Research Corner - Q&A Cervical Disc Rupture Recovery by Lenny Parracino | Date Released : 01 Jul 2000 0 comments Print Close Question: I have a 40-year-old client who has ruptured her third, fourth and fifth cervical disks. She also has two degenerating thoracic disks. I am trying to find exercises that would be the most beneficial to her without putting stress on her back and neck. Any suggestions? Answer: Without a comprehensive assessment, we could not give you exact exercises, but we can explore possibilities. The exercises presented are not intended to replace medical advice! Consult with your client’s health care provider, keeping in mind that many treatments dispersed by physicians, chiropractors and physical therapists are prescribed for symptoms and are not directed toward preventing future problems. It is important to communicate with the medical world; however, your role should concentrate on the prevention of your client’s dysfunction. The term dysfunction could be used whenever changes in the disk alter its biomechanical properties and prevent normal function. The goal of the exercise program should focus on reducing pain, restoring “normal” function or as much movement as possible under the given circumstances. If your client is experiencing painful positions, move around the pain or up to the pain, then release the pressure and return to the starting position. To prevent further dysfunction, it is important to correct all postural impairments. If there is dysfunction in the cervical spine, more than likely there is dysfunction throughout the entire kinetic chain. WHERE TO START Breathing re-education! Excessive use of the secondary respiratory muscles is a common finding in cervical dysfunction, which can add a compression load to the cervical spine. Diaphragmatic breathing encourages an optimal breathing pattern and unloads the cervical spine. Suggestions: In-between sets, as active rest, teach proper breathing techniques. Diaphragmatic Breathing Lie down in a comfortable position with legs straight. If lying down is impractical or not comfortable, sit in a chair. Close eyes and place one hand on breastbone and the other over belly button. Without trying to change the normal breathing cycle, become aware of the parts of the body that are moving as your client inhales and exhales. This will assess her subconscious actions and what you need to help her with. The hand on the breastbone monitors chest breathing, and the other hand monitors belly breathing (diaphragmatic). If the abdomen moves up with inhalation, followed by a lateral excursion of the ribs, your client is breathing diaphragmatically. This is the breathing you’re looking for! Practice this technique in a relaxed state. If the chest is first to rise with inhalation, this is considered to be chest breathing. This breathing pattern needs to be corrected. Follow the tips below. If your client is having difficulty breathing diaphragmatically, have her press her hand down on the abdomen as she exhales and allow the abdomen to push the hand back up as she inhales deeply. The pressure from the hand increases the awareness of the action of the abdomen during breathing. Another position that may increase the awareness of proper breathing is lying on the stomach. The head can rest on the hands. Instruct her to take deep abdominal breaths so that the belly pushes against the floor as she inhales. Additional Tips Place tongue on palate Do not clench teeth Breathe through the nose STRENGTHENING EXERCISES The most common muscles to become weak with neck dysfunction are the deep, single segment cervical flexors. An isolated exercise for this region is the head-nod exercise. It is important to remember that function is integrated, multi-dimensional movement and involves the control of systems, which allow load to be transferred and movement to be smooth and effortless. In other words, when you isolate, you must integrate! Head Nod Lying supine, place a rolled up towel under the cervical spine. The towel supports (as opposed to distorts) the normal cervical curve. Place tongue on palate while breathing diaphragmatically and draw the chin toward the sternum as far as can be controlled without lifting off the rolled towel. Hold for five seconds, rest for five seconds and repeat for one minute (this is just a guideline, change as necessary). Note: The head should not lift off the towel! This is a sign of excessive anterior translation and recruitment of other cervical flexors substituting for the deep cervical flexors. The range of motion will depend on individual anatomical factors as well as strength. Base range of motion on control. Whole Body Exercises with Cervical Strength Emphasis The head-nod technique can and should be integrated into whole body exercises. Examples include: Supine Swiss Ball Chest Press - Place the back of the head and shoulders on the ball and repeat the head-nod directions while performing the chest press. Seated or Standing Uni-Lateral Row - Maintain perfect cervical alignment throughout the exercise. Make sure your client is aware of her posture during movement. NEVER allow the head to jut forward! Push-Up - Maintain cervical alignment. This prone position is more challenging due to gravity being 90 degrees to the cervical spine. Monitor for fatigue! *Examples of the above can be found by going to the PTN Exercise & Flexibility Library. Postural correction and maintenance should form the foundation of the exercise program. Teach your client how to lift, sit, stand, walk, sleep, push, pull, reach, turn, bend and drive. This functional approach will positively affect her for the rest of her life. Good postural habits are essential to prevent further degeneration. Back to top About the author: Lenny Parracino Lenny Parracino is a former author, hands on instructor and clinician for The National Academy of Sports Medicine. Currently, he serves as a faculty member of the Gray Institute of Applied Functional Science. He has spent over 20 years serving the health industry as an international lecturer, soft tissue therapist and movement therapist. Lenny has performed over 300 lectures/workshops, has written educational materials and consulted/lectured in the fitness, manual therapy and educational industry and for various medical organizations around the world. Lenny has earned his degree in Health Science, is a Fellow of Applied Functional Science, holds a California certification/license to practice soft tissue therapy. As a full time clinician, he integrates an eclectic approach of movement conditioning with Dr. Vince Guagliano and Dr. Carina Escudero at AIM Sports Medicine in Hermosa Beach, California. Full Author Details Related content Content from Lenny Parracino Degenerative Disc Disease Alex Allan | Articles Disc Herniation Recovery Program Lenny Parracino | Articles Herniated Discs Paul Chek | Articles Herniated Discs and Overweight Paul Chek | Articles Disc Injury Surgery Alternatives Paul Chek | Articles Disc Herniation and Steroids Craig Burris | Articles Herniated Disc Steve Rhyan | Articles Case Study - Lumbar Disc Rehabilitation Bryce Hastings | Articles Knee Instability Lenny Parracino | Articles Nerve Damage in Shoulder Lenny Parracino | Articles Disc Bulge Lenny Parracino | Articles Arm Amputation Lenny Parracino | Articles Toe Walking Lenny Parracino | Articles Bicep Injury Lenny Parracino | Articles Plantar Flexion and Walking Lenny Parracino | Articles Narrow Chest Lenny Parracino | Articles Pain, Numbness in Anterior Tib Lenny Parracino | Articles Under Active Glutes and Over Active Erector Spinae Lenny Parracino | Articles Pubic Symphysis/Osteitis Pubis Lenny Parracino | Articles Inguinal Herniation Lenny Parracino | Articles Hamstring Injury Lenny Parracino | Articles Over Pronation and Running Lenny Parracino | Articles Heavy Weights After Shoulder Surgery Lenny Parracino | Articles Calcification of Shoulder Joint Lenny Parracino | Articles Stiffness/Pain in Knee Lenny Parracino | Articles Bilateral Patella Tendonitis Lenny Parracino | Articles Numbness Below Shoulder Blade Lenny Parracino | Articles Overweight, Diabetes and Herniated Disc Lenny Parracino | Articles Ab Roll Up Lenny Parracino | Articles "Snapped" Medial Deltoid Lenny Parracino | Articles Bulging Disc, Numbness in Leg Lenny Parracino | Articles Chin Tuck Lenny Parracino | Articles Tight Hamstrings and Calves Lenny Parracino | Articles Corrective Exercise for Back Injury Lenny Parracino | Articles Impingement During Squats Lenny Parracino | Articles Leaning Forward During Lunge Lenny Parracino | Articles How Many Degrees Should the Feet Point Out? Lenny Parracino | Articles Orthotics - Good or Bad? Lenny Parracino | Articles Reduced Pubic Symphysis Gap Lenny Parracino | Articles Too Much Weight Loss with Running? Lenny Parracino | Articles Arm/Opposite Leg Tightness Lenny Parracino | Articles Post Abdominal Surgery Lenny Parracino | Articles Kinetic Chain Dysfunctions (I-T Band) Lenny Parracino | Articles Standing Quad Stretch Lenny Parracino | Articles Asymmetrical Pec Growth Revisited Lenny Parracino | Articles Sway Back and Pelvic Misalignment Lenny Parracino | Articles Super Slow Training Lenny Parracino | Articles Leg Extension Machine vs. Function? Lenny Parracino | Articles Weight Loss Plateau Lenny Parracino | Articles Tremors with Leg Curls Lenny Parracino | Articles Plantar Fasciitis and Server's Disease Lenny Parracino | Articles Spinal Muscular Atrophy Lenny Parracino | Articles Post C-section and Exercise Lenny Parracino | Articles Training with No Pectoralis Lenny Parracino | Articles Muscle Spasms with MS Clients Lenny Parracino | Articles Developing Quads for Sports Lenny Parracino | Articles Training Variables for Muscle Endurance Lenny Parracino | Articles Patella Injury Lenny Parracino | Articles Arthritis in the Hip Lenny Parracino | Articles SI Joint Trouble & Prolotherapy Lenny Parracino | Articles Lymphedema and Exercise Lenny Parracino | Articles Large Legged Female Athletes Lenny Parracino | Articles Lactic Acid Lenny Parracino | Articles Back Popping with Rotation Lenny Parracino | Articles Back Extension Technique Lenny Parracino | Articles Extreme Rheumatoid Arthritis Lenny Parracino | Articles Shooting Knee Pain with Squats Lenny Parracino | Articles Improving Vertical Leap Lenny Parracino | Articles Asymmetrical Pec Growth Lenny Parracino | Articles Wheelchair Client Lenny Parracino | Articles Whiplash with Racing Sports Lenny Parracino | Articles Out-turned Foot with Running Lenny Parracino | Articles Client with No Legs Lenny Parracino | Articles Core Controversy: To Draw In or Not? Lenny Parracino | Articles Hearing Impaired Client Lenny Parracino | Articles Elderly Prolapsed Uterus Lenny Parracino | Articles Whiplash with Racing Sports Lenny Parracino | Articles Controlled Hypertension & Exercise Lenny Parracino | Articles Disc Herniation Recovery Program Lenny Parracino | Articles Upper Crossed Syndrome in Seniors Lenny Parracino | Articles Pigeon Chest Strength Training Lenny Parracino | Articles Bench Press: Pushing the 1RM Lenny Parracino | Articles Pregnancy Trimesters and Exercise Lenny Parracino | Articles Exercise and Parkinson's Disease Lenny Parracino | Articles Training Rotational Movements Lenny Parracino | Articles Exercise and Parkinson's Disease Lenny Parracino | Articles Post Knee Replacement Lenny Parracino | Articles Eccentric vs. Isometric vs. Concentric Load Lenny Parracino | Articles Muscle Symmetry & Dominance in Youth Lenny Parracino | Articles Power Lifting Fanatic Lenny Parracino | Articles Hypertrophy in Lower Body for Men Lenny Parracino | Articles Client with One Arm Lenny Parracino | Articles Fat Calipers Lenny Parracino | Articles Hip Disparity Lenny Parracino | Articles White Water Kayaking Lenny Parracino | Articles Exercise Hypertension Lenny Parracino | Articles Upping Your 1 Rep Max Lenny Parracino | Articles Formula 1 Race Training Lenny Parracino | Articles Epilepsy and Exercise Lenny Parracino | Articles Lower Back Pain with Ab Work Lenny Parracino | Articles Cellulite on Stomach Lenny Parracino | Articles Kinetic Chain Exercises for Home Lenny Parracino | Articles Strength Training for Weight Loss and Sculpting Lenny Parracino | Articles Step Up Routines Lenny Parracino | Articles Quadricep Exercises Lenny Parracino | Articles Right Grip Lenny Parracino | Articles Fluid Intake Consequences Lenny Parracino | Articles PNF (Proprioceptive Facilitation) Lenny Parracino | Articles Shoulder Tendonitis Lenny Parracino | Articles Incontinence and Exercising Lenny Parracino | Articles Burning Sensation in Feet on Elliptical Machines Lenny Parracino | Articles Osteitis Pubis and Exercise Lenny Parracino | Articles Back Pain and Flexibility Lenny Parracino | Articles T-Bands Swelling Lenny Parracino | Articles A Simple Guide to Stretching Lenny Parracino | Articles Chest Exercises on Bench Lenny Parracino | Articles Strength Lost if Focus on Endurance Lenny Parracino | Articles Lower Trapezius Exercises Lenny Parracino | Articles Degenerative Facet Joints Lenny Parracino | Articles Muscle Balance or Flexibility Profile Lenny Parracino | Articles Hypertrophy and Genetics Lenny Parracino | Articles Postural Profile Lenny Parracino | Articles Overhead Squat: Total Body Profile Lenny Parracino | Articles Hydrotherapy Techniques Lenny Parracino | Articles Winged Scapula Lenny Parracino | Articles Anorexia and Exercise Lenny Parracino | Articles Boxing Performance Lenny Parracino | Articles Bi-lateral Piriformis Release Surgery Lenny Parracino | Articles Muscle Hypertrophy Lenny Parracino | Articles Marfan Syndrome Lenny Parracino | Articles Piriformis Lenny Parracino | Articles Benching Myths Lenny Parracino | Articles Overtraining and Hypertrophy Lenny Parracino | Articles Vegans and Protein Lenny Parracino | Articles Integrated Anatomy for the New Millennium Lenny Parracino | Articles Neck Exercises Lenny Parracino | Articles Upper Crossed Syndrome Lenny Parracino | Articles Fat Loss Plateau Lenny Parracino | Articles Post Viral Fatigue Syndrome Lenny Parracino | Articles Varicose Veins Lenny Parracino | Articles Wheelchair and Cardio Lenny Parracino | Articles Lou Gehrig Disease Lenny Parracino | Articles Hysterectomy Lenny Parracino | Articles Sherwins Disease Lenny Parracino | Articles Lupus Lenny Parracino | Articles Bad Knees and Cardio Lenny Parracino | Articles Weight Belts Lenny Parracino | Articles Knee Pathology Lenny Parracino | Articles Lifting Posture Lenny Parracino | Articles Bruising Lenny Parracino | Articles Chemotherapy and Exercise Lenny Parracino | Articles Kidney Transplant and Exercise Lenny Parracino | Articles Body Fat Loss and Muscle Loss Lenny Parracino | Articles New Shoes and Pain in Calf Lenny Parracino | Articles Back Squat vs Front Squat Lenny Parracino | Articles Multiple Sclerosis and Weight Loss Lenny Parracino | Articles Stretches During Pregnancy Lenny Parracino | Articles Weight Loss: No Results from Exercise Lenny Parracino | Articles Abdominal Wall Strain Lenny Parracino | Articles Multivitamins - Yes or No Lenny Parracino | Articles Breastfeeding and Weight Loss Lenny Parracino | Articles Cervical Disc Rupture Recovery Lenny Parracino | Articles Client Goals Lenny Parracino | Articles High Cholesterol Lenny Parracino | Articles Sciatica Lenny Parracino | Articles Muscle Failure Lenny Parracino | Articles Ephedra Lenny Parracino | Articles Decline in Cardio Fitness and Strength Lenny Parracino | Articles Polycystic Ovarian Syndrome Lenny Parracino | Articles Abdominal Surgery Lenny Parracino | Articles Restaurant Eating Lenny Parracino | Articles Thoracic Tumor Rehab Lenny Parracino | Articles Office Stretch Handout Lenny Parracino | Articles HIV Positive Client Lenny Parracino | Articles Postural Deviations Lenny Parracino | Articles Bicep Rehab Lenny Parracino | Articles Irritable Bowel Syndrome Lenny Parracino | Articles Too Large for Machines Lenny Parracino | Articles Pooch Belly Lenny Parracino | Articles Slow Metabolism Lenny Parracino | Articles Computer Headaches Lenny Parracino | Articles Exercise Guidelines for Pregnancy Lenny Parracino | Articles Deadlifts - The Right Way Lenny Parracino | Articles Preacher Curl Pain Lenny Parracino | Articles Range of Motion Lenny Parracino | Articles Osteoporosis: A Case Study Lenny Parracino | Articles Replacement Drinks for Weight Loss Lenny Parracino | Articles Building Chest Mass - Incline, Decline or Flat Chest Exercises? Lenny Parracino | Articles Knee Extension Research Lenny Parracino | Articles Pregnancy and Weight Gain Lenny Parracino | Articles Functional Carry Over - Applying it to Personal Training Lenny Parracino | Articles Pelvic Tilt Before Crunch Lenny Parracino | Articles Lower Back Pain Lenny Parracino | Articles Biceps Workout Lenny Parracino | Articles Fibromyalgia Lenny Parracino | Articles Please login to leave a comment Comments (0) Back to top