Web12-05 - Safe and Contraindicated Exercises

Flexibility Exercises

 

Each of the following exercises is considered to be a “contraindicated” exercise which means they aren’t recommended for most people due to a greater risk for harm or injury. While it may be possible to perform these movements without pain for a number of repetitions, the accumulated damage or microtrauma can lead to injuries or significant pain over time. In nearly all cases, the goals of these exercise movements can be more safely be performed with alternative exercises. The risks associated with each of the exercises below are described followed by an explanation of a safer alternative exercise.

 

 

The Swan

Repetitive hyperextension of the lower back has several objections. First, it stretches the abdominals. These muscles are too long and weak in most people and should not be further lengthened. Second, it can be harmful to the back, causing an impingement on the nerve, compression and even herniation of the disk, myofascial “trigger points” and spondylolysis. Examples of exercises in which this occurs include cobras, back bends, straight leglifts, straight leg sit-ups, prone back lifts, donkey kicks, fire hydrants, prone swans, backward trunk circling, weight lifting with the back arched, and landing from a jump with the back arched. One of the back hyperextension exercises commonly seen is the swan.

 

ALTERNATIVE: Back extension

Lie prone over a roll of blankets or pillows and extend the back to a neutral position.

 

 

 

 

 

The Back-Arching Abdominal Stretch

The same hazards are present in the back-arching abdominal stretch exercise. This exercise can stretch the hip flexors, quadriceps, and shoulder flexors (such as the pectorals) as well as the abdominals, but it has the additional problem of possibly hyperflexing the knee joint, because of the arm pull. If your goal is stretching the hip flexors and quadriceps, try substituting the hip and thigh stretcher. If used for the shoulders, substitute the PNF pectoral stretch.

ALTERNATIVE: Pectoral Stretch

Stand erect in doorway with arms raised 45 degrees, elbows bent, and hands grasping doorjambs; feet in front-stride position. Press forward on door frame, contracting the arms maximally for several seconds. Relax and shift weight on legs so muscles on front of shoulder joint and chest are stretched; hold. Repeat with arms at 90 degrees and 135 degrees.

 

 

 

 

 

Arm Circles with the Palms Down

Arm circles with the palms down (circumduction with the arms straight out to the sides) may cause the bony knob near the head of the humerus to impinge upon a shoulder ligament or the lip of the socket, and squeeze some of the muscles and the bursa in the shoulder every time the arm is lifted. In addition, if these are done in a forward direction (top of the circle is forward), there is a tendency to emphasize the use of the stronger chest muscles (pectorals) rather than to stretch those muscles and emphasize the weaker upper back muscles. Finally, if they are done while standing, there is a tendency for the head to protrude forward and the low back to arch. To strengthen the upper back muscles, try arm lifts or seated rowing. To stretch the pectorals try pectoral stretch.

ALTERNATIVE: Backwards arm circles (palms up)

Sit, turn palms up and pull in chin, contract abdominals. Circle arms backward.

 

 

 

 

The Knee Pull-Down Exercise

Hyperflexing the knee by pulling it to the body with the arms or hands placed on top of the shin places undue stress on the knee joint. The knee pull-down exercise is one example. In this case, the exercise is intended to stretch the lower back. The hand position should be changed to hug the thigh rather than the shin to make this a good exercise. Try single knee-to-chest.

ALTERNATIVE: Single knee-to-chest

From the hook-lying position, draw one knee to the chest by pulling on the thigh with the hands, then extend the knee toward the ceiling; hold. Pull to chest again and return to starting position. Repeat with other leg.

 

 

 

 

 

The Hero

The hero places the knee in a rotated position with torque on the flexed knee, which is apt to stretch the ligaments and capsule, and damage the cartilage. It may also cause strain in the groin muscles and the lower back. If the exercise is used to stretch the quadriceps. The hurdler's stretch is a sitting toe-touch exercise with one leg turned out rather than two, as in the hero. It produces the same kind of stress on the knee joint. Try substituting the hamstring stretch or backsaver hamstring stretch.

 

ALTERNATIVE: Hamstring stretch

Lie supine in a hook-lying position. Raise left leg and grasp toes with right hand while pulling on back of thigh with left hand. Push heel toward ceiling and hold. Repeat on other leg. (You may pull on a rope placed around the ankle of the extended leg, rather than pulling on the toe and thigh.)

 

 

 

 

 

Neck Circling

As a general rule, exercises that hyperextend the neck should be avoided. Tipping the head backward during an exercise, such as is done in neck circling, can pinch arteries and nerves in the neck and at the base of the skull, grind down the disks, and produce dizziness or myofascial trigger points. It also aggravates arthritis and degenerated disks.  Another hazardous neck exercise is bridging on the head. This places extreme pressure on the cervical disks. If the purpose of the exercise is relaxation of the neck, substitute the Head Clock. If your purpose in doing the exercise is strengthening, try some isometrics keeping your head in good alignment, using your hands as the resistance, or use contract-relax PNF neck rotation.

 

ALTERNATIVE: Head clock

Pretend your neck is a clock face with the chin at 12:00 when you assume good posture. Flex the neck and point the chin at 6:00, hold, return to 12:00; repeat pointing at 4:00 and 8:00, then turn the head to 3:00 and 9:00.

 

 

 

 

 

Standing Toe Touch

The knee joint should not be hyperextended. This action stretches the ligaments and joint capsule of the knee. Bending the back while the legs are straight may cause back strain, particularly if the movement is done ballistically as in the standing toe touch. Repetitive bilateral straight-leg toe touches, whether standing or sitting, may stretch the lower back excessively if the hamstrings are very tight. This can lead to backache and spondylolisthesis. If performed only on rare occasions as a test, there is less chance of injury than if incorporated into a regular exercise program. Standing hamstring stretches with the back flat have also been condemned (especially when done ballistically) because they can produce degenerative changes at the lumbosacral joint. Safer stretches of the lower back include the leg hug, and single knee-to-chest. To stretch the hamstrings, substitute a sitting or lying stretch such as the back-saver stretch or the hamstring stretcher.

 

ALTERNATIVE: Back-saver hamstring stretch

Sit with one foot against the wall, one knee bent, foot close to buttocks. Clasp hands behind back and bend forward, keeping lower back as straight as possible. Allow bent knee to move laterally so trunk can move forward. Stretch and hold.

 

 

 

 

 

Quadriceps Stretching Exercises

When the knee is hyperflexed 120 degrees or more, the ligaments and joint capsule are apt to be stretched and the cartilage may be damaged. Among the many exercises that place this type of stress on the knee joint are certain so-called ``quadriceps'' stretching exercises. (Note: one of the quadriceps,  the rectus femoris, is not stretched by this exercise.)  It is usually not necessary to stretch the shin muscles, since they tend to be weak and elongated; however, if you need to stretch the shin muscles to relieve muscle soreness, try the shin stretcher. To avoid injuring the knee when stretching the quadriceps substitute the hip and thigh stretcher.

 

ALTERNATIVES: Shin stretcher

Kneel on both knees, turn to right, and press down on right ankle with right hand and hold. Keep hips thrust forward to avoid hyperflexing knees. Do not sit on heels. Repeat on left side.

OR

Kneel with right knee directly above right ankle and stretch left leg backward so knee touches floor. If necessary, place hands on floor for balance. Press pelvis forward and downward and hold stretch for several seconds. Repeat on right side. Do not bend front knee more than 90 degrees. This stretches the rectus femoris and more importantly, the hip flexors (iliopsoas).

 

 

 

 

 

Shoulder Stand Bicycling

As a general rule, exercises that force the neck and upper back into hyperflexion should not be used. It has been estimated that 80 percent of the population has forward head and kyphosis (hump back) with accompanying weak muscles. Hyperflexion of the neck can be as harmful as hyperextension by causing excessive stretch on the ligaments and nerves. It can also aggravate preexisting thin disks and arthritic conditions. Examples of exercises that tend to promote these conditions include shoulder stand bicycling and the Yoga positions called the plough and the plough shear. If the purpose for these exercises is to reduce gravitational effects on the circulatory system or internal organs, try lying on a tilt board with the feet elevated. If the purpose is to warm up the muscles in the legs, try a stationary leg change.  If the purpose for doing the exercise is to stretch the lower back, try the leg hug or single knee-to-chest exercise.

 

ALTERNATIVE: Leg hug

Begin in a hook-lying position. Contract the gluteals and lumbar muscles. Lift hips. Hold for three seconds. Relax and pull knees to chest with arms as hard as possible. Hold. Hug the legs behind the knees rather than over the top of the knees. 

 

 

 

 

 

Leg stretches at the Ballet Bar

Leg stretches at the ballet bar may be potentially harmful. Some experts have found that where the extended leg is raised 90 degrees or more and the trunk is bent over the leg, it may lead to sciatica and pyriformis syndrome, especially in the person who has limited flexibility.

 

ALTERNATIVE: Hamstring Stretch

Start in a hook-lying position. Bring right knee to chest and grasp toes with right hand. Place left hand on back of right thigh.

1.  pull knee toward chest

2.  push heel toward ceiling and pull toes toward shin

3. attempt to straighten knee. Stretch and hold.

Repeat on left side.