Flexibility

1. Flexibility

2. Flexibility • Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints.

3. Flexibility • Identify those joints and muscle groups which are in need of improvement and select an appropriate exercise mode and specific exercises for the flexibility program.

4. Flexibility • The specificity and progressive overload principles apply to the design of flexibility programs.

5. Flexibility • Flexibility is highly joint-specific; therefore, to increase flexibility of a particular joint, select exercises that stretch the appropriate muscle groups.

6. Flexibility • To improve ROM at the joint, your client must overload the muscle group by stretching the muscles beyond their normal resting length - but never beyond the pain-free range of motion.

7. Flexibility • Periodically your client will need to increase both the amount of time the stretched position is maintained and the number of repetitions of the exercise to ensure the overload required for further improvement.

8. Flexibility • Of particular importance is maintenance of flexibility in the lower back and posterior thigh regions. • See next set of notes on back health.

9. Flexibility • Lack of flexibility in this area may be associated with an increased risk for the development of chronic lower back pain.

10. Flexibility • Lack of flexibility is prevalent in the elderly among whom this condition often contributes to a reduced ability to perform activities of daily living (ADL).

11. Flexibility • Accordingly, exercise programs for the elderly should emphasize proper stretching, especially for the upper and lower trunk, neck, and hip regions.

12. Flexibility • There are different types of stretching techniques (e.g., static, ballistic, and PNF) that can be performed.

13. Flexibility • All three types of stretching are effective in increasing the ROM.

14. PNF • PNF stretching increases ROM by inducing muscle relaxation through spinal reflex mechanisms.

15. PNF • Using the contract-relax technique, your client first performs an isometric contraction of the muscle group being stretched, and then proceeds with the slow, static stretching (relaxation phase) of the muscle group.

16. PNF • This technique is based on the concept of reciprocal inhibition. • Contraction on one muscle causes relaxation in another.

17. PNF • Theoretically, the isometric contraction of the antagonists (muscle group being stretched) induces a reflex facilitation and contraction of the agonist during the slow, static stretching phase.

18. PNF • The isometric contraction of the antagonists also stimulates the Golgi tendon organs, resulting in a reflex relaxation of the same muscle group.

19. PNF • Another type of PNF stretching is the contract-relax with agonist contraction (CRAC) technique.

20. PNF • This method is identical to the contract-relax technique except that the stretching is assisted by a submaximal contraction of the opposing (agonist) muscle group.

21. PNF • Theoretically, the voluntary contraction of the agonists induces additional inhibitory input to the antagonists (muscles being stretched) through reciprocal inhibition.

22. Steps for PNF Stretching • 1. Stretch the target muscle group by moving the joint to the end of its ROM. • 2. Isometrically contract the pre-stretched muscle group against an immovable resistance (such as a partner or wall) for 5 to 6 seconds.

23. Steps for PNF Stretching • 3. Relax the contracted muscle group as you or your partner statically stretch the muscle to a new point of limitation.

24. Steps for PNF Stretching • 4. With the contract-relax agonist contraction technique, the opposing muscle group, (agonist) contracts submaximally for 5 to 6 seconds to facilitate relaxation and further stretching of the target muscle group.

25. Static Stretching vs Ballistic Stretching • Many exercise specialists recommend using slow, static stretching rather than ballistic stretching because there is more chance of injury and muscle soreness resulting from jerky, rapid movements.

26. Static Stretching vs Ballistic Stretching • The ballistic technique uses a relatively fast, bouncing motion to produce stretch.

27. Static Stretching vs Ballistic Stretching • The momentum of the moving body segment, rather than external force, pushes the joint beyond its present ROM.

28. Static Stretching vs Ballistic Stretching • This technique appears to be counterproductive for increasing muscle stretch. • Muscle spindles signal both changes in length and speed of contraction.

29. Static Stretching vs Ballistic Stretching • The spindle responds more to the speed of movement than to the muscle’s length or position. • In fact, muscle spindle activity is directly proportional to the speed of movement.

30. Static Stretching vs Ballistic Stretching • Thus, ballistic stretching evokes the stretch reflex, producing more contraction and resistance to stretch in the muscle group being stretched.

31. Static Stretching vs Ballistic Stretching • This places strain on the muscle-tendon unit and may cause microscopic tearing of muscle fibers and connective tissue.

32. Static Stretching vs Ballistic Stretching • In slow, static stretching, your client stretches the muscle with the joint positioned at the end of its ROM.

33. Static Stretching vs Ballistic Stretching • While maintaining this position, the client slowly applies torque to the muscle to stretch it further. • Because the dynamic portion of the muscle spindle rapidly adapts to the lengthened position, the spindle discharge is decreased.

34. Static Stretching vs Ballistic Stretching • This lessens reflex contraction of the muscle and allows the muscle to relax (viscoelastic stress relaxation) and to be stretched even further.

35. Is PNF stretching better than slow, static stretching? • Limited research. • It may be, but it produces greater feelings of being uncomfortable.

36. PNF Stretching vs Static Stretching • A major disadvantage of the PNF technique is that the exercises, in some cases, cannot be performed alone.

37. PNF Stretching vs Static Stretching • A partner is needed to resist movement during the isometric contraction phase and to apply external force to the muscle during the stretching phase.

38. PNF Stretching vs Static Stretching • Thus, the amount of time required for both individuals to complete the flexibility exercises is increased.

39. Comparison of Stretching Techniques • See table 11.1, p. 284, Heyward Book

40. Exercise Program for Flexibility • A well-rounded program includes at least one exercise for each of the major muscle groups of the body.

41. Exercise Program for Flexibility • Use the results of the flexibility tests to identify specific muscle groups with relatively poor flexibility, and include more than one exercise for these muscle groups.

42. Exercise Program for Flexibility • A general exercise program for achieving and maintaining flexibility should adhere to the following guidelines:

43. Flexibility • F = At least 3 days/week, preferably daily. • I = To a position of mild discomfort. • Slowly elongate to low force hold. • T = 15 to 30 secs. for each stretch. • Not much improve beyond 30 secs. • S = 3 to 5 reps for each stretch. Perform static stretches and/or PNF with a major emphasis on the lower back and thigh area.

44. Safe Intensity? • The joint should not be stretched beyond its pain-free range of motion. • Some mild discomfort will occur.

45. Duration of Stretch? • ACSM recommends holding the stretched position only as long as it feels comfortable (usually 15 to 30 seconds).

46. Number of Repetitions? • Beginners should start with 3 reps of each exercise. • As flexibility improves, they may increase the reps to 5.

47. Flexibility Tips • Perform in an unloaded body position. • Stretch muscles, not ligaments. • Focus on problem areas. • Target “normal” static range of motion. • Extreme stretching causes increased risk of injury.

48. Flexibility Tips • Emphasize active warm-up prior to stretching. • Stretch during cool down. • Focus on areas of increased static range of motion demand.

49. Tips • Focus on the target muscle involved in the stretch, relax the target muscle, and minimize the movement of other body parts.

50. Tips • Stretch to the limit (endpoint) of the movement, not to the point of pain.