1. Dpt 5th semester Azra naheed medical college
Stretching

2. Common Errors and Potential Problems in stretching
Nonselective or poorly balanced stretching activities.
Stretching to regions of the body that are already mobile or even hypermobile
example,
in sedentary population, some degree hypomobility
in the hip flexors
trunk flexors
shoulder extensors and internalrotators
and scapular protractors from sitting in a slumped posture.
many flexibility program emphasize exercises that stretch posterior muscle already overstretched
Result????

3. Common Errors and Potential Problems in stretching
Insufficient warm-up.
fail to warm up prior to stretching.
Ineffective stabilization.
lack effective methods of self-stabilization.
fail to stretch the tight structures and may transfer the stretch force to structures that are already mobile or even hypermobile.

4. Common Errors and Potential Problems in stretching
Use of ballistic stretching.
This form of stretching is not well controlled, it increases the
likelihood of postexercise muscle soreness and
injury to soft tissues.
Excessive intensity.
effective flexibility routine should be pro-gressed gradually
should not cause pain or excessive stress to tissues.

5. Abnormal biomechanics.
Some stretching exercises do not respect the biomechanics of the region.
For example, the “hurdler’s” stretching

6. Common Errors and Potential Problems in stretching
Insufficient information about age-related differences.
One flexibility program does not fit all age groups.
elderly individuals, whose physical activity level has diminished with age, typ-ically exhibit less flexibility than young adults.

7. Strategies for Risk Reduction
assess the appropriateness and safety of exercise
Stay up-to-date on current exercise programs
monitoring the content and safety of exercise
exercise plan should be for individ-uals of the same age or with similar pathological condi-tions.

8. Strategies for Risk Reduction
5. Eliminate or modify those exercises that are inconsistent
6. flexibility program maintains a balance of mobility between antagonistic muscle groups
7. Teach patient
basic principles of self-stretching
Educate importance of warming up prior to stretching.
how to warm up before stretching.

9. Strategies for Risk Reduction
how to provide effec-tive self-stabilization to specific muscle groups.
how to determine the appropriate intensity of stretch.
patient should know that, postexercise muscle soreness should be mild and last no more than 24 hours.

10. ADJUNCTS TO STRETCHING INTERVENTIONS

11. 1.Relaxation Training
using methods of general relaxation (total body relaxation),
help patients to relieve
pain,
muscle tension
anxiety or stress,
associated physical impairments
including tension headaches,
high blood pressure,
respiratory distress.

12. Common Elements of Relaxation Training
quiet environment with low lighting and soothing music
deep breathing exercises
visualizes a peaceful scene.
therapist uses a soft tone of voice when giving instructions
Comfortable position, and be sure that restrictive clothing is loosened.

13. Common Elements of Relaxation Training
Contraction the distal musculature in the hands or feet voluntarily for several (5 to 7) seconds and then consciously relax those muscles for 20 to 30 seconds.

14. Common Elements of Relaxation Training
Progress to a more proximal area active contract and active relaxation the more proximal musculature.
Eventually patient isometrically contract and consciously relax entire extremity.
Suggest patient to feel relaxation

15. Indicators of Relaxation
Decreased muscle tension
Lowered heart and respiratory rates and blood pressure
Increased skin temperature in the extremities associated with vasodilation
Constricted pupils

16. Indicators of Relaxation
5. Little to no body movement 6. Eyes closed and flat facial expression 7. Jaw and hands relaxed with palms open 8. Decreased distractability

17. Heat
Warming up prior to stretching increases the extensibility of contractile and non contractile soft tissues.
as temperature of muscle increases,
the amount of force required
and the time the stretch force must be applied decrease.

18. Heat
also decrease in the rate of firing of the type II efferents from the muscle spindles
and increase in the sensitivity of the GTO

19. Methods of Warm-up Superficial heat (hot packs, paraffin)
deep-heating modalities (ultrasound, shortwave diathermy)
Low-intensity, active exercises, increase circulation and core body temperature, also used to warm up prior to stretching

20. common warm-up exercises are
brief walk,
non fatiguing cycling on a stationary bicycle,
use of a stair-stepping machine,
active heel raises
a few minutes of active arm exercises

21. Effectiveness of Warm-up Methods
The use of heat alone without stretching has shown to have either little or no effect on improving muscle flexibility

22. Massage Massage for Relaxation
Local muscle relaxation can done by massage,
with light or deep stroking techniques
self-massage, using light stroking techniques (effleurage), performed for relaxation .

23. Soft Tissue Mobilization Techniques

24. Joint Traction or Oscillation
Slight manual distraction of joint surfaces prior to
joint mobilization
muscle-tendon stretching
used to inhibit joint pain and spasm of muscles around a joint