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Stretching(lecture 3)
By: Dr. Khazima Asif
Copyright 2008 PresentationFx.com | Redistribution Prohibited | Image © 2008 Thomas Brian | This text section may be deleted for presentation.
Procedural Guidelines for
Application of Stretching
Interventions
Examination and Evaluation of the
Patient:
• Carefully review the patient’s history
and perform a thorough systems
review.
• Select and perform appropriate
tests and measurements.
• Determine if hypomobility is related
to other impairments of body
structure.
Copyright 2008 PresentationFx.com | Redistribution Prohibited | Image © 2008 Thomas Brian | This text section may be deleted for presentation.
• When moving the patient’s extremities or
spine, pay close attention to the patient’s
reaction to movements to determine the
probable dosage (such as intensity and
duration) of stretch that stays within the
patient’s comfort range.
• Assess the underlying strength of muscles
in which there is limitation of motion.
• Be sure to determine what outcome goals
(i.e., functional improvements) the patient is
seeking.
• Analyze the impact of any factors that could
adversely affect the projected outcomes of
the stretching program.
Preparation
for Stretching
Copyright 2008 PresentationFx.com | Redistribution Prohibited | Image © 2008 Thomas Brian | This text section may be deleted for presentation.
• Review the goals and desired outcomes.
• Select the stretching technique.
• Warm up.
• Comfortable stable position.
• Explain the procedure to the patient.
• Free the area to be stretched of any
restrictive clothing.
• Explain to the patient that it is important to
be as relaxed as possible.
Application of Manual
Stretching
Procedures
• Do not attempt to gain the full
range in one or two treatment
sessions. Resolving mobility
impairment is a slow, gradual
process. It may take several
weeks of stretching to see
significant results. Between
stretching sessions, it is important
to use the newly increased range
to maintain what has been gained.
After Stretching
• Apply cold to the soft tissues that have
been stretched and allow these
structures to cool in a lengthened
position.
• Regardless of the type of stretching
intervention used, have the patient
perform active ROM and strengthening
exercises through the gained range
immediately after stretching.
• Develop a balance in strength in the
antagonistic muscles in the new range,
so there is adequate neuromuscular
control and stability as flexibility
increases.
Precautions for
Stretching
• Do not passively force a joint beyond
its normal ROM.
• Use extra caution in patients with
known or suspected osteoporosis due
to disease, prolonged bed rest, age, or
prolonged use of steroids.
• Protect newly united fractures.
• Avoid stretching edematous tissue.
• Avoid overstretching weak muscles.
• Progress the dosage (intensity,
duration, and frequency) of stretching
interventions gradually to minimize soft
tissue trauma and post exercise
muscle soreness
Common Errors and
Potential Problems
• Nonselective or poorly balanced
stretching activities.
• Insufficient warm-up.
• Ineffective stabilization.
• Use of ballistic stretching.
• Excessive intensity.
• Abnormal biomechanics: “hurdler’s”
stretch.
Adjuncts to Stretching
Interventions
1.Relaxation Training.
Common Elements of Relaxation Training:
• Relaxation training involves a reduction in
muscle tension in the entire body or the
region that is painful or restricted by using
conscious effort and thought.
• Training occurs in a quiet environment
with low lighting and soothing music or an
auditory cue on which the patient may
focus.
• The patient performs deep breathing
exercises or visualizes a peaceful scene.
• When giving instructions, the therapist
uses a soft tone of voice.
Examples of Approaches to
Relaxation Training
• Autogenic training.
• Progressive relaxation.
• Awareness through
movement.
2.Pilates
• Components of a Pilates
exercise session typically
include deep breathing and
core stabilization exercises,
focus on activation and
relaxation of specific muscle
groups, posture control and
awareness training, strength
training (primarily using body
weight as resistance), balance
exercises, and flexibility
exercises.
Stretching lec 3
3.Heat
• Methods of Warm-Up
• Superficial heat (hot packs, paraffin) or
deep-heating modalities (ultrasound,
shortwave diathermy) provide different
mechanisms to heat tissues.
• These thermal agents are used primarily to
heat small areas such as individual joints,
muscle groups, or tendons and may be
applied prior to or during the stretching
procedure.
• Low-intensity, active exercises, which
generally increase circulation and core
body temperature, also have been used as
a mechanism to warm up large muscle
groups.
• Some common warm-up
exercises are a brief walk, non
fatiguing cycling on a stationary
bicycle, use of a stair-stepping
machine, active heel raises, or
a few minutes of active arm
exercises.
4.Cold
• Cooling soft tissues in a
lengthened position after
stretching has been shown to
promote more lasting increases
in soft tissue length and
minimize post stretch muscle
soreness.
5.Massage
• Increases circulation to
muscles and decrease
muscle spasm, it is a
useful adjunct to
stretching exercises.
6.Biofeedback
• Biofeedback
instrumentation.
• Through visual or
auditory feedback, a
patient can begin to
sense or feel what
muscle relaxation is.
Stretching lec 3
7.Joint Traction or
Oscillation
• Slight manual distraction of joint
surfaces prior to or in
conjunction with joint
mobilization/manipulation
techniques or stretching a
muscle-tendon unit can be used
to inhibit joint pain and spasm
of muscles around a joint.
Stretching lec 3
Activity no.1
• Identify a recreational/sport
activity that your partner
enjoys (i.e., tennis, golf,
cycling, jogging, etc.) and
design and demonstrate a
program of self-stretching
exercises to prepare your
partner for the activity and
reduce the risk of injury.
Activity no.2
• Design an effective and
efficient series of self-
stretching exercises that a
person who works at a desk
most of the day could
incorporate into a daily
home fitness routine.
• Demonstrate and teach
each self-stretching
exercise to your laboratory
partner.
Stretching lec 3

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Stretching lec 3

  • 1. Stretching(lecture 3) By: Dr. Khazima Asif Copyright 2008 PresentationFx.com | Redistribution Prohibited | Image © 2008 Thomas Brian | This text section may be deleted for presentation.
  • 2. Procedural Guidelines for Application of Stretching Interventions Examination and Evaluation of the Patient: • Carefully review the patient’s history and perform a thorough systems review. • Select and perform appropriate tests and measurements. • Determine if hypomobility is related to other impairments of body structure. Copyright 2008 PresentationFx.com | Redistribution Prohibited | Image © 2008 Thomas Brian | This text section may be deleted for presentation.
  • 3. • When moving the patient’s extremities or spine, pay close attention to the patient’s reaction to movements to determine the probable dosage (such as intensity and duration) of stretch that stays within the patient’s comfort range. • Assess the underlying strength of muscles in which there is limitation of motion. • Be sure to determine what outcome goals (i.e., functional improvements) the patient is seeking. • Analyze the impact of any factors that could adversely affect the projected outcomes of the stretching program.
  • 4. Preparation for Stretching Copyright 2008 PresentationFx.com | Redistribution Prohibited | Image © 2008 Thomas Brian | This text section may be deleted for presentation. • Review the goals and desired outcomes. • Select the stretching technique. • Warm up. • Comfortable stable position. • Explain the procedure to the patient. • Free the area to be stretched of any restrictive clothing. • Explain to the patient that it is important to be as relaxed as possible.
  • 5. Application of Manual Stretching Procedures • Do not attempt to gain the full range in one or two treatment sessions. Resolving mobility impairment is a slow, gradual process. It may take several weeks of stretching to see significant results. Between stretching sessions, it is important to use the newly increased range to maintain what has been gained.
  • 6. After Stretching • Apply cold to the soft tissues that have been stretched and allow these structures to cool in a lengthened position. • Regardless of the type of stretching intervention used, have the patient perform active ROM and strengthening exercises through the gained range immediately after stretching. • Develop a balance in strength in the antagonistic muscles in the new range, so there is adequate neuromuscular control and stability as flexibility increases.
  • 7. Precautions for Stretching • Do not passively force a joint beyond its normal ROM. • Use extra caution in patients with known or suspected osteoporosis due to disease, prolonged bed rest, age, or prolonged use of steroids. • Protect newly united fractures. • Avoid stretching edematous tissue. • Avoid overstretching weak muscles. • Progress the dosage (intensity, duration, and frequency) of stretching interventions gradually to minimize soft tissue trauma and post exercise muscle soreness
  • 8. Common Errors and Potential Problems • Nonselective or poorly balanced stretching activities. • Insufficient warm-up. • Ineffective stabilization. • Use of ballistic stretching. • Excessive intensity. • Abnormal biomechanics: “hurdler’s” stretch.
  • 9. Adjuncts to Stretching Interventions 1.Relaxation Training. Common Elements of Relaxation Training: • Relaxation training involves a reduction in muscle tension in the entire body or the region that is painful or restricted by using conscious effort and thought. • Training occurs in a quiet environment with low lighting and soothing music or an auditory cue on which the patient may focus. • The patient performs deep breathing exercises or visualizes a peaceful scene. • When giving instructions, the therapist uses a soft tone of voice.
  • 10. Examples of Approaches to Relaxation Training • Autogenic training. • Progressive relaxation. • Awareness through movement.
  • 11. 2.Pilates • Components of a Pilates exercise session typically include deep breathing and core stabilization exercises, focus on activation and relaxation of specific muscle groups, posture control and awareness training, strength training (primarily using body weight as resistance), balance exercises, and flexibility exercises.
  • 13. 3.Heat • Methods of Warm-Up • Superficial heat (hot packs, paraffin) or deep-heating modalities (ultrasound, shortwave diathermy) provide different mechanisms to heat tissues. • These thermal agents are used primarily to heat small areas such as individual joints, muscle groups, or tendons and may be applied prior to or during the stretching procedure. • Low-intensity, active exercises, which generally increase circulation and core body temperature, also have been used as a mechanism to warm up large muscle groups.
  • 14. • Some common warm-up exercises are a brief walk, non fatiguing cycling on a stationary bicycle, use of a stair-stepping machine, active heel raises, or a few minutes of active arm exercises.
  • 15. 4.Cold • Cooling soft tissues in a lengthened position after stretching has been shown to promote more lasting increases in soft tissue length and minimize post stretch muscle soreness.
  • 16. 5.Massage • Increases circulation to muscles and decrease muscle spasm, it is a useful adjunct to stretching exercises.
  • 17. 6.Biofeedback • Biofeedback instrumentation. • Through visual or auditory feedback, a patient can begin to sense or feel what muscle relaxation is.
  • 19. 7.Joint Traction or Oscillation • Slight manual distraction of joint surfaces prior to or in conjunction with joint mobilization/manipulation techniques or stretching a muscle-tendon unit can be used to inhibit joint pain and spasm of muscles around a joint.
  • 21. Activity no.1 • Identify a recreational/sport activity that your partner enjoys (i.e., tennis, golf, cycling, jogging, etc.) and design and demonstrate a program of self-stretching exercises to prepare your partner for the activity and reduce the risk of injury.
  • 22. Activity no.2 • Design an effective and efficient series of self- stretching exercises that a person who works at a desk most of the day could incorporate into a daily home fitness routine. • Demonstrate and teach each self-stretching exercise to your laboratory partner.