Knee Extension Tool

POSITIONING/ PHASE ONE

• Sit in chair with knees flexed over side.
• ankle harness should be around the ankle.
• bulb of the tool should be at knee.

UP PHASE

• left leg up by straightening (extending) the knee.
• Knee Joint:
• rectus femoris in sagittal plane, concentrically, to extend knee.
• vastus intermedius in sagittal plane, concentrically, to extend knee.
• vastus lateralis in sagittal plane, concentrically, to extend knee.
• vastus medalis in sagittal plance, concentrically, to extend knee.

DOWN PHASE

• slowly put leg back down by bending (flexing) the knee.
• Knee Joint:
• Bicep femoris in sagittal plane, eccentrically, to control flexing of the knee.
• popiteus in sagittal plane, eccentrically, to control flexing of the knee.
• semimembranous in sagittal plane, eccentrically, to control flexing of the knee.
• semitendinous in sagittal plane, eccentrically, to control flexing of the knee.

Drill/ Stretch:

The following is a home exercise one could do to stretch their hamstring muscle that is used for the knee extension tool.

Lever Tool

POSITIONING/ PHASE ONE

• elbow should be extended
• shoulder should be flexed
• should be arms length away from the lever

PULL PHASE

• pull lever towards you
• shoulder should go down slightly (depression)
• elbow should bend (flexion)
• Shoulder Girdle:
• pectoralis minor in frontal plane, eccentrically, for depression of shoulder.
• trapezius lower fibers in frontal plane, eccentrically, for depression of shoulder.
• Elbow/ Radioulnar Joints:
• biceps brachii long head in sagittal plane, concentrically, for elbow flexion.
• biceps brachii short head in sagittal plane, concentrically, for elbow flexion.
• brachialis in sagittal plane, concentrically, for elbow flexion.
• brachioradialis in sagittal plane, concentrically, for elbow flexion.
• pronator teres, isometrically, in transverse plane to keep forearm slightly pronated.
• Wrist/ Hand Joints:
• flexor digitorium superficialis, isometrically, in sagittal plane to keep fingers flexed around tool.
• flexor digitorum profundus, isometrically, in sagittal plane to keep fingers flexed around tool.

RELEASE PHASE

• slowly release lever back to original position.
• shoulder should elevate slightly.
• elbow should extend.
• Shoulder Girdle:
• Trapezius upper fibers in frontal plane, concentrically, for elevation of shoulder.
• Trapezius middle fibers in frontal plane, concentrically, for elevation of shoulder.
• Rhomboids in frontal plane, concentrically, for elevation of shoulder.
• Levator scapulae in frontal plane, concentrically, for elevation of shoulder.
• Elbow/ Radioulnar Joints:
• Triceps brachii long head in sagittal plane, eccentrically, to control extension of elbow.
• Triceps brachii lateral head in sagittal plane, eccentrically, to control extension of elbow.
• Triceps brachii medial head in sagittal plane, eccentrically, to control extension of elbow.
• Anconeus in sagittal plane, eccentrically, to control extension of elbow.
• Wrist/ Hand Joints:
• flexor digitorum superficialis, isometrically, in sagittal plane to keep fingers flexed around tool.
• Flexor digitorum profundus, isometrically, in sagittal plane to keep fingers flexed around tool.

Drill/ Home Exercise:

The following is a home exercise one could use to flex elbow.

Wheel Tool

POSITIONING/PHASE ONE

• Right arm should be above left arm.
• elbow of right arm should be bent (flexed) at about 45 degrees and wrist should be slightly abducted.
• elbow of left arm should be slightly bent (flexed) and wrist should be adducted slightly.
• right shoulder should be slightly flexed.
• left shoulder should be relaxed.

PULL PHASE (PART ONE)

• Pull wheel down by using your right arm.
• Right shoulder should extend slightly and right elbow should flex more.
• Let right arm do the work, left arm should just be following through.
• Glenohumeral Joint:
• pectoralis major lower fibers, concentrically, in sagittal plane to pull down wheel by slightly extending shoulders.
• suscapularis, concentrically, in sagittal plane  to pull down wheel by slightly extending shoulders.
• latissimus dorsi, concentrically, in sagittal plane to pull down wheel by slightly extending shoulders.
• teres major, concentrically, in sagittal plane to pull down wheel by slightly extending shoulders.
• teres minor, concentrically,in sagittal plane  to pull down wheel by slightly extending shoulders.
• Elbow/ Radioulnar Joints:
• Biceps brachii long head, concentrically, in sagittal plane to flex elbow.
• Biceps brachii short head, concentrically, in sagittal plane to flex elbow.
• Brachialis, concentrically, in sagittal plane to flex elbow.
• Brachioradialis, concentrically, in sagittal plane to flex elbow.
• Wrist/ Hand Joints:
• Flexor carpi radialis, concentrically, in frontal plane to slightly abduct wrist.
• Extensor carpi radialis brevis, concentrically, in frontal plane to slightly abduct wrist.
• Extensor carpi radialis longus, concentrically, in frontal plane to slightly abduct wrist.
• Extensor pollicis longus, concentrically, in frontal plane to slightly abduct wrist.
• Extensor pollicis brevis, concentrically, in frontal plane to slightly abduct wrist.
• Abductor pollicis longus, concentrically, in frontal plane to slightly abduct wrist.
• Flexor digitorum superficialis, concentrically, to flex fingers to grab the wheel.
• Flexor digitorum profundus, concentrically, to flex fingers to grab the wheel.
• Extensor digitorum for fingers to let go of wheel.
• Extensor indicis for fingers to let go of wheel.
• Extensor digiti minimi for fingers to let go of wheel.

PULL PHASE (PART TWO)

• alternate arms when pulling down the wheel.

RELEASE PHASE (PART ONE)

• slowly release the wheel in the opposite direction.
• shoulders should flex slightly and elbow should extend slightly.
• Glenohumeral Joint:
• Pectoralis major upper fibers, eccentrically, in sagittal plane to control flexion of shoulder.
• Deltoid anterior fibers, eccentrically, in sagittal plane to control flexion of shoulder.
• Elbow/ Radioulnar Joints:
• Triceps brachii long head, eccentrically, in sagittal plane to control extension of elbow.
• Triceps brachii lateral head, eccentrically, in sagittal plane to control extension of elbow.
• Triceps brachii medial head, eccentrically, in sagittal plane to control extension of elbow.
• Anconeus, eccentrically, in sagittal plane to control extension of elbow.
• Wrist/ Hand Joints:
• Flexor carpi ulnaris, eccentrically, in frontal plane to slightly adduct wrist.
• Extensor carpi ulnaris, eccentrically, in frontal plane to slightly adduct wrist.
• Flexor digitorum superficialis, concentrically, to flex fingers to grab the wheel.
• Flexor digitorum profundus, concentrically, to flex fingers to grab the wheel.
• Extensor digitorum for fingers to let go of wheel.
• Extensor indicis for fingers to let go of wheel.
• Extensor digiti minimi for fingers to let go of wheel.

RELEASE PHASE (PART TWO)

•  alternate arms while releasing the wheel in the opposite direction.

Drill/ Home Exercise:

The following is the arm bike that will help get the shoulders moving and alternating.

Screwdriver Tool

POSITIONING/ PHASE ONE

• place hand on screwdriver with fingers wrapping around the handle.
• the machine should be high enough so that the elbow is bent(flexed) at about 90 degrees.
• shoulder should be relaxed.
• wrist is slightly turned to the right (supination)

ROTATE RIGHT PHASE

• rotate wrist to the right (supination) slightly so that you are rotating the screwdriver
• elbow should stay flexed
• shoulder should stay relaxed
• Elbow/ Radioulnar Joints:
• Biceps brachii long head, isometrically, in sagittal plane to keep elbow flexed.
• Biceps brachii short head, isometrically, in sagittal plane to keep elbow flexed.
• Brachialis, isometrically, in sagittal plane to keep elbow flexed.
• Brachioradialis, isometrically, in sagittal plane to keep elbow flexed.
• Biceps brachii long head, concentrically, in transverse plane to supinate forearm.
• Biceps brachii short head, concentrically, in transverse plane to supinate forearm.
• Supinator, concentrically, in transverse plane to supinate forearm. 
• Wrist/ Hand Joints:
• Flexor digitorum superficialis, isometrically, in sagittal plane to keep fingers flexed to hold on to screwdriver.
• Flexor digitorum profundus, isometrically, in sagittal plane to keep fingers flexed to hold on to screwdriver.
• Flexor pollicis longus, isometrically, in sagittal plane to keep fingers flexed to hold on to screwdriver.

RELEASE PHASE (ROTATE BACK TO POSITION)

• control rotating your wrist back to original position (pronation).
• elbow should stay flexed.
• shoulder should stay relaxed.
• Elbow/ Radioulnar Joints:
• Pronator teres, eccentrically, in transverse plane to control the pronation forearm.
• Pronator quadratus, eccentrically, in transverse plane to control the pronation forearm.
• Wrist/ Hand Joints:
• Flexor digitorum superficialis, isometrically, in sagittal plane to keep fingers flexed to hold on to screwdriver.
• Flexor digitorum profundus, isometrically, in sagittal plane to keep fingers flexed to hold on to screwdriver.
• Flexor pollicis longus, isometrically, in sagittal plane to keep fingers flexed to hold on to screwdriver.

Drill/ Home Exercise:

The following is a home exercise to help with pronation and supination of the forearm.

Ladder Tool

POSITIONING/ PHASE ONE

• place hands on alternating handle bars
• the machine should be high enough so that the shoulder that is up (forward flexion) starts to feel the stretch in the muscle.
• the other shoulder that is not in extension, should be in front of you.
• you should be about arms length away from the machine, so that the shoulder that isn't up, is straight in front of you.

PULL DOWN PHASE (PART ONE)

• Pull down the ladder tool by bending (flexing) the elbow and pulling the shoulder down (extension), this part of your body is doing all the work.
• Start to let go of the other handle with your other hand as you are pulling down the ladder.
• Glenohumeral Joint:
• Pectoralis major upper fibers in sagittal plane to flex joint and reach for ladder.
• Deltoid anterior fibers in sagittal plane to flex joint and reach for ladder.
• Pectoralis major lower fibers, concentrically, in sagittal plane to extend joint to pull down ladder.
• Subscapularis, concentrically, in sagittal plane to extend joint to pull down ladder.
• Latissimus dorsi, concentrically, in sagittal plane to extend joint to pull down ladder.
• Teres major, concentrically, in sagittal plane to extend joint to pull down ladder.
• Teres minor, concentrically, in sagittal plane to extend joint to pull down ladder.
• Elbow/ Radioulnar Joints:
• Biceps brachii long head, concentrically, in sagittal plane to flex elbow to pull down ladder.
• Biceps brachii short head, in sagittal plane to flex elbow to pull down ladder.
• Brachialis, in sagittal plane to flex elbow to pull down ladder.
• Brachioradialis, in sagittal plane to flex elbow to pull down ladder.
• Triceps brachii long head in sagittal plane to extend elbow to reach for ladder.
• Triceps brachii lateral head in sagittal plane to extend elbow to reach for ladder.
• Triceps brachii medial head in sagittal plane to extend elbow to reach for ladder.
• Anconeus in sagittal plane to extend elbow to reach for ladder.
• Wrist/ Hand Joints:
• Flexor carpi radialis in sagittal plane to slightly flex wrist when grabbing for ladder.
• Palmaris longus in sagittal plane to extend elbow to reach for ladder.
• Flexer carpi ulnaris in sagittal plane to extend elbow to reach for ladder.
• Flexor digitorium  superficialis in sagittal plane to extend elbow to reach for ladder.
• Flexor digitorium profundus in sagittal plane to extend elbow to reach for ladder.
• Flexor pollicis longus in sagittal plane to extend elbow to reach for ladder.
• Extensor carpi ulnaris in sagittal plane to extend wrist to pull ladder down.
• Extensor carpi radialis brevis in sagittal plane to extend wrist to pull ladder down.
• Extensor carpi radialis longus in sagittal plane to extend wrist to pull ladder down.
• Extensor digitorum in sagittal plane to extend wrist to pull ladder down.
• Extensor pollicis longus in sagittal plane to extend wrist to pull ladder down.
• Flexor digitorum superficialis, concentrically, to flex fingers around handles of ladder.
• Flexor pollicis longus, concentrically, to flex fingers around handles of ladder.
• Extensor digitorum in sagittal plane to extend fingers to let go of handles of ladder.
• Extensor indicis in sagittal plane to extend fingers to let go of handles of ladder.
• Extensor digiti minimi in sagittal plane to extend fingers to let go of handles of ladder.
• Extensor pollicis longus in sagittal plane to extend fingers to let go of handles of ladder.
• Extensor pollicis brevis in sagittal plane to extend fingers to let go of handles of ladder.
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PULL DOWN PHASE (PART TWO)

•  shoulder that was originally in the up position  should now be in front of you.
• shoulder that was originally in front of you, should now be in the up position.

PULL DOWN PHASE (COMPLETED TRANSITION)

• now arms should be in the opposite places than where they originally started from.
• continue the steps for three minutes.

Drill/ Home Exercise:

The following is a home exercise to help with shoulder flexion.

Hand Gripper Tool

POSITIONING/ PHASE ONE

• place hand on tool with thumb on the bar closest to your body and the other four fingers on the bar furthest away from your body.
• The height of the machine should be in such a way that the elbow is bent(flexed) at about 100 degrees.
• shoulder should be relaxed.

SQUEEZE PHASE

• Squeeze the bar furthest from  your body by bending (flexing) your four fingers, to the bar that is closest to you.
• keep elbow flexed in the same position.
• keep shoulder in the same position.
• only use your fingers.
• Elbow/ Radioulnar Joints:
• Bicep brachii long head, isometrically, in sagittal plane to keep elbow flexed.
• Bicep brachii short head, isometrically, in sagittal plane to keep elbow flexed.
• Brachialis, isometrically, in sagittal plane to keep elbow flexed.
• Brachioradialis, isometrically, in sagittal plane to keep elbow flexed.
• Wrist/ Hand Joints:
• Flexor digitorum superficialis, concentrically, in sagittal plane to flex fingers.
• Flexor digitorum profundus, concentrically, in sagittal plane to flex fingers.
• Flexor pollicis longus, isometrically, in sagittal plane to keep thumb flexed.

RELEASING PHASE

• slowly release and control your hand/finger opening(extension) until its back into original position.
• shoulder and elbow should not move.
• only fingers should be moving.
• Elbow/ Radioulnar Joints:
• Bicep brachii long head, isometrically, in sagittal plane to keep elbow flexed.
• Bicep brachii short head, isometrically, in sagittal plane to keep elbow flexed.
• Brachialis, isometrically, in sagittal plane to keep elbow flexed.
• Brachioradialis, isometrically, in sagittal plane to keep elbow flexed.
• Wrist/ Hand Joints:
• Flexor pollicis longus, isometrically, in sagittal plane to keep thumb flexed.
• Extensor digitorum, eccentrically, in sagittal plane to extend fingers.
• Extensor indicis, eccentrically, in sagittal plane to extend fingers.
• Extensor digiti minimi, eccentrically, in sagittal plane to extend fingers.

Drill/ Home Exercise:

The following is a home exercise to help with gripping; flexion and extension of the fingers.