Stretching - Class 2 Flashcards
stretching
any therapeutic maneuver designed to
-lengthen shortened soft tissue structures
-increase ROM
stretching will cause
structures that have become adaptively shortened become lengthened
hypomobility
decreased or restricted motion caused by adaptive shortening of the tissues
what causes hypomobility
immobilization
lifestyle
posture
postural alignment
neuromuscular disorders
contracture
adaptive shortening of a the muscle-tendon unit and other soft tissues that cross of surround a joint
what does a contracture result in
significant resistance to passive stretch
what can a contracture show
obvious limitations in ROM
great affects on fxnal ability
what is detrimental
the supporting structures of a joint and the strength of the muscles around a joint are insufficient –> cannot hold a joint in a stable, fxnal position during activities
stretching can decrease
power generation
indications of stretching
decreased ROM
prevent structural deformities
muscle weakness and shortening of opposing tissues
component of total fitness or conditioning program
pt desire
what may stretching be used
prior to or after vigorous exercise
contraindications to stretching
bony block that limits joint motion
recent fx or incomplete bony union
sharp pain w/ movement
hypermobility
contraindications to stretching (2)
acute hematoma
shortened tissues that provide stability
certain mm on an individual with SCI
life threatening situations
when to be cautious
if someone hasn’t been stretched in an extended period of time
immobilization, inactivity, injury, frail, elderly
principles for stretching to be effective
alignment
stabilization
intensity
duration
principles for stretching to be effective (2)
speed
frequency
mode
inhibition or facilitation
alignment
position of a limb or the body that the stretch force is given tot he appropriate muscle group
what is necessary to maintain good alignment
stabilization
how does stabilization help stretching
one site of attachment of a muscle being stretching is stabilized so that the stretch force is applied to the other body attachment
intensity of stretch
magnitude of the stretch applied
duration of stretch
length of time stretch is applied
speed of stretch
speed on initial application of stretch force
what speed is generally recommended
slow force
why use a slow force
minimize mm activation
reduces risk of injury and soreness
avoids stimulation of stretch reflex
frequency of stretch
number of sessions per day or wk
mode of stretch
form or matter in which force is applied
pt participation
source of the stretch
form or matter in which force is applied –> mode of stretch
statis
ballistic
cyclic
pt participation –> mode of stretch
passive
assisted
active
source of the stretch –> mode of stretch
manual
self
mechanical
how to prepare a pt
general warm up
local heat application
relaxation techniques
proper hand placements/grip
watch pt response
general warm up –> prepare
increase blood flow
watch pt response –> prepare
watch for pain/guarding
stretching techniques
static stretching
ballistic stretching
proprioceptive neuromuscular facilitation stretching
static stretching
muscle and connective tissue are help in a stationary position at their greatest possible length
duration of static stretching
30-60 s
ballistic stretching
quick movements
impose a rapid change in length of muscle or connective tissue
what initiates ballistic stretching
active contraction of the muscles antagonistic to the muscles and connective tissue being stretching
what does ballistic stretching have a greater chance of
mm soreness and injury
proprioceptive neuromuscular facilitation stretching
principles of reciprocal and autogenic inhibition
principles of reciprocal and autogenic inhibition
contact-relax sequence
agonist contraction
contract-relax-agonist contraction
contract-relax
bring limb to end range - gentle stretch
ask for and resist an isometric contraction of the muscle being stretched for approx 6 sec
then ask the pt to relax the muscle
increase the stretch and repat the procedure two to four times
prolonged passive stretching
low-intensity external force applied to shortened tissues over a prolonged period
stretching of a short muscle should always be followed by
active strengthening of the opposing muscle in the shortened range
follow stretching w/
fxnal activity
effects of stretching
limited short and long term effects of pain, spasticity, contracture and activity limitations
can improve ROM if performed consistently
stretching should be
selective and pt centered
educate pt and ourselves on
effectiveness and necessity
what can stretching be replace dby
eccentric exercises
progression
PROM –> stretch –> A/AAROM with new range –> resistive exercise -fxnal activities
dosage –> frequency
lower intensity exercise performed for a shorter duration
exercise frequency is related to
purpose of the exercise
physiologic/kinesiologic purposed
2-5x/day
learning purposes
performed frequently throughout the day
