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Determining which RJR stretch to do first

Determining which RJR stretch to do first

Sequencing Releasing Joint Restrictions (RJR) can be difficult especially if you have Restriction Indicators (RI)s on both the front and back of the spine.  Determining the correct order for treatment is easier to do with a pre-test which can help you decide what your first treatment should be.   Before getting out of bed in the morning and at night before sleeping assess your spine's ability to move and tolerate different positions.  Lie on your back with legs straight and see how you feel, then bend both knees (one at a time until both are bent) and see how you feel.  The following information will help you interpret the findings.

Flexed or forward bent spine

Aching pain that feels worse lying on your back with knees straight, standing or bending backward that improves with knees bent, sitting or curling forward, indicates you are being pulled forward into a bent position.  Imagine a bow-string pulling the bow into a forward bend. 

Bowstring holding the straight bow into a bend.

Pinched Pete being pulled forward into flexion.

Look for the RIs on the front of the body and turn these off by doing the forward bending postures.  Look at the side of the pubic bone, the front of the pubic bone, and the pelvis and ribs.  Make sure to move into and out of your treatment positions holding the inner core. 

By bending the bow into the tight string putting the string on slack it allows the string to be released and the bow returned to a straight or neutral position.  

By curling into a ball this allows the muscles on the front of the spine to be put on slack which eventually calms the nerve down which relaxes and allows the muscle to lengthen which lets the bones slide back to neutral.  

After you have resolved the RIs on the front of the body then perform the backward stretching hanging foot off bed x 90 seconds to each side.  Finally, repeat the movement tests to decide if you have resolved the problem.   GOAL:  No pain with the knees bent or straight.

Extended or backward bent spine

Easily localized or sharp / stabbing pain that is worse lying on your back with knees bent, sitting or bending forward and is better with knees straight, standing, or bending backward indicates you are being pulled into a backward bend.  Imagine a bow-string pulling the bow backward.   

The bowstring pulls the straight bow into a bend.

Pinched Pete pulled into a backward bent or extension.

 

 

 

 

 

 

 

 

 

 

 

The bowstring put on slack to allow the bow to return to neutral or straight.

By bending backward this allows the muscles on the back of the spine to be put on slack which eventually calms the nerve down which relaxes and allows the muscle to lengthen which lets the bones slide back to neutral.  

Backward bending can be done in standing or lying on the bed.

Perform the backward stretching foot off bed x 90 seconds to each side.  Make sure to move into and out of your treatment positions holding the inner core.

Immediately repeat the movement tests of bending forward or bending knees to determine if you released the joint that was pulling backward.  GOAL:  No pain with the knees bent or straight.

If it is still more painful to bend knees than it is to have knees straight, the joint did not get unlocked and will need to alter this stretch - i.e. try hanging the leg off the bed farther, or tilting the shoulders farther toward the hip.  Some people need to put a pillow or a folded towel under the shoulder blades to get back far enough.  After you try this, repeat the movement test of bending the knees.  Once you have no pain with the knees bent, this indicates that you have unlocked the joints pulling you backward.  Now look for and treat the RIs on the front of the body.

Handout: 

Trial and error

Sometimes if you treat going one direction first, the opposite side of the body can flare so you will have to experiment with finding the right sequence for you.   In other words, some people find they have to start with the backward bend, then treat the RIs on the front of the body and repeat the backward bending.  I suggest experimenting with the order of your treatment until you find what works best for you.

Treat worst RI first

Another thing I have found when treating RIs is that the order of treating RIs can matter.  Treating the most tender RIs first is always the best plan.  If you cannot turn off an RI it may be that something somewhere else is worse and needs to be unlocked before another one can release.  Using the scientific method of changing one variable at a time can really help determine in which order you should treat using the RJR treatment protocol.  If you have turned off all of the RIs that have been instructed so far (side of the pubic bone, front of the pubic bone, ribs, and pelvis), done the backward stretch to both sides and still have pain, it is likely that there are more RIs that you have not yet learned. I will continue to teach more RIs and the movement combinations needed to unlock these restricted joints.

 

Contact:  Loraine@doctorlovejoyevans.com

 

© Dr. Loraine Lovejoy-Evans, DPT