In this post, we go over one of the staples of Mckenzie method treatment for neck pain - the retraction and extension exercise. This, combined with chiropractic and manual therapy, helps resolve many neck problems quickly.
This exercise is prescribed almost exclusively when an injury is unilateral, which means WE ONLY PERFORM THEM GOING IN ONE DIRECTION. End range loading protocols work by placing directionally specific force on tissues to help them heal, so performing them bilaterally is not only unnecessary, but may actually slow recovery.
Side glides are the main lateral movement used in end range loading of the low back. To perform, lean against a wall. Typically your painful side will be away from the wall, but follow your specific prescription. Pin your elbow between the wall and your rib cage. Stand tall to avoid leaning forward and keep your low back as relaxed as possible. Use your hands to push your hips towards the wall. If the wall stops your hip movement, slide your feet further away from the wall. The exercise is most effective when you reach end range, meaning the movement stops because your hips can’t go any further. If the wall stops your hips, you are not reaching end range. Be careful not to separate your elbow from your torso. While it may seem like this provides more range of motion, it spreads the range of motion throughout your spine, and our goal is to focus the movement to the injured segments, typically in the lowest area of your low back.
If you have a lateral shift or if the movement is painful, take caution. Go only far enough to when you start to feel the pain. With this approach, you will often be able to go just a little bit further and further before the pain surfaces as you do more repetitions. With a lateral shift, this can be a slow, but necessary process. Once you correct the lateral shift, be sure to stay upright when you take your weight off of the wall.
Typical prescription is 10-15 repetitions every 2 hours.
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