Download Flexibility

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.
Flexibility

The specificity and progressive overload
principles apply to the design of
flexibility programs.
Flexibility

Flexibility is highly joint-specific;
therefore, to increase flexibility of a
particular joint, select exercises that
stretch the appropriate muscle groups.
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.
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.
Flexibility

Of particular importance is maintenance
of flexibility in the lower back and
posterior thigh regions.
Flexibility

Lack of flexibility in this area may be
associated with an increased risk for the
development of chronic lower back
pain.
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).
Flexibility

Accordingly, exercise programs for the
elderly should emphasize proper
stretching, especially for the upper and
lower trunk, neck, and hip regions.
Flexibility

There are different types of stretching
techniques (e.g., static, ballistic, and
PNF) that can be performed.
Flexibility

All three types of stretching are
effective in increasing the ROM.
PNF

PNF stretching increases ROM by
inducing muscle relaxation through
spinal reflex mechanisms.
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.
PNF

This technique is based on the concept
of reciprocal inhibition.
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.
PNF

The isometric contraction of the
antagonists also stimulates the Golgi
tendon organs, resulting in a reflex
relaxation of the same muscle group.
PNF

Another type of PNF stretching is the
contract-relax with agonist contraction
(CRAC) technique.
PNF

This method is identical to the contractrelax technique except that the
stretching is assisted by a submaximal
contraction of the opposing (agonist)
muscle group.
PNF

Theoretically, the voluntary contraction
of the agonists induces additional
inhibitory input to the antagonists
(muscles being stretched) through
reciprocal inhibition.
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.
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.
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.
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.
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.
Why is slow, static stretching
safer than ballistic stretching?

The ballistic technique uses a relatively
fast, bouncing motion to produce
stretch.
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.
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.
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.
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.
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.
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.
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.
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.
Is PNF stretching better than
slow, static stretching?


Limited research.
It may, but it produces greater feelings
of being uncomfortable.
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.
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.
Is PNF stretching better than
slow, static stretching?

Thus, the amount of time required for
both individuals to complete the
flexibility exercises is increased.
Exercise Prescription for
Flexibility

A well-rounded program includes at
least one exercise for each of the major
muscle groups of the body.
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.
Flexibility

A general exercise prescription for
achieving and maintaining flexibility
should adhere to the following
guidelines:
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.
Risky Exercises?


Hyperextension
Hyperflexion
Safe Intensity?


The joint should not be stretched
beyond its pain-free range of motion.
Some mild discomfort will occur.
Duration of Stretch?

ACSM recommends holding the
stretched position only as long as it
feels comfortable (usually 10 to 30
seconds).
Number of Repetitions?


Beginners should start with 3 reps of
each exercise.
As flexibility improves, they may
increase the reps to 5.
Client Guidelines


Warm-up before stretching to increase
body temperature and ROM.
Stretch all major muscle groups, as well
as opposing muscle groups.
Client Guidelines

Focus on the target muscle involved in
the stretch, relax the target muscle, and
minimize the movement of other body
parts.
Client Guidelines


Hold the stretch for 10 to 30 seconds.
Stretch to the limit (endpoint) of the
movement, not to the point of pain.
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.