Changes

# Hygienicexerciseswhichincludethemoregeneralexerciseroutineswhicharedesigned for Hygienic improvement of the health and vitality of an individual.

# Hygienicexerciseswhichincludethemoregeneralexerciseroutineswhicharedesigned for Hygienic improvement of the health and vitality of an individual.

# Remedialexercisesaredesignedtoaffectcertaindesirablechangesinpersonsafflicted with adverse physical results from poliomyelitis (less common now with improved sanitation than in former years), paralysis resulting from accidental or other injury, certain spastic conditions, respiratory ailments, and so on. Remedial exercises are usually done under the tutelage of a physical therapist and must be carefully monitored.

# Remedialexercisesaredesignedtoaffectcertaindesirablechangesinpersonsafflicted with adverse physical results from poliomyelitis (less common now with improved sanitation than in former years), paralysis resulting from accidental or other injury, certain spastic conditions, respiratory ailments, and so on. Remedial exercises are usually done under the tutelage of a physical therapist and must be carefully monitored.

# Corrective exercises are specific in kind, being designed and targeted for a particular area of the body and to accomplish a precise purpose. Corrective exercises can, Obviously be pushed more rapidly and more vigorously than possibly might be done with remedial exercises. 96.2.2 The Physics of Corrective Exercises  The proper use of exercises to correct a deformity or anatomical defect is based on certain well-known physiological facts and physical laws.  The physiological basis for the use of corrective exercises lies in the fact that while life exists there is change. The body is always in a state of organized flux. Every day cells die and every day new cells are born—all kinds of cells including bone cells but excluding brain and nerve cells.  Brain cells, once dead, do not replace themselves. We lose several millions of brain cells every day, never to be retrieved. Severed nerves cannot be restored but intact nerves, even though damaged, do tend to improve, albeit slowly, under careful Hygienic care.  In considering the physical basis for the effectiveness of corrective exercises we observe that the muscles of the human body have two main purposes:

# Corrective exercises are specific in kind, being designed and targeted for a particular area of the body and to accomplish a precise purpose. Corrective exercises can, Obviously be pushed more rapidly and more vigorously than possibly might be done with remedial exercises.

# To produce a desired movement as and when directed by the central nervous control mechanisms, and

# To produce a desired movement as and when directed by the central nervous control mechanisms, and

# To hold the bones in position both in rest and in movement. Muscles are differentiated from the various and several ligaments which are simply sheets of fibrous tissue which connect two or more bones, cartilages, or other structures; or they serve to support the fasciae or muscles and retain organs in place. Every muscle and each ligament has received a specific name and is registered in the complex volumes of medical nomenclature, but such precise terminology is not a necessary part of a Hygienist’s training unless s/he so desires. There are many medical reference books to supply such information. It should be remembered that it is the stronger muscles and their accompanying and therefore stronger tendons that become shortened, while the weaker muscles and their tendons become lengthened and weaker over the years. Such changes are accompanied, in general, by a corresponding change in the length and strength of the ligaments and often, too, in the shape of the bone, and especially so in the ends of the bones where articulation occurs. Dr. Herbert M. Shelton provides an example of what may occur as when there exists a concave curvature of the spine, there simultaneously develops a shortening of the side muscles, tendons and ligaments of the individual thus impaired. In working with clients, it must be remembered that forcing is always contraindicated. Bones cannot be carried beyond their prescribed normal range of movement without causing injury to the ligaments attached to or near the joint being moved. It is these ligaments that bind the bones and permit their articulatory movement. Damaged and injured ligaments can prove extremely painful and difficult to heal. It is the counterbalancing effect of muscles together with the constant turnover of cells that gives effectiveness to corrective exercises.

# To hold the bones in position both in rest and in movement.

Muscles are differentiated from the various and several ligaments which are simply sheets of fibrous tissue which connect two or more bones, cartilages, or other structures; or they serve to support the fasciae or muscles and retain organs in place.

 

Every muscle and each ligament has received a specific name and is registered in the complex volumes of medical nomenclature, but such precise terminology is not a necessary part of a Hygienist’s training unless s/he so desires. There are many medical reference books to supply such information.

 

It should be remembered that it is the stronger muscles and their accompanying and therefore stronger tendons that become shortened, while the weaker muscles and their tendons become lengthened and weaker over the years.

 

Such changes are accompanied, in general, by a corresponding change in the length and strength of the ligaments and often, too, in the shape of the bone, and especially so in the ends of the bones where articulation occurs. Dr. Herbert M. Shelton provides an example of what may occur as when there exists a concave curvature of the spine, there simultaneously develops a shortening of the side muscles, tendons and ligaments of the individual thus impaired.

 

In working with clients, it must be remembered that forcing is always contraindicated. Bones cannot be carried beyond their prescribed normal range of movement without causing injury to the ligaments attached to or near the joint being moved. It is these ligaments that bind the bones and permit their articulatory movement. Damaged and injured ligaments can prove extremely painful and difficult to heal.

 

It is the counterbalancing effect of muscles together with the constant turnover of cells that gives effectiveness to corrective exercises.

== Deformity Is Widespread ==

== Deformity Is Widespread ==

* 7 cervical vertebrae in the neck.

* 7 cervical vertebrae in the neck.

* 12 thoracic or dorsal vertebrae in the region of the chest or thorax. These provide the attachments for twelve pairs of ribs.

* 12 thoracic or dorsal vertebrae in the region of the chest or thorax. These provide the attachments for twelve pairs of ribs.

* 5 lumbar vertebrae in the small of the back.

* 5 lumbar vertebrae in the small of the back.

* 5 fused sacral vertebrae forming a solid bone, the sacrum, which fits like a wedge between the hip bones. Plus a number of vertebrae which are fused together to form the bottom or base of the spine, known as the coccyx at the bottom of the sacrum. During the fetal period, the spinal column forms a single curve with the convex surface toward the back. However, at birth, two main curvatures are present, both of which are concave forward. The upper curvature is located in the thoracic and the lower one in the sacral region. With normal development, two compensatory forward curvatures develop in the cervical and lumbar regions, just above the primary curvatures. These provide the resiliency which a stacked bone structure could not possibly provide. Unfortunately, as we have noted, a perfectly-formed spine is a rarity, indeed, in today’s world. As can be seen in the diagrams which follow, the vertebrae serve as protective housing for the spinal cord which functions in the transmission of ascending impulses from all parts of the total body up to the brain and of descending impulses and directives from the brain via the cord to all parts of the total body. This housing is known as the spinal canal. Peripheral nerves from many parts of the body enter into this housing and are affiliated with the main nerve cord. These transmit all manner of information from peripheral centers to the cord and thence to the brain and also appropriate responses from the cerebral centers back to the peripheral regions, and finally to individual cells. Every single muscular movement requires this transmission of information, the cerebral interpretation and the psychological and physical result(s) of the interpretation, the response. 96.4.1 Not Just a Cosmetic Problem A spinal abnormality is not just a cosmetic problem, although that can be psychologically damaging in itself since it can lead possibly to rejection by one’s peers particularly during the teen years and to depression and social isolation. But, additionally, since all such irregularities tend to cramp all the abdominal and chest organs and can act. as an impediment to breathing, to digestion, and, in fact, to all bodily processes and will continue to do so throughout all of a shortened life, they should be corrected as early as possible and to the extent possible. Unless mechanical corrective exercises and perhaps even braces are worn, the deformity can provide a seat for continued degenerative processes with later development of arthritis of the spine with increasingly severe back pain and disability. The curvature tends to increase, and as it does it pushes down on the ribs attached to the spine. This in turn, narrows the chest cavity and restricts the ability of the lungs to expand. Thus, the lack of sufficient oxygen intake hampers full metabolic efficiency throughout the lifetime, which as we have noted, is usually shortened.

* 5 fused sacral vertebrae forming a solid bone, the sacrum, which fits like a wedge between the hip bones.

Plus a number of vertebrae which are fused together to form the bottom or base of the spine, known as the coccyx at the bottom of the sacrum.

 

During the fetal period, the spinal column forms a single curve with the convex surface toward the back. However, at birth, two main curvatures are present, both of which are concave forward. The upper curvature is located in the thoracic and the lower one in the sacral region. With normal development, two compensatory forward curvatures develop in the cervical and lumbar regions, just above the primary curvatures. These provide the resiliency which a stacked bone structure could not possibly provide. Unfortunately, as we have noted, a perfectly-formed spine is a rarity, indeed, in today’s world.

 

As can be seen in the diagrams which follow, the vertebrae serve as protective housing for the spinal cord which functions in the transmission of ascending impulses from all parts of the total body up to the brain and of descending impulses and directives from the brain via the cord to all parts of the total body. This housing is known as the spinal canal. Peripheral nerves from many parts of the body enter into this housing and are affiliated with the main nerve cord. These transmit all manner of information from peripheral centers to the cord and thence to the brain and also appropriate responses from the cerebral centers back to the peripheral regions, and finally to individual cells. Every single muscular movement requires this transmission of information, the cerebral interpretation and the psychological and physical result(s) of the interpretation, the response.

 

=== Not Just a Cosmetic Problem ===

A spinal abnormality is not just a cosmetic problem, although that can be psychologically damaging in itself since it can lead possibly to rejection by one’s peers particularly during the teen years and to depression and social isolation.

 

But, additionally, since all such irregularities tend to cramp all the abdominal and chest organs and can act. as an impediment to breathing, to digestion, and, in fact, to all bodily processes and will continue to do so throughout all of a shortened life, they should be corrected as early as possible and to the extent possible.

 

Unless mechanical corrective exercises and perhaps even braces are worn, the deformity can provide a seat for continued degenerative processes with later development of arthritis of the spine with increasingly severe back pain and disability.

 

The curvature tends to increase, and as it does it pushes down on the ribs attached to the spine. This in turn, narrows the chest cavity and restricts the ability of the lungs to expand. Thus, the lack of sufficient oxygen intake hampers full metabolic efficiency throughout the lifetime, which as we have noted, is usually shortened.

Dr. Hugo Keim of the Columbia University College of Physicians and Surgeons is reported to have said, “Telling a child with a scoliotic back to stand up straight is like telling a man with tuberculosis to stop coughing.” Thus, most specialists insist on using the brace.

Dr. Hugo Keim of the Columbia University College of Physicians and Surgeons is reported to have said, “Telling a child with a scoliotic back to stand up straight is like telling a man with tuberculosis to stop coughing.” Thus, most specialists insist on using the brace.

# Stand behind a straight chair. Hold on to the back. Now assume a squatting position.  Maintain this position as long as possible. Repeat for from two to five or more minutes  several times a day.

# Stand behind a straight chair. Hold on to the back. Now assume a squatting position.  Maintain this position as long as possible. Repeat for from two to five or more minutes  several times a day.

# Atworkorathome,sitonastraight-backedchair.Leanforwardinthechairandlower  the head to your knees. Maintain this position for at least one minute. Repeat, until you can hold the position for as long as five minutes. Notice how the back muscles are being pulled.

# Atworkorathome,sitonastraight-backedchair.Leanforwardinthechairandlower  the head to your knees. Maintain this position for at least one minute. Repeat, until you can hold the position for as long as five minutes. Notice how the back muscles are being pulled.

# Use the slanting board several times a day. If a slanting board is inconvenient to use, as at work, simply lie on the floor and place both legs on a chair. Press shoulders back to floor. Maintain position for from five minutes (at first beginning) to as long as thirty minutes, after practice.  Many people think that just because the muscles on their arms and legs are strong and muscular, that the muscles on the back will be in a like condition. This is not necessarily so.  The muscles of the back should be thought of as being similar to the guide-wires that support a growing tree. If these wires are strong and kept taut, the tree will grow straight and be flexible but if, however, the wires are loose and malpositioned, the tree may not fare at all well, becoming crooked. It is the same with the spine. If the tools for proper maintenance are lacking, the spine may become crooked with swayback or some other impairment developing. Therefore, it is important for both the back and the abdominal muscles to be strengthened in all persons, but especially when a scoliotic spine is evidenced. These back and abdominal muscles are the “guide-wires” to impart strength and flexibility to the spine.  96.4.5 Exercises for More Severe Scoliotic Impairments  These exercises may be performed in addition to those already suggested for milder impairments of the spine.

# Use the slanting board several times a day. If a slanting board is inconvenient to use, as at work, simply lie on the floor and place both legs on a chair. Press shoulders back to floor. Maintain position for from five minutes (at first beginning) to as long as thirty minutes, after practice.  Many people think that just because the muscles on their arms and legs are strong and muscular, that the muscles on the back will be in a like condition. This is not necessarily so.  The muscles of the back should be thought of as being similar to the guide-wires that support a growing tree. If these wires are strong and kept taut, the tree will grow straight and be flexible but if, however, the wires are loose and malpositioned, the tree may not fare at all well, becoming crooked.

# It is the same with the spine. If the tools for proper maintenance are lacking, the spine may become crooked with swayback or some other impairment developing. Therefore, it is important for both the back and the abdominal muscles to be strengthened in all persons, but especially when a scoliotic spine is evidenced. These back and abdominal muscles are the “guide-wires” to impart strength and flexibility to the spine.

# Partialbendingforwardwhilemaintainingastraightback.Clientmaysitinachairwhile performing this exercise. The number of repetitions (reps) will vary with the vigor of each client. Start with five.

# Partialbendingforwardwhilemaintainingastraightback.Clientmaysitinachairwhile performing this exercise. The number of repetitions (reps) will vary with the vigor of each client. Start with five.

# Sit on the floor with legs extended out in front. Lean forward and touch toes with the fingers.

# Sit on the floor with legs extended out in front. Lean forward and touch toes with the fingers.

# Hangonbar.Extendlegsoutwardandupwarduntiltheyareatrightangles.Holdfora few seconds. Relax. Repeat.

# Hangonbar.Extendlegsoutwardandupwarduntiltheyareatrightangles.Holdfora few seconds. Relax. Repeat.

# Hangingonabar,flexkneesasinExerciseNumber10above.Now,straightenlegsoutwards. Hold. Relax. Repeat.

# Hangingonabar,flexkneesasinExerciseNumber10above.Now,straightenlegsoutwards. Hold. Relax. Repeat.

# Simply hang from the bar in a relaxed position for a few seconds. Repeat several times.  96.4.6 Exercises to Strengthen Abdominal Muscles  As previously noted, it is just as important to strengthen the muscles of the abdomen as those ‘supporting the spine in the back. However/in this connection, it is important to choose exercises wisely.  Exercise, to be constructive, should not be easy but, on the other side of the coin, neither should they cause pain. If pain results from a particular exercise, that exercise should immediately be stopped. Pain is a body signal that injury has either occurred, or that one may be imminent. A wise precaution for therapists to follow is to do less than you should early on in working with a client. One can always add on, i.e., increase the intensiveness and/or the extensiveness of a particular muscle movement but, once an injury has resulted from the wrong kind of exercise or the manner in which a particular exercise was performed, then it is too late and further activity must be delayed until full healing has taken place, this sometimes requiring a prolonged rest—delaying progress. It is best always to keep in mind our “baby step” approach. Succeed with small successes. The following exercises are suggested to strengthen abdominal muscles. They can be done in sequence or selections made to suit a special need.

# Simply hang from the bar in a relaxed position for a few seconds. Repeat several times.  96.4.6 Exercises to Strengthen Abdominal Muscles  As previously noted, it is just as important to strengthen the muscles of the abdomen as those ‘supporting the spine in the back. However/in this connection, it is important to choose exercises wisely.  Exercise, to be constructive, should not be easy but, on the other side of the coin, neither should they cause pain. If pain results from a particular exercise, that exercise should immediately be stopped. Pain is a body signal that injury has either occurred, or that one may be imminent. A wise precaution for therapists to follow is to do less than you should early on in working with a client. One can always add on, i.e., increase the intensiveness and/or the extensiveness of a particular muscle movement but, once an injury has resulted from the wrong kind of exercise or the manner in which a particular exercise was performed, then it is too late and further activity must be delayed until full healing has taken place, this sometimes requiring a prolonged rest—delaying progress. It is best always to keep in mind our “baby step” approach. Succeed with small successes.

 

The following exercises are suggested to strengthen abdominal muscles. They can be done in sequence or selections made to suit a special need.

# Lyingflat,onthebackonthefloor,legsoutstretchedinfrontofyou,pointthetoesand stretch to the extent possible. Relax. Notice the pull on the abdominal muscles. This exercise strengthens ligaments and muscles that lie vertically.

# Lyingflat,onthebackonthefloor,legsoutstretchedinfrontofyou,pointthetoesand stretch to the extent possible. Relax. Notice the pull on the abdominal muscles. This exercise strengthens ligaments and muscles that lie vertically.

# This next exercise may be done in three levels of achievement.  Lie flat on your back with both legs and thighs straight. Point the toes of both feet  and raise both legs. Lower and repeat.  The three stages of effort exerted in doing this exercise will depend, of course, upon  the strength of individual muscles. It is not wise to attempt Stages 2 or 3 before gaining sufficient strength to perform Stage 1 with ease. After Stage 1 is accomplished, then the client may progress to Stage 2, and so on.  Stage 1. Have an assistant hold down the back while another assists the client in performing the upward movement of the legs. As strength increases, less assistance should be given.  Stage 2. The client places hands under the buttocks and lends support himself as legs are raised. An assistant may hold down the back in the early days of progression, but all assistance should eventually be abandoned as strength improves.  Stage 3. The client should perform this exercise unassisted.

# This next exercise may be done in three levels of achievement.  Lie flat on your back with both legs and thighs straight. Point the toes of both feet  and raise both legs. Lower and repeat.  The three stages of effort exerted in doing this exercise will depend, of course, upon  the strength of individual muscles. It is not wise to attempt Stages 2 or 3 before gaining sufficient strength to perform Stage 1 with ease. After Stage 1 is accomplished, then the client may progress to Stage 2, and so on.  Stage 1. Have an assistant hold down the back while another assists the client in performing the upward movement of the legs. As strength increases, less assistance should be given.  Stage 2. The client places hands under the buttocks and lends support himself as legs are raised. An assistant may hold down the back in the early days of progression, but all assistance should eventually be abandoned as strength improves.  Stage 3. The client should perform this exercise unassisted.