.

The working muscles are: -

(a) Coraco-brachialis and the anterior fibres of Deltoid; act on the humero-scapular joint.

(b) Trapezius and Serratus Magnus; act on the sterno- and acromioclavicular joints.

This position compresses the thorax slightly, because the weight of the arms tends to rotate the scapulae backwards and inwards; this is prevented by Serratus Magnus, thus causing a dragging backward and downward of the costal origin of Serratus, so that the ribs are lowered.

That the same effect is not present in Yard, Forward-bend, and Heave-standing positions depends upon the fact that the lowering of the ribs is counteracted by stretching of the Pectorals.

Reach-grasp-standing

8. Reach-grasp-standing ("against") (Fig. 43). - Like the above position, but the hands rest against or catch hold of some apparatus, boom, rib, etc.

Effects And Uses

It fixes the body, especially the shoulders and trunk, and is therefore used in Head-rolling, Back-raising, Neck-raising, and many other exercises where the position is otherwise hard to maintain; also in Heel-raising Knee-bending, so that the muscles of the arms may help to make the movement easier (for weak patients and beginners); and, lastly, in the early practice of balance movements and positions, e.g., Crook-half-standing position and others.

Fig. 42.

Neck-firm, or Neck-rest-standing

9. Neck-firm, or Neck-rest-standing (Fig. 44). - Taken by carrying the hands up to the back of the neck, against which the fingers rest, with the tips touching or slightly interlocking. The elbows well back, hands and finger joints well stretched, head high.

The working muscles are : - (a) Same as in Heave-standing, but the flexors of the elbow as well as Trapezius and Serratus Magnus are more contracted.

(b) The posterior shoulder muscles must also work strongly to counteract the tendency of the elbows to be drawn forward by the increased stretching of the Pectorals.

(c) Similarly the neck muscles, and those muscles which go from the upper part of the back to the neck and occiput, must increase their action in order to prevent forward bending of the head by the tense inward rotators of the arm.

Effects And Uses

(a) The thorax is more strongly expanded than in the preceding positions.

(b) The centre of gravity for the body is raised, so that trunk movements are made more difficult.

(c) The upper back muscles are strengthened and developed, so that the position of the head is improved.

(d) Used in trunk movements, the position gives the operator along lever for resisting, and in this way makes the exercise more difficult.

Fig. 43.

Fig. 44.

(e) The sides of the thorax are more easily got at for treatment by hacking, clapping, etc.

(f) If the position is taken with one arm only it produces a raising of the shoulder on the same side, for which reason it is used in treatment of scoliosis.

Head-rest, or Forehead-rest

10. Head-rest, or Forehead-rest (firm). - Taken by carrying the hands up and resting them on the crown of the head or the forehead.

The working muscles and the effects and uses are practically the same as in the preceding position, but, because the elbows are not so strongly carried back and the upper arms are rotated less out, the muscle action, both for taking the position and keeping it, is considerably less. It is therefore used for beginners and weak patients instead of neck-rest position.

Stretch - standing

11. Stretch - standing (Fig. 45). - Arises when the arms from bend, reach, or yard position are carried up to vertical position. Elbow, wrist, and finger joints extended. Distance between the hands equal to or rather greater than shoulders-width, palms facing each other, fingers closed. (N.B. - Position of the trunk must not be altered.)

Beginners and people with stiff shoulder joints have a tendency to help the complete stretching to vertical positron by bending backward in the joints of the vertebrae.

The chief working muscles are: -

Deltoid, Trapezius, and Serratus Magnus, but all the shoulder muscles are of course more or less brought into action.

Effects And Uses

(a) The thorax is expanded more than in all the previous positions; the four lowest ribs especially are raised by stretching the digitations of Latissimus Dorsi, which arc attached to them.

(b) The centre of gravity of the body is raised, making trunk movements more difficult.

(c) The operator has a long lever, and at the same time the shoulder muscles are forced into strong action to maintain the position of the arms, so that the movement is made more difficult, e.g., in Stretch-stride-standing Alternate-side-bending.

Half-stretch-standing

12. Half-stretch-standing. - Is taken by stretching only one arm. If the extension is made as complete as possible, the longitudinal muscles of the upper part of the back on the opposite side take part also in the movement.

Fig. 45.

Used partly to give the operator a long leverage, partly in the treatment of scoliosis to raise a low shoulder and to exercise and strengthen the muscles on the convex side. The arm on the opposite side to the convexity of the curve is upward stretched.

Crutch-standing

13. Crutch-standing (Fig. 46). - Taken by laying one arm over a boom at the level of the axilla, when the arm is pressed in towards the side and fixes the body.

It is used to fix the body, especially the shoulder, in Head Side-bending.

Grasp Positions

14. Grasp Positions (Yard-, Heave-, Reach-, and Stretch-grasp-standing). - Arise from the respective positions by grasping some suitable apparatus, such as the boom, wall-bars, poles, etc.

Effects And Uses

The shoulders and upper part of body are fixed, so that: -

(a) Certain movements are made easier, because the working muscles are given a firm origin, e.g., in Stretch-grasp-standing Knee-updrawing and -downpressing, Heave-grasp-close-standing Alternate Hip-rotation.

(b) Maintenance of the position is made possible in certain passive movements, e.g., Stretch-grasp-standing Forward-drawing, Heave-grasp-standing Chest-expansion.