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WHAT IS RANGE OF MOTION?Range of motion (ROM) means the amount of movement you have at each joint. Every joint in the body has a "normal" range of motion. Joints stay loose by being moved. If you have a spinal cord injury and can't move your arms and legs, your joints can become stilf and hard to bend. A therapist can help you with your ROM exercises.
WHY IS GOOD RANGE OF MOTION IMPORTANT?
It is very important to move all your joints every day so they stay loose. Stiff joints can cause pain and permanent deformities. Stiff joints can also make it hard for you to do your normal daily activities. For example, if your knees and hips become st iff, it will be hard for you to dress yourself and to sit in a wheelchair.
WHAT THINGS CAN YOU DO TO KEEP GOOD ROM?
Your physical and occupational therapists will teach you any exercises you should do to keep good range of motion. Some patients may need splints to keep the muscles around their joints stretched. Your therapist will give you a splint if needed.
LOWER EXTREMITY PASSIVE RANGE OF MOTION EXERCISES
These exercises show someone else how to stretch your legs if you are unable to do this yourself. These exercises should be done slowly and gently. Each exercise should be done ten times on each leg.
The following exercises are done while you are Iying on your back.
Hip and Knee Flexion and Extension
One hand is placed under your knee and the other hand is placed under your heel. The knee is bent toward your chest with the kneecap pointed toward the ceiling. The leg is then lowered to the starting position.
Hip Internal and External Rotation
Again, your knee is bent halfway to the chest so that there is a ninety degree angle at the hip and knee. One hand is placed on top of your knee and the other hand is placed under your heel. Your foot will then be pulled toward the person exercising you and then pushed away.
Hip Abduction and Adduction
One hand is placed under your knee and the other hand is placed under your heel. Keeping your knee straight, your whole leg will be pulled toward the person exercising, you with your kneecap pointed toward the ceiling. Your leg will then be brought back t o your other leg.
Hamstring Stretching, or Straight Leg Raises
Method # 1
The person exercising you will kneel between your legs and will support your ankle with their arm or shoulder. Your knee will be straight. One or both hands will be placed just above your knee. If one hand is used, the other hand will be placed on the th igh of your other leg to keep it on the bed. If both hands are used, the person's knee may rest lightly on your other thigh.
Method #2
One hand is placed under your knee and the other hand is placed under your heel. With your knee straight and your kneecap pointed toward the ceiling, your whole leg will be raised toward the ceiling. When your raised knee begins to bend slightly, the han d under your knee should be moved to the top of your knee.
Heelcord Stretching
One hand cups the inside of your heel and the forearlll is placed against the ball of your foot. The hand will pull down toward the foot of the bed and the forearm will press on the ball of your foot, bending your foot toward your knee.
Foot Inversion and Eversion
One hand holds your foot near your heel and the other hand holds your lower leg near your ankle. Your foot is moved from side to side.
Toe Flexion and Extension
One hand stabilizes the foot just below the toes. The other gently moves each or all toes forward and backward.
Hip Extension
This exercise is done while you are Iying on your side. The person exercising, you will be behind you. One hand is placed under your knee with your lower leg resting, on the person's forearm. The other hand will hold your pelvis in place. Your leg, will b e pulled backwards toward the person exercising, you.
SELF-STRETCHING
What are some important points to remember
- Never use torce whell stretching,. All that is required is enoug force to allow the muscle to stretch.
- Hold the position still, instead of bouncing,, especially if you have spasms. This allows your muscle to relax and stretch.
- A good time to do your stretching program is in the morning, or in the evening, as you do your skin inspection.
SELF RANGE OF MOTION FOR QUADRIPLEGICS
Do these exercises leaning against the head board of the bed, leaning, against a piece of furniture that will not move or sitting in your wheelchair.
- Hook your lelt wrist under the left knee. Pull Ieft knee toward the chest. Hold for a count of 10. Repeat 5 times.
- Sit with left knee bent toward chest. Use left wrist and forearm to push the outside of the left knee towards the right leg. Do not force. Hold for a count of I 0. Repeat 5 times.
- Sit with left knee bent up. Slowly lower it out to the side towards the flat/bed. Use left wrist and forearm to push gently down against the inside of the left knee. Do not force. Hold for a count of 10. Repeat 5 times.
- Facing, a bed or chair place one leg straight out on the bed/chair and hold the knee straight. Do not lean forward as this will stretch you too much. Hold for 3-5 minutes on each leg.
- Sit with legs stretched out in front; lean forward. You may use your elbows or hands to keep knees straight. Loop strap around the bottom of your foot. Pull towards you stretching the foot without turning to either side. Hold for a count of 5. Repeat 10 times.
UPPER EXTREMITY PASSIVE RANGE OF MOTlON EXERCISES
These exercises teach someone else how to stretch your arnls if you are unable to move your arms by yourself. These exercises should be done slowly and gently, and can be done with the person sitting in a chair or Iying down.
Do each exercise ten times.
Shoulder Flexion
Place one hand on the shoulder. Turn the person's palm inward and let the lift over the head.
Shoulder Abduction
Place one hand on the shoulder. Use the other hand to turn the palm outward. Then, bring the person's arm out to the side as high as it will go.
Shoulder Internal and External Rotation
Place one hand on shoulder. Hold under forearm with your other hand. Bring arm out to side to shoulder level. Turn arm so that hand points to ceiling. Then turn arm back down so that hand points to floor.
Elbow Flexion and Extension
Hold upper arm with one hand and forearm with the other hand. Bend arm at elbow so that hand touches shoulder, then straighten arm all the way out.
Forearm Supination and Pronation
Hold under the elbow with one hand. hold at wrist with the other hand. Turn palm of hand so it faces up to the ceiling, and then down to the floor.
Wrist Flexion and Extension
Hold forearm above the wrist. Hold hand and bend it up at the wrist, then down at the wrist.
Finger Flexion and Extension
Place hand palm down to make a fist. While bringing wrist up, bend fingers. Then straighten out the fingers as you bend the wrist down.
Thumb
Bend and straighten thumb. Stretch thumb out to side to stretch "web space'