This week we will consider unilateral stretch for the dorsal-lumbar fascia.
As we already know, the dorsal-lumbar fascia is a diamond-shaped visco-elastic, soft, connective tissue that is vital to static and dynamic stability of the spine and pelvis as well as thoracic-scapular region, permitting the body various degrees of freedom in movement of the trunk and extremities.
The DLF is a multi-layered, wide expanse of fascial connective tissue. Various movements bring about a stretch in a segment or particularly oriented fibers of the fascia. It is stretched unilaterally by side-bending and turning activities. Let’s look at some of these. As always, we will look at right sided stretch. The pattern may be reversed for left sided stretch.
This is done while lying supine on the mat. The physical therapist flexes the hips and knees, and turns them as far as possible to the left, ensuring the pelvis and hips move as a unit while both the shoulders are on the ground/mat. This brings about rotation in mid to lower thoracic spine and lumbar spine. The stretch is held as long as possible between 5 seconds to 30 seconds. Then the legs are brought back to neutral in supine.
Active Static stretch:
i) Supine trunk rotation or jathar parivritasana: Begin in the supine position. Bend the hips and knees so that heels are closest to, or touching, the buttocks. The inner thighs, knees, and ankles touch each other throughout the stretch. Bring the arms to the sides by abducting the shoulders (shoulders should stay on the ground) and pronating forearms, so that the palms are facing the floor. Lift the feet slightly off the ground, ensuring the tailbone is still resting on the ground. Rotate the trunk by moving the legs to the left while the head turns to the right. Hold the end position for as long as possible between 5 seconds to 30 seconds. Bring the legs back to center and rest them on the ground.
ii) Ardh Matsyendrasana: This asana is done on the floor or on a mat in seated position. Begin in cross-legged seated position. Bring the right foot next to the left thigh, just above the left knee, so that thigh and leg is upright and the right knee is pointing toward ceiling. Reach overhead with the left hand and elongate the spine while bringing torso close to the right thigh. With the left arm reach across the right knee, gently pushing the right thigh across midline, into hip adduction and if possible, bring a left flat palm onto the floor by hooking it under the left knee. The left arm is externally rotated and supinated to achieve this position. Next, turn the trunk and neck to the right bringing the right hand to the floor behind the torso for spinal rotation to right. Ensure the pelvis is facing forward, while the left shoulder moves away. This stretches the diagonal fascial fibers /aponeurosis of right gluteus maximus and left latissimus dorsi. Hold the position for few seconds. Release asana by bringing spine to neutral rotation, unhooking the left hand and bringing right leg back to cross-legged sitting position.
Active Dynamic Stretch:
i) Side bending or Ardh kati chakrasana: Stand with feet about hip width apart, spine upright and elongated. Raise both arms up overhead elongating spine, and join palms in namaste as you inhale. Slowly exhale as you bend to the left and hold in fully exhaled, side-bend position (that is pure lateral flexion) for as long as possible. It is important to keep hip and trunk neutral in the sagittal plane without bending forward or backward (no hip or spine forward flexion or extension). This stretches the DLF on the right side. Slowly return to neutral trunk position as you inhale.
ii) Kati Chakrasana: Begin in the standing posture with feet slightly more than shoulder width apart. As you inhale, raise both arms to shoulder level with palms facing the floor and middle fingers meeting in the midline, in front of the heart. Exhale as you rotate trunk over the right shoulder and extend right elbow looking behind. The pelvis should face forward without rotation in transverse plane, so that rotation takes place only in the spine (no hip rotation). This stretches the diagonal fascial fibers /aponeurosis of right gluteus maximus and left latissimus dorsi. Hold at end range for as long as possible. Inhale as you rotate trunk to neutral and face forward.
Stretching with tools and equipment:
This was described in detail in the last post, dated May 19th.
Ami Gandhi is a licensed physical therapist in the state of California. She is the owner of StableMovement Physical Therapy, a small boutique practice in San Jose that offers patient centered, one-on-one, hands-on physical therapy.