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Proprioceptive Exercise Ideas
845 Plays2 years ago
Josh and Miranda talk about different proprioceptive exercise ideas.
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Transcript
Introduction to Hand Therapy Academy
00:00:06
Speaker
Hi, I'm Josh McDonald. And I'm Miranda Materi and we are Hand Therapy Academy. Today we're going to talk about proprioceptive wrist treatment ideas for your clinic.
Importance of Proprioceptive Wrist Exercises
00:00:16
Speaker
Some of our favorite things, some of the things we do, but why do we need to do it? Miranda, give us a little summary of why we should be doing proprioceptive wrist stuff. Right. So after you've had an injury or maybe you just have some instability or maybe you're hypermobile, proprioceptive exercises are
00:00:34
Speaker
Can be very popular to be very helpful and sometimes I'll have to explain to patients and to new students Well, why are we doing this disk stacker? That doesn't even seem like that's that beneficial, but it really can be And there's been a lot of new research done by dr. Hager
00:00:49
Speaker
And where they're finding that the ligaments in the wrist, more specifically, the bowler wrist capsule has these proprioceptive input fibers on them. So when these proprioceptive input fibers are in the ligaments, when they start to fire, they kind of tighten up. So when they tighten up, that's how we get our wrist to have more stability and how we improve our proprioception.
Exercises and Methods for Proprioception
00:01:14
Speaker
So there's been
00:01:16
Speaker
A number of things that we see now on social media and even in research articles of different things that you can do for proprioception in the wrist and hand. Does that sound how you explain it to your people or?
00:01:28
Speaker
Yeah, yeah, that's a great explanation. If patients want more detail than that, we'll talk about SL friendly, LT friendly muscles. We'll talk about the mind-brain connection, mind-body connection, that kind of stuff. But yeah, there's just really good support for the connection between the mechanical receptors in the ligaments of the wrist and the functionality of the muscles we need to inhibit or activate to support those different structures.
00:01:56
Speaker
So what are some of your favorite proprioceptive wrist exercises to start with, or what are you giving your patients? So I'll start with one that's really outside the box that we don't do a lot of, that I haven't seen anyone else use. I got it from a pediatric vision course years ago when I was doing Peds. It's a plastic tube that is made to protect fluorescent light bulbs in warehouses, but it's a clear plastic tube with a cap on either end. We put the alphabet stickers across the whole thing and a golf ball inside.
00:02:25
Speaker
So the patient holds this clear tube, and the golf ball, when they tip a little bit one way or the other into pronation or supination, the ball rolls back and forth, and they have to get the ball to stop on the letters that spell out their name, or hand therapy, or whatever holiday we're at, or we make it something fun, and they're trying to spell things by getting this ball to roll one way or the other, but it's so reactive.
00:02:46
Speaker
that it moves very fast they have to have very subtle small controlled movements so it's a very short arc of motion but lots of proprioceptive awareness and feedback to feel like whoa it rolled too far too fast and and get some control yeah that's a great one it's probably pretty inexpensive to make i needed a new one for my peoria clinic and i think all in the tube off of amazon a golf ball and some stickers it was like 10 bucks yeah you know and that in a rehab catalog would have cost at least 150
00:03:15
Speaker
I think when I bought it, it was about 150 and that was maybe 20 years ago. Yeah. Yeah. What's one of your favorite things?
Creative Proprioceptive Exercise Tools
00:03:22
Speaker
Um, I like doing the power web. So sometimes I'll do the power web and I'll put the alphabet around it, or I might do numbers and then have them do the clock. So I'll have them hold it with both wrists and roll a ball around on the power web. Um, and then I've used like a plate. I tell them use a plate at home. They could use something. It could even be a paper plate or.
00:03:44
Speaker
you know, whatever they might have, depending upon, you know, how much weight they can hold. You can grade it up or down or a tennis ball with numbers on it. So there's different all sorts of different things I've done with like a flat circular surface. I would say that's probably one of my favorites. And I love doing that. We've seen like you take one of the empty little tubs of putty and put a marble in it and they got to make the marbles turn one time and then back and forth and kind of chase it around on the plate.
00:04:14
Speaker
I have enough patients who can't go into full supination either because of tightness, or if it's an SL injury, we don't want them going into supination if we're worried about that attenuating that SL ligament. So I took a frisbee, dollar store frisbee, and cut a hole in it dead center.
00:04:30
Speaker
And I took thermoplasts and made a vertical handle. I just rolled it up into a cylinder and shoved it through the hole and mushroomed it at the top so they can hold it in a neutral grip and still let that marble track around. So they still work on clockwise and counterclockwise. They put a little line so they stop at the line and change directions. But that gives them a neutral grip to still work on that if they can't do that full supination. Yeah, that's a very clever idea.
00:04:56
Speaker
I'm all about, yeah, I, again, I needed to buy a new Frisbee for our Peoria office and I didn't want to spend 10 bucks on Amazon. So I got to go to a dollar store to buy a Frisbee because I couldn't bring myself to spend $10 on a Frisbee. Right. Yeah. Yeah. A lot of times you can find free Frisbees too, right? They're always up at those exhibit halls. Sometimes they'll have Frisbees.
00:05:15
Speaker
Right? Absolutely, absolutely.
DIY and Commercial Wrist Therapy Tools
00:05:17
Speaker
So some of the things that we have, we just buy off of Amazon because they're super convenient to get and we don't need to make all our own stuff and reinvent the wheel. What are some of your things that you have that you've bought from Target or Amazon or stuff like that?
00:05:29
Speaker
We'll do the balance you disk stacker So it's like the disk with the magnets that stacks up and they have different sizes so you can order different ones They have a kids one on Amazon so you can get all varying degrees from easy to harder There's like a double one so in each of our clinics I think we have three or four disk stackers that we give out for people to try and
00:05:52
Speaker
One thing that you don't have to buy, if you have a phone or a tablet in your clinic, you can do the labyrinth app, which is a great app for proprioception. And we've had where we put that app or the tablet directly on like a BOSU ball, where they have to like move the BOSU ball while the tablet's sitting on it. And that's a really good high, high level proprioceptive exercise. And that's when they can do weight bearing.
00:06:22
Speaker
That's a little bit harder one.
00:06:24
Speaker
Another standard one for us that we just buy periodically is the Powerball. Whether you're yanking, it's the one with the gyroscope inside and you either yank the string out or you can get the one where you hit the button to ramp it up or whatever version you have. That's a great one for finding a rhythm and finding it's that sensory awareness of the rhythm and then trying to match it and duplicate it. That's a good one to have. And we love one that's called the Pindaloo.
00:06:53
Speaker
I found it at Target walking through the toy department. It's this blue U-shaped tube. And there's a little yellow ball inside. And we put it in a room where there's some space. You're not going to hit anybody in the head with this thing. And your job is to just like flip this ball. You hold the U-shape by one end and you flip it in the air and catch it in the tube. And flip it up and catch it in the tube. And you can cycle it, but it's again this a little bit more dynamic, active,
00:07:15
Speaker
But it's awareness of position in space and getting that wrist cycling a little bit. Just another fun way to have patients aware of slightly higher level dynamic skill with their wrist.
Innovative Wrist Exercises with Balance Board
00:07:25
Speaker
Yeah, I feel like for the proprioceptive stuff, there's not a lot available like in hand therapy catalogs or rehab catalogs. It's mostly therapists coming up with stuff that will work that is fairly inexpensive.
00:07:39
Speaker
Yeah. Getting creative with things and thinking about like thinking outside the box. Yeah. Yeah. Super, super difficult or complicated stuff.
00:07:48
Speaker
Yeah, we have, I actually started this because I saw it at a PT clinic. They had a patient standing on their 360 degree balance board, you know, just with a single point underneath and they had to push and put their foot on it. And they were trying to get a ball to go around their foot by moving their ankle. So I put it up on the mat table and they put their hand on it dead center. And they're trying to get that ball to travel once the clockwise, once counterclockwise, once by moving their wrist and I can grade it into or out of weight bearing.
00:08:16
Speaker
depending how high or low that table is elevated, or if they're standing on an object, leaning down onto it more, but trying to get that ball to track one direction or another by moving that balance board.
Cost-effective Hand Therapy Solutions
00:08:28
Speaker
Yeah. All of this proves you don't have to have a big budget to open a hand therapy clinic, right? It can be very low budget. Absolutely. Some of my favorite things are the things that we've made or created or come up with, or patients have shown us like, hey, this is my version at home. I'm like, that's fantastic. Let's do that here.
00:08:45
Speaker
Yeah. Great ideas. And it's stuff people can do at home, right? They easily can replicate that piece of equipment at home and be within budget. Yeah. Or if they want to go buy one of those things off of Amazon, I will frequently have patients say, Oh, I bought that at home. So we don't do the power ball anymore at home. We are at the clinic because they've got it at home and it's great exercise for them. That's it. It's a way that they can have some good ownership of their care. Yeah. Awesome ideas.
00:09:11
Speaker
All right, so we'll wrap this one up, but if you have any questions for us, feel free to reach out at info at handtherapyacademy.com or on Instagram, info at handtherapy. And you can also check out on our website, handtherapyacademy.com, all of our courses, our membership information where we have a ton of stuff included in each of our different tiers. It has more stuff as you go up in the tiers.