It’s essential to stress to patients that spine mobilization exercises should be done before even getting out of bed in the morning. ately upon awakening. In my experience, patients get the best results when they mobilize while we are still in the bed, supine, and be-fore gravity takes effect. Our spines decompress, and muscles typically re-lax during sleep, making us more likely to benefit from mobilization from that state. The mobilizations I recommend are simply alternating knee to chest, and bilateral knee to chest and spinal twist, each with a five-to ten-second hold, repeated twice in the morning and twice in the evening before sleep. Complete these in bed with mild inten-sity. These mobilizations are similar to what’s typically recommended else-where, but the distinction is they are being performed before weight-bearing (at least in the case of the morning exercises). I find it essential to stress the importance of doing them before arising in the morning if they are to be as effective. Patients with sacroiliac joint disor-ders may find significant help including www.canadianchiropractor.ca a “standing” alternating hip flexion maneuvers up to 100 times a day in small doses of five repetitions after a maximum of 20 -30 minutes sitting. I refer to this maneuver, which loads and unloads the sacroiliac spine and thus helps the adjustment and prevents pelvic subluxations as standing alter-nating hip flexion exercise (SAHFE). Cervical spine patients are asked to forward flex – extend and laterally flex their c-spines four times daily along with similar analogous maneuvers for their shoulders. Each position held for two to 10 seconds. I may suggest pair-ing the timing of these maneuvers with meals and before bedtime so that the association serves as a reminder. Are you tired after adjusting? Can you spare me 30 minutes once a week? Strength training is another area where patients can be reluctant to engage, particularly given the onerous per-ceived time investment required. About eight years ago, I became interested in the book “Body by Science,” written by Dr. Doug McGuff. His book also had the subtitle: “A research-based pro-gram for strength training, bodybuild-ing, and complete fitness in 12 minutes a week.” I had worked out in the past and was convinced of the value of strength training for a host of condi-tions. The possibility of increasing strength in such a short period of training was highly motivating for my patients and me. In Ottawa at the time, there were no fitness clinicians specially trained in this area with one exception who hap-pened to practice at my gym. I waited three months to get an appointment, and I had to pay for 12 visits in advance before I was accepted into his waiting list. I can tell you that it was worth the wait, and after a short period of two years, I was much stronger than ever before. Given my personal story and the science behind this method, I started recommending strength September 2019 Canadian Chiropractor 21
Chiropractic + Naturopathic Doctor September 2019: Page 21
