7th Inning Stretch
Demonstration of Exercises to
Improve Mobility, Balance, &Strength
Chad Shinabery MS ATC CPT
Owner of Atlantis Personal
Training LLC
Denver, Colorado
Purpose of Talk




Goals of Exercise Program
Behavioral Changes to Improve Overall
Quality of Life
Safe Progression of Exercise Routine
Demonstrate a Sample Workout to Include
Warm-up, Strength, and Balance Exercises
Goals of an Exercise Program and
Peripheral Neuropathy




Maintain or Improve Muscle Strength
Safely Challenge Proprioception and Body
Position Awareness
Prevent or Slow Down Neurological
Degeneration
Implement Exercises Into Daily Life
Lifestyle changes that could improve
Peripheral Neuropathy (PN)

Get Physical Exercise
–

–

Balanced Nutrition Plan

Decrease Weight, If
Overweight or Obese
Explain this later
If you Smoke, STOP
–

Decreases circulation
Increase Heart Disease
Carefully Limit Alcohol
Before Starting an Exercise Program


Discuss Conditions and Plan of Care with
your Physician involved in your PN
Treatment
Remember, Take it slow.
–
Rome wasn’t built in a day!!
Progression of Exercise


Be done with caution
First, increase frequency
–

Then, increase duration
–

20 minutes to 30 minutes
Lastly, increase intensity
–

From 4 days to 5 days to 6 days to everyday
Small increases to reduce the risk of harmful cardiovascular
events, muscle soreness and relapses
Advance slowly and with careful monitoring
Lets talk about Pain




Level I - Intial Discomfort (established, minimal)
Level II - Moderate Discomfort (attention can
be diverted)
Level III – Intense Pain (attention can not be
diverted
Level IV – Excruciating and unbearable pain
Pain, cont.




Keep Pain at Level II or
below
Exercise selection
should reflect your pain
level
Take caution before
progression
Not a Wise Exercise
choice for PN
Factors that may assist in maintaining
a physical activity program:



Take measures to avoid
injury: warm-up, cooldown, & stretches
Set objective goals
rather than hopeful
outcomes
Set an exercise
schedule in advance.

Include a partner
–
–

Motivation
Encouragement
Identify alternative
exercises.
–
–
Reduces boredom
Opens the door for more
options
Exercise Routine Format






Warm-up
Stretches
Cardiovascular exercises
Strength Exercises
Balance Exercises
Cool-down
Warm up Exercises, Arm Circles

Instructions:
1. Start by holding your
arms out to the side at
shoulder height.
2. Swing your arms in a
small circular rotation.
3. Continue for the
recommended time and
then repeat going the
opposite direction.
Across Body Arm Swings

Instructions:
1. Stand tall and hold arms
out to your side.
2. Slowly swing your arms
back and forth across the
front of your body.
3. Repeat this continuous
motion until warm or until
recommended time is met.
Lateral Side Bend

Instructions:
1. Stand with your feet parallel
and shoulder width apart.
2. Keeping your body in a
straight line bend to the side
and reach for the floor with your
hand.
3. Bend only until you reach a
comfortable range of motion.
4. Make sure to not bend
forward or backward while
completing this movement.
5. Repeat for the desired
repetitions
Forward Backward Leg Swing

Instructions:
1. Start by standing with your
feet shoulder width apart. You
can stand on a small step or on
the ground.
2. Keeping your upper body
perpendicular to the ground
swing one leg forward and
backward.
3. Do not swing your leg so
hard that you can not keep your
upper body from moving.
4. Repeat for the recommended
repetitions and repeat with the
other side.
Lateral Leg Swings

Instructions:
1. Start by holding onto a
secure object and raise your
outside leg out to the side.
2. In a smooth and continuous
motion swing your leg back and
forth across the front of your
body.
3. Swing through your full range
of motion but keep your upper
body stable throughout the
movement.
4. Repeat for the recommended
repetitions and then flip sides
and repeat with the other leg.
Goals of Cardiovascular Exercise

Start Slow and Progress
–


5 minutes to start, progress to 10 and so forth
AMA recommends 20-30 minutes of daily CV
Exercise
Monitor Heart Rate
–
–
–
Target Heart Rate (220-age) x .7-.85
Pulse method (radial, carotid)
Heart Rate Monitors
Aerobic Exercise Choices

Swimming
–
Preferably without your
shoes and fully clothed
like the picture
encourages you!
Cardio, Elliptical


Elliptical
Instructions:
Place your feet on the foot
plates and grab the arm
handles.
Set your resistance so that it is
challenging and start the
elliptical motion by pulling
machine arm with one arm and
push the other machine arm.
Pick a pace that will elevate
your heart rate yet let you stay
on the machine for a while.
Cardio Exercise, Bike Progression
Cardio

Advanced Bike
Progression
Cardio

Walking
Goals of a Strength Routine







Work Large Muscle Groups
Start slow and Progress as tolerated
Repetitions of 15-20
Set of 1-3
Non-weight bearing exercises
Partial-weight bearing exercises
Full weight bearing exercises
Lower Body Exercises NWB

Single Leg Kickbacks

Instructions:
1. Start in a four point position with
your hands and knees on the
ground.
2. Proceed to kick your leg back
and up until you reach full
extension.
3. Squeeze your glute muscle while
performing this movement.
4. Repeat with the other leg.
5. For a more advanced movement
you can attach an ankle weight
around your leg.
Lower Body Exercises NWB

Hip Hikes
Instructions:
1. Start by lying face down
with your legs straight.
2. Slowly raise one leg
keeping it straight using just
your glute muscles.
3. Return to the starting
position and repeat for the
desired repetitions. Repeat
with the other leg.
Lower Body Exercises PWB


Partial WB Leg Swings
Instructions:
1. Start by standing on the
platform and placing a foot in
the foot harness. Step to the
side so that your foot hangs off
the edge of the platform.
2. Proceed to curl your foot
back and up keeping your knee
stabilized next to your other
knee and bringing your foot all
the way to your butt.
3. Return to the starting position
and repeat according to the
prescribed repetitions. Repeat
with the other leg.
Lower Body Exercises FWB


Bodyweight Squats

Instructions:
1. Start by placing feet shoulder width
apart and holding your arms out in front
of you.
2. Proceed to squat down like you are
going to sit in a chair. Your upper body
will lean forward slightly and your hips
will shift backwards while going down.
3. Remember to keep your knees from
going out in front of your toes while
squatting.
4. Repeat according to your required
repetitions. If you want to make the
exercise more challenging hold your
arms at your sides or behind your head.
Lower Body Exercises FWB

Bodyweight Lateral Squat

Instructions:
1. Stand with your feet shoulder
width apart.
2. Start by stepping to the right with
your right foot and proceed into a
squat.
3. Return to the standing position
with your feet shoulder width apart.
4. Now step to your left with your
left foot and proceed into a squat.
5. Return to the starting position
and repeat.
Chest Exercises NWB

Instructions:
1. Start by lying on the floor
on your back holding a
dumbbell in each hand.
2. Proceed to bend your
arms until the back of your
arms touch the floor.
3. Push the dumbbells back
up to full extension.
4. Repeat for the desired
repetitions.
Chest Exercises PWB

Instructions:
1. Start by placing your hands
on the wall at shoulder level
with your feet approximately 2
feet away from the wall.
2. Bend your elbows so that
your chest gets closer to the
wall.
3. Once your elbows are bent to
about 90 degrees then press
back out to the starting position.
4. Repeat according to the
required repetitions.
Chest Exercises FWB

Instructions:
1) Sit in upright position on ball with feet
flat on floor and DB in each hand. (You
may rest each DB on the corresponding
thigh.)
2) Walk feet forward allowing ball to roll
underneath body until it is positioned on
mid to upper back region (you may rest
head on ball). Raise hips to create a
“table top” position parallel to floor.
3) Start position: Maintaining stability,
bring DB’s to shoulders and press up
positioning DB’s above the chest with
palms facing forward.
4) Lower the DB’s keeping your forearms
perpendicular to the floor and your hands
aligned at the nipple line.
Low Back, NWB

Alternating Superman

Instructions:
1) Lie face down on floor with arms
extended overhead. You may place
a rolled towel under forehead to
clear face from floor.
2) Raise right arm and left leg 4-8
inches off floor.
3) Lower and raise alternate
opposite arm and leg.
Remember to keep head and back
in a neutral position. Shoulders and
hips should remain squared
throughout movement.
Low Back, NWB


Cobra on Floor
Instructions:
1. Start by lying on your
stomach with your arms at
your sides.
2. Slowly raise your
shoulders up off the ground
by contracting your low
back.
3. Return to the starting
position and repeat.
Low Back, PWB


Bridging
Instructions:
1. Begin by lying on your back,
knees bent, and feet on the floor.
Extend your arms out to steady
yourself.
2. Squeeze buttocks and raise your
hips and lower back off the floor to
form a straight line from your knees
to your chest. Do not arch your
back.
3. Hold for 5-10 seconds and slowly
return to starting position. Relax for
5 seconds.
4. Repeat for required number of
repetitions.
Low Back, FWB

Bodyweight Good Mornings

Instructions:
1. Start by placing your hands
behind your head and your feet
shoulder width apart.
2. Keeping your low back flat and
your legs semi-straight bend
forward until your individual range
of motion is reached.
3. Return to the starting position
and repeat.
4. Make sure to keep good
technique and bend from the hips
keeping your lower back relatively
flat.
Shoulder, NWB/PWB


Seated DB Shoulder Press
Instructions:
1. Sit in upright position or
stand with feet shoulder width
apart and knees slightly bent.
2. Start position: Position DB’s
to ear level with an overhand
grip (palms facing forward).
3. Press hands up above head
keeping wrists over the elbows
and arms moving parallel to
body at all times.
4. Return to start position.
Shoulder, FWB

DB shoulder press

Instructions:
1. Starting position: Dumbbells
are at shoulder level with your
palms facing your head.
2. Press the dumbbells over
your head keeping your palms
facing each other.
3. Return to the starting position
and repeat. Remember to not
arch your lower back as your
press the dumbbells over your
head.
Biceps, NWB/PWB

Seated Dumbbell Bicep Curl

Instructions:
1) Sit in upright position on stability
ball.
2) Start position: Grasp DB’s with
underhand grip (palms facing
forward) and allow arms to hang
down at sides. Elbows should be
close to sides.
3) Flex at the elbows and curl DB’s
up to approximately shoulder level.
Keep elbows close to sides
throughout movement.
4) Return to start position.
Biceps, FWB

Dumbbell Curl

Instructions:
1) Stand with feet shoulder width
apart and knees slightly bent or sit
in upright position.
2) Start position: Grasp DB’s with
underhand grip and allow arms to
hang down at sides. Elbows should
be close to sides.
3) Flex at the elbows and curl DB’s
one at a time up to approximately
shoulder level. Keep elbows close
to sides throughout movement.
Return to start position.
Triceps, NWB/PWB

Overhead tricep extension

Instructions:
1) Sit on ball with feet shoulder
width apart in upright position.
2) Start position: Grasp DB and
place palms on inner side of weight
plate as shown. Press DB directly
overhead (now palms are up).
3) Stabilize shoulders and lower
weight moving only at the elbow
joint until forearm is parallel to floor.
Keep elbows pointing forward
throughout movement.
4) Return to start position.
Triceps, FWB

Standard Pushup

Instructions:
1. Lie face down on the floor with
hands palm down, fingers pointing
straight ahead, and aligned at the
nipple line.
2. Place hands slightly wider than
shoulder width, and feet should be
at hip width with toes on floor.
3. Start position: Extend the elbows
and raise the body off the floor.
4. Lower your entire body (legs,
hips, trunk, and head) 4-8 inches
from the floor.
5. Return to the start position
Goals of a Balance Routine





Select exercises that safely challenges
stabilization.
Repititions of 15-20
Set 1-3
Can be Done Daily if Tolerated
Progress with caution
Balance, Beginner

Seated Reverse Wood Chop

Instructions:
1. Sit on a stability ball with
your knees bent at 90 degrees.
2. Hold a medicine ball and
start at your right hip.
3. Rotate your trunk and arms
to lift the ball above your left
shoulder.
4. You should rotate at your
trunk first and then lift and twist
your arms.
5. Return to the starting position
and repeat to the other side.
Balance, Intermediate

Same Side Superman

Instructions:
1. Start position: Lie face
down on ball with hands
down at sides. Raise left
arm and left leg off floor.
2. Return to start position
and repeat with the other
side.
Balance Exercise, Intermediate

1 Leg Balance Squat

Instructions:
1. Start by standing on one leg
with the other leg elevated.
2. Bend forward keeping your
planted leg semi straight and
reach for the ground.
3. Keep your back relatively flat
during the exercise.
4. Repeat for the prescribed
repetitions and then repeat with
the other leg.
Balance, advanced

Leg ext/Tricep Ext with band

Instructions:
1. Start by placing the band
underneath your foot and
holding it with one hand over
your head.
2. With your knee bent and
elbow bent simultaneously
straighten the limbs until both
are in full extension.
3. Return to the starting position
and repeat with the other leg.
Balance, Not a good idea!!!

Kneeling Balance

Instructions:
Start Position: Position yourself
on the ball by placing your
shins on top of the ball and
balancing in this position.
Use the tops of your feet to help
control the movement of the
ball by placing them against the
ball.
Hold for the prescribed number
of seconds.
Cool Down


Repeat Warm-up Exercises
Stretch any Muscles That May Have
Bothered You during the Workout
Conclusion




Check with your doctor before starting any
exercises program
Progress slowly and with caution
Pain at a Level II or below
Have Fun and Enjoy your Workouts
Thank you For your Time

Any Questions?