0:35 calves and feet are supported on a chair
0:39 box or something similar the hips and
0:41 knees are flexed to a little more than
0:47 knees should be slightly wider than
0:50 hip-width apart there should be about
0:52 six inches between the soles of the feet
0:55 this places the hips in a slight
0:58 external rotation position it is crucial
1:00 to maintain this externally rotated hip
1:03 position throughout all the different
1:05 movements in the supine three-month position
1:06 position [Music]
1:13 the spine should be straight without any
1:16 side bending or exaggerated curvatures
1:19 the neck is maintained in line with the
1:22 spine most people will probably need to
1:24 rest their head on a folded towel or
1:27 thin pillow to help maintain a neutral
1:35 the ribcage must be moved downward into
1:38 its expiratory position breathe in
1:41 correctly for five seconds then hold for
1:44 two seconds exhale forcefully for ten
1:47 seconds your abdominals should become
1:50 fully activated to expel all the
1:53 remaining oxygen from your lungs the
1:55 oblique abdominals will pull your
1:57 ribcage down toward the pelvis any
2:01 ribcage flare should disappear keeping
2:04 the ribcage in the expiratory position
2:07 resume correct breathing do not allow
2:09 the ribcage to lift towards your head
2:12 during inspiration do not allow the
2:15 abdominal cylinder to collapse
2:18 losing intra-abdominal pressure during
2:20 expiration repeat this breathing
2:22 technique to reposition the ribcage
2:26 three to four times until the correct
2:29 position is achieved [Music]
2:34 [Music]
2:37 here are a few points to focus on during
2:40 the active exercises never hold your
2:43 breath be sure to breathe correctly and
2:45 maintain intra-abdominal pressure
2:48 throughout the entire exercise neutral
2:51 posture do not allow the spine to flex
2:55 extend or side Bend all movements are
2:58 meant to be slow and controlled take
3:00 your time to perform the movements with
3:01 good form [Music]
3:12 as soon as we have established neutral
3:15 posture in the initial position we're
3:17 going to move on to active movements the
3:20 first level is being able to move one
3:22 leg independently of the rest of the body
3:22 body
3:24 while maintaining intra-abdominal
3:27 pressure so we're gonna go ahead and ask
3:29 her to create the intra-abdominal
3:33 pressure holding the pelvis into a
3:36 neutral position we're gonna take her
3:38 hands and place them all around the
3:40 pelvis and into the lower abdominal area
3:43 and she's gonna use this to be able to
3:45 monitor her own abdominal pressure and
3:48 to be able to make sure her pelvis is
3:51 not in motion with her leg so from here
3:53 I'm gonna ask her to lift one leg at a
3:56 time and see can't you hold that
3:59 maintain pressure and not have her
4:02 pelvis in motion at the same time from
4:05 here we can go ahead and try and move
4:08 both legs at the same time so she's
4:10 gonna go ahead and lift both her legs at
4:12 this time and try and maintain
4:14 neutrality and intra-abdominal pressure
4:16 while breathing through the whole
4:21 abdominal region once we can establish
4:24 control of both legs being held up in
4:26 the air we're gonna try and introduce
4:29 some movement so we're gonna have her
4:32 start we're gonna be working towards the
4:34 dead bug exercise using one leg at a
4:37 time she's going to be reaching with one
4:40 leg down and making sure again that the
4:43 pelvis does not move with the leg nor do
4:45 we want to see the ribcage lift or flare
4:47 we don't want to see the neck move up
4:50 into extension now quite often what
4:52 people will do is they will try and
4:55 establish that that control over this
4:58 section of their body by crunching down
5:01 using their rectus abdominus there's six
5:03 pack muscles that's not a pattern that
5:05 we want that's something we're trying to
5:08 get away from so the control is coming
5:10 exclusively from the oblique abdominals
5:13 she's going to hold this position for a
5:15 certain number of breaths breathing deep
5:18 and down into the lower abdominal area
5:19 in that correct
5:22 circumferential breathing pattern
5:24 bring the leg back we're gonna try the
5:30 other one quite often people will
5:33 struggle moving one leg as opposed to
5:35 the other one and that's quite normal
5:38 because most people do have a side of
5:40 weakness compared to the other one and
5:42 so whatever side you feel you're
5:44 struggling on work a little harder on
5:47 that side spend more time with it try
5:50 and get that leg to be able to match the
5:54 motor control of the other side from
5:57 here we can move into contralateral
6:00 pattern using both limbs so what she's
6:02 going to be doing here is one arms gonna
6:04 stay down here we want to be able to
6:07 keep control over the pelvis and she's
6:09 going to be moving the leg on that side
6:14 in the opposite arm a little bit harder
6:16 to control this a little bit more of a
6:19 demand and so again holding this
6:22 position breathing for a certain number
6:24 of breaths deep down into that lower
6:28 abdominal area and back now from here
6:30 you can either just drop the legs down
6:31 and rest or if you feel comfortable
6:37 immediately go into the other side the
6:39 next level would be to introduce weight
6:42 so we're gonna put a weight into one of
6:46 the hands she's gonna repeat the same
6:51 pattern but this time using weight so
6:54 again now we have a weighted lever which
6:56 is putting more stress on the on the
6:59 chest and the abdominal wall trying it's
7:00 the weight and the leg or tried to
7:03 separate her and she's trying to hold
7:11 now ideally the weight is going to be
7:13 held loosely in the hand we don't want
7:15 to grip as soon as you grip with the
7:17 hand you're going to tighten up the arm
7:20 and the shoulder muscles and it defeats
7:31 perfect great control mean monitoring
7:34 with the hand keeping ribs down
7:36 breathing through the whole time never
7:50 and coming back to neutral the next
7:52 pattern we can begin moving with our
7:55 rotational patterns so from here we're
7:57 gonna have her place her hands on the
8:00 outside of the knees this is gonna help
8:02 her connect the upper body to the lower
8:05 body so she's going to press in with her
8:09 hands and with equal force pressing
8:13 outwards with legs from there when I ask
8:16 her to she's going to try and rotate but
8:18 we want to make sure that the that the
8:22 plane of the pelvis stays parallel to
8:23 the plane of the upper body
8:26 what plate often what we see people will
8:29 do is as they're rotating one will
8:32 rotate before the other one will so we
8:34 don't want to see that separation of
8:37 those of the lower body from the upper
8:39 body we also don't want to have the
8:42 spine go into side bending either way
8:45 like that at the same time we also don't
8:47 again want to make sure people aren't
8:50 crunching down to try and cheat and get
8:53 stability artificially so she's getting
8:55 pressing in with with the hands pressing
8:58 out with the knees tucking her chin down
9:01 while she's rotating the body the head
9:04 has to move in unison with the body you
9:06 also want to make sure that when she's
9:09 rotating that she's not initiating the
9:12 rotation by moving the leg across the
9:15 movement comes from the abdominals as
9:17 she's trying to pull the pelvis and the
9:21 ribcage over towards me so the leg moves
9:24 with the body it's not the body moving
9:28 with the leg go ahead and rotate and
9:31 she's pulling her way through well
9:34 making fours can she pull up and over
9:37 around this way now she's going to hurry
9:39 about position for a certain number of
9:43 breaths and then with control moving
9:47 back and again if she needed to rest
9:49 here she'd just drop her legs down and
9:51 if she feels up to it she's going to
9:54 create the same rotation but pulling up
9:57 through here towards the front
10:04 and maintaining that perfect another way
10:07 to do this would be to use a stability
10:09 ball so we're gonna place the ball in
10:13 here on her chest with the hands on the
10:16 ball she's going to be pressing into the
10:20 ball diagonally so the right hand will
10:22 press into the ball towards the left
10:25 knee the left hand presses into the ball
10:28 towards the right knee she's holding the
10:31 ball with with all four extremities and
10:33 once again she's going to create the
10:40 rotational pattern get to a certain
10:42 point you want to rotate to the point
10:44 where you feel like you're just about to
10:46 topple right over but you're using your
10:49 core to maintain that that isolated
10:52 position balanced towards the side
10:55 always making sure that the head moves
10:56 with the body
10:58 you're never holding your breath always
11:00 breathing deep down into the abdominal wall
11:10 and back to neutral now we can take this
11:13 one step further and we can introduce a
11:15 diagonal pattern into a rotational
11:18 movement so here she's gonna be rotating
11:22 towards one side so she rotates towards
11:25 her left the left leg and the right lit
11:26 upper arm
11:29 will move it will be moving while she
11:31 compresses the ball with the other with
11:33 the other extremities so once again
11:37 she's pressing in diagonally was old for
11:41 she rotates towards me and she's gonna
11:44 maintain that that compression while she
11:47 reaches and Brie's holding out for
11:51 anywhere from 4 to 15 breaths whatever
11:53 you feel comfortable with bringing it
11:56 back rotating to neutral and rotating
11:59 over toward the other side and creating
12:05 that compression and extend out come
12:08 back now it's important that when the
12:10 leg is in motion that we keep that
12:14 relative rotation of the foot the knee
12:17 and the hip another problem we see quite
12:18 often when people are extending the leg
12:21 they're rotating out bringing it down
12:24 like that the leg has to stay in that
12:27 relative position moving that way back
12:30 and forth great so there you have it
12:32 that is the supine three-month position
