prolonged immob, sedentary lifestyle, poor posture, muscle imbalance, weakness assiciated with muscle disorder, inflamation, pain, deformities
adaptive shortening that results in resistance to stretch, limitation in ROM and decreased functional ability (designated by action of shortened muscle)
indications for use of stretching
limited ROM due to adhesions, contractures, scar tissue formation/ Restricted motion my lead to otherwise preventable structural deformities/ Muscle shortening due to weakness of opposing tissue/ As part of a total fitness program designed to prevent injury/ Before and after vigorous exercise to minimize post exercise muscle soreness
contraindications for use of stretching
bony block limits, recent fracture, acute inflammtion or infection, sharp or acute pain w/joint movement or muscle elongation, hematoma, hypermobility,if contracture or shortened soft tissues are "functinal", if contractures or shortened tissues provide increased joint stability in lieu of normal structures or neuromuscular control
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
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)
positioning of the body or segment to ensure stretch is applied to appropriate muscle group
cycles- slow repeated low intensity and ballistic- bouncing rapid forceful high intensity (bad)
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
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
soft tissues are elongated just past point of tissue resistance and held in lengthened position w/sustained stretch for 30-60 sec.
short duration stretch force repeatedly but gradually applied, released, reapplied...with stretches held between 5-10 sec.
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.