3 STRETCHING

Question 1

STRETCHING

Answer 1

Any therapeutic maneuver designed to lengthen or elongate pathologically shortened soft tissue structures and thus increase range of motion.

It is NOT PROM, AROM, or AAROM.

Question 2

FLEXIBILITY

Answer 2

Muscle’s ability to relax and yield to stretch force.

Question 3

SELECTIVE STRETCHING

Answer 3

Stretch certain structures but not others.

Question 4

OVERSTRETCH

Answer 4

Stretch beyond normal ROM.
Leads to hyper-mobility of joint and structural problems.

Question 5

CONTRACTURES

Answer 5

Shortened muscle and soft tissue leading to decreased ROM.

Question 6

WHY IS THERE A LOSS OF ROM?

Answer 6

Prolonged immobilization.
Casting.
Restricted movement.
Connective tissue disorder.
Hypertonicity.
Trauma.
Scar tissue at muscle, tendons, skin, etc.
Adhesions between tissues.
Bony deformities.
Muscle bulk.

Question 7

HOW TO LENGTHEN

Answer 7

Surgery.
Splinting.
Continuous Passive Motion (CPM).
Proper positioning.
Therapeutic exercises.

Question 8

GOALS OF STRETCHING

Answer 8

Regain or re-establish normal ROM.
Prevent contractures of all structures.
Prevent resulting skeletal deformities.
When there is muscle weakness and opposing.
Muscle tightness.
When contractures interfere with ADL.

Question 9

PRECAUTIONS OF STRETCHING

Answer 9

Do not passively stretch beyond normal ROM.
Newly united #.
Osteoporosis.
Frail elderly.
Cancer.
Vigorous stretching after prolonged immobilization.
Pain longer than 24 hrs. after stretching.
Edematous tissue.

Question 10

CONTRAINDICATIONS TO STRETCHING

Answer 10

Bony block.
Recent #.
Non-united #.
Acute inflammation/infection.
Sharp/acute pain.
Signs of tissue trauma.

Question 11

HOW TO STRETCH

Answer 11

Passive.
Active.

Question 12

PASSIVE/STATIC STRETCHING

Answer 12

Manual: direction, speed, intensity, and duration controlled by an outside person.

Prolonged mechanical: LLLD, low load long duration.

Self stretching: patient uses body weight to stretch.

Question 13

ACTIVE STRETCHING

Answer 13

Uses one muscle group to reflexively relax the opposing muscle group.

Question 14

AUTOGENIC INHIBITION

Answer 14

Same muscle.
Patient isometrically contracts muscle, then the same muscle is passively stretched.
Pushing against someone then stretch.

Question 15

RECIPROCAL INHIBITION

Answer 15

Opposite muscle.
patient isometrically contracts muscle, then the antagonist muscle is stretched.
Pushing against with triceps then stretch biceps.

Question 16

STRETCHING PARAMETERS

Answer 16

Somewhere between 15-60 seconds.

Question 17

5 RULES FOR EFFECTIVE STATIC STRETCHING

Answer 17

1. Stretching should not hurt.
2. Muscle must be relaxed in order to lengthen.
3. Position your body so the line of pull is functional and maintain neutral spine.
4. Take muscle to point of comfortable tension and hold.
5. If the stretch feeling does not go away, back off, and try a lower ROM.