Flexibility Archives - MelioGuide

Is The Side Bend Safe for Your Spine ?

Margaret Martin — Sun, 07 Sep 2025 14:44:38 +0000

September 7, 2025

If you’ve been diagnosed with osteoporosis or osteoarthritis of the spine, there’s one popular move you’ll want to consider modifying: the side bend. Whether it is performed as a standing side bend or a seated side bend, this stretch can be unhealthy for your spine and put it at risk of a vertebral compression fracture.

Side bend exercises, performed with or without weights are popular in gym classes, fitness videos and senior exercise classes. This popular exercise could put your spine at risk of a compression fracture or an osteoarthritic flare up. (1, 2, 3)

After I explain how side bends can harm your spine, I will share two great alternatives that will make your spine feel great and allow you to put your mind at ease.

Standing Side Bend and Seated Side Bends

The standing side bend and seated side bend exercises create what’s called “an asymmetrical loaded compression” on your vertebrae and the facet joints.

Here’s what happens to your spine during this movement:

Uneven weight distribution: Instead of your spine bearing weight evenly and leveraging all of the trabeculae, all the force concentrates into the side you are bending towards. This means fewer trabeculae support the vertebral body.
Excessive compression: The weight of your head (about 11-12 pounds), shoulders, upper body, and any additional weights you’re holding gets channeled through a smaller surface area in your spine.
Increased fracture risk: For people with osteoporosis, this concentrated pressure significantly raises the risk of compression fractures.
Arthritis aggravation: If you have arthritic spinal joints, you have a disproportionately higher load being taken through the facet joints on the side you are bending towards. This loading pattern can trigger painful flare-ups.

The bottom line? If you have osteopenia, osteoporosis, or osteoarthritis of your spine, you are not helping your spine with loaded side bends, rather you may be hurting yourself. (1,2,3)

This is why I want to show you two wonderful alternatives.

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Two Safe Alternative Side Bends

Don’t worry! You don’t have to give up that satisfying side stretch entirely.

Here are two spine-safe alternative side bends that provide the same range of motion without the dangerous loading.

Option 1: Hands and Knees Side Bend

Setup:

Get on your hands and knees with hands directly under your shoulders
Keep your elbows slightly bent (bonus: this gives your triceps a gentle workout!)
Use knee pads if kneeling is uncomfortable

The Movement:

Bring your right shoulder forward while moving your right pelvis back
Focus on opening up the entire side body
Take a breath in, then exhale as you return to center
Repeat on the other side
For a deeper stretch: Place your right hand over your left hand for additional side opening

Why it’s safer:

This side bend does not load the weight of your head, shoulders, or upper body onto a small portion of your spine. This allows you to get that satisfying stretch without risk of a vertebral compression fracture.

Option 2: Lying Down or Supine Side Bend

Setup:

Lie on your back with legs straight
Raise both arms overhead
Place a pillow under your head/neck for comfort if needed
If shoulder compression feels uncomfortable, place a pillow under your arms

The Movement:

Walk your feet away from your body’s midline
Simultaneously walk your shoulders in the same direction
Continue until you feel a “delicious stretch” through your entire side body
Hold and breathe, then slowly return to center

Side Bend smart exit strategy:

If you feel pulling in your lower body: Come out with your upper body first
If you feel more stretch/pulling in your upper body: Lead with your lower body when returning to center.

Why These Side Bend Modifications Matter

These alternatives give you the satisfying range of motion and side body opening that you crave, but with a crucial difference: minimal to zero spinal loading.

You do not have to worry about the uneven loading created by your upper body weight being placed through your vertebrae.

Instead, you can enjoy the feeling of stretching your muscles and fascia knowing your keeping your spine free from harm.

Conclusion

Too many people contact me after injuring themselves while “just trying to help themselves” by following along with exercise classes or workout videos. If you have osteoporosis, osteopenia, or severe osteoarthritis, generic fitness routines aren’t designed with your specific needs in mind.

These simple modifications are not limitations—they empower you by learning intelligent alternatives so you can stay active for years to come.

The goal is to avoid vertebral compression fractures and arthritis flare-ups that could sideline you from the activities you love.

These spine-friendly side bend alternatives will keep you moving while protecting your most important structural support system — your spine.

Margaret Martin

Margaret Martin is a Physical Therapist with 40 years of clinical experience. Her expertise is in the treatment and prevention of osteoporosis through exercise, safe movement and fall prevention. For the last 20 years, she has concentrated on bone health and has treated thousands of patients for their osteoporosis, osteopenia and low bone density.

References

Marras WS, Granata KP. Spine loading during trunk lateral bending motions. J Biomech. 1997 Jul;30(7):697-703. doi: 10.1016/s0021-9290(97)00010-9. PMID: 9239549.
Wiatt E, Flanagan SP. Lateral Trunk Flexors and Low Back Pain: Endurance and Bilateral Asymmetry. Athletic Therapy Today. 2009 May
Sungwook Kang, Chan‑Hee Park, Hyunwoo Jung, Subum Lee, Yu‑Sun Min, Chul‑Hyun Kim, Mingoo Choi, Gu‑Hee Jung, Dong‑Hee Kim, Kyoung‑Tae Kim, Jong‑Moon Hwang.

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Is The Spine Twist Safe If You Have Osteoporosis?

Margaret Martin — Fri, 05 Sep 2025 14:37:46 +0000

September 5, 2025

Many of my clients tell me about a “really great morning stretch routine” they’ve discovered that “increases thoracic mobility and range of motion”. However, when they demonstrate these routines, I often notice they include the spine twist. These are unsafe for them due to their either their osteoporosis, osteopenia or low bone density. In this post, I’ll show you two alternative ways to safely perform the spine twist (sometimes called the “t spine twist”, “torso twist”, or “thoracic twist”).

Spine Twist

The spine twist can help improve the mobility of our rib cage. However, when you have osteopenia or osteoporosis, doing a spine twist in sitting or standing can increase your risk of a vertebral compression fracture.

It’s important to note that while most of the rotation during the spine twist occurs in the thoracic region of your spine, there is also rotational movement happening in the cervical (neck) and lumbar (low back) regions of the spine.

Avoid the Standing Spine Twist and Sit Twist Exercise

It’s impossible to completely avoid twisting your spine during daily activities — turns and rotations are natural parts of everyday movement. However, if you have low bone mass, osteopenia, or osteoporosis, you should avoid doing full twisting motions while sitting or standing.

This is particularly important when you twist only from your spine without moving your pelvis or feet. These isolated spinal twists can put extra stress on weakened bones and potentially cause a vertebral compression fracture.

Later in the post, I have a video where I demonstrate how to do common activities of daily living without incorporating a spine twist.

Standing Spine Twist

When you stand straight, your spine supports the full weight of your head, shoulders, and arms. Adding a twisting motion creates what’s called a “loaded twist motion” — you’re twisting your spine while it’s under pressure. For people at risk of a vertebral compression fracture, this combination of uneven load and twisting, significantly increases the stress on your spine and can cause a compression fracture or worsen an existing injury.

You might think this doesn’t apply to you if you don’t have a compression fracture. But here’s an important fact: studies show that about 70% of people with osteoporosis actually have compression fractures they don’t know about.

Many of these fractures happen with little to no pain, so you may not realize you have one. The problem is that the spine twist and other risky movements can make existing compression fractures worse or cause new ones in nearby vertebrae.

Sit and Twist Exercise

Most people do not realize that when you do the spine twist you potentially create 40% more load on your spine than standing! My advice: Avoid the sit and twist exercise if you have osteoporosis, osteopenia or low bone density.

Spine Twist and Vertebral Compression Fracture Risk

Vertebral compression fractures most commonly occur in the middle portion of the thoracic spine, (T6, T7, T8) though they also commonly occur closer to the low back, most commonly at T12 and L1. Compression fractures rarely occur in the cervical spine (neck area).
The problem for people with osteoporosis or osteopenia is significant. The movement involved in the traditional spine twist performed while standing or sitting (often found in Pilates, yoga and aerobic exercise classes) puts them at much greater risk of vertebral compression fractures compared to the general population.

Unfortunately, most fitness, Pilates, and yoga instructors aren’t aware of this risk. Even more concerning, many people don’t realize they’re at risk for compression fractures until they’re actually diagnosed with one.

Let’s explore two much safer alternatives for performing the spine twist. In both cases, we do a supine spine twist lying on the floor.

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Supine Spine Twist and Mobility: Option #1

Before trying any new stretch, I highly encourage you to get a recommendation from your physical therapist about whether the supine spine twist is safe for you.

This safer approach uses two key modifications: first, we’ll use a towel at the waist to support your lumbar curve and the space between your pelvis and ribs. Second, we’ll place a pillow behind your back. The thickness of this pillow depends on your flexibility level.

This supine spine twist is actually a modified Feldenkrais movement called the shoulder spine integrator.

Supine Spine Twist Setup and Execution

Start by lying on your side with the towel positioned in the hollow of your waist. Position your arms out at 90 degrees from your body, creating a straight line with your shoulders and pelvis. Your knees and hips should also be at 90 degrees.

From this position, sweep your top hand across the forearm of your bottom hand and bring it to rest at your breastbone. Then reach back toward the pillow. The pillow should provide enough support that you can feel it and rest into it comfortably. If it doesn’t offer adequate support, adjust accordingly.

Take a deep breath in, then exhale as you rotate back into the pillow.

Supine Spine Twist Hand Placement Options

There are two reasons I recommend bringing your hand to your breastbone rather than extending your arm fully. First, depending on the health of your neck, you have an alternative: you can bring your hand to rest on your bottom ear, transitioning it to your top ear as you rotate.

The second reason is crucial for safety. If I allowed you to bring your arm all the way back, the movement would shift from active rotation (using your own muscles) to passive rotation (where the weight of your arm pulls you down). This means your body would go beyond its active limits, which isn’t safe.

By keeping your hand either on your bottom ear or at your breastbone, you maintain control while still achieving excellent rotation. Most of this rotation occurs through the thoracic spine — the part of your spine with ribs attached.

Lying Twist Stretch and Mobility: Option #2

If you want to focus slightly more on the lower lumbar spine area (though most rotation still happens in the Thorcic spine), here’s another safe alternative. You can use a pillow for this variation.

Lying Twist Stretch Setup and Execution

Lie flat on your back and continue using the towel support at your waist. This time, place the pillow down beside your knees. You can open up your chest, which creates a nice variation of the stretch.

Shift your hips about an inch away from the side you’re going to rotate toward. Take a breath in, then exhale while dropping your knees to that side, creating a gentle rotational stretch.

Without the pillow, you would be “hanging” in the stretch, which creates a greater twist.
However, since I don’t know each person’s individual situation—and many people might have compression fractures without realizing it—I’m not comfortable suggesting that everyone can safely do the more intense version.

This is why it’s always best to check with your individual therapist.

Lying Twist Stretch Proper Positioning

Breathe in and exhale as you lower your knees to the side
Position the pillow close enough to support your thighs so you can relax into the stretch
Focus on breathing deeply into the stretch
Remember to always roll over onto your shoulder when transitioning back up to a sitting position.

How to Safely Twist Doing Activities

I demonstrate how to modify your activities of daily living so that your twist and rotation movements are safer.

Conclusion

One of my main motivations for creating these educational posts is to help you avoid compression fractures or arthritis flare-ups in your back. I receive too many emails from people saying, “But I was just trying to help myself”—people who were simply doing exercises or following along in fitness classes.

If you know you have osteoporosis or severe osteoarthritis, please make these modifications to keep your spine safe. Your long-term spinal health is worth the extra precautions.

Margaret Martin

References

Takano, H. , Yonezawa, I. , Todo, M. , Hazli Mazlan, M. , Sato, T. and Kaneko, K. (2017) Biomechanical Study of Vertebral Compression Fracture Using Finite Element Analysis. Journal of Applied Mathematics and Physics, 5, 953-965. doi: 10.4236/jamp.2017.54084.
Wiklund P, Buchebner D, Geijer M. Vertebral compression fractures at abdominal CT: underdiagnosis, undertreatment, and evaluation of an AI algorithm. J Bone Miner Res. 2024 Aug 21;39(8):1113-1119. doi: 10.1093/jbmr/zjae096. PMID: 38900913.
Li, Y., Yan, L., Cai, S. et al. The prevalence and under-diagnosis of vertebral fractures on chest radiograph. BMC Musculoskelet Disord 19, 235 (2018). https://doi.org/10.1186/s12891-018-2171-y

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Flexibility for Osteoporosis Guide

Margaret Martin — Sat, 15 Jul 2023 20:20:25 +0000

July 15, 2023

This flexibility exercises for osteoporosis guide discusses flexibility and stretching for people diagnosed with osteoporosis, osteopenia, and low bone density. It covers:

The importance of flexibility for good posture and body mechanics.
How different types of stretches target muscles, nerves, and fascia.
Testing for hypermobility and tips to keep you safe when you stretch.

Benefits of Flexibility for People With Osteoporosis

Many of my clients are concerned about their forward head posture, rounded shoulders, and apparent midsection bulge. Stretching the correct muscles is essential before strengthening the weak ones.

Regular stretching and flexibility exercises help to maintain joint and muscle range of motion.

Combining flexibility exercises with weight bearing and strength training effectively maintains your joint and muscle range of motion.

It is always best to consult a Physical Therapist, who can help you identify which muscles need stretching. We have you covered if you cannot access a professional near you. You can access numerous resources that I will place in this guide.

How Flexible Are You?

Flexibility is an important component of overall physical fitness. However, an individual’s flexibility is largely genetically determined.

Over my many years as a Physical Therapist and Yoga instructor, I noticed that individuals who need to stretch do not particularly like to stretch, while those who like to stretch don’t need to.

Avoid comparing how flexible you are to other people; instead, try to be as flexible as you need to perform daily activities and complete your osteoporosis exercise program.

Stretches That Reduce Fracture Risk

You can find hundreds of videos, photos, suggestions, and programs on the internet focused on stretching. However, these stretches and flexibility routines may be wrong for you.

The stretches in my book, Exercise for Better Bones, in my videos, and on this website are specifically designed for people with low bone density, osteopenia, or osteoporosis. They are safe and effective. They are intended for you.

I have given much thought to ensuring that each stretch provides you with the flexibility you need without compromising the health of your hip or spine.

Below is a video on hamstring stretching that explains how flexible hamstrings help protect your spine.

Stretching for Function and Injury Prevention

A flexible body allows you to reach farther before spraining or straining a muscle or joint. In this section, I cover the fundamentals of stretching for injury prevention.

Posture Stretches

Improving your posture involves both stretching and strengthening. My four daily stretches video focuses on the muscles to stretch daily.

We get tight when we spend too much time in one position. Whether you are sitting behind a computer, reading a book, knitting, doing housework, or doing woodwork. Most activities of daily living involve forward movement from a sitting or squatted position.

Repeated or sustained forward movements tighten our chest muscles, the front of the hips and thighs. I have a video specifically for those of you working from home.

An imbalance in the muscles around your pelvis can lead to either a posterior or anterior pelvic tilt. I have videos addressing these conditions and which stretches to focus on.

Regular stretching will help you regain your correct postural alignment.

Myofascial Stretching Guidelines

Follow these myofascial stretching guidelines:

Choose a time and place that will be undisturbed.
Use support as needed to be comfortable in the stretch.
Telescope the area you are stretching.
Adjust your position to limit the intensity to 4 out of 10.
Breathe slowly in a relaxed manner. If you find yourself holding your breath, adjust your position.
Breathe into an area of tightness and visualize it softening and letting go.
To achieve an effective release, maintain the stretch uninterrupted for at least 2 minutes.
After 2 minutes, if your body is comfortable, hold for 2 to 4 more minutes.

After the stretch, drink a glass of water. The fascia needs hydration to remain healthy.

Muscle Stretches: Dynamic and Static Stretching

Muscles respond well to both dynamic and static stretches. Dynamic stretches make an excellent warm-up for the activity. They are held for one to two seconds and repeated ten times.

Static stretches make a great cool-down and are generally held for thirty seconds and repeated two to three times.

Self-Massage for a Better Stretch

Trigger points, or very tender areas in your muscles, are a common experience. They are often sources of referred pain.

Muscles stretch far better after you have treated their trigger points. Let’s cover guidelines for releasing trigger points through massage.

Trigger Point Massage Guidelines

You can follow these guidelines when working on any tight, painful/tender muscle. (2)

Imagine you are massaging a dog or cat that is in pain.
Approach the muscle with kindness.
Aim for a pain level of five on a scale of one to ten. You are looking for a purring effect or a pleasant pain.
Massage with short (one to two inches) repeated strokes.
Emphasize one direction and move slowly over the tender area (two to three seconds).
Limit the massage to six to twelve strokes per trigger point/tender spot.
A more frequent, gentle daily treatment is far better than one longer, more aggressive session.
Massage the trigger point(s) three to four times per day.
Breathe and be patient. You may have had these trigger points for years. They may take a few days/weeks to disappear.

I have videos demonstrating how to massage your upper thigh with a rolling pin or a foam roller and massage your shoulder muscles using a ball.

Nerve Stretches

Suppose you ever experience zinging, pins and needles, or a deep, painful sensation when you stretch. In that case, you may have adhesions around your nerves.

Our nerves carry impulses between our brain, organs, muscles, bones, and other body structures. The nervous system directs highly skilled movements under different levels of tension.

Nerves travel a long way and must be flexible to stretch and retract to accommodate the many movements of the human body.

Adhesions around a nerve, whether from direct trauma, lack of movement, surgery, or trauma to surrounding tissue, impact its flexibility. Unlike muscles and fascia, nerves do not like static stretches. (3)

They look like dental floss and respond best to movements that resemble flossing. For specific nerve stretches, it is best to seek guidance from a Physical Therapist.

Flexibility Exercises for Osteoporosis Resource

This video series is a safe and effective stretching exercise workout for people concerned with their bone health. It includes three separate flexibility sessions.

Hypermobility

Hypermobility means that your joints are more flexible than the average person’s.

I have a video demonstrating the Beighton hypermobility test. You can follow along with me to test whether you are hypermobile.

If you are anywhere on the hypermobility scale, I highly recommend that you exercise in front of a mirror. A mirror is critical to giving you the feedback you do not get from your joints.

Many individuals with hypermobile feet and ankles experience frequent ankle strains, sprains, near falls, or actual falls because they do not receive feedback fast enough from their joints to be able to react. Wearing ankle braces and using walking sticks/poles are beneficial ways to reduce fall risk.

I have several videos on hypermobility within this guide.

References

John Barnes, Myofascial Training Level I course notes.
The Trigger Point Therapy Workbook – Your Self-Treatment Guide for Pain Relief Authors: Clair and Amber Davies, 3rd ed. Available on Amazon or Indigo. This book is a great resource and very user-friendly.
David S. Butler. Mobilisation of the Nervous System. Churchill Livingstone. 1991

Margaret Martin

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How to Stretch Hamstrings

Margaret Martin — Wed, 16 Jan 2019 18:58:36 +0000

Flexible hamstrings help keep spines safe and strong. They allow you to hinge from your hips and bend forward without flexing your spine. In today’s post I demonstrate how to stretch hamstrings and make them more flexible.

How to Stretch Hamstrings

Discuss hamstring anatomy.
Show you how to test hamstring flexibility or tightness and determine the right hamstring stretch for you.
Demonstrate how to stretch hamstrings with four variations of a lying hamstring stretch.
Identify whether you should do calf stretches before you try to increase your hamstring flexibility. If your calf muscles are tight it is important that you first take time to stretch your calf otherwise it will limit your ability to fully stretch your hamstrings.

Benefits of Flexible Hamstrings

There are many benefits of flexible hamstrings. Here are three benefits that immediately come to mind:

Perfect posture.
Reduced risk of compression fracture.
Avoidance of injury.

Flexible Hamstrings Improve Your Posture

Hamstring flexibility and tightness can affect your posture in a detrimental way. In his book, Low Back Disorders — Evidence-Based Prevention and Rehabilitation, Dr. Stuart McGill states “Lower extremity capability is needed to facilitate spine-sparing postures when lifting and when performing a host of other tasks.” (1)

Lower extremity capacity encompasses the strength and flexibility of the lower extremities, meaning your legs. When it comes to your back and how you move, your hamstrings play a big role. They allow you to do a range of activities and not compromise your posture. The hamstring flexibility exercises I recommend in this blog are designed to achieve that goal.

Flexible Hamstrings Reduce Your Risk of Compression Fracture

Tight hamstrings are especially problematic for people with osteoporosis. When hamstrings are not flexible, they pull the pelvis in a downward direction. The downward pull causes a posterior tilting of the pelvis which, in turns, causes our lower back to lose its natural inward arch.

The loss of the arch leads to the rounding of the mid back. Along with weak core muscles, tight hamstrings predisposes us to bend from our the spine rather than through the knees and hips. When we bend from our spine it creates an increased “kyphosis” or hump back.

Why is this a concern for individuals with osteoporosis? Because this rounded back posture, or kyphosis, puts a lot of pressure at the front of the vertebrae, as well as our discs.

When you have low bone density in your spine, repeated forward bending at the spine creates micro-trauma to the vertebrae. Over time, these repeated micro-traumas can evolve into a more serious trauma. Eventually, a minor movement — like reaching into a fridge or even coughing — can cause a compression fracture. In reality, that small, everyday movement was “the straw that broke the camel’s back”.

In the photo, below, a young woman performs a pose and demonstrates her hamstring flexibility. The concern is the alignment of her spine.

For a more detailed understanding of how flexion of the spine can cause minute trauma to the vertebra which accumulates to finally cause a compression I encourage you to revisit the blog article titled Osteoporosis Posture Explained.

Flexible Hamstrings Make Your Exercises and Yoga Practice Safer

Flexible hamstrings will help you perform many Yoga poses without compromising your posture. I discuss this in detail in this blog post on Standing Forward Bends.

Flexible Hamstrings Help You Avoid Injury

How do we avoid these potential injuries? By increasing the flexibility our hamstrings via simple, safe hamstring stretches like the ones demonstrated in this article.

In 2015 an international consensus by leading researchers on physical activity and exercise for adults with osteoporosis (2) recommended that prescribed exercise, for individuals with or without vertebral fractures, encourages safe movement patterns.

The hamstring stretches demonstrated in this blog are, onto themselves, safe movement patterns and prescribed exercises, as defined by the research team. But, even more importantly, they provide you the flexibility you need so you can incorporate safe functional moves into your day-to-day life.

Let’s quickly cover hamstring anatomy and the key functions of the hamstring muscles. If you are already familiar with these topics, I suggest you jump to the Hamstring Flexibility Test.

Hamstring Anatomy

The hamstring connects our pelvis and femur to our lower legs. The hamstring muscle is actually composed of three muscles that make up the back of our thighs:

Biceps femoris
Semimembranosis
Semitendinosis

The image, above, shows the back of the right leg and illustrates each of the three muscles that make up the hamstring.

On the outer posterior thigh lies biceps femoris (like the bicep muscle in our arms this muscle has two heads, hence the name biceps), semimembranosis and semitendinosis cover the inner posterior of the thigh.

Biceps femoris’ long head attaches from the outside of the our sit bone, while the short head originates from the lower half of the shaft of the femur. Together they connect down below the knee to the head of the fibula (the tall slim bone on the outside of the lower leg).

Semimembranosis and semitendinosis attach from the inside of the sit bone at the pelvis and connect down to the tibia both on the back and wrapping around to the front of the tibia (the large lower leg bone that we often refer to as our shin bone).

Functions of the Hamstring Muscles

Hamstrings have several important functions. First, one key hamstring function is the ability of the muscles to pull the pelvis into a posterior pelvic tilt. This is a common cause of low back pain and poor posture when forward bending. Tight hamstrings will limit the ability of your pelvis to tilt forward as you start to bend from your hips. The pulling into a posterior pelvic tilt will flatten your natural arch of your lower back and cause a rounding of your spine.

Second, the hamstring group also bends the knee, extends the hip, and helps in rotating the thigh inward and outward.

Third, strong, flexible hamstrings are important to ensure you can enjoy the sports and activities you love such as brisk walking, running, cross country skiing, and other common activities.

Before I demonstrate how to stretch hamstrings, I will walk you through a hamstring flexibility test so you can determine how flexible your hamstrings are. Let’s start by finding out how tight your hamstrings are.

I encourage all my clients to aim for 90 degrees of flexibility. Remember you did not get tight overnight and it may take a few weeks to become more flexible.

Hamstring Flexibility or Tightness Test

In this section I will cover how to do a self test to determine hamstring flexibility or tightness, whether you should initially increase calf flexibility, and what hamstring flexibility exercise is best for you.

Let’s get started with the test. When you play video below, it will go directly to the part that describes the hamstring flexibility test.

Hamstring Flexibility or Tightness Test

This hamstring flexibility test will help you determine your level of hamstring tightness. These are the step by step instructions:

Lie flat on the mat and bend your left knee, sole of the foot to the mat. This is not critical for stretching your hamstrings, but it is important in order to keep your back safe.
If you have any back pain or you’ve had a herniated disc, I suggest you also put a little rolled towel in the small of your back.
Lift the right leg toward the sky and keep your leg straight. You’re going to feel muscle tightness in the thigh, as the quadricep muscles lift your leg along with your hip flexors.
Continue to lift the right leg until you feel your back flattening to the mat, or push into the rolled towel you may be using. You can check this by simply feeling with your hand if that little arch in your back that you started with is gone.
Once you reach the point where the back is flattening, that is the limit of your hamstring flexibility.
Lower the leg slowly.
Switch and repeat on your other side with the right knee bent, lifting the left leg.

What to Measure in the Hamstring Flexibility/Tightness Test

When performing the hamstring tightness test, I measure the approximate angle by straightening my bottom leg. This angle is referred to as the straight leg test and it is a measure of hamstring flexibility.

As shown in the video demonstration, with the non-testing leg straight, I have about 80 degrees of hamstring flexibility. Ideally, I wish all my clients to have 90 degrees of hamstring flexibility as this will allow them to bend over more easily, hinging from their hips rather than rounding their spine.
When testing your hamstring flexibility you may feel tightness behind or below the knee. If so, I recommend you stretch your calf muscles first.
The hamstring and the calf muscles cross one another behind the knee, so tightness in the calf muscle will limit your ability to get a full stretch of your hamstring.

Four States of Hamstring Flexibility

Hamstring flexibility can vary from individual to individual. Generally, I find people fall into one of four states of hamstring flexibility. These are based on my clinical observations.

Very tight. You feel tightness before your leg reaches 45 degrees from the floor. Do the stretch using a ball.
Moderately tight. You feel tightness between 46 and 80 degrees. Do the stretch using the wall.
A little bit tight. You feel tightness between 81 and 90 degrees. Do the stretch using a rope or belt.
Not tight. You are able to lift your leg past 90 degrees. The rope or the wall versions will work for you.

The next exercise will stretch that tight calf muscle so we can progress to the hamstring stretches.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?

A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.

Tight Calf Muscle Stretch

How do you stretch tight calf muscles?

For some people, repetitions of flexing the foot and pulling their toes up towards their nose and then releasing is efficient. It’s a wonderful thing to do first thing in the morning!

If this calf stretch is at all uncomfortable for your knee, you can place a pillow under the leg and knee, low enough so your heel is hanging just over the pillow. This supports the knee, as some of us hyperextend in this area.

When doing this stretch, simply point and flex the foot for as many repetitions as comfortable. The pointing is not as important for the flexibility of the calf, but it’s a lovely way of keeping the front of the ankle flexible as well.

Calf Muscle Stretch with a Belt, Strap or Rope

If the stretch starts to feel less significant, I suggest that you loop a soft belt, strap or rope around your foot to get a deeper stretch.
Please note, you can do this stretch with or without a shoe. Some find a shoe more comfortable as it keeps the prop in place and you’ll feel less pressure on your foot.
Be sure to have the belt, strap or rope at the ball of the foot rather than the arch. At the ball mound you’re able to get a more active, deeper stretch.
Keep your elbows by your side, shoulder blades tucked and stay long through the back of your neck.
Begin pointing and flexing the foot, and keep the leg down still resting on the floor or pillow.
Keep your breath comfortable and relaxed. Exhale through the stretch.
The muscles of your feet to do 90% of the work, so the foot is pulling the toes towards the nose rather than the rope. Only that last little pound or two of pressure is lifted by the rope.

This is what we refer to as active isolated stretching. By actively contracting the muscles in the front of your lower leg, you’re relaxing the muscles on the backside — your calf muscles. A wonderful way to get more flexibility in the calf!

It may take about 30-40 repetitions to get them loosened up, or two weeks of 30-40 repetitions per day. Either way, keep up this stretch until you feel you’ve loosened up the calf muscle.

How to Choose a Hamstring Stretch Exercise

Once you identify your hamstring flexibility, you can select the hamstring stretch exercise that is best for you. Over time, you can progress onto more challenging exercises as your flexibility increases. These hamstring stretches are:

Easy to do.
Safe for your spine.
Address different levels of hamstring tightness.
Progressively increase the range of your muscles.
A key element in being able to move with safe body mechanics.

Supine Hamstring Stretch with Stability Ball

This hamstring stretch is done on your back using a stability ball.

Lie on your back, with both knees bent.
Place one foot onto the front of the ball.
Straighten the leg that is resting on the ball until you feel a gentle stretch in the hamstring.
Inhale as you roll the ball toward you, the knee towards your chest.
Exhale as you roll the ball away, straightening your knee.
As your flexibility is improves, explore bringing the ball a bit closer to your buttocks. As you straighten, the leg will be higher providing more of a stretch.
Endeavour to straighten the knee completely each time you roll the ball away.

Supine Hamstring Stretch in Doorway

If your hamstrings are moderately tight and the ball does not provide a stretch, I recommend you do the supine hamstring stretch lying on the floor using a doorway/doorframe.

Start by turning sideways to the wall, butt sideways with your shins perpendicular to the wall.
The distance that you are from the doorway will change the depth of your stretch. I recommend starting about six to eight inches from the wall.
As your flexibility increases you will be able to straighten the opposite leg through the doorway. You may explore wearing socks to help your foot slide up the doorframe.

How to Do the Supine Hamstring Stretch in Doorway

Softly inhale at rest.
Exhale as you slowly slide the foot up the wall.
The stretch should be felt in the back of your upper leg.
Inhale as you slowly lower the leg back down.
Keep repeating these movements, exhaling up and inhaling down.
Keep your shoulders tucked back, and your neck long.
A small rolled towel in just above your pelvis will help remind you to keep the arch of your spine neutral.
When you slide up, if you feel your back flattening into the towel, that’s your cue that you’ve found the limit of your hamstring.
Your goal is to be able to stretch without flattening your spine.

Use the head support that you need maintain a neutral head and neck posture.

Deepen the Supine Hamstring Stretch

After doing around 20 or 30 repetitions, you may feel that you’re getting more flexible. To deepen the stretch you have two options:

Get closer to the wall or,
Straighten the non-stretched leg.

If straightening the opposite leg does not increase your stretch explore getting the buttocks all the way to the wall.

Lower Hamstring Stretch with Rope

This stretch is great option for those who are a little tight in their hamstrings or if they want to maintain their flexibility. Do this hamstring stretch lying down on your back and you will need a 3/4 inch rope or Yoga belt.

Lie on your back just as we did with the calf stretch. One knee is bent, sole of the foot to the mat.
Place the rope around the arch of the opposite foot. Use the rope to help you lift the leg, toes of the foot toward the sky.
Once the leg is lifted, slowly and rhythmically move in and out of bending and re-extending the leg.

Depending on your flexibility, the leg may lift all the way to 90 degrees, or lower. If the leg is lower than 90 degrees, you may need to recruit more help from the rope. Below, I’ll give more options for those of you that are tighter.

Upper Hamstring Stretch with Rope

The upper hamstring stretch targets the part of the hamstring that is closer to the sit bone, or the ischial tuberosity. We will perform the same setup as before.

Lie on your back, bend one knee with the sole of the foot to the mat.
Take the rope on the opposite ball mound and once more.
Use the rope to lift the leg, foot toward the sky. The difference here is that we will now lift and lower the leg, but keep the knee straight for the entire stretch.
Use your breath here.
Inhale as you lower, exhale as you lift.

Be sure to keep the elbows by your side. Shoulders are tucked. Hold both ends of the rope in one hand.
Explore which hand feels best.
Make sure you keep your knee nice and straight.

Remember that when doing active isolated stretching, each stretch is held for just one to two seconds. The leg muscles are doing 90% of the work, and then at the end you give it a little extra stretch.

Active Isolated Stretching Versus Static Stretching

All of the stretches I’ve explained so far are called Active Isolated Stretches. The founder of Active Isolated Stretches is Aaron Maates. (3)

With Active Isolated Stretching each stretch is held for one to two seconds and repeated at least 10 times. Active Isolated Stretching is very dynamic and therefore can be used as a warm up to exercise, yard work, house work or sports.

Static Stretch

After you’ve completed those active isolated stretches, whether it was using the ball or extending your leg up against the wall, you can turn your dynamic stretch into a static stretch. A static stretch is as the name implies — there is no movement. The intensity of the stretch should allow you to relax in that position.

While relaxing, you are looking for an intensity of about 4 to 5 out of 10. This lower level of intensity allows your muscles and your fascia to release and relax.

If you enter a static stretch with too much intensity, your body is just going to fight it. Make sure you’re in a position to where you are stretching but are also comfortable, similar to what you may see in a Yin yoga class. It should feel like a delicious stretch.

If you are stretching with the support of the doorway you may choose to slide the opposite leg down if you haven’t already. You can get a little closer to the wall, or for individuals that are very flexible you might even place a bolster behind the leg to deepen the lengthening of the hamstring. You can also extend your arms out to the side to open your chest lengthening through the back of your head and neck, as bonus stretches.

To exit the stretch, slowly bend one knee at a time bring your knees towards your chest. With your knees together roll onto your side. Pause for a few breaths before pushing yourself up.

Stretch Goals

All of these stretches and tips will allow you to reach your goals of:

Moving with better body mechanics.
Keeping your spine protected and strong.
Improving and/or maintaining flexible hamstrings.

References for How to Stretch Hamstrings

McGill, Stuart. Low back Disorders, Evidence-based Prevention and Rehabilitation. p. 240.
Giangregorio, L.M., et al, Too Fit To Fracture. Outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures. Osteoporosis International, 2015 Mar; 26(3): 891-910
Mattes, Aaron. Active Isolated Stretching: The Mattes Method. Privately published.

Osteoporosis Exercise Plan

Visit my Osteoporosis Exercise Plan page for more information on this topic.

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Hypermobility Exercises

Margaret Martin — Mon, 19 Jun 2017 12:22:12 +0000

Today I am going to talk about hypermobility exercises and specifically what modifications you need to make to have a hypermobility syndrome exercise program that is safe and effective. I have a section dedicated to core exercises for hypermobility. Finally, I answer the question: Do people who have hypermobility syndrome need to be careful with their choice of exercise and should they modify their exercise routine?

Hypermobility Exercises

Hi. I’m Margaret at MelioGuide, and today I’m covering part three of the hypermobility spectrum disorder, hypermobility exercises.

We will look at elements of exercise as it relates to people who are more mobile than the average individual — people who have hypermobility syndrome.

We will discuss specific challenges and modifications you should make to your exercise routine.

I suggest you go back my first blog on this, so that if you’re wanting a clearer definition of what hypermobility syndrome is all about.

(In the first two parts of this series, I covered hypermobility test and yoga and hypermobility. To determine if you have hypermobility syndrome, I encourage you to complete the hypermobility test.)

Core Exercises for Hypermobility

The following are recommended core exercises for hypermobility.

Plank exercise.
Side plank exercise.
Basic abdominal activation exercise.
Abdominal activation with a leg drop.
Abdominal activation with a 90/90 leg drop.
Advanced abdominal activation with leg drops.
Horse stance in vertical position.
Horse stance in vertical position.

Core exercises for hypermobility will help you offset the postural, flexibility and balance issues associated with hypermobility syndrome. I recommend certain clients practice several core exercises for hypermobility.

Each of the core exercises for hypermobility listed above is described in detail in Strengthen Your Core and Exercise for Better Bones.

Here are a few points to consider regarding core exercises for hypermobility.

Benefits of Core Exercises for Hypermobility

Core exercises, when done properly, benefit the back and abdominal muscles, which in turn protect your spine. Core exercises for hypermobility help you establish and maintain a neutral position so that your movements and exercises are executed without causing hypermobility of the joints.

Components of Core Exercises for Hypermobility

Core strength goes beyond the abdominal muscles. It incorporates the diaphragm, pelvic floor, and the muscles of the spine, the hips, and the shoulders. Core exercises for hypermobility are designed to address address all of these areas while delivering the benefits. Here are the key components of program of core exercises for hypermobility:

Establish a neutral spine position to eliminate or reduce flexion and extension of the spine.
Integrate the pelvic floor. The pelvic floor is the foundation of core stability.
Use core breathing from the diaphragm to support your core.

Exercise Challenges for People with Hypermobility Syndrome

Individuals who have hypermobility syndrome have several challenges when it comes to exercise.

Hypermobility and Posture

The first challenge to hypermobility exercises is maintaining perfect posture. Perfect posture is much easier to obtain if you have normal mobility. Because if somebody with normal mobility goes out of range, we can start feeling it, we can feel the tightness in the joints and our ligaments are starting to yell at us a little bit.

I have hypermobile knees and used to just be able to stand with my knees way back (hypermobile knees that went too far back). I could hold this position for a long period and compensate by keeping my hips in a forward position. My lower body never told me (or “cued” me) that I was hypermobile.

However if you’re hypermobile in many parts of your body, you never get that cueing about what your neutral body position needs to be.

Exercise form requires starting in a neutral position. If you are not getting cues that you are hypermobile, then you never get into that starting neutral position. For many people, getting into a neutral position and transitioning into exercise is a huge step.

It’s critical for somebody that has hypermobility syndrome to have a teacher that:

Teaches them well
Looks at how they are moving and makes sure that they are moving within a safe range of motion.
Makes corrections as they are needed.

Hypermobility and Alexander Technique

At the hypermobility.org website they talk about the “Alexander Technique“. Check it out.

Physical Therapy for hypermobility syndrome is also important. However, make sure that the practitioner is trained in movements and teaches you proper hypermobility exercise and movements.

Because a lot of people with hypermobility have pain, passive modalities in treatment might not be as effective as learning proper hypermobility exercise and movements. To get out of the pain spectrum you need to learn to move well.

Hypermobility and Flexibility (Stretching)

The second challenge for individuals with hypermobility syndrome are their flexibility exercises — often seen in yoga. If you practice hypermobility exercises, you might need to adjust your stretching routine.

As I mentioned in the blog on yoga and hypermobility you need to learn how to stretch the muscles that are tight and not over stretching the joints that are already loose. That’s very critical if you have hypermobility syndrome.

Hypermobility and Balance

The third challenge to hypermobility exercises is balance.

Because your joints are so much more mobile, you’re not getting proper feedback on your balance.

Your little joint receptors that give your brain that information, the proprioceptors, aren’t firing as quickly as those for of individuals who have less mobile joints.

Safe and effective balance exercises and gradual progression of balance exercise is very very critical for individuals that have hypermobility syndrome.

Hypermobility and Osteoporosis

Many of my clients are diagnosed with osteoporosis or osteopenia and a large majority of them also happen to be hypermobile. They often score anywhere between one and nine on the Beighton Hypermobility Scale.

A study (1) going back to 2006 looked at 25 premenopausal women that were prediagnosed, using the BeightonHypermobility Scale, as being benign hypermobile or having the Benign Hypermobility Syndrome.

The researchers matched this group with 25 age-matched controls. All of the women in the control group were Caucasian. Further, they matched in terms of:

Body mass index.
Number of pregnancies they had had.
If they had nursed.
How many years they had nursed or lactated for.
Their calcium intake.
Physical activity level.

This is a very good control study in the terms of matching all of the characteristics that we know affect our bones.

The researchers looked to answer the following questions:

Was there a difference in their bone mineral density at the hip — specifically the trochanteric bone mineral density?
Was there a risk for lower bone mass?

The research team found that the women diagnosed with Benign Hypermobility Syndrome showed a decrease in the bone mineral density at the trochanteric site located at the hip and demonstrated an increased risk for low bone mass, by as much as 1.8 times, compared to the control group.

What does this mean?

If you are hypermobile and you are premenopausal, I strongly encourage you to have a bone mineral density test well before the recommended age of 65.

Conclusion

If you have hypermobility syndrome, your approach to exercise and movements needs to be different than most people. You should have a better idea of adjustments you need to make to your exercise regime. Your persistence in safe movement (during exercise and your activities of daily living) will lead to you having a healthier and stronger body.

References

Gulbahar S, et al., Hypermobility syndrome increases the risk for low bone mass. Clin Rheumatol, 2006 Jul:25(4):511-4

Joint Health

Visit my page dedicated to Joint Health.

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Hypermobility Test

Margaret Martin — Wed, 07 Jun 2017 15:57:47 +0000

What is the hypermobility test that you or your Physical Therapist can do to determine if you have hypermobility syndrome? What are the implications for you if you happen to have hypermobililty syndrome? I discuss these issues in this video blog and work with Victoria — one of my clients — to determine if she has hypermobility syndrome (answer: she is).

Hypermobility Syndrome

Margaret: Hi, I’m Margaret Martin at MelioGuide. Thank you for tuning in.

Today, I am going to cover Hypermobility Syndrome. I have invited a very special client, Victoria, who we have (already) determined has hypermobility syndrome. In this video blog, we are going to recreate the hypermobility test that we did a few weeks ago on Victoria.

I invited Victoria to take the hypermobility test again because when Victoria originally came to see me for Physical Therapy she wanted an exercise program to strengthen her bones. However, when she started her exercise program she had two experiences:

Her hesitation towards exercise because of negative consequences in the past.
Like many of my clients who have hypermobility syndrome, she ran into problems early on with pain and discomfort when doing her exercises.

As Physical Therapists, it is important to find out that somebody has hypermobility. This allows you to take slower steps in working with somebody.

As individuals, if you test yourself and find out that you have hypermobility, there’s a lot of other implications that are important.

I cover two important topics related to hypermobility syndrome in other blogs, namely yoga and hypermobility and hypermobility exercises guidelines.

Hypermobility Syndrome Questionnaire

Today, what I would like to cover is the way in which you go about performing the Hypermobility test.

One of the first ways is simply a questionnaire. If you do not have the client with you or you decide you don’t have the time in your practice, you can at least have them complete a questionnaire.

Five questions that have an 85% specificity and sensitivity. This means that it is pretty accurate, and it was tested in both internationally and in different languages. These five questions are as follows.

Question 1 • Hands Flat on Floor

Margaret: Can you now, Victoria, or could you ever place your hands flat on the floor without bending your knees?

Victoria: Yes.

Question 2 • Hypermobile Thumbs

Margaret: Can you now or could you ever bend your thumb to touch your forearm?

Victoria: Yes.

Question 3 • Hypermobile Body

Margaret: As a child, did you amuse your friends by contorting your body into strange shapes or could you do the splits?

Victoria: I could do the splits.

Question 4 • Kneecap or Shoulder Dislocation

Margaret: As a child or teenager, did your shoulder or kneecap ever dislocate more than once?

Victoria: No.

Question 5 • Double Jointed

Margaret: And do you consider yourself double-jointed?

Victoria: I do.

Interpretation of Questionnaire Results

Margaret: If an individual scores 2 or more of the 5 questions, they have an 85% chance, really, of being hypermobile.

Hypermobility Test

We’re going to run through the actual physical hypermobility test that allow you to be even more specific. Let’s go through the five tests. These tests are scored for a total of nine points.

Test 1 • Hypermobile Fingers

I have a very little bit of hypermobility. The audience can kind of see the difference between a relatively normal range of motion — which is to have your forearm and hand in a straight line and to bring your little finger back.

Could you repeat that same thing on the other hand for me? So for every finger that…little finger, right, left, that Victoria’s able to do at 90 degrees, that’s 1 point. So one point for right, one point for left.

Test 2 • Hypermobile Thumbs

The next one would be to bring your thumb down to your forearm. Okay. And could you repeat that on the other side as well? Okay. Very good. Thank you. And so then you get two more points.

Test 3 • Hypermobile Elbows

Then it’s the elbow, the ability to straighten the elbow past the horizon. I’m going to take my goniometer out. And so just measuring the distance from the inside of the arm down through and seeing how far she can go, and we’re getting about minus 20 degrees. Okay.

And could you repeat that on the other side, please? So straight out, and bring that elbow down. Okay, now weight is flexible here, but we’re still about minus 15. Okay. Very good. So again, you get one point for each side.

Test 4 • Hypermobile Knees

The other one that’s done double are the knees. Okay, so I’ll have you lie down on your back, please.

Thank you for lying down on your back.

Heels up, perfect.

Then if you could bring the back of your knees down, perfect.

Her ability to bend backward. All right. Just coming in at minus 10 degrees. Okay.

Test 5 • Hypermobile Hips

The last test that is done is the test where she would actually be standing straight and bringing her hands flat to the floor. So then the score is issued out of nine points.

But within the Hypermobility Syndrome, just because you score nine out of nine, doesn’t mean that you’re going to have more problems than somebody that scores one out of nine.

There’s a spectrum of other issues that you may face, that is important for you to be aware of and for your clinician to be aware of as well.

So please stay tuned for the other blogs where we’ll discuss yoga and hypermobility.

Resources for Individuals

Individuals seeking further help or advice on hypermobility syndrome should use this resource.

Physical Therapy for Hypermobility Syndrome

The physical test demonstrated in the blog is referred to as the Beighton Score.

Please note that this test does fall short of highlighting all potential hypermobile joints.

Physical Therapists are encouraged to assess individual joint especially when function or pain is involved. The updated criteria for clinicians is located here.

Joint Health

Read more articles like this on Joint Health

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Chair Sit and Reach Test Alternative for Senior Fitness Test

Margaret Martin — Wed, 20 Apr 2011 13:39:02 +0000

I was recently contacted by a Physiotherapist who completed my MelioGuide Building Better Bones course on osteoporosis prevention, treatment and management. She asked if I could suggest an alternative to the Chair Sit and Reach Test in the Senior Fitness Test.

This article is a part of my Physical Therapist and Physiotherapist Continuing Education series for Physical Therapists, Physiotherapists, Physiotherapy Assistants and Physical Therapy Assistants.

Sit and Reach Test for Senior Fitness Test

Please feel free to comment on my response and alternative suggestions are certainly welcome. Below is our exchange:

Hi Margaret,

I would appreciate your professional opinion on one of the items in the Senior Fitness Test – specifically the Chair Sit and Reach Test.

Do you have any suggestions for an alternative position?

We are opening a Cardiac Out-Patient Clinic and will be using the Senior Fitness Test for those patients who are unable to complete our full evaluation work-up. The Chair Sit and Reach Test is contraindicated for many of the patients that we will receive.

I took your course a year ago and refer to your text and videos frequently.

Hello Jane,

Thank you for your question. I appreciate you consulting with me.

If you are simply looking for a measure of hamstring flexibility, I would suggest either of the following tests:

Supine Flexibility Test

Standardize your test by having your client lie supine, a small rolled support the size of their flat hand in their lumbar area and support under their head (indicate what you use for duplication/retesting) since not all clients will be able to lay flat.

Bend one knee so that the foot is resting beside the knee of the straight leg.
Ask client to straighten the knee as they point the foot away from them. This will give you hamstring flexibility without limitation from gastrocnemius or neural tension.
Cue your client to inhale, then exhale and tighten lower abdominals as they assist you in raising the straight leg up off the table/floor: “Take a deep relaxed breath and exhale and tighten your deep tummy muscles as you raise your leg as high as you comfortably can without bending your knee. Keep your foot relaxed.”
Passively assist to where they feel tension at a level of 6 on 10 but no pain.
Remind them to keep the knee as they point the foot away from them. This will give you hamstring flexibility without limitation from gastrocnemius or neural tension.
Measure the angle from the floor.

Chair Sit and Reach Test

Standardize your test by having the client sit on a flat chair, both thighs supported, knees and hips bent 90 degrees, and feet flat on the floor (or use a 1 inch or 2 inch, etc lift for short legged clients. Place the same lifts on the chair for long legged clients).

Have the client maintain a tall posture and ask him to straighten the knee as he points his foot away: “Take a deep relaxed breath and exhale and tighten your deep tummy muscles as you straighten one knee as much as you can comfortably.
Keep your foot relaxed. This will give you hamstring flexibility without limitation from gastrocnemius or neural tension.
Measure the degree of knee straightening: 0 degrees would be equal to full extension.

In either test, I would ask client to chose the leg of their choice or, if you have time, measure range of motion on both legs. Look forward to hearing back from you. Be well.

A Note to All MelioGuide Pros:

Please feel free to comment on my suggested alternatives to the Chair Sit and Reach Test. Let’s come up with more safe alternatives.

Physical Therapy Continuing Education

To learn more about how to Physical Therapy Continuing Education, visit my page dedicated to Physical Therapy Continuing Education.

The post Chair Sit and Reach Test Alternative for Senior Fitness Test appeared first on MelioGuide.

Flexibility Archives - MelioGuide

Is The Side Bend Safe for Your Spine ?

Table of Contents

Standing Side Bend and Seated Side Bends

Free Osteoporosis Exercise Course

Two Safe Alternative Side Bends

Option 1: Hands and Knees Side Bend

Setup:

The Movement:

Why it’s safer:

Option 2: Lying Down or Supine Side Bend

Setup:

The Movement:

Side Bend smart exit strategy:

Why These Side Bend Modifications Matter

Conclusion

Margaret Martin

Further Reading

References

Is The Spine Twist Safe If You Have Osteoporosis?

Table of Contents

Spine Twist

Avoid the Standing Spine Twist and Sit Twist Exercise

Standing Spine Twist

Sit and Twist Exercise

Spine Twist and Vertebral Compression Fracture Risk

Free Osteoporosis Exercise Course

Supine Spine Twist and Mobility: Option #1

Supine Spine Twist Setup and Execution

Supine Spine Twist Hand Placement Options

Lying Twist Stretch and Mobility: Option #2

Lying Twist Stretch Setup and Execution

Lying Twist Stretch Proper Positioning

How to Safely Twist Doing Activities

Conclusion

Margaret Martin

Further Readings

References

Flexibility for Osteoporosis Guide

Table of Contents

Benefits of Flexibility for People With Osteoporosis

How Flexible Are You?

Stretches That Reduce Fracture Risk

Stretching for Function and Injury Prevention

Posture Stretches

Myofascial Stretching Guidelines

Muscle Stretches: Dynamic and Static Stretching

Self-Massage for a Better Stretch

Trigger Point Massage Guidelines

Nerve Stretches

Flexibility Exercises for Osteoporosis Resource

Hypermobility

Recommended Posts on Flexibility

References

Margaret Martin

How to Stretch Hamstrings

Table of Contents

How to Stretch Hamstrings

Benefits of Flexible Hamstrings

Flexible Hamstrings Improve Your Posture

Flexible Hamstrings Reduce Your Risk of Compression Fracture

Flexible Hamstrings Make Your Exercises and Yoga Practice Safer

Flexible Hamstrings Help You Avoid Injury

Hamstring Anatomy

Functions of the Hamstring Muscles

Hamstring Flexibility or Tightness Test

Hamstring Flexibility or Tightness Test

What to Measure in the Hamstring Flexibility/Tightness Test

Four States of Hamstring Flexibility

Exercise Recommendations for Osteoporosis

Tight Calf Muscle Stretch

Calf Muscle Stretch with a Belt, Strap or Rope

How to Choose a Hamstring Stretch Exercise

Supine Hamstring Stretch with Stability Ball

Supine Hamstring Stretch in Doorway

How to Do the Supine Hamstring Stretch in Doorway

Deepen the Supine Hamstring Stretch

Lower Hamstring Stretch with Rope

Upper Hamstring Stretch with Rope

Active Isolated Stretching Versus Static Stretching