Gliding for Physical Therapy

Gliding for Physical Therapy is a 48 min. instructional DVD led by Michelle Schwahn (who is a physical therapist, ACE & AFAA certified fitness instructor and a NASM certified personal trainer) w/ Mindy Mylrea demoing the exercises (shows correct form & common form issues in exercises). Progressions to increase challenge and modifications are shown for most exercises (and how to test & observe client/patient for issues & how to vary the exercise to work for them). There are some exercises that are repeated in the different segments (push-ups, knee pull-ins in plank, bridge/leg curl), but the focus is a bit different (feet or hand placed on floor or discs or use other equipment or exercise has variation). It has 5 chapters (Introduction, upper kinetic chain, core & lower back, lower kinetic chain & summary).

I bought this DVD to provide me with some ideas on exercises w/ gliding discs (which I really enjoy using) for rehab exercises for the shoulders & lower back for at home use. I am already incorporating many of the exercises demoed (lunges, push-ups, exercises in plank), but it's nice to have a better understanding of the exercises (areas engaged) & how variations can change the focus (different equipment, & tweaks to movement of arm or leg). There is a variety of shoulder exercises that I have not used before, as well as hip (circle) exercises in prone & supine position & lunges on balance trainer that will be neat to incorporate into my routines.

Equipment: gliding discs (multiple), BOSU, body bar, resistance band

Introduction (3:07 min): Michelle discusses the purpose of rehab exercises w/ gliding discs (prevent & overcome issues), conditions & issues that can be focused on w/ exercises, benefits (low impact, "closed kinetic chain" on most exercises/ has benefit of co-contraction on both sides of joint, total body focus, balance, coordination, muscle imbalances, cardio & strength benefits, proprioception) & conditions (arthritis, osteoporosis, balance disorders, joint issues/hip & shoulder, knee & ankle) & focus of each segment.

Upper Kinetic Chain/cervical, scapular & upper extremity (11 min.)- uses gliding discs (paper plates may work/slide more easily on some walls)

*Facilitate & Increase range of motion in shoulder*

Shoulder (uni-lateral) flexion: person faces wall w/ one gliding disc, held to wall, w/ bent arm (90 degrees)> gently slide arm up wall & straighten, reverse motion (to bent arm).

Shoulder abduction: from previous position, person holds disc w/ straight arm on wall, and turns outward to face side, lower arm to 90 degrees> arm glides up wall and straightened & down wall to reverse motion> to allow more (larger range of motion) abduction, person can place foot flush against wall & when gliding up w/ the arm, place the armpit closer to the wall (outer leg has a slight heel lift)> reverse motion.

Bi-lateral shoulder flexion: same form & set-up as previous shoulder flexion exercise, but patient glides discs up & down the wall w/ both hands.

Single arm circle: person faces wall w/ one hand on disc & bent arm> glides disc on wall in a circular fashion, clockwise & counterclockwise (arm straightens when gliding upward).

Wall push-up: person faces wall w/ both hands on discs, and bent arms> glide arms out & bring the face & upper body close to the wall, reverse motion.

Alphabet: person faces wall w/ one hand on a disc> glides the disc to spell letters of the alphabet on the wall

Upper neck, upper back

Modified plantigrade position: person kneels over a cube (flat surface) that is hip level w/ both hands on gliding discs> slide discs forward w/ slight lean & pull back to reverse motion> oscillations: same movement but w/ fast pace (more core engagement & scapular muscles)> alternate sliding one disc forward w/ arm, while other arm slides back *Neck & head in neutral position, scapula remains adducted not elevated (shoulders up), retraction of scapula not protraction (rounding forward of shoulders)*

Quadruped (on all fours, facing floor) exercises: head & spine in neutral position, person places discs under both hands and feet (4)> alternate arm slide/reach forward, then alternate single arm circles, clockwise direction> arm circles w/ both arms> counter clockwise direction> alternate opposite arm & leg slide extension (Bird Dog)> Same-side arm & leg extension

Progressions (for those who can complete the previous exercises): person is in quadruped position w/ both feet on gliding discs

Different variations demoed: lift both knees off ground & both legs slide back into plank position> slide one leg to the back (straightens), then slide knee in (close to arms), reverse motion> Easier variation: One knee stays on floor, while other leg alternates sliding to back & pulling knee in> Advanced variation: both knees pull into chest & reverse motion (to straight legs)> child's pose for stretch.

Push-ups: in plank position w/ both feet on discs> more advanced: add adductions (both legs slide out to sides) when body lowers to floor, legs slide in on lift of push-up> child's pose.

Core & Lower back/pelvis, lower back & hips (16 min.)- some exercises use BOSU (balance trainer) & resistance band

Mountain Climber: person is in quadruped position w/ both feet on gliding discs> alternate sliding one leg to back & reversing motion> more intensive version: person is in plank position & alternates sliding one leg to back, while other leg's knee pulls in> Advanced variation: from plank position, both knees pull into chest & reverse motion (to straight legs)> another advanced w/ oblique focus: from plank position, one leg slides out to side, then the knee pulls in diagonally (head/gaze follows knee) & crosses over to midline (other side of body), reverse motion.

Oblique focus: person is in quadruped position w/ both feet on discs> alternate sliding one knee to the side of body/near arm (head/gaze follows knee) and reverse motion.

Push-up: person has both hands on discs w/ bent knees (lower legs & feet held in air)> slide hands to side and reverse motion> Diagonal push-up: from previous position, alternate sliding one arm forward, the other to the back (at a diagonal), modified version: perform in quadruped position> child's pose. *discusses importance of having patient/client work to fatigue not exhaustion or failure*

Plank position: have person perform an isometric hold in plank position w/ both feet on gliding discs, elbows/forearms on floor, and observe if he/she is able to execute properly> if so, then are able to move onto hip circles in clockwise direction: slide leg out to side, then bend knee to pull into body (hip lifts a bit) & slide back to plank> hip circle w/ both legs (higher hip lift than single-leg), clockwise direction, then counter-clockwise (towards the end Mindy's legs are straight, so it looks more like a pike when both legs circle around)> child's pose.

Advanced variations (uses BOSU): person has hands on BOSU (ball side up), w/ both feet on discs, and in plank position: alternates knee pull-in & slide out to rear, modification: performed on knees> hip circles, clockwise, counter clockwise, bilateral> BOSU is on flat side, person places hands on outside of it, both feet on discs> easiest version: alternate leg slide to back & knee pull-in> intermediate: plank position, perform mountain climbers> advanced: add rotation, knee turns out on pull-in (head/gaze follows knee)> hip circles, clockwise & counter clockwise. *recommends to end exercise in a elongation position or relaxation technique, like child's pose, to allow body to return to restorative length*

Lunge w/ rotation (uses resistance band): person has one foot on disc, other is "point of stability" (not traveling leg)> have person perform rear lunge w/ arm reach forward & observe form> trainer or PT gives person handle of resistance to hold (holds w/ both hands), while he/she holds other side w/ some tension> as person lowers into rear lunge, he/she rotates body to other side (head/gaze follows arms), reverse motion on lift of lunge> same exercise, w/ rotation of body, but the foot on disc is switched w/ the other (point of stability changes), make sure to have person perform rotations in both directions.

Lateral flexion w/ lunge (uses resistance band): person has one foot on disc, resistance band is held overhead (w/ straight arms)> person lowers into lunge & laterally flexes (side bend) trunk to side (same side as leg lunging, head/gaze follows arms), reverse motion, modification: band not held overhead, but in front of face w/ bent elbows> switch foot on disc.

Person is in prone position (face down on floor) w/ both hands on discs, arms extended in front of body, legs straight, head off floor (neutral position)> person slides back w/ arms and lifts upper body for Cobra, back extension, lowers to reverse motion> Swimmer (clockwise): arms slide open to sides, slide to side of body w/ lift of upper body, then out to front when body lowers to floor> Reverse (counter-clockwise) swimmer direction: arms slide back to chest w/ lift of upper body, then open to sides & front w/ lowering of upper body> Opposite arms: one arm slides in clockwise swimmer pattern, other the reverse counter-clockwise swimmer, reverse motion.

Advanced add BOSU: person is in prone position (straight legs) lying on BOSU (ball side up) w/ both hands on discs> person slides arms back & lifts upper body into back extension, reverse motion> add bilateral leg lift when arms slide/reach forward & upper body lowers back to floor> add swimmer (scissor) legs in lowered position (small range of motion)> relax body over BOSU for stretch.

Lower Kinetic Chain/hip, knee, ankle & foot (15 min.)- some exercises use BOSU (balance trainer) & body bar

Bridges: person starts in supine position (face up) on floor w/ bent knees, both heels on discs, arms to side of body> beginner: alternate sliding one leg to front & reverse motion> slide both legs to front & reverse motion> increase intensity: lift hips/bottom, slide one leg to front & reverse motion, then lower hips/bottom, alternate sides> add isometric hold w/ both arms held over chest to add more intensity to lower body movement> advanced: slide both legs out to front & reverse motion.

Circular movement (external & internal rotation of hips) in bridge (focuses on pelvic, core & hip control): person lifts hips/bottom, brings knees together, then lowers hips/bottom down & knees open to the sides> reverse motion: knees in, hips/bottom lift up, then hips/bottom lower down & knees open to the sides> advanced: lift hips/bottom and both arms above chest and hold, alternate sliding one leg forward & reversing motion (hips should not rock side to side w/ movement, but stay level)> advanced: slide both legs out to front & reverse motion, while isometric hold for hips (in lifted position)> hug knees into chest for stretch, then knee circles in each direction.

Lunges (uses body bar, good for use for those w/ ACL injuries, ligamentous injuries, meniscus): person has disc under ball of one foot, and other side hand holds body bar for support (foot on ground also provides support/point of contact)> observe person perform rear lunge, check for form issues> rear lunge can have leg sliding back w/ a bend or straight leg (deeper) w/ trunk flexion (upper body at 45 degree angle)> side lunge: same leg slide out to side, straightens as it lowers, bends to reverse motion> increase challenge: person holds body bar between hands and performs bicep curl in lowered position of lunge.

Leg slides (front & back): person has disc under ball of one foot, and other side hand holds body bar>from lowered position of side lunge, person slides leg to the front, returns to side, slides to back, then returns to side (free arm counterbalances body)> have person close eyes & perform same movement to enhance proprioceptive feedback> have person hold a position (front or back) w/ eyes closed.

Lunges w/ rotation: person has ball of one foot on disc> add counter-rotation w/ trunk (upper body, head & arms) as he/she lowers into lunge> person can hold lowered position of lunge for more intensity.

Basic gliding technique (total body engagement, can be used as a resistance or cardio exercise): person has balls of both feet on discs> bend knees, slide one leg to the side by lifting up heel and placing heel down, then pull other leg in (lift heel to travel & place down to stop> add squat to each slide to side> perform two side steps (shuffle)> add toe raise after squat (lift both heels, externally rotating hips & bring heels together)> add twist to squat (lift both heels & turn to face same side w/ hip twist), arms reach to same side as heels.

Lunges (uses BOSU & body bar): person has ball of one foot on gliding disc, other foot on center of BOSU (ball side up) w/ same side hand holding body bar for support> person performs rear lunge> more challenge: person holds body bar in both hands, and performs front raise w/ lowered position of lunge> adds rotation: performs front raise into rotation w/ body bar & upper body to one side with lowered position of lunge, then reverse motion> perform overhead lift into rotation w/ body bar & upper body in lowered position of lunge, reverse motion> lower body bar to BOSU in lowered position of lunge, reverse motion into wide upright row w/ lift> hold upper body & bar in lowered position of lunge w/ trunk flexion, and knee slides in & out, or bar can be held over (static) knee, or rotations w/ bar to each side (rowing) or on floor for support> *combo of gliding discs & BOSU, good to use for someone who is in recovery stage of treating achilles tendonitis & plantar fasciitis, not when he/she is in stages of inflammation*

Summary (1:18 min.): Michelle summarizes the key points of instructional video.