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TRANSCRIPT
MontroseAccess DMD – A Team Approach to Management 163
Passive self-stretch for tendo achilles on standing Board
Position • Positionstandingboardagainstwall• Childstandsonboardrestingbackagainstwall• Feetpointstraightahead(orslightlypigeontoed)
stretch• Childpositionsheelsasfarbackonboardaspossible• Keepkneesstraight• Keepheelsdown• Stretchisfeltatbackofbothcalves
Duration
special instructions
164 MontroseAccess DMD—A Team Approach to Management
Manual achilles tendon stretch
Position• Childlyingonback• Placesmallrolledtowelunderthekneeofthelegbeingstretched• Cupheelinhand• Restsoleoffootonforearm• Stabiliseabovethekneewiththeotherhand
stretch• Pulldownfirmlyontheheelwhilepushingtheballofthefootup.Keepkneestraight• Stretchisfeltincalf
Hold seconds
Repeat times
special instructions Ifresistancetostretchisfelt,bendtheknee,stretchtheanklethenstraightenthekneewhilemaintainingtheanklestretch.Placesupportunderthekneetopreventhyperextension.
MontroseAccess DMD – A Team Approach to Management 165
Passive sitting haMstring stretch Position
Position• Asinphotograph• Kneeshouldbeasstraightaspossibleandlegslightlyouttotheside• Lowerspinestraight• Sitwithhipswellbackagainstthewall
stretch • Stretchisincreasedbyleaningforwards• Stretchisfeltatbackofstraightthigh
Duration
Repeat other side
special instructions
166 MontroseAccess DMD—A Team Approach to Management
Passive self-stretch for haMstrings
Position • Childliesonbackindoorwayorbesidepost• Placelegtobestretchedonthewallwithkneeslightlybentandbottomclosetothewall• Keepotherlegstraight
stretch•Straightenthekneeuntilstretchisfeltinbackofthigh
Hold seconds
Repeat times
special instructions
MontroseAccess DMD – A Team Approach to Management 167
Manual haMstring stretch
Position • Childliesonback• Placeankleonshoulder(asinphotograph)• Stabilisetheoppositelegwithotherhand• Keepkneeofmovinglegstraightwithhand
stretch• Rockforwardusingthismovementtoperformthehamstringstretch• Stretchisfeltatbackofupperthigh
Hold seconds
Repeat times
special instructions
168 MontroseAccess DMD—A Team Approach to Management
hiP flexor stretch (Plus iliotiBial tract)
Position • Childliesflatontummy• Cupbentkneeinhand• Anklerestsonelboworupperarm• Placeotherhandonbottom
stretch • Pullkneeupand towardstheotherlegwhileapplyingdownwardpressureonthebottom• Stretchisfeltingroinandoutsideofhip
Duration
repeat on other side
special instructions
MontroseAccess DMD – A Team Approach to Management 169
iliotiBial tract (Manual stretch in Prone)
Position • Childliesontummy• Grasplegtobestretchedatknee• Stabiliseandkeeppelvisandtrunkflatwithkneeandhand
stretch • Liftlegup• Pulllegacrosstowardsotherleg• Applypressureonbuttockstokeeppelvisflat• Stretchisfeltdownouterthigh
Hold seconds
Repeat times
special instructions
170 MontroseAccess DMD—A Team Approach to Management
iliotiBial tract (Manual stretch in side lying)
Position • Childliesonsidewithlowerlegbent• Legtobestretcheduppermostwithkneestraight• Stabilisepelviswithhandandknee
stretch • Takelegbackwardsasfaraspossible• Applyfirmdownwardpressureattheknee• Stretchisfeltdownouterthigh
Hold seconds
Repeat times
special instructions
MontroseAccess DMD – A Team Approach to Management 171
hiP flexor stretch in side lying
Position • Childliesonsidewithunderneathlegbent• Holdasinphotograph• Lowerhandcupsknee• Otherhandappliespressureonuppermostbuttock• Stabilisepelviswithknee.
stretch • Movetoplegbackwardsuntilstretchisfeltingroin
Hold seconds
Repeat times
special instructions
172 MontroseAccess DMD—A Team Approach to Management
hiP flexors on Back
Position • Childliesonback• Stabilisethelumbarspinebyholdingnon-movinglegbentuponchest
stretch • Pushdownonlegtobestretchedwhileholdingotherkneeinbentposition(asinphotograph)• Stretchisfeltingroin
Hold seconds
Repeat times
special instructions
MontroseAccess DMD – A Team Approach to Management 173
elBow stretch
Position • Childliesonbackorsitsonchair• Withpalmfacingupwards• Onehandsupportsshoulderjointorupperarm• Holdabovewristwithotherhand
stretch • Straightenelbowasfaraspossible,untilstretchisfeltinfrontofelbow
Hold seconds
Repeat times
special instructions
174 MontroseAccess DMD—A Team Approach to Management
forearM stretch (Pronators)
Position • Holdchild’shandasinphotograph• Stabilisethewrist• Stabiliseattheelbow
stretch• Slowlyturnhandto‘palmup’positionuntilstretchisfelt
Hold seconds
Repeat times
special instructions
MontroseAccess DMD – A Team Approach to Management 175
long finger flexors
Position• Withelbowasstraightaspossible• Supportthechild’spalm,maintainingstraightfingers• Keepthumbouttotheside• Supportthewrist
stretch • Slowlybendthewristandhandbackuntilastretchisfeltintheforearm
Hold seconds
Repeat times
special instructions
176 MontroseAccess DMD—A Team Approach to Management
tiBialis Posterior stretch
Position• Boyliesonback
• Operatorgraspsfootfirmlyaroundtheheadof1stMetatarsal
• Providecounterpressureonthelateralaspectofheel
• Pullfootintoeversionanddorsiflexion
Hold seconds
Repeat times
special instructions