Mobility through Stretching

Definition and purpose of stretching.

any therapeutic maneuver designed to increase soft tissue extensibility and subsequently improve flexibility and ROM by elongating structures that have adaptively shortened and have become hypomobile

Neurophysiologic Basis of Stretching role of mechanoreceptors.

are in muscle and tell CNS what is happening w/in that muscle

what is manual passive stretch?

a low intensity manual stretch applied for as long a duration as possible will be more comfortable and more readily tolerate by the patient

Define Laxity

ability of a joint; excessive joint laxity can be a result of injury or some sort of hereditary condition

Types of Flexibility what is static/passive flexibility?

ability to hold an extended position at one end in a joints ROM; dependent on your ability to tolerate stretched muscles, joint structure and tightness of connective tissue

Types of Flexibility what is dynamic (functional) flexibility?

ability to move a joint through its ROM with little resistance

what is dynamic stretching?

active movement that takes the body through full ROM

Stress-Strain Curve Define stress.

amount of force or load put on tissue

Define muscle spindle.

sensitive to changes in muscle length; sends a sensory impulse to spinal cord that is sent back to muscle spindle causing the muscle to reflexively contract

what is autogenic inhibition?

serves a protective role which allows muscle to not be damaged through action of GTO

Dynamic stretch Handwalks work what muscles?

shoulders, core muscles and hamstrings

Advantages of dynamic stretching.

-focused on sport specific movement -development of dynamic flexibility -increase temp -muscle is active

disadvantages of dynamic stretching

-inadequate tissue adaptation (ROM) -soreness after first session -inadequate neurological adaptation

What are the 7 CONTRAINDICATIONS to stretching:

1) bony block 2) nonunion fracture 3) acute inflamm or infection 4) sharp or acute pain with elongation 5) hematoma or tissue trauma 6) hypermob 7) hypomob provides stability or control

Disadvantages of Manual Passive Stretching:

1) boring 2) may overly dominate routine due to time needed 3) allows body to cool during warm up

Advantages to Manual Passive Stretching:

1) historical preference 2) effective and optimal 3) decrease possibility of exceeding normal ROM

what are the 4 types of PNF stretches?

1) hold relax 2) contract relax 3) agonist contraction 4) hold relax with agonist contraction

Benefits of Flexibility:

1) increase blood supply and nutrients to joint structure 2) increase quality and quantity of joint synovial fluid 3) increase muscular coordination 4) relaxation 5) improve ease and efficiency of movement 6) reduce muscular soreness 7) joint health 8) prevent of low back pain and injuries 9) relief of aches and pains 10) relief of muscle cramps 11) improved body position and strength for sports 12) maintenance of good posture and balance

7 Factors that influence flexibility.

1) joint structure 2) age 3) gender 4) exercise 5) muscle mass 6) temp 7) pregnancy

Limits due to Connective tissue Aging: what happens w/ joints, collagen?

1) joints become less stable and less mobile 2) degradation fo collagen, joint surface, and decreased viscosty of synovial fluid 3) increased collagen diameter and more collagen cross-links (cause tissue to become less tensible)

what are the indications of stretching?

1) limited ROM due to adhesions and scar tissue formation leading to shortening of muscle, connective tissue and skin 2) prevention of structural (neglected soft tissue > shortening > structural limitation > skeletal deformities) 3) when contractures interfere with every day functional activities 4) when there muscle muscle weakness and opposing tissue tightness

Causes of soft tissue shortening:

1) prolonged immobilization due to intrinsic or extrinsic factors 2) sedentary lifestyle due to bed rest, work environment 3) muscle imbalance, paralysis or tone abnormality 4) postural malalignment which may be congenital, acquired (EX: scoliosis or kyphosis)

what are the goals of stretching?

1) regain normal ROM of joints and mobility of soft tissue surrounding the joint 2) prevent irreversible contractures 3) increase the general flexibility of muscle and soft tissues before vigorous strengthening exercises 4) minimize and prevent the risk of musculotendinous injuries related to specific physical activities and sports

what are the guidelines for proper stretching:

1) stretch muscles that are warm- unless dynamic stretching exercises warm up the muscles and improve elongation with flexibility 2) warm up before stretching 3) do not rush stretch 4) stretch gentle and slow and smooth, avoid ballistic 5) do not bounce 6) should breathe 7) stretch muscle group and perform stretch 3-4 times

what are the 6different types of stretching. NAME THEM

1)manual passive stretching 2)PNF - active neuromuscular inhibition 3)self stretch 4)mechanical stretch 5)ballistic stretching 6)dynamic stretching

FITT principle for stretching Time:

15 to 30 sec, perform 2 to 4 time; aim to hold for a minute

FITT principle for stretching Frequency:

2-3 days a week

Connective tissue deformation and neural inhibitory effects does require how many seconds to effect tissue change and relaxation?

30 to 90 sec

flexibility should be held for how many seconds in order to achieve the elastic region?

30 to 90 sec

GTO or muscle spindle? serves as a protective function and allows the muscle to relax so it is not overstretched or damaged

GTO

GTO or muscle spindle? sensitive to changes in muscle TENSION

GTO (T=tension)

what are 2 mechanoreceptors important in stretch reflex?

GTO and muscle spindle

Manual Passive stretch vs. ballistic stretch

Manual= inhibit stretch reflex, decrease muscle tension ballistic= facilitate muscle contraction, increase tension

Define Hypermobility

ROM that is in excess of acceptable ROM of most of the joints; exceeding the normal of for a particular joint

ROM vs. stretching.

ROM= movement of joints; can have limited ROM due to periarticular structures, due to joint issues, or joint integrity stretching= contractile tissues impacted and muscles, fascia, periarticular tissue around a joint

Men or Women are more flexible ?

Women

3 components of ballistic stretching

bouncing, quick lengthening, very short duration

Advantages of PNF stretching

capable of producing greater improvements in flexibility

Stress-Strain Curve what is the toe region?

collagen fibers unwrinkled and straighten out with force applied; there is an automatic elongation of tissue; this is the range where most functional activities occur

what surrounds muscle fibers (fascia) and is in major component of tendons and ligaments?

connective tissue

what is reciprocal inhibition?

contraction of agonist muscle that causes a reflex relaxation in antagonist muscle

Define Hypomobility

decrease mobility/restricted motion at series of joints; result of joint issue, contractile issue and a non-contractile issue

ROM bay be selected as as therapeutic exercise in order to:

decrease pain, prevent contractures, promote circulation/brings nutrients to joint, increase mobility of synovial fluid

Stress-Strain Curve Define relaxation.

describes how soft tissue length decreases when load is removed

advantages of ballistic stretching

development of dynamic flexibility, effectiveness

stretching will not impact a muscle working w/ what type of contraction- eccentric or concentric?

eccentric; most injuries occur with eccentric

Stress-Strain Curve Name region "tissue sustains the elongation achieved"

elastic region

Stretching may be selected as a therapeutic exercise in order to:

elongate the tissue will increase ROM, correct postural impairments, decrease pain, reduce functional mobility impairments

Define flexibility

extensibility of periarticular tissues to allow pain free, normal or physiological motion

Stress-Strain Curve Name region "point of injury"

failure point

Dynamic Stretching Straight leg march works what muscles?

hamstrings and glute medius

Stress-Strain Curve Define Creep.

how soft tissue will become increasingly stretched over time when load on soft tissue is constant

More muscle mass= more flexible or less flexible?

less flexible

is elastic deformation linear or nonlinear?

linear

if the stretch is held for how long then the impulse is from the GTO and will begin to override the muscle spindle?

longer than 6 sec

Dynamic stretching Scorpion works what muscles?

low back, hip flexors and gluteus muscles

what is a mechanical stretch?

low intensity external force (5 to 15 lb) applied to shortened tissues over a prolonged period by mechanical equipment stretch force is applied through positioning with weighted traction, pulley system, dynamic split and serial casts

Define agonist W/ PNF

muscle opposite to the tight muscle

GTO or muscle spindle? sensitive to change in muscle LENGTH

muscle spindle

is plastic deformation linear or nonlinear?

nonlinear

Stress-Strain Curve Define strain.

percentage of deformation you are going to achieve/elongation you will see when you do stretch

Stress-Strain Curve Name region "point of NO return"

plastic

Dynamic stretch Lunge works what muscles?

quads, gluteals, hams, VMO, soleus and gastro

what is ballistic stretching?

repetitive contractions of agonist used to produce quick stretches of antagonist

Disadvantages of PNF stretching

requires a partner

Define Contracture.

restriction in motion caused by adaptive shortening of the musculotendinous unit and other soft tissues that cross or surround a joint resulting in significant resistance to passive or active stretch resulting in limited ROM

disadvantages of ballistic stretching

soreness and injury and initiation of stretch reflex; there is inadequate neural adaptation, the brain or muscle does not keep tissue in elongated state

Early healing ROM follows a predictable sequence:

start with PROM > AAROM > AROM type of ROM is based on the tissue healing stages surrounding the joint

FITT principle for stretching intensity:

stretch to the point of mild discomfort BUT NOT PAIN

define antagonist w/ PNF

tight muscle

Tightness vs. Muscle Tightness

tightness/shortness= motion restricted due to shortening of soft tissue muscle tightness= adaptive shortening of contractile tissue (muscle) and noncontractile elements (fascia, tendons)

Types of Flexibility what is ballistic flexibility?

usually associate with bobbing or bounding motion

3 components of manual stretching

very slow, maintained & gentle, prolonged 15 to 30 sec or more

Stress-Strain Curve Name region "when soft tissue will NO longer return to original resting position"

yield point

Stress-Strain Curve Name region "where you would stop/end range of tissue; going beyond this will cause tear in the structure and discomfort."

yield point