Stretching Exercises with assistance – Physiotherapy

Stretching Exercises with assistance – Physiotherapy image

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Stretching Exercises with assistance – Physiotherapy

STRETCHING

Stretching is important in order to maintain muscle length and joint range. Stretching can help improve your flexibility and any problems with muscle stiffness.

A stretch must be gradual with a sustained hold at the end of the movement.  Make sure all stretches are slow and smooth, and be careful not to apply too much force to the stretch. If a stretch is applied too quickly, the muscle responds with a strong contraction, which can cause an increase in spasticity.

Hold each stretch for 30 seconds to allow the muscle to relax and repeat x3.

Your Physiotherapist will show your carer how to do the stretches. Do not attempt if you are not sure.

The neck and shoulder exercises can be done in sitting or lying. 

Exercise 1 – Neck rotation

  • Cradle the head in a pillow and slowly rotate head to one side and hold.
  • Repeat to other side.
Diagram of an individual lay on ground or bed turning their head to one side to stretch neck

Exercise 2 – Shoulder elevation

  • Support arm at the wrist/hand and above the elbow.
  • Gently raise arm up above head with palm facing inwards. Hold this position.
Diagram of an individual in a wheelchair having their straight arm lifted by a helper to stretch shoulder

Exercise 3 – Shoulder abduction

  • Support arm above the elbow and at the wrist.
  • Keep the elbow bent at 90 degrees.
  • Gently bring arm away from the body until you feel some resistance. Hold this position.
Diagram of an individual having shoulder stretched by a helper who is supporting upper arm and wrist by holding them and gently pulling arm away from the body

Exercise 4 – Elbow flexion & extension

  • Support upper arm and wrist
  • Straighten the elbow as far as able and rotate the forearm so the palm is facing upwards, hold this position.
  • Now bend the elbow as far as able and hold.
Diagram of an individual having elbow stretched by a helper who is supporting upper arm and wrist by holding them and gently raising and lowering forearm

Exercise 5 – Wrist flexion and extension

  • Supporting the forearm, gently move the wrist backwards whilst applying gentle distraction to the wrist. Hold position.
  • Then move wrist forwards and hold position.
  • To increase this stretch, straighten the elbow.
Diagram of a hand being gently pressed backwards and then forwards by a helper to stretch the wrist

Exercise 6 – Fingers and thumb stretches

  • Stabilise wrist and gently move fingers from a bent position to as straight as possible (diagram A).
  • Then, stabilise palm of hand and gently bend and straighten the thumb, moving it across the palm and out as much as possible as shown (diagram B).

A)

Diagram of fingers and thumb being gently pressed manipulated to stretch them

B)

Exercise 7 – Back stretch

  • In lying, bring both the knees into the chest.
  • Hold this position (a stretch should be felt in the lower back.)
  • To increase the stretch, lift the head up and bring chin towards chest.
A diagram of a helper aiding an individual lay flat on the ground or bed to push knees in towards their chest

Exercise 8 – Trunk rotation

  • In lying with knees bent and feet flat on the bed.
  • Gently roll the knees to one side and hold the position.
  • Then, roll knees to opposite side and hold.
  • To increase the stretch, straighten the top leg.
A diagram of a helper aiding an individual doing trunk rotations laying flat on the ground with bent knees twisting to the side helper is supporting knees

Exercise 9 – Adductor stretch

  • In lying with knees bent and feet flat on bed.
  • Place your hands on the inside of the person’s inner thighs above the knees.
  • Slowly move knees apart. The person should feel a stretch in the inner thighs.
  • Hold this position.
A diagram of a helper aiding an individual lay flat on the ground with feet facing each other and knees bent and dropped out to each side. Helper is assisting with knees

Exercise 10 – Hip flexor stretch

  • Lying on your side, keep the pelvis forward with one hand.  With your other hand, support the inside of the knee.
  • Move the leg backwards to feel a stretch in the front of the hip.
  • Hold this position.
A diagram of a helper aiding an individual lay on their side with leg bent the helper is pushing forward on the hip and pulling the knee backwards

Exercise 11 – Quadriceps stretch

  • Lying on front or side as in Exercise 10
  • Hold one leg at the ankle and stabilise the knee with the other hand.
  • Slowly bend the knee and move their ankle towards their bottom. A stretch should be felt at the front of the thigh. Hold this position.
  • To increase the stretch, lift the leg slightly off the bed.
A diagram of a helper aiding an individual lay on their front with leg bent by holding ankle and bending knee so the foot moves towards their bum

Exercise 12– Hamstring stretch

  • Lying on your back, lift one leg up but keep the knee slightly bent.
  • Keeping the thigh still with one hand, gently try and straighten the knee.  A stretch should be felt at the back of the thigh.
A diagram of a helper aiding an individual lay on their back by holding leg and moving it towards their body

Exercise 13 – Ankle dorsiflexion and plantarflexion

  • Lying on your back with a rolled up towel underneath the knee.
  • Cup the heel in your hand, and with the other hand, support the knee.
  • Stretch the ankle so the toes are pointing towards their head (diagram A). Hold this position. Keeping one hand cupping the heel, move the other hand to the top of the foot and gently move in the opposite direction (diagram B).
  • This stretch can be done with the knee bent or straight.

A)

A helper is aiding an individual to stretch by pushing knee down into a rolled up towel whilst pulling on heel

B)

A helper is manipulating a foot backwards and forwards to stretch the ankle

 If you are unsure about any of the advice and information given in this leaflet or if you require further advice from a Chartered Physiotherapist:-

Please contact your local Physiotherapy Department between 8.30 am and 4.30 pm, Monday to Friday on the direct dial numbers below:

Worcestershire Royal Hospital
01905 760622 / 760187

Alexandra Hospital, Redditch
01527 512114

Kidderminster Hospital & Treatment Centre
01562 513214

Feedback for Inpatient Therapies

Please scan the QR code or follow the link below: 

If you have been seen by a Physiotherapist or Occupational Therapist during your admission, please leave us some feedback by scanning the QR code or following the link and filling in the short survey.

QR code

https://apps.worcsacute.nhs.uk/PublicSurvey/AHPFeedback

Ward admitted to:__________________________________

Therapy team who treated you: _______________________

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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