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stretching- indications, precautions, techniques, etc...

stretch function

to increase ROM and mobility around a joint or series of joints


elongate structure around joint


ability to be moved


move through unrestricted pain free ROM


restricted motion caused by adaptive shortening

adaptive shortening

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)

myostatic contracture

shortening of muscle without pathology


apparent contracture, spacticity, muscle guarding


intra-articular pathology ie capsular restriction


fiberous changes to soft tissue (scar tissue)

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

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)


positioning of the body or segment to ensure stretch is applied to appropriate muscle group


fixing one end of the segment


how much force is used (low load optimal lengthening)


amount of time stretch force is applied


static or prolonged 30 second is avg

static progressive

lengthen, muscle gives lengthen more


cycles- slow repeated low intensity and ballistic- bouncing rapid forceful high intensity (bad)


slow and sustained force applied gradually


# of sessions per day/week, base on cause of limitation, avg 2 to 5 sessions a week


manual, self, mechanical, neuromuscular inhibition


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 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


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.

"Ideal" stretch

low load and prolonged

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