Stretching for Improved Mobility

Question 1

What is mobility?

Answer 1

• The ability of structures or segments of the body to move or be moved to allow the presence of range of motion for functional activities (fx ROM)
• The ability of an individual to initiate, control, or sustain active movements of the body to perform simple to complex motor skills (fx mobility)

Question 2

What is hypomobility?

Answer 2

Restricted motion caused by adaptive shortening or decreased extensibility in soft tissues

Question 3

Factors that cause hypomobility

Answer 3

• Prolonged immobilization of a body segment
• Sedentary lifestyle
• Postural malalignment and muscle imbalances
• Impaired muscle performance (weakness) associated
• Tissue trauma resulting in inflammation and pain
• Congenital or acquired deformities

Question 4

What is flexibility?

Answer 4

The ability to rotate a single joint or series of joints smoothly through an unrestricted, pain-free ROM.

Question 5

What is dynamic flexibility?

Answer 5

aka Active ROM / Active mobility, is dependent on the degree a muscle can move a joint through ROM and the degree of tissue restriction during motion.

Question 6

What is passive flexibility?

Answer 6

aka Passive ROM/ Passive mobility is the ability for a joint to be passively rotated through its available ROM. The amount an external force can move a segment through.

Question 7

What is a contracture?

Answer 7

It is defined as the adaptive shortening of the muscle-tendon unit and other soft tissues that cross or surround a joint. Resulting in significant resistance to passive or active stretch.

Question 8

What is a myostatic contracture?

Answer 8

The musculotendinous unit has adaptively shortened and there is a significant loss of ROM, there is no specific muscle pathology present.

Responds best to stretching exercises.

Question 9

What is a pseudomyostatic contracture?

Answer 9

An impaired mobility and limited ROM as a result of hypertonicity or spasticity associated with a Central Nervous System injury.

Responds best to inhibition techniques.

Question 10

What are arthogenic contractures?

Answer 10

Contractures that are a result of intra-articular pathology.

Question 11

What are periarticular contractures?

Answer 11

Develops when connective tissue that crosses or attach to a joint or the joint capsule loses mobility, therefore decreasing ROM.

Responds best to joint mobilization.

Question 12

What are fibrotic contractures?

Answer 12

Fibrous changes in the connective tissue of muscle and periarticular structures that can cause adherence of these tissues.

Although it is possible to stretch a fibrotic contracture and eventually increase ROM, it is often difficult to reestablish optimal tissue length.

Question 13

What are irreversible contractures?

Answer 13

Permanent loss of soft tissue extensibility that cannot be reversed by nonsurgical intervention.

Question 14

What are indications for stretching?

Answer 14

• ROM is limited because soft tissue have lost their extensibility
• Restricted motion may lead to structural deformities that are otherwise preventable
• Muscle weakness and shortening of opposing tissue have led to limited ROM
• May be a component of a total fitness or sport-specific conditioning program designed to prevent or reduce the risk of musculoskeletal injuries
• May be used prior to and after vigorous exercise

Question 15

What are contraindications to stretching?

Answer 15

• Bony block limits joint motion
• A recent fracture and bony union is incomplete
• Evidence of an acute inflammatory or infectious process (heat + swelling) or soft tissue healing
• Sharp, acute pain with joint movement or muscle elongation
• Hematoma or other indication of tissue trauma
• Joint hypermobility already exists
• Shortened soft tissues provide necessary joint stability in lieu of normal structural stability or neuromuscular control
  Shortened soft tissues enable a patient with paralysis or severe muscle weakness to perform specific functional skills otherwise not possible

Question 16

What are general precautions for stretching?

Answer 16

• Do not passively force a joint beyond its normal ROM
• Use extra caution in patients with known or suspected osteoporosis
• Protect newly united fractures
• Always be aware that point of force application on each of segments will influence tensile load on target tissue (longer lever arm creates greater torque)
• Avoid vigorous stretching of muscles and connective tissues that have been immobilized for an extended period of time
• Progress the dosage (intensity, duration, and frequency) gradually to minimize soft tissue trauma and post-exercise muscle soreness
• Avoid stretching edematous tissue (more susceptible to injury, causes increased pain and edema)
• Avoid overstretching weak muscles

Question 17

What is stretching?

Answer 17

A general term used to describe any therapeutic maneuver designed to increase the extensibility of soft tissue, (contractile and noncontractile components of muscle-tendon units and periarticular structures) thereby improving flexibility by elongating structures that have adaptively shortened and have become hypomobile over time.

Question 18

What is selective stretching?

Answer 18

A process whereby the overall function of a patient may be improved by applying stretching techniques to some muscles and joints while allowing motion limitations to develop in other muscles or joints.

Question 19

What is overstretching?

Answer 19

A stretch well beyond the normal length of muscle and ROM of joint and the surrounding soft tissues.

Question 20

What is hypermobility?

Answer 20

Excessive mobility.

Question 21

What is self-stretching?

Answer 21

Any stretching exercise that is carried out independently by a patient after instruction and supervision by a therapist.

Question 22

What is a passive stretch?

Answer 22

A sustained end-range stretch, applied with overpressure.