Download fexibility and low-back health

FEXIBILITY AND LOW-BACK
HEALTH
Chapter 9
Test your knowledge
• Stretching exercises should be performed
▫ At the start of a warm-up
▫ First thing in the morning
▫ After endurance exercise or strength training
 C. it’s best to do stretching exercises when your
muscles are warm. Stretching muscles before
exercise may temporarily reduce their explosive
strength and interfere with neuromuscular control.
Test your knowledge
• If you injure your back, it’s usually best to rest in
bed until the pain is completely gone. True or
False?
 FALSE. Prolonged bed rest may actually worsen
back pain. Limit bed rest to a day or less, treat pain
and inflammation with cold and then heat, and
begin moderate physical activity as soon as possible.
Test your knowledge
• It is better to hold a stretch for a short time than
to “bounce” while stretching. True or false?
 TRUE. “Bouncing” during stretching can damage
your muscles. This type of stretching, called ballistic
stretching, should be used only by well-conditioned
athletes for specific purposes. A person of average
fitness should stretch slowly, holding each stretch
for 15 – 30 seconds.
Flexibility
• Ability of a joint to move through its
normal, full rage of motion.
 2 types:
 Static flexibility ability to hold an extended
position at one end or point in a joint’s range of
motion
 Dynamic flexibility ability to move a joint
through its range of motion with little resistance.
Involves strength, coordination and resistance to
movement.
What determines flexibility?
• The flexibility of a joint is affected by
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Structure
Muscle elasticity
Length
Nervous system regulation
Joint structure
• Joint capsule
▫ Provides support and
stability to the joint
• Cartilage
• Synovial fluid
▫ Cushions the bones and
reduces friction
• Ligaments
▫ Found on both inside and
outside the joint capsule
▫ Serve to strengthen and
reinforce the joint.
Joint structure
• Hinge joint
• Ball – and – socket joint
Muscle elasticity and length
• Soft tissues limit the flexibility of a joint
▫ Skin, muscles, tendons, and ligaments
▫ Muscle tissue is the key to develop flexibility
 Connective tissue: provides structure, elasticity and bulk
 Collagen: white fibers, provide structure and support
 Elastin: yellow fibers, provide elasticity and flexibility
▫ Regular stretching contributes to flexibility by
lengthening muscle fibers through the addition of
contractile units called sarcomeres.
Nervous system regulation
• Proprioceptors: nerves that send information
about the muscular and skeletal systems to
the nervous system.
• Control the speed, strength and coordination
of muscle contractions.
• Proprioceptors adapt very quickly to
stretching (or lack of stretching). Frequent
training is beneficial for developing flexibility
• Stretches than involve rapid, bouncy
movements can cause injury.
• Performing a gradual stretch and then
holding it allows the proprioceptors to adjust
to the new muscle length and to reduce the
signals sent to the spine, allowing muscles to
lengthen and over time to become more
flexible.
Benefits of flexibility and stretching
exercises
• Joint health
▫ Poor joint flexibility can cause:
 Abnormalities in joint
lubrication
 Joint deterioration
 Expose joint to abnormal
stresses
▫ Good joint flexibility
 Prevents arthritis
 Lessens pain
 Increases balance and stability
Benefits of flexibility and stretching
exercises
• Prevention of low-back pain
and injuries
▫ Low-back pain is related to poor
spinal stability
▫ Strength and flexibility in the
back, pelvis and thighs may help
prevent this type of pain.
▫ Good hip and knee flexibility
protect the spine from excessive
motion.
▫ Overstretching may decrease the
stability of a joint, increasing the
risk of injury
Benefits of flexibility and stretching
exercises • Relief of aches and pains
• Relief of muscle cramps
▫ Related to increase electrical activity within the
affected muscle
• Improved body position and strength for sports
and life.
▫ Lets you assume more efficient body positions and
exert force through a greater range of motion.
• Maintenance of good posture and balance
▫ Contributes to body symmetry and good posture
• Relaxation
▫ Reduce mental tension, slows breathing rate,
reduces blood pressure.
Lab 9.1
• ASSESSING FLEXIBILITY
Creating a successful program to
develop flexibility
• Your goal should be to attain normal flexibility
in the major joints.
• Extreme flexibility causes joint instability which
can lead to pain in the back, hips, shoulders and
knees.
• Balanced flexibility provides joint stability and
facilitates smooth movement patterns.
Apply the FITT principle
• Frequency
▫ 2-3 days a week – ideally 5-7 days a week
▫ Stretch when your muscles are warm
▫ Pre-exercise stretching decreases muscle strength
and performance and disturbs neuromuscular
control.
• Intensity and time
▫ Slowly stretch your muscles to the
point of slight tension or mild
discomfort.
▫ Hold the stretch for 15 – 30 seconds
▫ Try to stretch a little bit farther
▫ During the stretch try to relax and
breath easily
▫ Rest 30 – 60 seconds between each
stretch
▫ Do 2-3 repetitions of each stretch
▫ A complete flexibility workout
usually takes about 20- 30 min.
• Types of stretching techniques
▫ Static stretching
 Each muscle is gradually stretched and
the stretch is held for 15 – 30 seconds.
▫ Ballistic stretching
 The muscles are stretched suddenly in a
forceful bouncing movement.
 Recommended only for well trained
athletes
• Types of stretching techniques
▫ Dynamic (functional) stretching
 Involves moving the joints through the range of
motion used in a specific exercise or sport in an
exaggerated but controlled manner.
• Types of stretching techniques
▫ Proprioceptive neuromuscular Facilitation – PNF
 Uses reflexes initiated by both muscle and joint
nerves to cause greater training effects
 Contract – relax stretching: the muscle is contracted
before it is stretched.
 Contract – relax – contract stretching: begins with the
contraction of the muscle to be stretched, then
relaxing it and then contracting the opposing muscle
(antagonist), finally relaxing the first muscle.
• Types of stretching techniques
▫ Passive vs. active stretching
 Passive stretching
 An outside force or resistance provided by yourself, a
partner, gravity or a weight helps your joints move
through their range of motion.
 Active stretching
 A muscle is stretched by a contraction of the opposing
muscle
Exercises to improve flexibility
Warm up 5-10
minutes or
following an
endurance or
strength
training
workout
Frequency: 2-3
days/week; 5-7
days/week ideal
Intensity:
stretch to the
point of mild
discomfort, not
pain.
Time: 15 – 30
seconds, 2-4
times
Type of activity:
stretching
exercises that
focus on major
joints.
Stretching exercises for major joints
Sample program
Exercise
Areas stretched
Head turns and tilts
Neck
Towel stretch
Triceps, shoulders, chest
Across –the-body and overhead
stretches
Shoulders, upper back, back of arm
Upper-back stretch
Upper back
Lateral stretch
Trunk muscles
Step stretch
Hip, front of thigh
Side lunge
Inner thigh, hip, calf
Inner thigh stretch
Inner thigh, hip
Hip and trunk stretch
Trunk, outer thigh, hip, buttocks, lower
back
Modified hurdler stretch
Back of thigh, lower back
Alternate leg stretcher
Back of thigh, hip, knee, ankle, buttocks
Lower-leg stretcher
Calf, soleus, Achiles tendon
Remember…
▫ Improper stretching does more harm than good
▫ Understand the different types of stretching
exercises and how they affect muscles.
▫ Do stretching exercises statically.
▫ Do not stretch to the point of pain.
▫ Relax and breathe easily as you stretch
▫ Perform all exercises on both sides of your body.
▫ Increase intensity and duration gradually over
time.
▫ Stretch when your muscles are warm
Preventing and managing lower-back
pain
• Back pain can result from sudden traumatic
injuries but it is more often the long-term result
of weak and inflexible muscles, poor posture, or
poor body mechanics during activities like lifting
and carrying
• Any abnormal strain on the back can result in
pain.
Function of the Spine
• Provides structural support for
the body
• Surrounds and protects the
spinal cord
• Supports much of the body’s
weight and transmits it to the
lower body
• Serves as an attachment site
for a large number of muscles,
tendons and ligaments
• Allows movement of the neck
and back in all directions.
Structure of the Spine
Nerve root
• Vertebrae
▫ Vertebral body: carries
stress of body weight and
physical activity
▫ Bony processes: joints to
adjacent vertebrae and
attachment sites for
muscles and ligaments.
▫ Invertebral disks: absorb
and disperse the stresses
placed on the spine,
separate vertebrae from
Vertebral
each other.
arch
Invertebral
disk
Vertebral
body
Structure of the Spine
• Vertebrae
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7 cervical
12 thoracic
5 lumbar
Sacrum
Coccyx
• 4 curves
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Cervical
Thoracic
Lumbar
Sacral
Core muscle fitness
• Muscles in the abdomen, pelvic floor, sides of
the trunk, back, buttocks, hip and pelvis
• 29 muscles
• Stabilize the spine and help transfer force
between the upper body and lower body
• During dynamic exercise, core muscles work
together to produce movement and stability
• When specific core muscles are weak or tired,
the nervous system steps in and uses other
muscles producing abnormal stress on the
joints, decreased power and an increase in the
risk of injury.
Causes of back pain
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Being greater than 34 years
Degenerative diseases such as arthritis or osteoporosis
Family or personal history of back pain or trauma
Sedentary lifestyle
Low job satisfaction
Low socioeconomic status
Smoking
Excess body weight
Psychological stress or depression
Physically hard work: frequent lifting, twisting,
bending, standing up or straining in forced
positions
• High concentration demands (computer
programming)
• Vibrations (truck driving)
• Underlying causes
▫ Poor muscle endurance and strength in
the core muscles
▫ Excess body weight
▫ Poor posture and body position when
standing, sitting or sleeping
▫ Poor body mechanics when performing
actions like lifting and carrying or sports
movements.
• Symptoms
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Numbness in the back, hip, leg or foot
Radiating pain
Loss of muscle function
Depressed reflexes
Muscle spasm
Preventing low back pain
• Lose weight, stop smoking, reduce stress
• Avoid sitting, standing or working in the same
position for too long.
• Use a supportive seat and a medium-firm mattress
• Use lumbar support when driving
• Warm up thoroughly before exercising
• Progress gradually when attempting to improve
strength or fitness.
Managing back pain
Acute
Chronic
• Cold treatments
• Heat treatments
• Nonsteroidal antiinflammatory medication
• Immediate rest following the
onset of back pain
• Limit bed rest to one day and
begin moderate physical
activity as soon as possible
• See your physician if acute
back pain doesn’t resolve
within a short time.
• Low-back pain is considered
chronic if it persists for more
than 3 months
• Prescription medications
• Exercise
• Physical therapy
• Massage, yoga or chiropractic
care
• Acupuncture
• Percutaneous electrical nerve
stimulation
• Psychological therapy
LAB ACTIVITIES
Lab 9.3
Lab 9.4
• Assessing muscular endurance
for low back health
• Posture evaluation