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Before You Start

Before you start trying to get relief using these pain clinic stretches and exercises, please read Before You Start.

Some of the exercises require you to use a piece of Thera-Band for muscle strengthening. If required you can buy it from Physio Med. I would suggest red for the upper limb exercises, and green for the lower limb exercises. Depending on your physical capabilities, you may need to go higher or lower in the treatment range.

Think about trying the Pain Gone Pen - a simple low-cost non-drug self-help pain device for home use.

Jaw

Warning - those with dislocating jaws should not do these exercises. Please consult your doctor for further advice.

Jaw Muscles  (including Temporalis and Masseter)

• Open your mouth to the point where you are comfortable.
• Question
  • How many knuckles you can comfortably insert between your front teeth as shown in the diagram above ?
• Answer = 1
  • If you can only get one knuckle joint between your front teeth, you have poor jaw opening. Proceed if you would like to improve this.
  • Place the tip of your thumb on your upper front teeth, and place the tip of your index finger on your lower front teeth.
  • Letting your facial muscles relax as much as possible, and whilst breathing out, gently separate your front teeth by using your index finger and thumb.
  • Spend a few minutes doing this, stretching only whilst breathing out (don't forget to breathe in sometimes !), without forcing it too much.
  • When you feel that your jaw muscles have stretched enough, try gently inserting two knuckle joints.
• Answer = 2
  • If you can comfortably get two knuckles between your front teeth, you have moderate jaw opening. Proceed if you would like to improve this.
  • Letting your facial muscles relax as much as possible, and whilst breathing out, gently separate your two knuckles feeling the stretch in your jaw muscles.
  • Spend a few minutes doing this, stretching only whilst breathing out (don't forget to breathe in sometimes !), without forcing it too much.
  • When you feel that your jaw muscles have stretched enough, try gently inserting three knuckle joints.
• Answer = 3+
  • If you can comfortably get three or more knuckles between your front teeth, you have good jaw opening and do not need to do this exercise.

Neck

Warning - those with vertebrobasilar insufficiency, cervical spine instability (e.g. rheumatoid arthritis), a large cervical spine disc prolapse, a trapped nerve in the neck, or other serious neck conditions should consult their doctor before attempting any of these exercises.

Posterior Neck Muscles  (including Splenius Capitis and Splenius Cervicis)

1. Sitting on a chair, let your head drop forwards as far as you are comfortable.
2. Place one or both of your hands over the top of your head, so that your finger tips are nearly at the back of your skull bone.
3. Whilst breathing out, let the weight of your arms carry your head further forwards, feeling the stretch at the back of your neck.
4. Do this for 1 - 2 minutes. Doing it in the shower may help your neck muscles relax further.
5. Try doing 1 - 4 with your head rotated to the left, and then with your head rotated to the right. Each time you will feel a pull in slightly different places.

Neck Rotation

1. Start with your head in the neutral looking ahead position and your head above your shoulders.
2. Turn your head gently to the right until you feel a tightness in your neck. Make sure that you are doing a pure rotation movement without any bending to the side.
3. Make sure that your mouth is closed and that your teeth are together. Place the middle three fingers of your left hand against the left hand side of your chin.
4. Whilst breathing out, gently push with the fingers of your left hand, to produce a few more degrees of rotation to the right. Spend a few minutes doing this gently using breathing out to help you relax.
5. Try doing 2 - 4 rotating your head to the left side, using your right hand on the right side of your chin to encourage rotation left.

Anterior Neck Muscles (including Sternocleidomastoid and Scalenes)

1. Lie on the floor with your left arm behind your back.
2. With your head in the neutral looking ahead position, place your right arm so that your hand rests over the top of your head. Gently pull your head to the right until you feel the stretch.
3. Relax your right hand and rotate your head a few degrees to the left, and then pull your head gently sideways to the right using your right hand, until you feel the stretch. Breathe out as you stretch.
4. Relax your right hand and rotate your head to the right. Once again use your right hand to gently pull your head sideways until you feel the stretch. Breathe out as you stretch.
5. Try doing 1 - 4 for the other side of your neck.

Sub-occipital Muscles

1. Stand or sit up straight with your head above your body.
2. With your mouth closed and teeth together, place three fingers on the front of your chin.
3. Keeping your neck straight, push backwards on your chin with your fingers until you feel a pulling sensation in the back of your neck just under the base of the skull. Breathe out as you stretch.
4. If you're doing this stretch correctly you will feel as though you're producing a double chin.

Shoulder Rolls (including Trapezius)

1. The name implies this is an exercise for the shoulder, but its main use  is for the root of the neck (cervico-dorsal junction), trapezius, clavicle (collar bone), and the upper thoracic spine (also functionally part of the neck).
2. Sit in a chair or stand up with your arms hanging loosely by your side.
3. Pretend that you are going to draw circles with the tips of your shoulders.
4. The circles should be as round as possible, and with as big a radius as possible.
5. Spend 1 -2 minutes rotating your shoulders clockwise, and then repeat rotating them anti-clockwise.
6. You may notice some popping of the neck and upper thoracic facet joints whilst doing this exercise fairly vigorously. Don't worry about it - it's just your old bones beginning to move again.

Upper Thoracics

1. Whilst standing hold hands behind your back.
2. Try to make your shoulder blades touch (like squeezing an orange between your shoulder blades) whilst pulling gently downwards with your hands. Feel the stretch in your pectoral muscles in the front of your chest.

Shoulder

Posterior Shoulder Muscles (including Infraspinatus and Rhomboids)

1. This stretch is also known as the Scarf Stretch.
2. Wrap your right arm over your left shoulder (like a scarf). Let your right shoulder relax and sag downwards - try not to hold it up in the air.
3. Place your left hand on the back of your right elbow.
4. Pull gently with your left hand, trying to get the inside edge of your right elbow close to the front of your left shoulder, dropping your right hand over the back of your left shoulder.
5. Whilst breathing out, feel the pull between the thoracic spine and the right shoulder blade.
6. Try doing 2 - 5 for the left shoulder.

Lateral Shoulder Muscles (including Teres and Triceps)

1. In the standing position, slide the palm of your right hand behind the base of your neck.
2. Bring your left arm across behind your head so that you can grab your right elbow with your left hand.
3. Whilst breathing out, use your left arm to pull on your right elbow, so that your right hand slides further down your back. Feel the pull on the lateral edge of your shoulder blade (and also down the back of your right arm if triceps is tight).

Anterior Shoulder Muscles (including Subscapularis, Pectoralis Major and Minor)

1. Pectoralis major has 3 parts - upper, middle and lower. Use the following stretch for all 3 parts as well as subscapularis and pectoralis minor.
2. Stand in a suitable doorway with your feet 6 inches away from the threshold. Place your palms and forearms flat against the frame of the door way.
3. To stretch the upper fibres start with your thumbs level with your ears.
4. Whilst breathing out, let your body fall forwards so that you can feel the pull in the front of the chest. If you are comfortable, let your body hand there for 30 seconds or so.
5. To stretch the middle fibres, slide your hands and forearms a little further up the door frame and repeat no.4.
6. To stretch the lower fibres slide your hands and forearms even further up the door frame and repeat no.4.
7. You can make this stretch easy or hard by changing the distance your feet away from the threshold of the doorway. The further your feet are away, the harder the stretch and vice versa.

Towel Stretch (good for those recovering from a Frozen Shoulder)

1. Hold a hand towel firmly in your right hand.
2. Swing your right arm over your head so that the towel dangles down behind your back.
3. Grab the lower end of the towel with your left hand firmly.
4. Letting your left arm and shoulder muscles relax, keeping hold of the towel in your left hand, raise your right arm in the air, pulling your left arm up behind your back.
5. Lower your right arm allowing your left arm to drop down again. The exercise is just like you're drying your back with a towel.
6. Repeat steps 4 - 6 again trying to get your left hand further up your back each time.
7. Try it for the other arm.

Chasing Spiders (good for those recovering from a Frozen Shoulder)

1. Stand facing a wall with your toes touching the skirting board.
2. Place the palms of your hands on the wall ahead of you.
3. Keeping your trunk fairly close to the wall, pretend that you're chasing a spider up to wall, by walking up the wall with your fingers.
4. Repeat steps 2 - 3 trying to get as high as you can with your fingers up the wall.

Scapular Elevation Thera-Band Exercise

1. Sit comfortably on a dining chair.
2. Loop a 50 cm piece of Thera-Band under your left foot and hold the other end in your left hand.
3. Let your left arm hand at the side of the chair.
4. Making sure you can feel some initial tension in the band, raise your left shoulder upwards whilst keeping your left arm straight. Feel the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Scapular Protraction Thera-Band Exercise

1. Stand with your back to the door.
2. Loop a 50 cm piece of Thera-Band around the door handle, holding on to the other end with your left hand.
3. Move away from the door slightly to pretension the band.
4. Start with your left fist close to your chest.
5. Slowly extend your arm out in front of you, feeling the tension build in the band.
6. Release the tension slowly back to the starting point.
7. Repeat 5 - 10 times. Repeat on the other side.

Scapular Retraction Thera-Band Exercise

1. Stand facing the door.
2. Loop a 50 cm piece of Thera-Band around the door handle, holding the other end in your right hand.
3. Move away from the door slightly to pretension the band.
4. Move your arm backwards keeping the forearm horizontal, feeling the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Shoulder Abduction Thera-Band Exercise

1. Stand with your left side towards the door.
2. Loop a 50 cm piece of Thera-Band around the door handle and hold the other end in your right hand.
3. Move away from the door slightly to pretension the band.
4. Elevate the arm away from your right side, keeping your arm straight at the elbow, and making sure your arm doesn't wander forwards.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Shoulder Adduction Thera-Band Exercise

1. Stand with your left side towards the door.
2. Loop a 50 cm piece of Thera-Band around the door handle, holding the other end in your left hand.
3. Move away from the door so that your arm is elevated to the side and the band is pretensioned.
4. Bring your down with the elbow kept straight, so that it lies against the side of your body.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Shoulder Flexion Thera-Band Exercise

1. Stand with your back to the door.
2. Loop a 50 cm piece of Thera-Band around the door handle, holding the other end in your left hand.
3. Move away from the door slightly to pretension the band.
4. Elevate your arm forwards keeping your elbow straight.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Shoulder Extension Thera-Band Exercise

1. Stand facing the door.
2. Loop a 50 cm piece of Thera-Band around the door handle, holding the other end in your right hand.
3. Step backwards so that your arm is straight out in front of you and the band is pretensioned.
4. Bring your right arm down to your side, keeping your elbow straight, feeling the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Shoulder Internal Rotation Thera-Band Exercise

1. Stand with your left side to the door.
2. Loop a 50 cm piece of Thera-Band around the door handle and hold the other end in your left hand.
3. Bend your left elbow to 90 degrees. Place your right hand over your left elbow to keep the left elbow in place.
4. Pretension the band by moving away from the door.
5. Rotate your left arm at the shoulder so that the left arm comes across the front of your body. Keep your elbow bent at 90 degrees. Feel the tension build in the band.
6. Release the tension slowly back to the starting point.
7. Repeat 5 - 10 times. Repeat on the other side.

Shoulder External Rotation Thera-Band Exercise

1. Stand with your left side to the door.
2. Loop a 50 cm piece of Thera-Band around the door handle and hold the other end in your right hand.
3. Bend your right elbow to 90 degrees. Place your left hand over tour right elbow to keep the right elbow in place.
4. Pretension the band by moving away from the door.
5. Rotate your right arm outwards at the shoulder so that your right arm moves away from your body. Keep your right elbow bent at 90 degrees and make sure your right elbow stays tucked into your side. Feel the tension build in the band.
6. Release the tension slowly back to the starting point.
7. Repeat 5 - 10 times. Repeat on the other side.

Shoulder Horizontal Abduction Thera-Band Exercise

1. Stand with your left side to the door.
2. Loop a 50 cm piece of Thera-Band around the door handle, and hold the other end in your right hand.
3. Move your right arm across your body at chest level, and move away from the door to pretension the band.
4. Keeping your arm straight at the elbow, move your right arm away from the door, all the while keeping it at chest level. Feel the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Shoulder Horizontal Adduction Thera-Band Exercise

1. Stand with your left side to the door.
2. Loop a 50 cm piece of Thera-Band around the door handle, and hold the other end in your left hand.
3. Hold your left arm out in front of you at chest level, and move away from the door to pretension the band.
4. Keeping your arm straight at the elbow, move your left arm across your chest, keeping the elbow straight. Feel the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Shoulder Diagonal Extension Thera-Band Exercise

1. Stand with your left side to the door.
2. Loop a 50 cm piece of Thera-Band around the door handle and hold the other end in your right hand.
3. Place your right arm across your body, at hip level, keeping it straight at the elbow. Move away from the door to pretension the band.
4. Move your right arm away from the door, and in an upwards diagonal direction, keeping the elbow straight. Feel the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Chest Pull Thera-Band Exercise

1. Hold a 50 cm loop of Thera-Band with your hands at either end.
2. Raise your arms in front of you horizontally.
3. Pretension the band by separating your arms slightly.
4. Keeping your elbows straight, move both arms outwards, keeping them at chest height. Try to ge the band to touch your chest - don't worry if you can't at first.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times.

Arms

Biceps Thera-Band Exercise

1. Sit comfortably on a dining chair.
2. Loop a 50 cm piece of Thera-Band under your left foot, holding the other end in your left hand.
3. Rest your left forearm on your left thigh.
4. Bend your left elbow as far as you can feeling the tension build in the band. Keep your elbow resting on your thigh.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Triceps Thera-Band Exercise

1. Stand facing the door.
2. Loop a 50 cm piece of Thera-Band around the door handle, holding the other end in your right hand palm up.
3. Bend your right elbow to 90 degrees, and move away from the door to pretension the band.
4. Keeping your right elbow tucked into your side, straighten the elbow trying to get the arm as straight as possible. Feel the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Wrist Flexion Thera-Band Exercise

1. Sit comfortably on a dining chair.
2. Loop a 50 cm piece of Thera-Band under your left foot and hold the other end in your left hand palm up.
3. Rest your left forearm on your left thigh, with the wrist and hand protruding beyond your knee.
4. Starting with your wrist in the extended position, flex it upwards, keeping your forearm on your thigh. Feel the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.

Wrist Extension Thera-Band Exercise

1. Sit comfortably on a dining chair.
2. Loop a 50 cm piece of Thera-Band under your left foot, holding the other end in your left hand palm down.
3. Rest your left forearm on your left thigh, with your left wrist and hand protruding beyond the knee.
4. Starting with your wrist in the flexed position, extend it upwards, keeping your forearm on your thigh. Feel the tension build in the band.
5. Release the tension slowly back to the starting point.
6. Repeat 5 - 10 times. Repeat on the other side.