Ch 9 Flashcards
Ability to maintain or control joint movement or position
Achieved by synergistic actions of the muscles, ligament and joint capsule and the neuromuscular system
_ must never be compromised
Joint stability
Joint mobility must not be compromised
Range of uninhibited movement around a joint or body segment
_ must never be compromised
Joint mobility
Joint stability must not be compromised
Specific movement of joint surfaces- rolling, gliding
Arthrokinematics
Movement efficiency=
Proximal stability promotes distal mobility
Lumbar spine is more _ than _
Stable - protecting low back from injury
Somewhat mobile - 15 degrees rotation
Thoracic spine is _
More mobile - allow for movement in upper extremities
Scapulothoracic is more_
Stable - rib cage and scapula for pushing and pulling
Foot stability varies during
4
Gait cycle -
Stability during push offs
Mobility - heel strike to accept body weight
ankle pronates and everts
foot forfeits some stability for MOBILITY to absorb impact forces
Glenohumeral
Scapulothoracic
Thoracic
Lumbar
Hip
Knee
Ankle
Foot
Mobility
Stability
Mobility
Stability
Mobility
Stability
Mobility
Stability
When Mobility is compromised the joint will seek to
Achieve desired ROM in another plane
Client performs birddog with hip extension and lacks flexibility in hip flexors in sagittal plane
Extended leg and hips externally rotate in the transverse place
Produces compensated movement pattern
_joints may need to compromise some stability to facilitate the level of mobility needed
Give example
Adjacent
Client with kyphosis attempts to extend thoracic spine an increase in lordosis occurs as a compensation for the lack of thoracic mobility
Lack of mobility contributed to 5
Repetitive movements Poor posture Side dominance Poor exercise technique Imbalanced strength training programs
Muscle imbalances alter 2
Physiological and neurological properties of muscles
Leads to dysfunctional movement
Inability to maintain muscle balance and neutrality at the joint
Movement compensations
Periods of inactivity when joints are held passively in shortened positions =
Example
Muscle shortening
Long periods of sitting without hip extension shortens hip flexors
Law of facilitation
Body achieves desired movement by path of least resistance
As the agonist _ the antagonist _
Shortens
Lengthens
relationship between actin and myosin (contractile proteins) and their force generating capacity
length-tension relationship
slight stretch of sarcomere beyond normal resting length, increases the spatial arrangement between the muscles contracting proteins and
increases force generating capacity
stretching the sarcomere beyond optimal length or shortening the sacromere beyond resting length =
decreases muscle’s force generating capacity
causes of muscle shortening 4
immobilization
passive shortening
trauma
aging
loss in the number of sarcomeres within the myofibril of the muscle fiber due to
muscle shortening
muscle has good force-generating capacity in shortened position, it will demonstrate:
reduced force generating capacity in normal resting length and lengthened positions
muscle can shorten in _ when held passively in shortened positions without being stretched or used through full ROM
2-4 weeks
to restore force generating capacity of a tight muscle
passive stretching or elongating will gradually add sarcomeres back in line to help restore the muscles normal resting length
lengthened muscles _ sarcomeres in series and demonstrate _force generating capacities in lengthened positions
add
greater
lengthened muscle demonstrate _force generating capacities in normal and shortened positions
reduced
to restore normal resting length to lengthened muscle
strengthening the muscle in normal resting position
protracted shoulders - exercise to restore normal resting length 2
perform high back rows INITIALLY with isometric contraction in a good postual position
perform rows with limited ROM
Muscles that provide opposing, directional, or contralateral pulls at joints to achieve efficient movement is termed
2 examples
Force couples
Pelvis - if one muscle is tight pelvic position is changed. Change in pelvis affects the position of the spine above and the femur below
Glenohumeral joint during arm abduction- collaborative action of rotator cuff and deltoid
Hypertonic muscles require _ to activate contraction
Smaller, weaker nerve impulse
Hypertonic muscles decrease the neural drive to the opposing muscle (antagonist) through
Reciprocal inhibition
Reciprocal inhibition of the opposing muscle group weakens the antagonist
Ability to generate adequate force at the joint is decreased
The body has to call on other muscles at the joint
This is called:
Synergistic dominance
Order in which to reestablish stability in the body: 5
Lumbar spine - core - COM center of mass
Pelvic and thoracic spine
Scapulothoracic region
Distal extremities
Static balance
Stabilizing muscles contain more _ muscle fibers…give example
Muscle used for joint movement and generating large forces contain _ fibers …these muscle are suited more for
Type 1 slow twitch …core muscle that protect spine
Type II fast twitch
Strength and power training - high intensity, low volume
Pre-exercise
Deconditioned client with poor flexibility and muscle imbalance 2
Self myofascial release
Static stretches
Pre-exercise
Conditioned client with good flexibility and muscle balance 2
Self myofascial release
Dynamic stretching
Pre-exercise
Performance athlete with good skill and flexibility 2
Dynamic stretching
Ballastic stretching
3 post exercise stretches
Myofascial release
PNF
Static stretches
client performs small, continuous back and forth movements on a foam roller
ares to cover
time
reduces _ in underlying muscle and improves _
self myofascial release
2-6 inches
30-60 seconds
tightness, ROM
resets the proprioceptive mechanisms of soft tissue
self myofascial release
stretch should be taken to the point of tension
4 reps
hold 15 to 60 seconds
static stretches
client performs hold-relax stretch
hold the isometric contraction for
PNF
6 seconds minimum
this type of stretching is effective for clients participating in sports that require ballistic activities
dynamic stretching
principle that states GTO inhibits a muscle spindle response
autogenic inhibition
when stretching, low grade muscle response decreases due to gradual desensitization of muscle spindle activity as the duration of the stretch progresses
stress-relaxation response
lengthening that occurs when a stretch force is applied
creep
2 reasons why ROM increases after acute static stretching
reduction in stress -relaxation response and creep
muscle spindle reestablishes stretch threshold again _% of recovery within the first _
70%
5 seconds
the principle stating;
activation of muscle on one side of the joint coincides with neural inhibition of the opposing muscle on the other side of the joint
6-15 seconds
reciprocal inhibition
holding a hamstring stretch for 7-10 seconds, will inhibit the muscle and allow greater stretching is an example of
autogenic inhibition
firing the glutes for 6-15 seconds, reciprocally inhibits the hip flexors temporarily thereby allowing the hip flexors to be stretched is an example of
reciprocal inhibition
acute injuries, chronic poor posture, and repetitive stress injuries can damage _which can in turn cause :
fascia
pain, restricted ROM and shortening of the muscle
applying pressure through _ to the tight muscle can bring about _ and inhibit muscle tension
myofascial release
autogenic inhibition
a series of low grade isometric contractions great then 50% MVC
2-4 reps
10 seconds
will accomplish what?
strengthen muscles to improve posture
goal with postural muscles is to condition them with:
volume as opposed to intensity
stabilizing the entire kinetic chain should emphasize
muscle isolation using supportive surfaces
floor, wall, chair backrest
to strenghten posterior deltoids and rhomboids (protracted shoulders)
perform reverse flys in a supine position
isometrically pressing backs of arms to the floor
dynamic strengthening for exercises do not involve _ but rather _ training to condition type I fibers
heavy loads
volume training
strengthening weakened muscles:
step 1
step 2
2 to 4 reps of isometric contractions 5-10 seconds
dynamic ROM exercises, 1 to 2 sets of 12-15 reps
small muscles rich in sensory nerve endings that provide continuous feedback to the brain regarding loading and the position of the spine
deep, most inner layer of core
muscles that make up the “core” 6
quadratis lumborum transverse abdominis multifidi internal obliques diaphragm pelvic floor
set of muscles and fascia that allow joints to stiffen in anticipation of loading and movement
provide a solid foundation from which the body can operate
middle layer “core” muscles
muscles of the outer layer of the core that produce gross movement and forces within the trunk 5
rectus abdominis erector spinae obliques - internal and external iliopsoas latissimus dorsi
key muscle that works reflexively with the neural system
produces a “hoop” tension similarly to tightening a belt
transverse abdominis (TVA)
delayed activation of the TVA can result in: 2
inadequately stabilizing the lumbar spine during movement
increases potential for injury
% of population affected by low back pain
80%
drawing the TVA in is referred to as : 3
hollowing
centering
drawing-in
co-contraction of core and abdominal muscles to create a wider base of support
this should be introduced
bracing
after centering is mastered
stage 1 core function emphasizes
what stage of the ACE IFT model is this encompassed in
core activation exercises and isolated stabilization under minimal spinal loading
phase 1 - stability and mobility
stage 2 static balance emphasizes
what stage of the ACE IFT model is this encompassed in
seated and standing stabilization over a fixed base of support
phase 1 stability and mobility
stage 3 dynamic balance emphasizes
what stage of the ACE IFT model is this encompassed in
whole-body stabilization over a dynamic base of support
phase 2 movement training
movement in the low-back, rib cage or pelvis during the centering/drawing in exercise indicates
inability to activate the TVA in an isolated manner
core activation progression 4
pelvic floor contractions - kegel / sets 1-2
TVA contractions - draw belly toward spine / sets 1-2
combination of both contractions / sets 1-2
contractions with normal breathing / sets 1-2, progress to 3-4
exercise to reestablish core control with minimal loading on the spine during hip and shoulder movments
quadruped drawing in-in with extremity movement
core stabilization progression 3
raise one arm off the floor and perform sequence of controlled shoulder movements
raise on knee and perform sequence of controlled hip movements
raise contralateral limbs and perform sequence of movements
2 joints that are prone to poor mobility
hips and thoracic spine
muscle that crosses 1 joint
example
monoarticulate
soleus
muscle that crosses 2 joints
biarticulate
hamstrings
when stretching a biarticulate muscle:
joint movement must be controlled at both ends of the muscle to avoid compromised stability to the adjacent joint
flexibility exercises should lengthen the muscle in
all 3 planes
- **focus on primary plane of movement FIRST
ex: hip flexors should be stretched in the sagittal plane first
exercise to improve extension within the lumbar extension muscles
cat-camel exercise
2-4 reps
exercise to improve hip mobility in the sagittal plane
pelvic tilts
1-2 sets
exercise to improve hip mobility in the sagittal plane without compromising lumbar stability during lower extremity movement 2
supine bent knee marches
modified dead bug with reverse bent knee marches
1-2 sets
exercise to improve mobility in the hip flexors in the sagittal plane without compromising lumbar stability
lying hip flexor stretch
exercise to improve mobility in the hip flexors in all 3 planes without compromising lumbar stability
half kneeling triplanar stretch
exercise to improve mobility in the hamstrings without compromising lumbar stability
lying hamstring stretch
to improve mobility and stability and core stability by activating the gluteal groups
shoulder bridge
glute bridge
to improve hip mobility in the transverse plane
supine 90-90 rotator stretch
to promote thoracic extension 2
spinal extensions and spinal twist
to promote hip and thoracic mobility while simultaneously maintaining lumbar stability
rocking quadrupeds
during shoulder ABDUCTION:
- what muscle initiates abduction for first 15 degrees, and after the _ muscle takes over as agonist
- muscle that compress the head of the humerus into the glenoid fossa
- supraspinatus, deltoid
2. subscapularis, infraspinatus and teres minor
during pushing and pulling movements what 3 muscle co-contract to move the scapulae WHILE help it maintain proximity to the rib cage
serratus anterior
lower trapezius
rhomboids
When the thoracic spine lacks appropriate mobility 2 things happen
Compensation stability within the scapulothoracic region
Mobility in the glenohumeral joint is affected
Stretch the inferior shoulders capsule of the shoulder by
Overhead triceps stretch
Stretch the posterior shoulder capsule by
Bringing arm across the front of the body
Stretch the anterior shoulder capsule by
Using a pectoralis stretch
Stretch the superior capsule
Placing rolled up towel 2 inches above elbow against the trunk
During open chain exercise the serratus anterior key role is
Control movement of the scapula against the rib cage
During closed chain exercise the key role of the serratus anterior is to move the
The Thorax toward a more fixed, stable scapulae
Pronation causes shortened soleus and gastrocnemius
Client will need to improve _ mobility and _ to promote stability within the foot
Ankle mobility
Calf flexibility
Foundational element of all programming
Balance
the degree of allowable sway away from the line of gravity that can be tolerated without a need to change the base of support
LOS - limits of stability
2 dimensional distance between and beneath the body’s points of contact with the floor
BOS - base of support
training progression for static balance 5
narrow BOS
raise COG - raise arms overhead
shift LOG - raise arms unilaterally, lean or rotate trunk
sensory alteration - shift focal point with finger
sensory removal - closing eyes
conscious contraction - contraction of both layers of core muscles for short periods of time during external loading
bracing
stance position progressions 6
narrow hip width split staggered tandem single-leg
before learning single leg movements clients must be able to effectively control
hip adduction - to control lateral shift during gait
progression of DYNAMIC movement patterns over a static base of support 3
upper extremity movements
lower extremity movements
upper and lower extremity movements
a client with excessive foot pronation may have weakened _ muscle
gluteus maximus
when walking, _ activity decelerates internal rotation of tibia and femur
gluteal activity
glute vs quad dominance crucial to women due to: 4
larger Q-angle
increased joint laxity (weakness due to hormones)
smaller ligaments
weaker muscles
excessive hip adduction that increases the Q-angle places stress on the
weakness in 2 muscles that can lead to excessive hip adduction
ACL and MCL
glutes and quadratus lumborum - lifts the hip
key limiting factor to proper squat technique
normal degree of ankle flexion
lack of ankle mobility
15-20 degrees
normal range of degree of hip flexion
amount of flexion required during squat
100-135 degrees
95 degrees
2-degree in lumbar extension during squat can can increase compressive forces on the vetebral discs by _ %
16% over a neutral spine
during the upward phase of the lunge these muscle propel the body upward 3
gluteus maximus
hamstrings
leading leg adductor group
the _ muscle should be engaged during the lowering phase of the overhead press to provide anterior containment to stabilize the shoulder
latissimus dorsi
to “pack” the scapula means to
retract and depress scaplula
exercise that involves pulling action DOWN ACROSS the front of the body, followed by a pushing action as the arms move away from the body
wood chops
exercise that involves pulling action to initiate the movement UP ACROSS the front of the body
*requires greater intensity
hay baler
the need for thoracic mobility is greater _ movement than with _ movements
rotational
pushing and pulling
Next appropriate progression after glute bridges
Single leg glute bridge with opposite knee to chest
Keeps body on stable surface
Places more emphasis on glutes
Progression of wood chop
Kneeling short arms
Kneeling long arms
Standing short arms
Standing long arms
