HW: Post C6-C7 Fusion with Chest and Back of Shoulder Tightness/Pain (11-8-17) Week 4

Organization Update
- Monday: Daily Sequence + Strength Circuits 1 and 2
- Tuesday: Daily Sequence only
- Wednesday: Daily Sequence + Strength Circuits 2 and 3
- Thursday: Daily Sequence
- Friday: Daily Sequence + Strength Circuits 1, 2, and 3 one set of each
- Saturday: Daily Sequence
- Sunday: Rest
Daily Sequence
- Try for one set of each movement 10-15reps
- This sequence is meant to be a warm up sequence prior to working out or simply a sequence to do end of the day or first thing in the morning
- It should not take long
- It should be attempted when you have pain to possibly reduce symptoms
  - Number One:
    - Childs Pose Hands Elevated Variation VIDEO
      - Stay short of excessive pressure on the top of the shoulder
  - Number Two
    - Shoulder Extension/Internal Rotation Bridge VIDEO
      - This combines shoulder mobility, quad stretch, light glute activation
      - 8-20 reps slow and controlled
  - Number Three
    - Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
      - Can be done seated or lying on a foam roll as depicted
      - In place of a foam roll, a yoga mat or thick towel roll will work
      - 8-20 reps
      - The chin tuck can be awkward, see video below for more instruction
        
        Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - Number Four
    - Tall Kneel with Scapular Depression/Retraction VIDEO
      - Be careful to not feel any pain in the lower back
      - If you do, email me and I will try to adjust the movement as needed
  - Number Five
    - Pec/thoracic rotation stretch options
      - Side Lying Thoracolumbar Rotation Stretch VIDEO
      - Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
Strength Circuits: 3 days a week we will start to build a strengthening routine
- Goal is 8-20 reps or 30-90sec for each movement
- Go through the 3 movements to fatigue in the parameters above
- Go through a second set but half as many reps for each movement as the first set
- Do this for each circuit listed below
- Circuit#1
  - Lat Activation Off Edge of Bed VIDEO OR Band Extension Deadlift VIDEO
    - 8-20 reps of either slow
    - If you do the band try to go with a light resistance band
    - Make sure you feel it in the back of the arm/tricep
  - Scapular Control with Weight Shift Side Plank Progression VIDEO
    - Start with pausing in single arm support 5 sec each arm
    - 8-20 reps
    - Start with a wall and can progress to gradually lower surfaces as able
  - Table Top Progression VIDEO
    - Start with 5 sec holds 8-20 reps
- Circuit#2
  - Squat With Single Arm Support Progression VIDEO
    - Start with just the 2 hands supporting squat
    - If that goes well you can progress to single arm hold in squat for 5 sec on each hand and then stand back up
    - Goal: 8-20 reps
  - Forward Arm raise progression
    - Phase 1: Full Can Regression Raise From Counter Height with Progression Laterally VIDEO
      - Try for 5 sec holds gradually progressing out to side
      - If this is easy for about 15-20 reps, progress to the movement below gradually adding weight
      - Full Can Fly Endurance VIDEO
        
        begin light and make sure you use a mirror to control shoulder position and don’t over arch low back
  - Arm Bar VIDEO
    - This requires the use of a dumbbell
    - pause for 5 seconds on your side and 5 sec on your back
    - try this one for time, goal of a total of 30sec to 2 minutes
    - Let me know how much time you get on each arm so we can establish how much weaker one side is compared to the other
- Circuit #3
  - Wall Sit Active/Band Abduction VIDEO
    - Make sure you feel muscle in the back of the shoulder working with no significant pain or pressure in the top of the shoulder
  - Laying on Back Weighted Pull Over VIDEO
    - A good way to progress into a weighted stretch
    - Focus on slowly lowering into the overhead position, short of pain on the top of the shoulder
  - Laying on Back External Rotation Phase 1 VIDEO
    - Phase 1 above, high reps lower reistance
    - Phase 2 below
      - Bilateral “W” External Rotation VIDEO
        
        slightly more challenging variation, just make sure there is no pain in the top of the shoulder