Question | Answer |
stretch function | to increase ROM and mobility around a joint or series of joints |
stretch | elongate structure around joint |
mobility | ability to be moved |
flexibility | move through unrestricted pain free ROM |
hypomobility | restricted motion caused by adaptive shortening |
adaptive shortening | prolonged immob, sedentary lifestyle, poor posture, muscle imbalance, weakness assiciated with muscle disorder, inflamation, pain, deformities |
contractures | adaptive shortening that results in resistance to stretch, limitation in ROM and decreased functional ability (designated by action of shortened muscle) |
myostatic contracture | shortening of muscle without pathology |
pseudomyostatic | apparent contracture, spacticity, muscle guarding |
arthogenic/periarticular | intra-articular pathology ie capsular restriction |
fibrotic | fiberous changes to soft tissue (scar tissue) |
indications for use of stretching | limited ROM due to adhesions, contractures, scar tissue formation/preventable structural deformities/Muscle shortening due to weakness/fitness program designed to prevent injury/ Before and after vigorous exercise to minimize post exercise muscle soreness |
contraindications for use of stretching | bony block,recent fracture,acute inflammtion/infection,acute pain w/joint movement or muscle elongation, hematoma, hypermobility,if shortened tissues are "functinal", if shortened tissues provide joint stability in lieu of normal structures or control |
precautions | don't force beyond normal ROM (and normal ROM varies!), osteoporosis, long period of immobilization, age, prolonged steroid use, newly united fractures, edema, overstretching weak muscles |
stretch reflex | muscle spindle - golgi tendon organ |
muscle spindle belly of muscle | reports velocity and changes in lenght of muscle to brain facilitates reflexive contraction to protect from injury |
golgi tendon organ | senses change in tension a muscle tendon junction inhibits motor neuron activity (relax tells motor nerve to shut down so no contraction) |
stress strain curve | visual representation of what happens to soft tissues under a stress (toe, elastic range, plastic range, neck, failure) |
alignment | positioning of the body or segment to ensure stretch is applied to appropriate muscle group |
stabilization | fixing one end of the segment |
intensity | how much force is used (low load optimal lengthening) |
duration | amount of time stretch force is applied |
long | static or prolonged 30 second is avg |
static progressive | lengthen, muscle gives lengthen more |
short | cycles- slow repeated low intensity and ballistic- bouncing rapid forceful high intensity (bad) |
speed | slow and sustained force applied gradually |
frequency | number of sessions per day or week |
mode | manual, self, mechanical, neuromuscular inhibition |
mechanical | use tool or device |
Proprioceptive Neuromuscular Faciliation (PNF) | Hold-relax (HR) or contract-relax (CR); Agonist contraction (AC); Hold-relax with agonist contraction (HR-AC) |
HR hold relax | the tight muscle (antatgonist) is lengthened isometrically contracts (5 second) followed by period of relaxation and passive elongation |
CR contract relax | the tight muscle (antagonist) is lengthened concentrically contracts through out the ROM followed by a period of relaxation and passive elongation |
HR-AC | HR technique followed by AC tech |
self stretch | pt. carries out independently after careful instruction |
manual stretch | therapist applies external force to move involved body segment slightly beyond the point of tissue resistance and available ROM |
AC agonist contraction | pt. concentrically contracts (shortens) muscle opposite the range limiting muscle then holds the end-of-range position for several seconds |
static | soft tissues are elongated just past point of tissue resistance and held in lengthened position w/sustained stretch for 30-60 sec. |
cyclic | short duration stretch force repeatedly but gradually applied, released, reapplied...with stretches held between 5-10 sec. |
ballistic | rapid,forceful intermittent high-speed and high-intensity stretch by the use of quick bouncing movements |
What is the difference between 'stretching' and 'ROM'? | Stretching takes soft tissue beyond their available length to INICREASE ROM. ROM exercises stay within the limits of tissue extensibility to MAINTAIN available length. |
"Ideal" stretch | low load and prolonged |