Flexibility

1. Flexibility

2. Role of Flexibility • Each joint has a defined attainable range that affects the way it functions and performs • Optimal levels of flexibility allow for efficient movement with adequate stability and articular support • Decreased range of motion or dysfunctional positioning or alignment (kyphosis) can throw off the kinetic chain and compromise other areas

3. Benefits of Flexibility • Increased movement range • Reduction in rate of functional decline • Postural symmetry and joint alignment • Stress reduction, reduced tension, and tissue relaxation • Reduced risk of injury • Relief of muscle pain • Improved quality of life

4. Properties of Soft Tissue • Elasticity – allows a stretched or deformed tissue to return to its original state or pre-stretched form • Plasticity – allows for permanent deformation or change which allows tissue to attain a new semi-permanent length • Viscosity – fluid resistance within a tissue. Cold tissue is viscous and resistance to change, warm tissue has a reduced viscosity and greater ability to stretch

5. Factors Affecting Joint ROM • Muscle tissue • Connective tissue • Neural receptors • Age • Gender • Body mass • Pain • Injury • Immobility • Disease

6. Tissue Factors • Muscle – the number of sarcomeres along a myofibril and their relative lengthening potential contribute to muscle stretch potential • Connective tissue – collagen distribution within tissue limits its stretch potential • Neural – proprioceptors and mechanoreceptors regulate tension and rate of tension to stimulate tissue reactivity through neural mechanisms. Velocity of a movement acts inversely to relaxation.

7. Age • Muscle elasticity declines due to a loss of sarcomeres along the muscles length • Lipid and collagen fibers inside the muscle tissue (fibrosis) increase tissue resistance. • Age also causes tissue mineralization further contributing to stiffness. Age related factors include: • Genetics • Quantity and type of physical activity • Health status

8. Gender, and Body Size Factors Gender differences, which may increase the possibility a female may have better range in certain movements occur due to: • Variations in pelvic shape • Differences in the curvature of the olecranon process • Shorter long bone length Body size limitations are most attributed to insufficient range of motion during activity, not muscle bulk. Individuals that possess extreme muscle mass or obesity may be subject to limitations due to excessive mass.

9. Factors of Dysfunction • Immobility – causes a loss of protein and elasticity in a short period of time. If constricted in a shortened position the loss it worsened. • Pain – optimal lengthening may be limited by participant discomfort or pain threshold. Increasing the temperature of the tissue prior to stretch may enhance relaxation. • Injury - Injured tissues may present loss in range due to decreased joint movement. Common inflammatory problems that limit movement range include tendonitis, bursitis, fasciitis, and impingement syndromes. • Disease – Bone and joint diseases present limitations to range of motion through pain and structural dysfunction. Arthritis may be monoarticulr or polyarticular and limit range in certain movements or in all affected joint movements.

10. Testing Flexibility • Tests may be assessed through direct measure using appropriate devices or employ screening using movement mats. Each test should be quantifiable. • Each joint movement should be assessed unilaterally • Limitations should be documented • Exercise prescription should include routine activities to address deficiencies

11. Programming Flexibility General Classifications Active – participant supplies the lengthening force Passive – external force is applied to move the relaxed body segment Categories of Flexibility Static – basic static, active assisted, active isolation, PNF Dynamic – basic dynamic, ballistic

12. Static Stretching • Basic static – tissue is actively lengthened to a desired range and maintained at full length for optimally 30 seconds. • Active assisted – force is added to the static stretch to increase movement range. External force may be mechanical, gravitational or human. Durations are 15-30 sec. Note: Static stretching reduces force output due to relaxation, negatively affecting strength and power movements performed following stretching.

13. Force Tension Stretching • Active Isolation – the body segment is actively stretched, then stabilized. The tissue is then forcibly lengthened using muscle contractions for 10 sec. • PNF – Contract relaxation technique of the agonist and or antagonist muscle group elicits proprioceptor modulation allowing for greater stretch. Contractions usually last 6 sec. followed by a 10 sec. active stretch

14. Dynamic Stretching • Basic dynamic flexibility – movement range is attained through slow controlled contractions using full range of motion. Repetitive actions attempt to reach the greatest functional range. • Ballistic stretching – often considered contraindicated due to stimulation of muscle spindles and mechanoreceptors preventing relaxation, it uses contractile force and momentum to attain greater range – common in ballet and karate

15. Dynamic Performed before or during the exercise bout 5-8 movements, 2-4 sets, accumulate 1-2 minutes of stretch time per muscle group Static Performed at the end of the exercise bout 10-12 movements, 2-4 sets, 15-30 second holds PNF – 5-10 second contraction followed by 6-12 second holds General Prescription Guidelines

16. Programming • Warm-up: required before elongating tissue • Intensity: tolerable discomfort, no pain • Duration: 15-30 minutes per session, may be integrated into multimodality training bout • Frequency: 2-3 days per week • Emphasis: deficient areas are prioritized and require multiple days; healthy range movements should be maintained by one day or more per week • Integration: select exercises that push tight tissue through controlled full range during the workout

17. Programming Integration • Warm-up • Dynamic flexibility • Power, Speed, or Strength training • Anaerobic endurance and Circuits • Cardiovascular training • Cool down • Static stretching