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Flexibility and
Low - Back Health
Chapter 5
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Flexibility



The range of motion in a joint or
group of joints
Important for general fitness and
wellness
Static versus dynamic flexibility
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
What Determines Flexibility?

Joint structure – joints vary in
direction and range of movement

Joint capsules = semielastic
structures that give joints strength
and stability but limit movement
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
What Determines Flexibility?

Muscle elasticity and length


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Collagen = white fibers that provide
structure and support
Elastin = yellow fibers that are elastic
and flexible
Titin = muscle filament with elastic
properties
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Nervous System Activity

Proprioceptors send information
about the muscle and skeletal
systems to the nervous system


Stretch receptors (muscle spindles)
Glogi tendon organs
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Nervous System Activity

If a muscle is stretched, signals
between the stretch receptors and
nervous system control muscle
length and movement and protect
muscles from injury
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Nervous System Activity

Proprioceptive Neuromuscular
Facilitation (PNF) = a technique for
stretching muscles that relies on
neuromuscular reflexes to
stimulate training effects
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Nervous System Activity


Regular stretching trains all of the
proprioceptors
Proprioceptors adapt very quickly
to stretching and lack of stretching
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Benefits of Flexibility and
Stretching Exercises


Joint Health
Prevention of low - back pain and
injuries
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Benefits of Flexibility and
Stretching Exercises

Other potential benefits


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
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Relief of aches and pains
Relief of muscle cramps
Improved body position and strength
for sports
Maintenance of good posture and
balance
Relaxation
Lifetime wellness benefits
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Creating a Successful Program
to Develop Flexibility

Applying the FITT principle




Frequency – how often to stretch
Intensity – how far to stretch
Time – how long to stretch
Type – which stretching exercises to
perform
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Frequency of Exercise

The American College of Sports
Medicine (ACSM) recommends that
stretching exercises be performed
a minimum of two to three days
per week; ideally five to seven days
per week
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Frequency of Exercise


Stretch when muscles are warm,
either after a workout or after the
active part of a warm - up
Do not stretch before a
high - performance activity
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Intensity and Time (Duration)
of Exercise




Stretch to the point of slight tension
or mild discomfort
Hold each stretch for 15 - 30
seconds
Do two to four repetitions of each
exercise
Rest for 30 - 60 seconds between
stretches
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Types of Stretching
Techniques


Static stretching = slowly stretching
a muscle and holding the stretched
position
Ballistic stretching = suddenly
stretching a muscle through a
bouncing or swinging movement
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Types of Stretching
Techniques

Dynamic stretching = stretching by
moving joints slowly through their
range of motions in a controlled
manner
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Types of Stretching
Techniques

Proprioceptive Neuromuscular
Facilitation = obtaining a greater
training effect by using
neuromuscular reflexes;
for example, contracting a muscle
before it is stretched
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Types of Stretching
Techniques


Passive stretching = muscles are
stretched by force applied by an
outside source
Active stretching = muscles are
stretched by a contraction of the
opposing muscles
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Types of Stretching
Techniques

Safest technique is active static
stretching, with an occasional
passive assist
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Low - Back Health

Function of the spine




Provides structural support for
the body
Surrounds and protects the
spinal cord
Supports body weight
Serves as attachment site for
muscles, tendons, ligaments
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Low - Back Health

Function of the spine

Allows movement of neck and back in
all directions
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Structure of the Spine


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Seven cervical vertebrae in the neck
12 thoracic vertebrae in the upper
back
Five lumbar vertebrae in the lower
back
Nine vertebrae at the base of the
spine fused into the sacrum and the
coccyx (tailbone)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Vertebrae


Vertebrae consist of a body, an
arch, and several bony processes
Intervertebral disks = elastic disks
located between adjoining
vertebrae; consist of a gel and
water - filled nucleus surrounded by
fibrous rings; serve as
shock absorbers
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Vertebrae

Nerve roots = base of pairs of
spinal nerves that branch off the
spinal cord
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Core Muscle Fitness


Core muscles include those in the
abdomen, pelvic floor, sides of the
trunk, back, buttocks, hip,
and pelvis
Core muscles stabilize the spine
and help transfer force between the
upper body and lower body
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Core Muscle Fitness


Lack of core muscle fitness can
create an unstable spine and stress
muscles and joints
Whole body exercises and
exercises using free weights or
stability balls all build core muscle
fitness
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Causes of Back Pain


Any movement that causes
excessive stress
Risk factors


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Age greater than 34 years
Degenerative diseases
Family or personal history of back
trauma
Sedentary lifestyle, overweight
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Causes of Back Pain

Risk factors




Low job satisfaction, certain
occupations
Low socioeconomic status
Smoking
Psychological stress or depression
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Underlying Causes of
Back Pain



Poor muscle endurance
and strength
Poor posture
Poor body mechanics
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Preventing Low - Back Pain



Lose weight, stop smoking, and
reduce emotional stress
Avoid sitting, standing, or working
in the same position for too long
Use a supportive seat and a
medium - firm mattress
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Preventing Low - Back Pain


Warm up thoroughly before
exercise
Progress gradually when
improving strength and fitness
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Protecting Your Back

An exercise program designed to
increase flexibility and strengthen
the legs, abdomen, and lower back
can help prevent low - back pain
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Protecting Your Back

When sleeping


Lie on your side with your knees
and hips bent
If you lie on your back, place a pillow
under your knees
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Protecting Your Back

When sitting


Sit with your lower back slightly
rounded, knees bent and feet flat
on the floor
Alternate crossing your legs or use a
footrest to keep your knees higher
than your hips
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Protecting Your Back

When standing


Keep your weight mainly on your
heels, with one or both knees slightly
bent
Try to keep your lower back flat
(not arched) by placing one foot
on a stool
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Protecting Your Back

When walking


Keep your toes pointed straight
ahead, your back flat, head up
and chin in
When lifting

Bend at the knees and hips rather than
at the waist and lift gradually using
your leg muscles
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Managing Acute Back Pain


Sudden back pain usually involves
tissue injury
Symptoms




Pain
Muscle spasms
Stiffness
Inflammation
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Managing Acute Back Pain

Treatment



Ice, then heat
OTC medication (ibuprofen or
naproxen)
Moderate exercise
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Managing Chronic Back Pain


Considered chronic if lasts longer
than three months
Symptoms



Stabbing or shooting pain
Steady ache accompanied by stiffness
Pain that is localized or that radiates
to other parts of the body
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Managing Chronic Back Pain

Treatment







Medication
Exercise
Physical therapy
Massage
Acupuncture
Education
Surgery
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Exercises for the Prevention and
Management of Low - Back Pain



Do low - back exercises at least
three days per week
Emphasize muscular endurance
Do not do full range of motion
spine exercises early in
the morning
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Exercises for the Prevention and
Management of Low - Back Pain


Engage in regular endurance
exercise
Be patient and stick with your
program
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5
© 2007 McGraw-Hill Higher Education. All rights reserved.