Stretching Flashcards
myostatic
- no specific muscle patho present, can be resolved quickly w stretching exercises
- contracture d/t prolonged posture
pseudomyostatic
result of hypertonicity, mm spasm, or guarding; full passive elongation possible w neuromuscular inhibition techniques
fibrotic/irreversible
result of fibrous changes in CT of muscle d/t immobilization/trauma, difficult to reestablish tissue length non-surgically
arthogenic/prearticular
result of intra-articular OR prearticular pathology
reduced functional motion
- d/t adaptive shortening or decreased extensibility in soft tissue
hypomobility
factors that influence hypomobility x7
prolonged immobilization
sedentary lifestyle
postural malalignment
tissue trauma
impaired mm performance
age-related decreases in tissue extensibility
congenital or acquired deformities
hypermobility/overstretching
excessive mobility
creates detrimental joint instability
normal in healthy active patients that require extensive flexibility
flexibility
ability to rotate 1 jt smoothly & easily through unrestricted, pain-free ROM
Dynamic flexibility
- active muscle contraction rotating a joint through its available ROM
- depends on: mm ability to contract & degree of tissue extensibility
Passive flexibility
- joint passively rotated through available ROM
- depends on: tissue extensibility
- prerequisite for dynamic flexibility
precautions x8
- do not stretch beyond normal ROM
- extra caution w pt’s w osteoporosis
- protect newly united fx’s
- torque → point of force application
- long lever arm = more torque
- vigorous stretching of previously immobilized tissue
- progress dosage gradually
- edematous tissue
- overstretching weak mm’s
contraindications x8
- bony block limits movement
- recent fx’s w incomplete union
- acute inflammatory/infectious process
- necessary healing can be disrupted
- sharp, acute pain w stretching
- hematoma /tissue trauma
- joint hypermobility
- shortened ST provides stability
modes of stretching x8
ballistic
manual
mechanical
PNF
static
self
cyclic/intermittent
selective
ballistic stretching
- rapid, forceful intermittent stretch
- high velocity, high-intensity stretch
- fast joint movement that quickly elongates the targeted soft tissue
manual stretching
- clinician applies external force
- early stages of program
- most appropriate if pt lacks NM control of body segment & can’t self-stretch
mechanical stretching
- device applies low-intensity, prolonged stretch
- PT’s role to recommend type of device
- pt/PTA’s role to teach pts how to safely use
PNF: proprioceptive NM facilitation
- performed w synergistic mm groups in diagonal pattern
- types:
- hold-relax or contract-relax
- agonist contraction
- hold-relax with agonist contraction
static stretching
- held in lengthened position over period of time
- manual/self: 5 seconds to 5 minutes
- mechanical: 1 hour to several days/weeks
- used to increase flexibility/ROM
self stretching
- independently complete after instructions
- integral component of HEP
- typically 30-60 seconds
cyclic/intermittent stretching
- short duration
- repeatedly but gradually applied, released, & reapplied
- similar to static stretching repeated multiple times
selective stretching
applying stretching techniques to some muscles and joints while allowing motion limitations to develop another muscles or joints
proper alignment for stretching
- patient comfort & stability
- influences baseline amount of tension
- one joint vs two joint
- maximized distance bt origin & insertion
adjunct to stretching x7
het
cold
massage
joint traction
biofeedback
relax techniques
ST mobilization
Ability of body structure or segment to move so ROM for functional activity is allowed
or
ability of an individual to initiate control or sustain active movements of the body to perform motor task
mobility
Increase soft tissue extensibility to improve flexibility in ROM by elongating adaptively shortened and hypomobile structures
Stretching
Around the tissue (ligaments)
Prearticular
adaptive shortening of a muscle tendon unit /soft tissue surrounding a joints
contracture
Contractors are due to: x4
prolonged joint positioning
neurological conditions
trauma
burns
t/f: Contractors are long term
true
- Hypermobility, muscle tightness, shortening = short term
Interventions to increase mobility of soft tissues x7
Stretching
self-stretching
neuromuscular facilitation/inhibition muscle energy
joint mobilization
soft tissue mobilization
neural tissue mobilization
Indications for stretching x5
- Limited ROM due to soft tissues
- restricted motion leads to structural deformities that are otherwise preventable
- muscle weakness slash shortening have led to limited ROM
- as part of fitness/sports specific program to reduce risk of injury
- part of warm-up/cooldown from vigorous exercise
returns to pre-stretch resting length after a short-duration stretch force is removed
elasticity
initially resists deformation when stretch force is applied, but will slowly lengthen if force is sustained
viscoelasticity
tendency of soft tissue to assume a new/greater length after stretch is removed
plasticity
properties of oft tissue x3
elasticity
viscoelasticity
plasticity
force per unit area (load)
stress
amount of deformation
strain
lengthening of wavy collagen fibers
toe region
direct relationship between stress/strain
elastic range
point beyond which tissue does not return to its original shape/size
elastic limit
permanent tissue deformation
plastic range
MAX strain the tissue can sustain
ultimate strength
considerable weakening of the tissue
necking
tissue ruptures
failure
Steepness of curve depends on rate at which load is applied
rate dependence
Continuous, slow elongation with maintained stretch
creep
Gradual decrease in force required to maintain deformation with constant load applied
stress-relaxation
Repetitive loading may cause failure at lower strain levels
Cyclic Loading & CT Fatigue
total time from all cycles
Lack of agreement on optimal duration/rep
Total elongation time
static, sustained, maintained, prolonged
Long duration stretching
cyclic, intermittent, ballistic
Short duration stretching
single cycle
duration
- Period of time stretch is applied and tissues are held in lengthened position
