STRETCHING Flashcards
In the presence of hematoma or other indication of tissue trauma, can you apply stretching techniques?
Not recommended
A patient has a hip extension contracture. What muscles are short?
Hip extensors are short
What is a pseudomyostatic contracture?
Limited ROM may be due to a CNS lession:
- CVA, SC injury, or TBI
- Hypertonicity: spasticity or rigidity.
Also:
-Muscle spasm or guarding and pain.
In both cases: excessive resistance to passive stretch.
What is a DYNAMIC muscle contraction?
-Eccentric or concentric muscle contraction
If a patient has knee flexion contracture, what muscle are short?
Patient has has shortened HAMSTRINGS and cannot extend knee fully
In what type of CONTRACTURE the patient has an adaptive shortening of musculotendinous unit without specific muscle pathology present. Can usually be resolved with stretching
exercises within a short period of time.
Myostatic contracture (myogenic contracture)
When a patient cannot fully abduct the leg because of shortened adductors of the hip, he or she is said to have an…
adduction contracture of the hip.
If a patient has shortened ankle plantar flexors and cannot fully dorsiflex the ankle, he or she is said to have a…?
Ankle plantarflexion contracture
Impaired mobility and limited ROM may also be the result of hypertonicity (i.e., spasticity or rigidity) associated with a central nervous system lesion, such as a cerebrovascular accident, a spinal cord injury, or traumatic brain injury.
What type of contracture?
Pseudomyostatic
In what type of contracture adhesions, synovial proliferation, joint effusion, irregularities in articular cartilage, or osteophyte formation may be the cause?
Arthrogenic contracture.
This type of contracture develops when connective tissues that cross or attach to a joint or the joint capsule lose mobility, thus restricting normal arthrokinematic motion.
periarticular contracture
Fibrous changes in the connective tissue of muscle and periarticular structures can cause adherence of these tissues and subsequent development of: (type of contracture)
a fibrotic contracture.
This type of contracture will not respond to non-surgical interventions. Results from muscle & connective tissue being replaced with a large amount of relatively nonextensible fibrotic adhesions, scar tissue or heterotopic bone.
Irreversible contracture.
Atrophy after inmobilization can begin within as little as… (Time)?
a few days to a week.
What is AUTOGENIC INHIBITION?
- Autogenic inhibition reflex is a sudden relaxation of muscle upon development of high tension. It is a self-induced, inhibitory, negative feedback lengthening reaction that protects against muscle tear.
- Golgi tendon organs are receptors for the reflex.
What happens if a muscle is stretched too fast?
muscle spindle is activated → stretch reflex → contraction of the muscle being stretched
What happens if a muscle is stretched too fast?
muscle spindle is activated → stretch reflex → contraction of the muscle being stretched
What type of fibers resist tensile deformation and are responsible for strength and stiffness of tissue?
-As tension increases, fibers stiffen to resist deformation
Collagen fibers
What type of tissue fibers provide extensibility and elongate significantly with light loads?
Elastin fibers
How are collagen fibers arranged in the skin?
Random and weakest in resisting tension
How are collagen fibers arranged in tendons?
In parallel, and can resist the greatest load
How are collagen fibers arranged in ligaments, joint capsules and fascia?
Vary between random and parallel
How long is each repetition of a static stretching?
30 seconds
A physical therapist is slowly applying and releasing the force applied during a stretch. Each cycle of stretch id held for 7 seconds. What type of stretching is this therapist using?
Cyclic stretching
Each cycle of stretch: 5-10 seconds in some studies
What do you do after a stretching session with a patient?
- Have the patient PROM or strength train the new ROM gained
- Apply cold, best in lengthened position.
- Advise the patient of post-exercise soreness.
Indications for stretching:
Limited ROM resulting from loss of extensibility of soft tissue due to adhesions, contractures & scar tissue formation which lead to functional limitations or disabilities
When restricted motion may lead to structural deformities
In the presence of muscle weakness & shortening of opposing tissue
As part of a total fitness program designed to prevent musculoskeletal injuries
Prior to and after vigorous exercise to potentially minimize post-exercise muscle soreness
CONTRAINDICATIONS TO STRETCHING
When a bony block limits joint motion
After a recent fracture before bony union is complete
If soft tissue healing could be disrupted in the tight tissues and surrounding region
When there is evidence of acute inflammation or infection
When joint movement or muscle elongation elicits a sharp, acute pain
