Paul Lewis teaches helpful positioning tips - Oakworks Side Lying Positioning System
Hi, my name is Paul Lewis, and today I’m going to be working with Bob. Bob, let’s get you on the table in the side-lying position, Bob. Bob is unable to lay on his back in a supine position, so I’m going to have him on his side, ok? So let’s have a look. Ok, Bob has wide shoulders, and Bob’s shoulders are a little bit wide, so you can see it’s a bit compressed, and in the neck area…How are you feeling there? Ok. He’s notified to me, he’s indicated to me that he’s a little bit scrunched up in this area, so what I’m going to do is have you sit up Bob, for a moment. You can just sit up. There, I’m going to use the Side Lying Positioning System to make Bob a little more comfortable, hopefully elongate the shoulder area to allow him to have a little more comfort, support the neck area, realign the spine with the cervical area. Let’s have you just…One second, Bob…Lets use this wedge to elevate it a little bit here, give you that extra distance in the shoulders. Let’s have you lay down right here. Ok. Excellent. Now I’m going to take the headrest and put it right there. Perfect. How’s that feel for you? Better? Better. Good. Ok, now what I want you to do is just back this leg up. Excellent.
Now I’m going to use the leg rest here. There. Comfortable? Yes. Perfect. Ok, so as I mentioned earlier, Bob is unable to lay in a supine position and so what I want to do here is go into his subscapularis . Of course you can do it in a supine position, sometimes in prone, but in this, I’m going to demonstrate for you in the side lying position. So what we want to do first is support the arm. Ok, you want to support the arm and I’m going to take my right thumb and go under the scapula to the subscapularis, but in order to do that, I have to bring the scapula slightly forward. So I’m going to place my hand just on the lateral border of the scapula. I’m going to use my left hand to support the shoulder and the body is totally relaxed. In this position here, what I’m going to do is just use the body, sink forward. As you notice, as I sink down, I’m not pulling with my arms, I’m sinking down and just letting my body weight bring the shoulder forward. At the same time, I’m just going to scoop my thumb under…Yes…Into the subscapularis, and you can slowly use your body to sit back and knead the tissue. Very little effort on my part. There. How are you feeling Bob? Comfortable? Yes. Excellent. There.
You can take you time to knead the tissue if necessary. And from this position here, you can mobilize the scapula if necessary, moving back and forth very easy using your legs, moving your body as one unit. Ok? Perfect. And then if you like, support the arm, then you can put it back. There. The next thing I’m going to demonstrate, because earlier Bob mentioned that he was working and his ribs are slightly contracted on the side, so he’s feeling a bit of pain. So what I wanted to do is, I’m going to support his arm and at the same time, I’m going to give him a bit of a stretch on the side, but between these two ribs here, they’re contracted, so I’m going to use a little bit of joint mobilizations, Ok? The joint mobilizations until I’m going to lengthen the arm I feel a bit of a pull at this point. At this point, what I want to do is stabilize the lower rib, between these two ribs, I want to stabilize the rib and bring this arm forward…There. And hold it for at least 30 seconds. At this point I’m laterally rotating the arm as I bring it above the head to avoid the acromial arch. There. And I release. And you can move down one rib again and stabilize. And there, let’s take it back. And lengthen. How are you feeling Bob? Good. Good. And you can do it all the way down the ribs, depending on how many are contracted and holding together.
So let’s release the arm, and we’ll put it down to the side. So from here, these are just a few things that I’ve been mentioning. The last thing is, from this position here, you have total access to the back which you can work if you need to. From here, you can rotate. Do some forearm work on the neck area. There’s a variety of things that you can do from this position which, I love the side-lying position, which seems to work for both Bob and myself. Thank you.