Lecture 1 Flashcards
Stretching
an exercise or therapeutic activity intended to increase the extensibility of shortened tissue
indications for stretching
limited ROM that affects function or causes structural deformity
goals for stretching
- improve joint ROM
- increase extensibility of structures around the joint
- prevent contractures
- decrease injury to neuromuscular structures
- improve flexibility prior to vigorous activity
flexibilty
ability to move a single joint series of joints smoothly through an unrestricted, pain-free ROM
a relaxed muscle’s ability to lengthen (passive flexibility)
dynamic flexibility (active mobility)
active ROM a joint; dependent upon amount of muscle contraction and amount of tissue resistance to movement
contraindications to stretching
- recent fracture
- acute strain, inflammation (anything acute)
- hypermobility
- post-surgical
- acute pain with joint mobility
- muscle tightness for c5 spinal cord injury in finger flexors – want to keep this grasping reflex
hypomobility
decreased mobility or restricted motion; can be due to a variety of pathological processes which – loss of motion
Effects of immobilization
- decay in contractile protein and decreased # of myofibrils = atrophy and weakness
- disorganized collagen laid down may lead to adhesions and decreased tensile strength
- shortened position = decreased sarcomere, increased tissue stiffness and increased CT
- lengthened position = increased sarcomeres - maintain optimal action/myosin overlap
contracture
adaptive shortening of the muscle-tendon unit and the other soft tissues that cross or surround the joint
how contractures are described by
identifying the action of the shortened muscle OR
the side of the joint that has decreased tissue extensibility
myostatic contracture
shortening of normal muscle tendon length; no specific muscle pathology noted
how fast does myostatic contractures resolve
-short time w/ angular stretching
pseudomyostatic (hypertonicity) contracture
occurs with CNS lesion or constant muscle spasm and pain
-muscle appear to be in a constant state of contraction
Arthogenic (adhesions) contracture
intra-articular pathology; may see with joint effusion and osteophyte formation
-often times surgery is required
periarticular (capsular) contracture
when connective tissue that crosses/attaches to the joint loses mobility or when the joint capsule loses mobility - the joint becomes stiff resulting in arthokinematic motion restrictions
Fibrotic contracture
fibrous changes in the muscle or periarticular tissue; difficult to re-establish optimal tissue length
general response to stretching
actin and myosin crossbridges relax and sarcomere of the muscle fiber lengthens and “gives way” and then returns to a resting length
if post-stretch resting length is the same as pre-stretch resting length
elasticity
if post-stretch resting length is changed (increased) compared to pre-stretch resting length
effect of plasticity
the golgi tendon organ is located near
muscle/tendon junction of extrafusal muscle fibers