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

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Page 1: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility Optimal musculoskeletal function

requires that an adequate range of motion be maintained in all joints.

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

Flexibility After assessing your client’s

flexibility, you must 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.

Page 3: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility The specificity and progressive

overload principles apply to the design of flexibility programs.

Page 4: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility Flexibility is highly joint-specific;

therefore, to increase flexibility of a particular joint, select exercises that stretch the appropriate muscle groups.

Page 5: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

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.

Page 6: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

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.

Page 7: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility Of particular importance is

maintenance of flexibility in the lower back and posterior thigh regions.

Page 8: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility Lack of flexibility in this area may

be associated with an increased risk for the development of chronic lower back pain.

Page 9: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

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).

Page 10: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility Accordingly, exercise programs for

the elderly should emphasize proper stretching, especially for the upper and lower trunk, neck, and hip regions.

Page 11: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility There are different types of

stretching techniques (e.g., static, ballistic, and PNF) that can be performed.

Page 12: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility All three types of stretching are

effective in increasing the ROM.

Page 13: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

PNF PNF stretching increases ROM by

inducing muscle relaxation through spinal reflex mechanisms.

Page 14: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

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.

Page 15: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

PNF This technique is based on the

concept of reciprocal inhibition.

Page 16: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

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.

Page 17: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

PNF The isometric contraction of the

antagonists also stimulates the Golgi tendon organs, resulting in a reflex relaxation of the same muscle group.

Page 18: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

PNF Another type of PNF stretching is

the contract-relax with agonist contraction (CRAC) technique.

Page 19: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

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.

Page 20: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

PNF Theoretically, the voluntary

contraction of the agonists induces additional inhibitory input to the antagonists (muscles being stretched) through reciprocal inhibition.

Page 21: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

How are PNF Stretches Performed? The following steps are

recommended when using PNF stretching techniques to increase static flexibility: Stretch the target muscle group by

moving the joint to the end of its ROM.

Page 22: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

How are PNF Stretches Performed? Isometrically contract the pre-

stretched muscle group against an immovable resistance (such as a partner or wall) for 5 to 6 seconds.

Page 23: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

How are PNF Stretches Performed? Relax the contracted muscle group

as you or your partner statically stretch the muscle to a new point of limitation.

Page 24: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

How are PNF Stretches Performed? 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.

Page 25: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than 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.

Page 26: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than ballistic stretching?

The ballistic technique uses a relatively fast, bouncing motion to produce stretch.

Page 27: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than ballistic stretching?

The momentum of the moving body segment, rather than external force, pushes the joint beyond its present ROM.

Page 28: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than ballistic stretching?

This technique appears to be counterproductive for increasing muscle stretch.

Muscle spindles signal both changes in length and speed of contraction.

Page 29: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than 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.

Page 30: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than ballistic stretching?

Thus, ballistic or dynamic stretching evokes the stretch reflex, producing more contraction and resistance to stretch in the muscle group being stretched.

Page 31: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than ballistic stretching?

This places strain on the muscle-tendon unit and may cause microscopic tearing of muscle fibers and connective tissue.

Page 32: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than ballistic stretching?

In slow, static stretching, your client stretches the muscle with the joint positioned at the end of its ROM.

Page 33: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than 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.

Page 34: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Why is slow, static stretching safer than ballistic stretching?

This lessens reflex contraction of the muscle and allows the muscle to relax (viscoelastic stress relaxation) and to be stretched even further.

Page 35: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Is PNF stretching better than slow, static stretching? Limited research. It may, but it produces greater

feelings of being uncomfortable.

Page 36: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Is PNF stretching better than slow, static stretching? A major disadvantage of the PNF

technique is that the exercises, in some cases, cannot be performed alone.

Page 37: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Is PNF stretching better than slow, 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.

Page 38: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Is PNF stretching better than slow, static stretching? Thus, the amount of time required

for both individuals to complete the flexibility exercises is increased.

Page 39: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Exercise Prescription for Flexibility A well-rounded program includes

at least one exercise for each of the major muscle groups of the body.

Page 40: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Exercise Prescription 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.

Page 41: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility A general exercise prescription for

achieving and maintaining flexibility should adhere to the following guidelines:

Page 42: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Flexibility F = At least 3 days/week, preferably

daily. I = To a position of mild discomfort. T = 10 to 30 secs. for each stretch. S = 3 to 5 reps for each stretch.

Perform static stretches with a major emphasis on the lower back and thigh area.

Page 43: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Risky Exercises? Hyperextension Hyperflexion

Page 44: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Safe Intensity? The joint should not be stretched

beyond its pain-free range of motion.

Some mild discomfort will occur.

Page 45: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Duration of Stretch? ACSM recommends holding the

stretched position only as long as it feels comfortable (usually 10 to 30 seconds).

Page 46: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Number of Repetitions? Beginners should start with 3 reps

of each exercise. As flexibility improves, they may

increase the reps to 5.

Page 47: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Client Guidelines Warm-up before stretching to

increase body temperature and ROM.

Stretch all major muscle groups, as well as opposing muscle groups.

Page 48: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Client Guidelines Focus on the target muscle

involved in the stretch, relax the target muscle, and minimize the movement of other body parts.

Page 49: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Client Guidelines Hold the stretch for 10 to 30

seconds. Stretch to the limit (endpoint) of

the movement, not to the point of pain.

Page 50: Flexibility Optimal musculoskeletal function requires that an adequate range of motion be maintained in all joints

Client Guidelines Keep breathing slowly and

rhythmically while holding the stretch.

Stretch the target muscle groups in different planes to improve overall ROM at the joint.