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Stretching, Definition of Terms Associated with Mobility and Stretching …

- - - - (stretching exercises routinely are recommended for warm-up prior to or cool-down following strenuous physical activity, essential part of conditioning programs for general fitness, for recreational or workplace activities, and for training in preparation for competitive sports).
      - increased power
        
        Increasing distance over which they are able to contract potential increase to our muscles power and therefore increases our athletic ability, while also leading to an improvement in dynamic balance, or the ability to control our muscles
        
        Injury prevention &
        reduced post exercise
        muscle soreness
        
        Few studies have suggested that stretching, as part of a warm-up routine immediately before vigorous physical activity prevents or reduces the risk of injury
        
        Enhanced performance
        
        Enhanced physical performance such as increased muscular strength, power or endurance or improvements in physical functioning, including walking & running speed & jumping ability
- - - - 3- Muscle weakness and shortening of opposing tissue have led to limited ROM
        
        4- May be a component of a total fitness or sport-specific conditioning program designed to prevent or reduce the risk of musculoskeletal injuries
        
        5- May be used to and after vigorous exercise to potentially reduce postexercise muscle soreness
- - - - 3- There is evidence of an acute inflammatory or
        infectious process (heat & swelling) , or soft tissue healing could be disrupted in the restricted tissues & surrounding region
        
        4- There is sharp acute pain with jnt movement or ms elongation.
        
        5- A hematoma or any other indication of tissue trauma is observed
        
        6-Hypermobility already exists.
        
        7- Shortened soft tissues provide necessary jnt stability in lieu of normal structural stability or neuromuscular control
        
        8- Shortened soft tissues enable a patient with paralysis or severe ms weakness to perform specific functional skills otherwise not possible
- - - - Fixation of one site of attachment of the ms as the stretch force is applied to the other bony attachment
      - INTENSITY OF STRETCH
        
        Magnitude of the stretch force applied
        
        DURATION OF STRETCH
        
        Length of time the stretch force is applied during a stretch cycle
        
        SPEED OF STRETCH
        
        Speed of initial application of the stretch force
        
        FREQUENCY OF STRETCH
        
        Number of stretching sessions per day or week.
        
        MODE OF STRETCH
        
        Form or manner in which the stretch force is applied (static, ballistic, cyclic)
        
        Degree of patient participation.
        (passive, assisted, active)
        
        Or the source of the stretch force.
        (manual, mechanical, self)
        
        Manual stretching
        Self-stretching
        Mechanical stretching
        PNF stretching
        
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        Refers to the number of bout (sessions) per day or per week a patient carries out a stretching regimen
        
        The recommended frequency of stretching is often based on the underlying cause of impaired mobility, the quality & level of healing of tissues, the chronicity & severity of a contracture as well as a patient’s age
        
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        To ensure optimal ms relaxation & prevent injury to tissues, the speed of stretch should be slow. The stretch force should be applied & released gradually
        
        Slowly applied stretch is less likely to increase tensile stresses on connective tissues or to activate the stretch reflex & increase tension in the contractile structures of the ms being stretched
        
        Stretch force applied at a low velocity is also easier for the therapist or patient to control & is therefore safer than a high-velocity stretch
        
        The duration of stretch refers to the period of time a stretch force is applied & shortened tissues are held in a lengthened position
        
        Duration most often refers to how long a single cycle of stretch is applied
        
        Classification of stretching according to duration of stretch cycle i.e. long duration stretch & short duration stretch:
        
        Static stretch
        
        Static progressive stretch
        
        Cyclic intermittent stretch
        
        STATIC STRETCH
        
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        the intensity (magnitude) of a stretch force is determined by the load placed on soft tissue to elongate it.
        
        There is a general agreement among clinicians & researchers that stretching should be applied at low intensity by means of a low load.
        
        Low intensity stretching in comparison to high-intensity stretching makes the stretching maneuver more comfortable for the patient & minimizes voluntary or involuntary muscle guarding so a patient can either remain relaxed or involuntary ms guarding so a patient can either remain relaxed or assist with the stretching maneuver
        
        Low-intensity stretching (coupled with a long duration of stretch) results in optimal rates of improvement in ROM without exposing tissues, possibly weakened by immobilization, to excessive loads & potential injury
        
        Low-intensity stretching has also been shown to elongate dense connective tissue, a significant component of chronic contractures more effectively & with less soft tissue damage & post-exercise soreness than a high intensity stretch
      - To achieve an effective stretch of a specific muscle or ms group & associated periarticular structures, it is imperative to stabilize (fixate) either the proximal or distal attachment site of the muscle-tendon unit being elongated
        
        Eg: When stretching the iliopsoas, the pelvis & lumbar spine must maintain a neutral position as the hip is extended to avoid stress to the low back region. Sources of stabilization include manual contacts, body weight, or a firm surface such as a table, wall
    - - For eg: To stretch rectus femoris ( a ms that crosses 2 jnts) effectively, as the knee is flexed & hip extended, the lumbar spine & pelvis should be aligned in a neutral position. The pelvis should not tilt anteriorly nor should the low back hyperextend
- - - -  Pseudomyostatic contracture:
        
         Impaired mobility and limited ROM may also be the result of hypertonicity (ie, spasticity or rigidity) associated with a central nervous system lesion, such as a cerebrovascular accident, a spinal cord injury or brain injury.
        
         Arthrogenic & peri-articular contracture:
        
         An arthrogenic contracture is the result of intra-articular pathology. These changes may include adhesions, synovial proliferation, joint effusion, irregularities in articular cartilage, or osteophyte formation.
        
         Fibrotic contracture:
        
         Fibrous changes in the connective tissue of the muscle and periarticular structures can cause adherence of these tissues & subsequent develop of fibrotic contracture. Difficult to re-establish optimal length, but possible to stretch & increase ROM.
      -  Shortening of Musculo tendinous unit. No specific pathology. Resolve in a short period of time.