Quiz 2: Stretching for Improved Mobility Flashcards
What is stretching?
any therapeutic maneuver designed to increase soft tissue extensibility and subsequently improve flexibility and ROM by elongating structures that have adaptively shortened and have become hypomobile.
What is flexibility?
the ability of muscles, joints, and soft tissue to move through an unrestricted, pain-free ROM.
What are the two types of flexibility?
Dynamic flexibility (AROM)
Passive flexibility (PROM)
What is hypomobility?
decreased mobility within a joint (restricted ROM)
What is hypermobility?
excessive mobility within a joint structure
True or False:
It is recommended to see how far a hypermobile patient can stretch a joint.
False. You want to be cautious with this. You can increase mobility while keeping the same stability.
What is a contracture?
a fixed limitation of a joint tat prevents normal ROM
What is a contraction?
the development of muscle tension resulting in a joint action
What are the types of contactions?
Isometric, Concentric, Eccentric
What are the 3 indications for stretching?
- When restricted ROM is due to soft tissue limitations
- When muscle weakness and shortening results in an agonist/antagonist muscle imbalance
- When restricted ROM impairs normal joint function
What is an agonist muscle?
a muscle that contracts to provide the main force to move or rotate a bone through its joint (main character energy)
What is an antagonist muscle?
a muscle that produces the opposite action of an agonist (limiting muscle/stretched muscle)
True or False:
Antagonist and agonist muscles in pairs are called antagonistic pairs.
True
What are 8 contraindications to stretching?
- Bony block (pain)
- Nonunion fracture (should have healed in time but didnt)
- Acute inflammation or infection
- Sharp or acute pain with elongation
- Hematoma or tissue trauma
- Hypermobility
- Hypomobility provides stability or control
- Limb fractures not fully healed
What are the benefits to stretching?
- Increased flexibility and ROM
- General fitness
What are 3 myths for stretching?
- Injury prevention
- Reduce post-exercise muscle soreness
- Enhanced performance
What is the procedure for stretching? (3 steps)
- Determine the degree of joint ROM restriction (goniometric measurement)
- Determine the stretch procedure to use
- Work within a safe range (meaning no pain is felt) of tissue extensibility and elasticity
What are the 4 mechanisms of stretches?
- Self stretch (on your own)
- Manual stretch (another person such as therapist)
- Passive stretch (relaxed and moved by someone entirely or partly)
- Assisted stretch (patient assists therapist in stretch)
What are other parts that stretch other than the muscle itself?
- tendons
- ligaments
- articular cartilage
- fascia
- skin
(these may not return to same length if over stretched)
What is elasticity?
the ability of soft tissue to return to its resting length after receiving a passive stretch (like a rubber band)
What is plasticity?
the tendency of soft tissue to assume a greater length once the stretch is removed
What is failure?
when soft tissue is pushed past the point of return, causing damage
True or False:
High intensity stretch applications should be applied frequently to allow time for healing to occur.
False, they should be applied INfrequently to allow for healing.
Once a restricted ROM is restored, the ________ muscle or muscles must be strengthened in concert to stabilize the restored length.
agonist
True or False:
There is no clear consensus on the optimal duration of the stretch cycle (how long a stretch should be held).
True, there is no consensus
What is the roundabout average time a stretch cycle is held with maximal or near maximal force?
15-60 seconds.
What are the 3 types of stretching?
- Static stretch (stretch and hold)
- Static progressive stretch (s.a.a. but until relaxation and repeat)
- Ballistic stretch (forceful, applied rapidly, high intensity)
*note that ballistic is contraindicated for sedentary persons
What are the negative aspects of ballistic stretching?
- difficulty controlling movements
- risk of injury with weakened tissues
- dense connective tissues associated with chronic contractures do not yield easily to rapid stretch and tend to tear more easily.
What are the practical types of stretching (the ones we will have to demonstrate)?
- PNF (the best)
- Hold relax
- Contract relax
- Agonist contraction
- Hold relax with Agonist contraction
What is PNF?
Proprioceptive Neuromuscular Facilitation
- move body part into static position and patient will have some type of contracture
What is reciprocal inhibition?
when a muscle contracts maximally, its opposite counterpart will relax maximally
What is autogenic inhibition?
a protective mechanism that prevents muscles from exerting more force than their bones and tendons can tolerate
What is stress relaxation?
the gradual reduction of stress over time while maintaining a constant strain
What is Hold Relax?
- extend the joint to the point of tightness
- apply an isometric contraction to the antagonist muscle for up to 10 seconds
- relax
- passively extend the joint to newly lengthened position
- rest and repeat 3 times
(patient is relaxed the entire time)
What is Contract Relax?
- Same as hold relax except the contraction is isotonic
(bring patients leg down)
What is Agonist Contraction?
- Extend the joint to the point of tightness
- Instruct patent to concentrically contract agonist muscle and maintain the contraction while simultaneously applying force to further extend the knee
- Let patient rest for several seconds and repeat
What is Hold Relax with Agonist Contraction?
(active assistive)
1. Combination of hold relax & agonist contract
2. Passive stretch the muscle to the end range, have patient perform an isometric contract for 6-10 seconds, then have then contract the agonist muscle into a new passive stretch position.
(can be done as contract relax antagonistic contract CRAC)
What are 7 tips for effective stretching?
- warm muscle prior to stretching
- promote relaxation for the patient
- move slowly and progress each set
- stabilize to prevent unwanted movements
- to avoid joint compression, apply traction prior to stretch
- hold for at least 30 seconds
- to increase flexibility, stretch 3x per week
- to maintain flexibility, stretch 1x per week
True or False:
Static stretching has been shown to dececrease force, power, vertical jump, speed and running economy.
True
What are PNF patterns?
diagonal movements for upper and lower extremity, upper and lower trunk that can be completed against manual resistance
What are the 4 advantages of PNF?
- Resistance through functional movement patterns
- Allows tri-planar movement against resistance
- Manual resistance allow fine adjustments
- Can be combines with PNF strengthening techniques (push-pull hold)
