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Side-lying vs. Supine Position Exercises – Why are they in my physical therapy routine?

 Side-lying Exercises Vs. Supinated Exercises – Why are they in my physical therapy routine?

By Christina Vivit


As a patient, you’re coming into Midwest Integrated for your back pain, shoulder pain, knee weakness, etc. The knowledgeable and friendly healthcare providers at MIPM can help through creating an exercise program to accommodate for your personal needs. Have you ever wondered why we incorporate side-lying range of motion exercises as well as supine (on your back) position exercises into your exercise program? Well, here’s why.

Range of Motion (ROM)

Range of motion is the measurement of joint movement in a given direction. Your range of motion can be inhibited by various pains, injuries, or weaknesses. Therefore, it is important that we incorporate ROM into one’s exercise program. There are two different kinds of ROM exercises: passive and active. Passive ROM occurs when joint movement is caused by an external force. An example of this would be a physical therapist working on a shoulder joint by moving it through various arm positions while the patient is relaxed in a side-lying or supine position. Why do we do passive ROM? It helps to maintain or regain normal ROM, improve joint lubrication, and decrease pain. In comparison to passive ROM, active ROM occurs when the patient is moving his or her joint without any external assistance. For example, a patient in a seated position kicking his or her leg out when working on knee extension. This type of ROM contains the same benefits as passive ROM but also helps with maintaining and improving strength, acts as a stimulus for bone integrity, and increases circulation and prevents thrombosis (blood clotting).

So what’s the big deal with side-lying vs. supinated positioning when doing these range of motion exercises?

When implementing these range of motion exercises into one’s exercise program, it is important to assess the patient’s level of weakness in respect to the joint and surrounding muscle. Side-lying positioning eliminates the force of gravity in one’s movement, therefore making it easier to achieve a greater ROM when performing exercises in the horizontal plane. This can be used for patients who have greater weakness or smaller ROM but can still achieve the various benefits of passive or active ROM exercises. On the other hand, supine positioning—laying on one’s back— includes the force of gravity when performing ROM exercises, which can increase difficulty in these exercises. This can be used for patients who have a 3/5 muscle grade or higher, which means that the patient can perform joint movement against gravity. Therefore, including exercises in both positions can significantly help maintain or improve one’s ROM and strength.


Want to know more? Ask one of our knowledgeable and friendly healthcare providers at Midwest for more information on why certain exercises are implemented in your personal exercise routine when coming to therapy.