ROM and Flexibility Flashcards
connective tissue (7)
- bone
- tendon
- muscle
- skin
- hyaline cartilage
- joint capsule
- fascia
building block of connective tissues, found in all connective tissue
provides tensile strength
collagen
< 1% found in connective tissue. Recoil of tissues
elastin
amount of tension or load placed on the tissues
stress
proportional degree of elongation that occurs during stress
strain
ability of tissues to return to their previous resting state
recovery
gradual lengthening of tissues when they are subjected to constant or repeated stress over a long duration
creep
ability of a tissue to return to its original resting length when stress is removed
elastic deformation
tendency of tissue to assume a new and greater length after the stretch force has been removed
plastic deformation
connective tissue properties (3):
- warmer temp = greater flexibility
- connective tissue is a passive restraint to joint motion
- muscle tissue is an active restraint to joint
the ability of a muscle to relax and yield to a stretch force
the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain-free ROM
flexibility
the amount of movement available to a joint moving within its anatomic range
ROM
What determines flexibility (6):
- muscle length
- joint ROM
- joint mobility
- extensibility of surrounding soft tissues
- joint arthrokinematics and osteokinematics
- strength
active mobility or active ROM (AROM)
dynamic flexibility
passive mobility or passive ROM (PROM)
passive flexibility
How to increase flexibility and ROM (3)
- stretch what’s tight (mm, restricted ROM, jt capsule)
- joint mobilization (if indicated)
- strengthen what’s weak.
4 types of stretching:
- static (passive)
- dynamic (active)
- ballistic (BAD)
- proprioceptive neuromuscular fascilitation (PNF)
stretch: placing a muscle in a fully elongated position and holding that position for a period of time
goals:
- prevent or minimize risk of soft-tissue injury during activity
- improve flexibility
- prevent contracture
static stretching
stretch: performed actively by moving joints - body weighted or eliminated position - through avaiable range - gradually increase range and speed - does not diminish torque production - good to warm-up for sport/activity
dynamic stretching
stretch:
bounce at the end of ROM
- high risk injury to the connective and contractile tissue with this type of stretching
- likely will NEVER use in rehab
ballistic stretching
stretch:
reflex inhibition and subsequent elongation of the contractile elements of the muscle
involves the Golgi Tendon Organs in the myotendinous junction, and the muscle spindles
proprioceptive neuromuscular facilitation (PNF)
a reflex relaxation that occurs in the same muscle where the golgi tendon organ is stimulated
(via isometric or isotonic contraction)
autogenic inhibition
contracting the opposing muscle group to that being stretched in order to achieve a reflex muscular relaxation that occurs in the muscle that is opposite the muscle where the golgi tendon organ is stimulated
reciprocal inhibition
types of PNF (3):
- hold relax
- contract relax
- slow reversal hold
PNF:
- gentle isometric contraction of muscle being stretched
- 6-10 seconds followed by stretch into new range
hold relax
PNF:
- gentle isotonic contraction of muscle being stretched
- 6-10 second followed by stretch into new range
contract relax
parameters for stretching/flexibility/ROM
- ALWAYS warm up 5-10 minutes
- determine mode
- intensity: mild to moderate stretch, no pain
- duration: 30-60 seconds, 3-5x per series
- frequency: daily
( must stretch at least 3x/wk to gain and 1x/per wk to maintain
due to scar tissue formation between tissue structures and results from the healing or union of two injured or torn parts
collagen fibers are highly unorganized initially but organize based on stresses placed on it
adhesions
adaptive shortening of the muscle-tendon unit and other soft-tissues that crcoss or surround a joint qhich results in significant resistance to passive or active stretch and limitation of ROM
can be transient or permanent
contractures
longer a contracture exists OR the greater % of normal tissue replaced by scar tissue or bone, the more difficult it becomes to regain optimal mobility of soft tissue =
more likely contracture will become irreversible
stretch parameters for contractures:
- requires low load, long duration (LLLD) stretching
- aggressive
- prolonged stretch into restriction 20-60 mins
- may be done in conjunction with heating
- bracing, serial casting
precautions to stretching (5):
- avoid ballistic stretching to allow relaxation and prevent injury
- avoid overstretching
- use caution with known diseases
- stretch carefully if swelling/edema present or in patient has been immoblized for prolonged length of time
- residual soreness should not last > 24 hrs
contraindications to stretching (5)
- if motion is limited by a bony block
- across an acute of non-unioned fracture
- acutely inflamed and infected tissue
- hypermobile tissues or joints
- hypomobile tissues that provide structural or neuromuscular support
