Therapeutic Exercise - Lecture 2 Flashcards
define flexibility:
refers to the mobility of muscles and the length to which they can extend
define hypomobility
restricted ROM
define hypermobility:
excessive ROM
define contracture:
adaptive shortening of the muscle-tendon unit and soft tissues surrounding joint
flexibility is a measure of __
ROM
flexibility has 2 components…
static and dynamic
static flexibility occurs during __
passive movement
dynamic flexibilty occurs during:
available ROM during active movements
define ROM
amount of mobility of a joint
determinants of ROM/flexibility:
- mechanical response of contractile tissue,
- neruphysiologic properties of contractile tissue,
- mechanical characteristics of non-contractile soft tissue,
- structure limitation of the joint,
- pain threshold
contractile tissue is individual __, __ and __
muscle fibres, myofibrils and sarcomeres
contractile tissues response to stress is ..
initial resistance to stretch followed by relaxation
chronic stretching of contractile tissue results in __
sarcomere addition
what is contractile tissues response to immobilization?
atrophy, loss of sarcomeres, increase in connective tissue
what does the muscle spindle trigger in accordance with the velocity and duration of a stretch?
muscle contraction in response to stretch
the golgi tendon organ is ___ to muscle tension
sensitive
what does the golgi tendon organ do in response to tension
relax muscle
does the golgi tendon organ have a low or high threshold during passive stretching
high
the __ reflex is a protective meachnism
stretch reflex
the stretch reflex increases __ in the muscle and provides resistance to __
increases tension in the muscle and provides resistance to lengthening
what is autogenic inhibition?
stretch applied is slow, low intensity, the muscle relaxes and there is reciprocal inhibition *** check to see if makes sense
list the types of connective tissue
collagen, elastin, reticulin and ground substance
what type of connective tissue has the highest tensile strength and transmits forces?
tendons
what type of connective tissue has properties that vary with location and provide intermediate strength?
ligaments
what type of connective tissue holds things together and is the weakest?
fascia
define elasticity:
ability to return to normal length after elongation
define plasticity:
ability of a substance to undergoe permanent change in size or shae
define viscoelasticity:
ability to resist change of shape when an outside force is applied, inability to completely return to shape
changes in collagen: immobilization
weakening of collage matrix as a result of turnover, slow to recover
changes in collagen: inactivity
decrease in size and amount of collagen, weakening
changes in collagen: age
loss of strength and elasticity,
slower adaptation and healing
changes in collagen: corticosteroids
loss of collagen and weakening
changes in collagen: injury
initiated by week 3, type III to type I remodelling
why stretch?
hypomobility, muscle tightness, muscle contracture, decrease muscle spasm
list the causes of hypomobility:
- extrinsic
- casts
- splints
- traction, - intrinsic
- pain
- swelling
- muscle tendon fascial disorders, - lifestyle,
- paralysis,
- congenital or acquired disease
list interventions for hypomobility
passive or assisted stretching, self-stretching, facilitated stretching. Joint mobilization, soft tissue mobilization, nerual tissue mobilization
after an injury, the architecture is less capable of withstanding ___ loads so you have to be mindful of the degree of __ that is used.
tensile, stretching
during which stage is scar tissue forming (primarily collagen) and thus the area is still fragile?
repair and remodelling stage
what will stretching of scar tissue help to do?
help convert the inelastic tissue into a more pliable, elastic tissue
what are some things stretching could be used to help achieve?
increase ROM, increase flexibility, enhance recovery, prevent injury, increase performance
stetching principles: alignment
positioning critical
stretching principles: stabilization
proximal or distal fixation
stretching principles: intensity
lower intensities generlly preferred
stretching principles: speed
dependent on injury state
stretching principles: duration
much debate, 15s-2 min
stretching principles: repetitions
much debate, 1-3
stretching principles: frequency
dependent on severity
guidelines for prescription:
Examine patient – swelling, pain, stage
Assess ROM – pre-test with muscle function
Establish goals – therapist and patient
Select appropriate techniques, modalities and principles
Warm-up the tissues
Inform patient of procedures
Ensure patient comfortImplement the stretching prescription
stretching techniques:
StaticHold-relax Contract-relax Slow reversal Agonist reversal Slow reversal hold Ballistic stretching Active isolated stretc
special considerations: elderly
Loss of balance and coordination
Increased stiffness, decreased elasticity
Muscle weakness
Bone weakness
special considerations: children
Often quite flexible
Very elastic
Muscle weakness
Overstretching can easily result in hypermobility
why warm up?
Increased core temperature
Increased mental preparedness
Increased neural conduction
Improved muscle elasticity and contractility
Increased metabolic rate
Unregulated cardiovascular and respiratory systems
Rehearsal of motor patterns
types of warm up:
General Increase core temp Large muscle group repetitive exercise Specific Enhance neural activity, coordination, prep specific muscle groups Movements that are part of the activity Passive Dependent on sport and demands
dynamic flexibility: sport specific stretching
Flexibility speed
Flexibility strength
Flexibility endurance
how should you initiate dynamic stretching?
slow initiation, then gradual increase in speed, ROM
with regard to dynamic flexibility you should avoid __ and movements should be __ not __
avoid fatigue and movements should be controlled not jerky
what is the catch 22 with regard to dynamic flexibility?
the muscle is not relaxing but is active through the ROM which is specific to the movements that occur in sport
dynamic vs static stretching which is better?
strong evidence to suggest that acutely, static stretching may limit human performance when compared to dynamic stretching
how do you maintain a warm-up?
Initial thorough warm-up Short sport-specific warm-up if idle for >45min Maintain mental focus Avoid chronic postures Use vigorous shaking or massage Appropriate clothing
Why should we cool down?
- Reduce muscle fatigue and soreness
- Facilitate muscle relaxation
- Aid muscle recovery
- Best time to enhance flexibility
- Mental review
basic cool down tips:
Sport specific <50% max intensity Up to 20min, Include mild dynamic and static stretching
