stretching indication, precautions, techniques, etc..
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| stretch function | to increase ROM and mobility around a joint or series of joints
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| stretch | elongate structure around joint
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| mobility | ability to be moved
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| flexibility | move through unrestricted pain free ROM
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| hypomobility | restricted motion caused by adaptive shortening
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| adaptive shortening | prolonged immob, sedentary lifestyle, poor posture, muscle imbalance, weakness assiciated with muscle disorder, inflamation, pain, deformities
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| contractures | adaptive shortening that results in resistance to stretch, limitation in ROM and decreased functional ability (designated by action of shortened muscle)
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| myostatic contracture | shortening of muscle without pathology
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| pseudomyostatic | apparent contracture, spacticity, muscle guarding
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| arthogenic/periarticular | intra-articular pathology ie capsular restriction
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| fibrotic | fiberous changes to soft tissue (scar tissue)
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| 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
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| 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
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| 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
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| stretch reflex | muscle spindle - golgi tendon organ
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| muscle spindle belly of muscle | reports velocity and changes in lenght of muscle to brain facilitates reflexive contraction to protect from injury
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| 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)
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| stress strain curve | visual representation of what happens to soft tissues under a stress (toe, elastic range, plastic range, neck, failure)
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| alignment | positioning of the body or segment to ensure stretch is applied to appropriate muscle group
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| stabilization | fixing one end of the segment
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| intensity | how much force is used (low load optimal lengthening)
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| duration | amount of time stretch force is applied
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| long | static or prolonged 30 second is avg
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| static progressive | lengthen, muscle gives lengthen more
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| short | cycles- slow repeated low intensity and ballistic- bouncing rapid forceful high intensity (bad)
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| speed | slow and sustained force applied gradually
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| frequency | number of sessions per day or week
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| mode | manual, self, mechanical, neuromuscular inhibition
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| mechanical | use tool or device
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| Proprioceptive Neuromuscular Faciliation (PNF) | Hold-relax (HR) or contract-relax (CR); Agonist contraction (AC); Hold-relax with agonist contraction (HR-AC)
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| HR hold relax | the tight muscle (antatgonist) is lengthened isometrically contracts (5 second) followed by period of relaxation and passive elongation
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| CR contract relax | the tight muscle (antagonist) is lengthened concentrically contracts through out the ROM followed by a period of relaxation and passive elongation
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| HR-AC | HR technique followed by AC tech
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| self stretch | pt. carries out independently after careful instruction
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| manual stretch | therapist applies external force to move involved body segment slightly beyond the point of tissue resistance and available ROM
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| AC agonist contraction | pt. concentrically contracts (shortens) muscle opposite the range limiting muscle then holds the end-of-range position for several seconds
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| static | soft tissues are elongated just past point of tissue resistance and held in lengthened position w/sustained stretch for 30-60 sec.
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| cyclic | short duration stretch force repeatedly but gradually applied, released, reapplied...with stretches held between 5-10 sec.
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| ballistic | rapid,forceful intermittent high-speed and high-intensity stretch by the use of quick bouncing movements
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| 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.
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| "Ideal" stretch | low load and prolonged
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