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Practical massage and corrective exercises online

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"concentric." Then the patient resists, while the op-
erator presses the limb down again, "excentric." Re-
peated two to ten times. (Fig. 34.)

This may also be performed with both legs at the
sauTe time when the patient is yi^ung and strong; but
often in the beginning, it is all the patient can do to
raise the leg" "actively" — without resistance — and let it
slowly down ; and sometimes it will be found enough
to simply raise the bent knees.

The muscles of the abdomen, the flexor muscles of
the thigh, and the extensor muscles of the leg are here-



84



PRACTICAL MASSAGE.



by brought into play. It is a fine exercise in cases of
constipation and obesity, and other cases where the
abdominal muscles need to be strengthened.

74. Backward Leg Traction (Standing). —
The patient, standing on a stool and holding on to a
bar or between the door, pulls one leg forward as far
as possible, while the operator resists, "concentric" ;
then the patient resists while the operator pulls the leg




Fig. 34. — Leg Elevation and Depression.



backward, "excentric." The operator resists with one
hand on the front of the ankle, and gives support on
the patient's hip with the other hand. (Fig. 35.)

This is another and very useful form of abdominal
exercise and very useful in constipation and obesity,
and to draw the blood from the pelvic organs.

y^. Leg Separation and Closing (Lying). —
The operator takes hold of the patient's ankle and re-
sists him when he brings his leg out to the side, "con-



RESISTIVE MOVEMENTS OF THE LEGS.



85



centric." Then the patient resists while the operator
presses the les^ into its former position, "excentric."
Repeated four to ten times.

This may also 1j€ perfomied with both leg's at the
same time, when the oi>erator stands in front of the



:^




Fig. 35. — Backward Leg Traction (Standing).



patient and takes hold of both his ankles, resisting,
while the patient separates his legs, and ag^ain pulls
them together under resistance of the patient.

The abductors of the legs, viz., the glutei muscles,
tensor .vagin?e femoris, pyrifonnis, gemelli, sartorius,
obturator internus, are hereby strongly contracted.



86



PR.\CTICAL MASSAGE.



while the adductors are kept passive ; and the exercise
becomes a strong one for the hips and thighs and
tends to reduce big hips as weh as to draw the blood
from the pelvic organs to the surface muscles.

76. Bent Knee Separation and Closing (Re-
clining). — The patient, reclining, bends his knees to
a right angle, the. feet resting on the bed or chair ; the
operator puts his hands on the outside of each knee




Fig. 36. — Bent Knee Separation and Closing.



(Fig. 36) and resists when the patient separates the
knees ; then the operator changes his hands to the in-
side of the knees and resists while the patient closes
them, "concentric." Repeated four to ten times.

Often the movement is reversed, so that the oper-
ator separates and closes the knees when the patient
resists, "excentric."

The feet should be kept firm in their place during
the mo^ ing of the knees.



RESISTIVE MO\EMEi\TS OE THE LEGS. 87

This brinc^s into play both the aiKhiclors aiul the
abihictors and strengthens the liips and thighs, and
the iloor of the i>elvis, and by its derivative effect from
the pelvic organs is an excellent exercise in diseases
of" these organs.

jj. Lkg Torsion (Lying). — The i)atient keeps his
legs straight and the operator takes iK^ld of the feet
and resists while the patient twists his legs out and
inward by opening and closing the feet, the heels being
kept together. Repeated five to ten times.

This is useful in stiffness and weakness of the hip-
joint and as a derivative from the organs of the jielvis.



CHAPTER XI.
Passive and Resistive Movements of the Trunk.

78. Trunk Rotation (Astride Sitting — Pas-
sive). — The patient sits astride over a box or stool,
while the operator, standing behind, takes hold of the
patient's shoulders and moves his trunk from the waist,
describing as large a circle as possible, first six to four-
teen times in one direction, then as many times; in the
other. The patient should be perfectly passive and al-
low the operator to move him without resistance, and
therefore it would be well to have some person to sup-
port the patient's knees.

This acts strongly on the portal system of the cir-
culation, strengthens the muscles of the waist, and has
a cjuieting effect.

79. Tritnk Torsion (Sitting — Resistive). —
The patient sits on a stool or lounge, with hands on
hips ; the operator, standing behind, puts his right hand
on the front of the patient's right shoulder and his left
hand on the back of his left shoulder, and resists tlie
patient when he twists his trunk to the left (Fig. 37).
Then the operator changes his grip, reverses his hands,
and resists when the patient turns to the right. Re-
peated four to eight times on each side.

80. Trunk Torsion (Kneeling — Resistive). —
The patient kneels on a lounge with hands on hips.

(88)



MOVEMENTS OF THE TRUNK.



89



The operator, staiulini;" behind and lixing the patient's
I)ack with one knee, takes hold and resists, as in the
former movement (Fig. 2)7) •

P)Oth of these movements have a good effect on the
spine, the nerves, and circulation; the former has a




Fig. 37. — Trunk Torsion (Kneeling).



Special effect on the respiration, and the latter on the
digestion, by strengthening and elevating the muscles
of the abdomen.

8i. Forward Trunk Flexion and Extension
(Sitting — Resistive). — The patient, sitting on a
lounge or stool, with hands on hips, bends forward,
and, Avhile rising up to the former position, the oper-



90



PR.\CTiCAL MASSAGE.



ator puts his hand on the patient's back and resists
him (Fig. 38). Repeated four to ten times.

In this exercise all the muscles of the back are
brought into play, and the chest is kept well expanded ;
which makes it a good respiratory movement as well




Fig. 38. — Forward Trunk Flexion and Extension.



as a strengthening to the muscles of the back and a
straightening of the spine.

82. Neck Flexion and Extension (Standing
OR Sitting). — The operator places his one hand on
the back of the patient's skull and resists him when he



MUX liMliXTS Ui'" THE TKL XK. 91

l)cn(ls his licad l)ack\varil as far as possible. ReiKatcd
five to ten times.

This acts on the muscles of the neck and the upper
part of the back, and on the* blood-vessels and nerves
of the neck and throat. It is a derivative from the
brain, and it tends to straighten the upper part of the
spine. \\'hen this is given to a patient in hanging
position it is very effective in straightening the spine,
and therefore exceedingly useful in the treatment of
cur\atures of the spine and round-shouldered persons.



CHAPTER XII.

Corrective Active Exercises of Arms.

The correct standing position is most essential and
a good method to obtain it is to stand with the back
agamst the wall; heels, buttocks, shoulders, and head
touchnig; then try hard to make the small of the back
also touch the wall,— this will hardly be possible, but
the effort is a very gooc^ one to, create a correct
position.

83. Stand firmly on both feet, knees straight,
without strain.'

Hips e^•en in the same plane and drawn well back,
so as to keep the abdomen in.

The chest raised well forward and expanded.
^ The shoulders even in the same plane, drawn back
without being pushed up, and without stiffness.

The arms hanging down by the sides in straight
• line from the shoulders to tip of fingers, palms^'in
toward the thigh.

The head raised even on the shoulders, and chin
drawn well in.

The weight of the body inclined a little forward so
as to rest on the balls of the feet, and not on the heels.

A line from the crown of the head should fall just
in front of the ear, armpit, hip, and knee-cap to the
instep. (Fig. 39.)

(92)




Fig. 39.— Standing Position.




Fiff. 42. — Arm Flins:in£? (Sideways).




Fig. 44.— Arm Flexion and Extension.




Fig. 45. — Arm Flexion and Extension (Upward).



ACTIVE EXERCISES OF ARMS. 93

84. Shoulder Circling (three to ten times). —
The shoulders are slowly moved upward, l)ackward.
dowmvard, and forward, so as to describe a circle, the
arms hanging down.

Inhale when shoulders go up and backward, and
exhale when they go down and forward.

I'his strengthens the chest and shoulder muscles,
expands the lungs, and' relieves the work of the heart.
It increases the flow of blood toward the heart, espe-
cially from the brain.

Useful in chronic catarrh of the air-passag^e, in
wenk heart-action, and in congestion of the brain.

85. Arm Circling (five to twelve times. Fig.
40). — The fully extended arms are slowly moved up-
ward, backward, downward, and forward, so as to
describe a conical figure in the air, with the apex in
the shoulder-joint. Inhale and exhale as in the former
exercise. Keep the head erect and motionless, and the
chest well expanded. Effects) as the former, but
stronger.

86. Arm Elevation — Forward, Upward (se\'en
to sixteen times. Fig. 41). — The fully extended amis
are quickly raised forward and upward over the head,
whereby the fo-llowing muscles are brought into action :
The anterior portion of the deltoid, the upper pecto-
ralis major, the short head of the biceps and the coraco-
brachialis bring the arms to horizontal position; from
this the posterior deltoid, the infraspinatus and teres
miinor, the trapezius, and also the rhomboids and leva-
tor anguli scapula? raise the arms to thes vertical posi-
tion. Concentric action.



94 PRACTICAL MASSAGE.

NoAV the arms are lowered sloAvly sideways to their
original position. Excentric action.

Keep the chest well forward, head and trunk mo-
tionless.

Inhale when arms are raised ; exhale when they
are lowered.

It expands and elevates the chest and lung's,
strengthens the nerves and muscles of the shoulders,
limbers the shoulder- joints, and straightens the back.

Useful in narrow and weak chest, in weakness of
the respiratory organs and the heart, and corrects
stooping shoulders.

87. Arm Flinging — Sideways (ten to sixteen
times). — The upper arms are raised horizontally, side-
ways, and kept well back with the forearms shaq>ly
bent upon them in front (Fig. 42). From this posi-
tion the forearms are smartly and energetically thrust
outward without moving the upper arms ; during this
movement inhale, the forearms being again bent for-
ward to their former position under exhalation.

The muscles used are: the deltoid, supraspinatus,
trapezius, levator anguli scapul?e, rhomboids, biceps
and triceps, and to some extent the latissimus dorsi.

Strengthens the nerves and muscles of the arms
aud back, expands and widens the chest, straightens
the back and increases the flow of blood to the arms.

If this exercise is taken with the trunk bent for-
ward (head up) it becomes a very powerful mo^•e-
ment for the back.



ACTIVE EXERCISES OF ARMS. 95

88. Arm Rotation (ten to twenty times). — Take
position as in Fig. 43 ; now rotate, or twist, lx)tli arms
in the shoulder-joints so as to bring- the forearms hori-
zontally forward, parallel with the lloor and with each
other; the right angle in the elbows is maintained, and
the upper arms kept in the same height as the shoul-
ders, with the chest well expanded.

Rotate back to the first position.

This is an excellent exercise to straighten round
shoulders, as it brings the following muscles into strong
action : Infraspinatus, teres minor, posterior deltoid,
trapezius, rhomlxDids, levator ang'uli scapulae, and latis-
simus dorsi.

In fonvard bent position it is very effective.

89. Arm Flexion and Extension (Upw^\rd,
Sideways, and Downward). — The foreanns are
slowly bent up against the upper arms, the elbows kept
close to the sides, the fingers slightly bent and pointed
toward the shoulders (Fig. 44). From this position
the arms are energetically stretched upward to a verti-
cal position a1x)ve the head, the palms facing each
other (Fig. 45). The arms are again slowly bent to
their fonner position and then quickly stretched hori-
zontally sideways, the palms turned downward and
arms kept well back. Now bend the arms and stretch
them sharply downward. This alternate l)cnding' and
stretching to be repeated as' above from eight to six-
teen times ; the head and back to be kept upright during
the movement, and shoulders well back.

Strengiihens the muscles and nen-es of the arms



96 PRACTICAL MASSAGE.

and shoulders, widens the chest, limbers the joints, in-
creases the circulation of the blood, and strengthens
the energy of the heart and lungs.

Useful in rheumatism and stiffness of the anns;
in weakness of nerves and muscles ; to draw the blood
away from the chest and head ; as a means of warming,
to prevent taking colds, and to energize the action of
the heart.

In case of one shoulder lower than the other,
stretch the corresponding arm upward and the other
arm downward.



CHAPTER XTTT.
Corrective Active Exercises of Legs.

(JO. Leg Elevation — Sideways (five to ten times).
— \\ ith the hands placed on the hips, or hohhng on to
a chair or a table, raise one leg slowly up sideways;
repeat five to ten times with each leg. After some
practice the amis may be raised sideways (Fig. 46).

Brings into strong action : the glutei muscles, ten-
soT \-agin3e femoris, pyriformis, gemelli, sartorius, ob-
turator internus, and, as all balancing exercises, has
a strengthening effect on the nervous system. It is
also useful in weakness of the organs of the pelvis, and
to reduce large hips.

91. Leg Elevation (Eorward). — Raise the leg
slowly forward as high as possible without bending
the body, then lower it slowly, and repeat five to ten
times with each leg; stretch the foot well (Fig. 47).

Here the abdominal muscles and flexors of the
thigh and extensors of the leg are strongly contracted,
viz., psoas magnus, iliacus, sartorius, pectineus, graci-
lis, gluteus minimus, obturator externus, tensor vaginae
femoris and rectus femoris.

At the same time the hamstrings and sciatic nerve
are passively stretched.

Useful in sciatic neuralgia, in stiffness of the joints,
in constipation, in weakness of the pelvis, and in
obesity.

■^ (97)



98 . PRACTICAL MASSAGE.

92. Leg Elevation (Backward). — With hands
on hips, raise one leg backward, without bending the
tniiik or knees ; point the toes well back and down ;
keep the chest well forward; repeat five to ten times.
Later with hands on neck '(Fig. 48.)

Contraction of : gluteus maximus, gluteus medius,
pyriformis, obturator internus, gemellus, cjuadratus
femoris, long head of biceps femoris, posterior part
adductor magnus.

Also passive stretching of the abdominal and flexor
muscles of the thigh.

Fine balancing exercise and. to straighten the back
and produce an easy and graceful carriage of the body.

93. Knees Bend (Deep). — Raise the heels, then
bend the knees slowly way down ; keep the knees well
out o\'er the toes ; then straighten knees slowly ; repeat
three to ten times; keep chest out and back erect (Fig,

49)-

Very strong exercise for the hip-joint extensors
and abductors, viz., the hamstring muscles, glutei and
tensor fasciae latre ; the quadriceps extensors of the
knee; the gastrocnemius, soleus, plantaris and other
extensors of the foot. First "excentric," then
"concentric."

The erector spina: is strongly contracted all through
the movement to keep the trunk erect.

This exercise therefore is very valuable for the in-
crease in size and strength of all these large muscles
of the lower trunk and the legs ; to limber the knees
and ankle-joints ; strengthen the nerves and muscles



ACTIVE EXERCISES OF LEGS. 99

of the loins and alxlomcn ; quicken the circulation of
hloocl toward the* leg's, and streng-thcn the organs of
the pelvis and the action of the intestines.

Useful in weakness of the nerves and muscles of
the lower limbs, in sciatica, ix)or digestion, hemor-
rhoids, weakness of the pel\-is, curvature of the spine,
and! to counteract too strong flow of l)lood to internal
organs.

94. Heel Elevation (ten to thirty times). —
Keep heels together and raise them, quickly as high as
possible without beuding the knees or trtmk, then sink
heels slow'ly and raise again ten to thirty times.

Strengthens the nerves and muscles of the legs and
feet (enlarges the calves), and straightens the back.

In case of "flat-foot," raise the heels and turn toes
in and heels outward.

95. Charge — or Fall out — Forward. — Right
foot is placed forward, leaving a distance of three
times the length of the foot between the heels. The
forw^ard knee is bent to a right angle and over the
foot (Fig. 50). The body is at once advanced so that
the back and rear leg, which is kept sraight, are in
the same plane (Fig. 51). Head up and both feet
firmly on the floor.

This movement consists of: flexion and some ab-
duction in the right hip-joint ; flexion in the right
knee- and ankle- joints ; rotation outward in the left
hip-joint ; some rotation to the left of the pelvis ; some
twist oi the spine to the right, with a slight bend to
the} same side and convexity to the left.



100 PRACTICAL MASSAGE.

The psoas, iliacus and rectus femoris muscles of
the right thigh raise it ; when the foot strikes the floor
the right hip-, knee-, and ankle- joint extensors con-
tract to check the flexion in these joints. There is
alsb a strong' contraction oi the left glutei, hamstring,
and quadriceps muscles, as well as the inward rotators
— tensor fascise latse, anterior part of gluteus medius
and minimus. The left foot is kept fimily on the floor
by the left hip-joint adductors and by the tibialis anti-
cus and posticus. The whole erector spinas group on
each side is strongly contracted ; the left) external and
right internali oblique abdominal muscles, the left ser-
ratus posticus superior and right serratus posticus in-
ferior, etc., are also brought into strong action ; and
z'icc versa when the feet are changed.

. The mo'vement is very efl^ective as a general exer-
cise as well as in cases of curvature of the spine, using
one or the other side according to the case.

By stretching one or bothi arms over the head and
also bending the trunk forward this movement becomes
an exceedingly strong exercise for the back.

96. Horizontal balance — standing (Fig. 52)
is another very powerful movement for the straighten-
ing and strengthening of the spine and back muscles.

97. "Back-curving/' or prone lying, trunk
RAISED BACKWARD (Fig. 53) is probably the best and
strongest movement to* counteract double curvature oi
the spine, as all the muscles of the back, hip-joint ex-
tensors and adductors O'f the scapukne are vigorously
contracting. It is also very effective for round
shoulders and narrow chest.




Fig. 47. — Leg Elevaiiun (^Forward).




Fig. 49. — Knees Bend (Deep).




Fig. SO.-rharge-or Fall out Fig. 52.-Horizontai MalancV (Standin-)
— Forward. '^




Fig. 53. — Back Curving.




Fie. 54. — Lefj Elevation CLving-).



ACTIVE EXERCISES OF LEGS. 101

But it produces a considerable liiin1)ar hyi^erex-
tension, and should therefore always l>e followed by

98. Leg Elevation — Lying (three to eii^ht
times). — Lying on the back, first pull Ixjth knees u\)
toward the chest (as high as possible) ; then straighten
the legs up (h'ig. 54), and lower them slowly to 45
degrees, when they should be bent with the feet rest-
ing on the couch. This will prevent the excessive
lumbar anterior curve, and should be given frequently
in cases of "lordosis."

It also strengthens the abdominal muscles and the
action of the Ijowels, stretches the sciatic nen-e, and
reduces obesity.



CHAPTER XIV.

Corrective Active Exercises of Head and Trunk.

99. Head Bending — Backward (five to ten
times). — The head is bent slowly backward with a
strong pull of the back and posterior neck muscles, re-
sisted gently by the flexors of the head and neck — rec-
tus capitis, anticus major and minor, longus co'lli, sca-
leni, and the small muscles numing between the stern-
urni, hyoid bone, and lower jaw — or, as we say, "draw
in the chin." The two sets of muscles thus working
against each other, the posterior in excess ol the an-
terior, keeiif the head steady on the top of the cervical
spine, produce a straightening of the latter, bind, the
two togetlier and make them move backward as one
piece.

It is valuable for the cultivation of good posture
of the head, for impro'ving the muscles o£ the neck,
straightening^ the upper spine, and to produce a mod-
erate expansion of the upper chest.

100. Trunk Flexion — Backward (Fig. 55). —
With the hands on hips the trunk is slowly bent back-
ward at the dorsal region, raising and arching the
chest and holding the abdomiinal muscles in so as not
to bend at the lumbar region, and keeping the legs firm
and straight.

If done well, this exercise produces a powerful
(102)



ACTIVE EXERCISES OE THE TRUNK. 103

contraction of all the Ixick nniscles of tiic thoracic
spine, viz., trapezius, rhonilxnds, latissinnis dorsi,
serratus posticus su])erior and inferior, erector spin;e,
sacrolunibahs, spinalis dorsi, semispinalis dorsi, and
also by the depressors of the scapula : lower serratus
magnus and pcctoralis minor. This again will elevate
the ribs.

A complete straightening of the| dorsal spine and
a considerable expansion of the chest through the
stretching of costovertebral, ligaments will ensue.

If this exercise is taken with inhalation, which is
a good way to teach l>eginners to do the exercise cor-
rectly, the following muscles will also be active, viz.,
external intercostals, anterior i>ortion of "internal inter-
costals, levatores costarum, scaleni, sternomastoid, and
suljclavius.

In such case the l)ackward flexion should immedi-
ately l3e followed by the raising of the trunk, wath
exhalation.

Later on this exercise should l^e practised with
hands on neck.

Very useful in narrow and contracted chest and
round shoulders ; in weakness of the lungs, curvature
of the spine, and to produce a correct and upright
posture.

loi. Trunk Flexion (Forward). — Hands on
hips, later on neck, and stretched over head (Figs. 56
and 57), the trunk is l)ent forward from the hips and
kept in this position for awhile, w'ith the shoulders
and head well back and chin in, the chest well forward
and the knees straig-ht.



104 PRACTICAL MASSAGE.

This exercise begins with a contraction of the ab-
dominal muscles and continues by gravity. Now all
the back muscles and posterior hip muscles are con-
tracting vigorously to keep the spine straight — the
more so, the longer the position is held ; and the same
muscles will again raise the trunk tO' the erect position.

Very valuable to strengthen the back and straighten
the spine.

102. Chopping Movement. — ^Standing with feet
apart and arms over head, bend the iDody quickly for-
ward and downward, and fling the arms to the floor;
then raise the body and bend a little backward with
arms and head well back; repeat six to twenty times.

This strengthens the nerves and muscles of the
back, arms, and abdomen, and increases the action of
the organs of the pelvis, as well as the stomach, liver,
and intestines. It should be followed by

103. Harvesting Movement (Figs. 58 and 59).
— The patient bends the trunk forward. Now fling
the arms forcibly from one side to the other and twist
the trunk with them ; repeat ten to thirty times.

This com]Diletes the effect of the former exercise,
increases the circulation of the blood, strengthens the
nerves and miuscles; of the chest and back, shonlders,
and loins, and is of great value in li^'er and stomach
troubles and obesity.

104. Trunk Flexion (Sideways). — The trunk
is bent alternately to the left and right, as far as pos-
sible without twisting (Fig. 60), first with hands on
hips, later on neck or sideways, etc.




l"iy". 5o.— Trunk i'lexion (Forward).




Fig, 57. — Trunk I'lcxion (Forward).




Fig. 60. — Trunk Flexion (Sideways").




Fig. 61. — Trunk Torsion.




Fig. 63. — Body Horizontal.



ACTIVE EXERCISES OF THE TRUNK. 105

The alxlominal muscles, lower erector spiiKV and
olnteiis luaxinnis, giuteus niedius, gluteus niiniiuus,
and tensor fjusciic latjc contract to Ix'gin the movement
on the left side; then gravity becomes the motor force,


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