Fundamental and derived

Positions

There are five FundamentalPositions which are usually describedwith their derivatives as the startingpositions from which exercises startor in which may be given.

Starting Positions

� They are five positions.

1- Lying position.

2-Sitting position.

3- Standing position.

4- Kneeling position.

5- Hanging position.

Derived Positions

� Derived positions are positions used by modification of the arms, legs or trunk in each of fundamental position.

The aims of derived positions are:

1- To increase or decrease the base of support.

2- To rise or lower the center of gravity (COG).

3- To gain local or general relaxation.

4- To gain fixation and good control of specific area.

5- To increase or decrease the muscle work required to maintain the position.

6- To increase or decrease the leverage.

1- LYING

� This is the easiestposition as the bodycan completelysupported in thesupine position andas stable as possible.

The body lies stretched out upon ahorizontal surface, arms to the sides andlegs straight with muscles relaxed. There isactually no real muscle work necessary formaintaining this position. The body is mostsupported with large base and low centreof gravity.

This position is Used:

� For weak patients.

� For small children, because they often do not understand how to maintain other starting positions

� it is suitable for many exercises.

� Frequantly for massage.

Positions Derived From Lying.

1- Side Lying

� An ideal position for relaxation for many people is provided by adapting. Three pillows are required, one for the head, one for the uppermost arm and one to support leg which is bent.

� Used in sling exercises.

2-Prone Lying

� Uses:

� Unsuitable for heart and respiratory diseased patients as breathing is so restrict.

� Used as corrective position for spine.

� May be comfortable for young and slim people.

3- Half Lying

The trunk is supported in the oblique position by inclination of the long end of the plinth, or by the arrangements of the pillows.

� Effect:The knees may be bent to increase

relaxation of the abdominal wall. � Uses: 1- It is much used forward exercises.2- Relaxed and comfortable position for weak and

elderly people.3- Breathing is easier than in lying, so it is used in

many chest conditions.

4- Crook Lying� From lying, the hip and knees are bent so that the feet rest on the floor or plinth. Very little muscle work is required Tension is removed from the structure anterior to the hip joint so that the pelvis rolls backward and the lumbar spine is relaxed on to the supporting surface.

� Uses:

1- To train relaxation and posture.

2- In pelvic and back exercises.

2- Sitting position

It is taken on a chair. In this position thebody rests chiefly on the tuberosities of theischium, but the back of the thighs should alsobe supported and the feet should rest upon thefloor. The hip, knee, and ankle joints should allform right angles. The knees should be slightlyapart so that the position of the legs is easy.The working muscles for maintaining theposition are principally the neck, back, andposterior shoulder muscles. Your weightshould be evenly distributed on both buttocks.

� Effects And Uses

1. General steadiness in this position isconsiderably greater, because : -

(a) The base is larger;

(b) The centre of gravity lies nearer the base;

2. The pelvis is also firmer, because it rests onthe supporting surface.

3. The leg muscles work little.

Positions Derived From Sitting:

1- Long Sitting

� This is similar to the previous position, but the knees are extended so that the whole leg is supported.

� Effect:

� It leads to increase tension of hamstring.

� Uses:

� Position is difficult due to instability.

2- Cross Sitting

� This is also similar to crook sitting, but the ankles are crossed and the hips strongly abducted and laterally rotated, so that the lateral aspect of the knees is pressed to the floor. Tension on the hamstring muscle is reduced but the adductors of the hip are stretched.

3- High Sitting

� The fundamental sitting position is taken on a high plinth or table but the feet remain unsupported.

� Uses:

� It is convenient some foot and knee exercise.

3- Standing Position1- The heels are on ground with angle not exceed 45°.

2- Keep your knee straight but not locked.3- The hips are in extension and slightly rotated laterally.

4- The pelvic is balanced on the femoral head.5- The spine is stretched to its maximum length6- The head is hold up straight with chin in. do not tilt your head forward, backward, or sideways.

7- Keep your shoulder back. 8- The arms are hanged loosely to the sides, palms facing sides of the body.

9- Your weight should be evenly distributed on both legs.

Effects And Uses

� The chest is expanded (the shoulders beingdrawn back and the spine extended).

� The internal organs have ample space, so thatthey are not hampered in their functions byundue pressure.

� The position is not steady partly, because thebase is small, because the centre of gravity lies sohigh above the base (centre of gravity liesbetween third and fourth sacral vertebrae).

� It is used as starting position for a number offree-standing exercises.

Positions Derived From The Standing

Position

1- Toe standing

The heels are pressed together and raised from the floor.

� Effect:

The base is reduced and the center of gravity is raised.

� Uses:

1- It is used as a balance position.

2- There is a tendency for the whole body to stretch so it is used as treatment.

2- Stride standing

� The legs are abducted and the heels are apart and remain in 45°.

� Effect:

� Large base lead to easy and stable position.

� Uses:

� Used as starting easy position for many exercises.

3- Walk standing

� One leg is placed forward to the same line of the other leg.

� Effect:

� The base is much enlarged in the antro-posterior direction stabilizing the body for exercises in a sagittal plane. Rotation of the pelvis towards the side of the forward leg is prevented by the position of the back leg.

� Uses:

1- Localize the hamstrings rotation of the spine.

2- Tension on of the forward leg prevents forward tilting of the pelvis in trunk flexion exercises.

4- Half standingThe whole weight of the body is

supported on one leg, the other may be free or supported in a variety of the positions.

Effects:

Balance is very difficult with one leg. The free leg can rest in many positions like stool with flexed hip and knee (step st.). This position reflexes the tension of the abdominal operations.

Uses in:

Increase tension of the hamstring of the lower leg and straightening of the lumbar spine.

4- KNEELING

� The body is supported on the knees which may be together or slightly apart.

� 1- The lower leg rests on the floor with the feet planter flexed.

� 2- The feet may be in the mid position over the edge of the plinth.

2- KNEELING

� Effect: uncomfortable position for most people due to difficult balance.

� Uses: as starting position for backward movements.

Positions Derived From The kneeling Position:

1- Half Kneeling

� One knee supports most of the weight and other leg is bent to a right angle at hip, knee and ankle so that the foot is supported on the ground in a forward direction.

2- Kneel Sitting

� The knees and hips are flexed so that patient sits on his heels.

� Uses:

� Sometimes used for small children, but most people find it very uncomfortable.

3- Prone Kneeling� The trunk is horizontal, supported under theshoulders by the arms, and at the pelvis by thethighs, which must be held vertical. The head isheld in line with the trunk.

� Effect and Uses:

The position is stable, comfortable and suitablefor many trunk and head exercises. The pelvis isfree for antro-posterior and lateral movement, butfixed rotation. The body may be inclined forwardsand downwards.

5- HANGING� The body is suspended by grasping over horizontal bar.

� The arms straight & at least shoulder width apart and forearm being pronated. The legs and trunk hang straight with the heels together and the ankle planter flexed.

Uses:

� it is suitable for athletic persons with high muscle strength.

� Produces a passive stretching of the spine and its ligaments, especially in the lower part, and is therefore used in treating spinal curvatures.

� Raises the ribs by stretching the shoulder muscles, and is therefore used in the treatment of flat chest.

Derived Positions From Hanging:

� Half Hanging

The body is supported in the oblique position by the arms which grasp a horizontal bar, while the rest of the body is inclined and straight.

� Effect and Uses:

The position requires very strong muscle work for the back muscle, especially the scapulae retractors, which work against gravity and the weight of the body.