At Home Care:
Upon the completion of your first visit at Carolina Active Health, you will likely be given an exercise (or a few) to be performed at home. These exercises will not only help improve your respective condition or functional deficit but also aid in confirming your diagnosis on following visits to the office. Many conditions require more “load”, meaning more time spent doing various activities at home to make changes in symptoms or function. Hence, the prescription of exercises to be done on your own by your doctor at Carolina Active Health.

You should also have received a care guide with descriptions of your condition and the plan moving forward.  You can access your exercises via the link below.

Your Patient Rehabilitation Portal can be found here.

Our YouTube Channel with TONS of exercises can be found here.

In the treatment of musculoskeletal injury, one of the biggest keys to success is to increase patient self-reliance and self-efficacy. At Carolina Active Health we strive to give you the tools to manage your own care once acute flare-ups have ceased. Diagnosis and treatment in the office are often necessary to get you on the right path towards recovery. However, at-home care is vital to the progression of any patient’s treatment plan and eventual return to normal activities.

The majority of exercises prescribed to patients at Carolina Active Health fall into 3 main
categories:

1. Mobility and Flexibility Exercises
2. Trunk Stabilization Exercises
3. Directional Preference Exercises

Mobility and Flexibility
What is it?
Mobility – The Latin word movere is the origin of the word mobility, and it means ‘to move’.  In the context of the human body, mobility refers to the ability to actively achieve a joint range of motion. Therefore, your capacity to control your body’s own movement is your mobility.

Flexibility – The capability of being bent without permanent damage to a structure is often the general definition of flexibility. From a human body perspective, flexibility refers to two things:
the ability to passively achieve a joint range of motion, and the overall pliability of connective tissue (muscle, tendon).

Why is this important?
A phrase often repeated to patients at Carolina Active Health is “motion is lotion”, and it certainly is true in this context. Oftentimes, the more we move the less we hurt and the greater resiliency we have in preventing injury. Having a requisite amount of mobility (active control) and flexibility (passive control) allows for optimal functioning in athletics, recreational exercise, and daily life.

What structures or areas are often involved?
Numerous areas can be considered less mobile or less flexible than ideal, some common examples are:

Mobility:           Flexibility:
• Shoulder        • Hip Flexors
• Hip                 • Lats/Traps
• Spine             • Pecs

What do I need to know about these exercises at home?
When working on mobility or flexibility at home consistency is vital. To make changes in soft tissue structure we typically need to develop a routine and stick with it for a few weeks.  Whether you are using a lacrosse ball or foam roller for flexibility or performing a mobility exercise, feeling the right sensations is important. Your Carolina Active Health doctor will assist you in finding those sensations in the office and will change exercises when need be!

Trunk Stabilization
What is it?
The trunk effectively consists of the muscles, soft tissues, and joints that support the spinal column, ribcage, and pelvis. Trunk Stabilization is the way in which we utilize the aforementioned components to anchor and steady ourselves prior to any and all motion.
Having the understanding and skill to stabilize one’s trunk is incredibly important in the presence of low back pain and a foundational aspect of all movement!

Respiration
Trunk Stabilization is uniquely tied to the way in which we breathe. In a normal respiratory pattern, the abdominal wall must expand upon inhalation (breathing in) and compress sightly on exhalation (breathing out). This occurs due to the descent of the diaphragm on inhalation and ascent on expiration. As the diaphragm drops when taking a breath in, the contents of the abdominal cavity (organs, fluid, etc) are pushed out in all directions. A comparison to this process that often resonates with patients is that of a piston inside the cylinder of an engine.

As the piston (diaphragm) descends (inhalation), gaseous pressure is pushed out in all directions in the cylinder (abdominal wall). To simply put it, it is important to be able to breathe out of your belly!

Intra-Abdominal Pressure (IAP)
Intra-Abdominal Pressure or IAP is the method by which humans stabilize their trunks. It is a process by which we regulate fluid pressure within our abdomen to support our lumbar spine.

To create IAP, we must be able to push our abdominal wall outwards in all directions. Often the cue, “do the opposite of sucking in your stomach” is a good way to feel this. During all Trunk Stabilization exercises, it is ideal to have this outward pushing force consistent throughout the task. Creating Intra-Abdominal Pressure is a skill possessed by many athletes, but perhaps the most relevant example is that of a powerlifter. During the execution of a heavy lift (squat, deadlift), competitive powerlifter’s often wear a belt around their abdomen. This belt provides a rigid surface for the athlete to expand his/her stomach into, thus creating IAP.

What do I need to know about these exercises at home?
At home, Trunk Stabilization exercises can be performed with a quality over quantity mindset. Your Carolina Active Health doctor may prescribe the exercise(s) for a specific time, a number of breaths, or repetitions. Attempt to follow the directions and cues you learned while in office and don’t get discouraged if the exercises are difficult to feel at first!

Directional Preference
What is it?
A Directional Preference refers to a specific joint motion that if repeated with enough volume produces a decrease in pain, improved motion, or centralization of symptoms. In-office, your Carolina Active Health clinician may attempt moving your painful or dysfunctional joint in several directions, until one is determined to be of the most benefit.

Centralization
Centralization refers to the movement of pain or symptoms towards the spinal column. This is a favorable outcome with Directional Preference exercises and indicates that a correct joint motion has been selected.

What conditions or regions are often involved?
Any joint may have a directional preference, but the most common to be involved are:
• Low Back
• Neck
• Hip
• Shoulder
• Knee

What do I need to know about these exercises at home?
Your doctor at Carolina Active Health will demonstrate and coach you on your Directional
Preference exercises in the office. Likely, you will be prescribed a specific amount of sets and reps (ex. 1 set of 10 reps every hour) of the exercise for at home. Follow the set guidelines to the best of your ability, unless an increase in pain or symptoms occurs!