This content details the proper setup and execution of the "prone three-month developmental position" and its kneeling variation, focusing on establishing foundational stability and alignment to address various musculoskeletal issues, particularly those related to the spine, shoulders, and pelvis.
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in this video we're going to be using
the prone three-month developmental position
position
to address several problems that can
present to the clinic
conditions such as chronic neck problems
shoulder issues
scapular instability issues dealing with
posture of the thoracic spine either being
being
accentuated thoracic curvature or a flattened
flattened
t-spine as well as issues related to the
pelvis in the lower back
before we get up into the active
exercise point
it's really important that we learn to
establish the initial position
and our points of support we're going to
go through each one of these step by
step to make sure
you're able to create an ideal exercise
in the prone three-month developmental
position the base of support
occurs in the front part of the pelvis
on the symphysis pubis
as well as the inside of both elbows
so we're going to begin by establishing
a neutral pelvic position
to create ideal support now before we
create a change in the pelvis you have
to be able to move from a point of stability
stability
so we're going to create activation of
the abdominal cylinder
i'm just going to place my fingers into
the side of the abdominal wall
and she's going to push out against my fingers
fingers
using the diaphragm to generate
intra-abdominal pressure
and i want to feel that pressurization
that activation
360 degrees around the abdominal cylinder
cylinder
in the front in the sides and in the back
back
portion of the abdominal wall as well
now from there she's going to begin to pull
pull
the pelvis into its neutral position
by trying to pull the the tailbone
down towards her heels she's not going
to be using
glute activation to do this so we don't
want to see
gripping of the gluteal muscles that are that
that
commonly create hip problems that we see
so so much in the clinic
so the glute muscles stay relaxed the
hamstrings and the inner thigh the
adductor muscles
also need to remain relatively relaxed
as well
so pelvic positioning is coming from the abdominal
abdominal
wall and pressurization of the abdominal cylinder
cylinder
as the pelvis is rotating backwards
the lumbar spine is going to be brought
into a more
neutral more correct position as well so
the spinous processes
are going to begin to fan open and we're
going to see a straightening a pulling
open of the lumbar spine bringing it to
its neutral position
so we establish lower body
support now we move up to the upper extremities
extremities
and as i mentioned the base of support
from the upper extremities is on the
inside of the elbows
ideally we want the crease of the elbows
to be about the same level
as the ear so her arms are a little high
we're just going to slide them back
just a little bit so now the crease is is
is
sitting correctly and we also want to
make sure that the
wrist is in line with the shoulder joint
so that the elbow isn't too
open or too closed so if we can create
that ideal alignment
next we're going to position the
shoulder joint itself
typically people who tend to have a lot
of dominance in their pec muscles or
their lats
their shoulder tends to sit in an
internally rotated position
now this is going to make the ball of
the hip the shoulder joint
sit in the front of the socket that's a decentrated
decentrated
unstable inefficient position to be in
so we want a centrated a neutral
position of the shoulder joint
so she's going to attempt to
rotate the arm backwards an
external rotation of the arm in the socket
socket
backwards like this that's going to help
her to load the elbow better
she's going to centrate her shoulder
joint we're going to keep the shoulder
girdle away from the ear now
another strategy people will tend to use
is over
activation of a lot the lat is not
part of the stabilizing mechanism for
this exercise so we don't want
over activation of the lat so instead
we are using the entire shoulder girdle
really focusing on the middle the lower trapezius
trapezius
to create a more neutral position of the
shoulder blade
so another common issue is
over activation of the upper trapezius
and that quite
commonly is involved when the pectoral
muscles are also
over activated and when you get the
upper trap over
activated and the pecan over activated
again we get this
upward migration of the shoulder girdle
that internal rotation of the shoulder joints
joints
so what she's going to be doing is
creating a
spread spreading across the chest and
across the shoulders
reaching down the shaft of her arm into
the elbow
so if i was to place my finger here
she's reaching down into my finger
and lightly pressing the inside of the
elbow into the table at the same time
now when people are doing this they will
also tend to create
a little bit of over activation here so
we want that shoulder blade to stay
away from the ear reaching down into to
the arm
keeping the shoulder blade away so as
she's reaching
that important stabilizer the serratus
anterior is activating
creating that pull through the shoulder
blade down to the arm
so now we're setting these the support
through the arm
lastly is going to be head position and
the correct position for the head is at
the very top of the forehead
so by creating a little bit of a chin tuck
tuck
we're going to be activating the deep
neck flexors
which are very important stabilizers of
the neck
so we're creating all this
pre-activation stabilization of the entire
entire
chain from the pubic bone all the way up
into the head
through the shoulder girdles into the
elbow now the ideal
uh movement that we're going to be
creating is an uprighting of the
of the upper thoracic spine in the neck
not by creating cervical extension
instead it's going to be cre maintain that
that
cervical flexion but lifting the head
towards the ceiling
we don't we never want to see this type
of movement
because that tends to create a lot of
issues in through the
lower cervical mid cervical spine c5 c6
where we typically see a lot of osteoarthritis
osteoarthritis
and disc degeneration in the cervical spine
spine
so instead it's going to be pulling the head
head
forward kind of like a turtle poking its head
head
out of its shell while she's lifting the
back of the head towards the ceiling
like that and always maintaining that
chin tuck
go ahead and bring your head back down
so what's occurring when we're doing this
this
is as she's trying to lift
she's always going to be pulling all the
muscles in the shoulder girdle the entire
entire
core is going to be pulling towards
their points as support
and if we look specifically at the
shoulder girdle
we have the middle trapezius the
rhomboids the lower trapezius
are all pulling from the spine towards
the shoulder blade from the shoulder
blade down towards the elbow
so people who tend to have have a
flat back or an accentuated curvature
we can use that activation to try and
normalize that
we're going to go through that in more
detail when she's up in the right position
position
so these abdominal cylinder
pressurization bearing through
through the pubic bone bearing through
the elbows
reaching separating spreading out the
whole time
and then she begins to lift and with my
fingers on
t4 t5 as she's lifting i want to feel
this part of the spine lifting into my
fingers and she's doing it very well
watching to make sure we're not getting
over activation of the upper trap
the hollowing into the neck we want to
watch all that
next we want to see multi-segmental
extension occurring
from the from the top of the sacrum
through the entire spine
all the way up to the top so every
segment is participating in the thoracic spine
spine
as she comes up so chin tucking
pulling forward support through the
elbow support through
through the pubic bone maintaining that pressurization
pressurization
and lifting and lifting and really getting
getting
that stabilization of the entire
very good and now she's just going to
maintain that position and breathe
really focusing on breathing through the
entire abdominal cylinder
and while she's doing that she's also
focusing making sure the shoulders stay
down everything stays spread reaching into
into
the elbows keeping that ideal position
on the pubic bone
not gripping with the glutes not
10 12 15 good breaths and then she'll
lower herself back down
now for some people they might find
being down in that
prone position flat on the table just simply
simply
too difficult to create a proper pattern
usually it's because the thoracic spine
is there's just too much curvature it's
too stiff
and they can't upright themselves
correctly so we can also use a low kneeling
kneeling
or in some people will call it a child's
pose position
to create the same type of patterns now
another problem we typically see is
people might tend to have too much
curvature in the lower back and the pelvis
pelvis
really wants to sit in that anterior tilt
tilt
when we try and control this and try and
control this and the head
there's just too much going on so what
we can do
is allow the pelvis to sit back
like this and as she's moving her body
this way
the pelvis will naturally begin to
rotate backwards
the pelvis will move into its more
natural position
and the lumbar spine will also go into
its its natural position as well
one less thing to battle with so
going back to to the thoracic spine
the idea with the arms is the same as we
did previously
your the elbows are out to the side a
little bit the hands are in a little
elbow the wrists are about the same
width as the shoulder joints
we're creating the same activation
through the abdominal wall
now we can accentuate this a little bit now
now
by by pressing the shins into the table
as soon as those shins press down
there's a little bit more uprighting
through the entire spine so we're going
to take advantage of the legs
to help with the exercise so she's going
to be pressing her shins into the table
and the whole time now she's going to be
pulling her coccyx her tailbone
down towards her heel i'm going to make
sure we have that ideal pressurization
through the cylinder
we want to keep the shoulders away from
the ears so
we're pulling them back opening up
through the chest
spreading through the chest and the
shoulders we want nice
width and then she's going to pull the
back of her head towards the ceiling
and while she's pulling the tailbone
this way she's also going to be pulling
her head
that way creating a lengthening of the spine
spine
now as we mentioned people who have
alterations in in the normal curvature
of the thoracic spine
we can use this exercise to help correct that
that
so let's say lana was someone who had
too much curvature
in her upper back now
with the too much curvature the spine
tends to sit
higher than the shoulder blades we're
going to be using
the activation of the rhomboids the
middle trap and the lower trap
that's pulling towards the shoulder
blade to take that accentuated thoracic curvature
curvature
and pull it down towards the shoulder blade
blade
and the opposite of that would people
who are dished really
flat in the thoracic spine now we're
going to be using those same muscles
pulling towards the shoulder blade to
lift the spine towards the shoulder blades
blades
we're creating act ideal postural
positioning of
the shoulder of the thoracic spine and
at the same time
we're pulling the rib cage up towards up to
to
the shoulder blade so people who have
shoulder instabilities
people have winging shoulder blades by
creating a full body activation
we're going to be dealing with those
patterns as well so let's go back to the beginning
beginning
the tailbone pulls down towards the heels
heels
shins press into the table we activate
that abdominal cylinder
ideal pressurization she's supporting
through her elbows
lifting the head up towards the ceiling
we're not
pushing the arms into the table you're
just feeling your support
and from that support you're lifting the head
head
to bring the thoracic spine into its
ideal position
and trying to go as long as possible and
the whole time
breathing correctly in through the cylinder
cylinder
and there you have it we have both the
prone three-month developmental position
the lot the low kneeling developmental position
position
to create uprighting the spine ideal
shoulder position
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