1. Flexibility and Low - Back Health
Chapter 5

2. Flexibility The range of motion in a joint or group of joints
Important for general fitness and wellness
Static versus dynamic flexibility

3. 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

4. What Determines Flexibility?
Muscle elasticity and length
Collagen = white fibers that provide structure and support
Elastin = yellow fibers that are elastic and flexible
Titin = muscle filament with elastic properties

5. Nervous System Activity
Proprioceptors send information about the muscle and skeletal systems to the nervous system
Stretch receptors (muscle spindles)
Glogi tendon organs

6. 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

7. Nervous System Activity
Proprioceptive Neuromuscular Facilitation (PNF) = a technique for stretching muscles that relies on neuromuscular reflexes to stimulate training effects

8. Nervous System Activity
Regular stretching trains all of the proprioceptors
Proprioceptors adapt very quickly to stretching and lack of stretching

9. Benefits of Flexibility and Stretching Exercises
Joint Health
Prevention of low - back pain and injuries

10. Benefits of Flexibility and Stretching Exercises
Other potential benefits
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

11. 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

12. 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

13. 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

14. Intensity and Time (Duration) of Exercise
Stretch to the point of slight tension or mild discomfort
Hold each stretch for seconds
Do two to four repetitions of each exercise
Rest for seconds between stretches

15. 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

16. Types of Stretching Techniques
Dynamic stretching = stretching by moving joints slowly through their range of motions in a controlled manner

17. 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

18. 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

19. Types of Stretching Techniques
Safest technique is active static stretching, with an occasional passive assist

20. 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

21. Low - Back Health Function of the spine
Allows movement of neck and back in all directions

22. Structure of the Spine 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)

23. 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

24. Vertebrae
Nerve roots = base of pairs of spinal nerves that branch off the spinal cord

25. 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

26. 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

27. Causes of Back Pain Any movement that causes excessive stress
Risk factors
Age greater than 34 years
Degenerative diseases
Family or personal history of back trauma
Sedentary lifestyle, overweight

28. Causes of Back Pain Risk factors
Low job satisfaction, certain occupations
Low socioeconomic status
Smoking
Psychological stress or depression

29. Underlying Causes of Back Pain
Poor muscle endurance and strength
Poor posture
Poor body mechanics

30. 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

31. Preventing Low - Back Pain
Warm up thoroughly before exercise
Progress gradually when improving strength and fitness

32. Protecting Your Back
An exercise program designed to increase flexibility and strengthen the legs, abdomen, and lower back can help prevent low - back pain

33. 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

34. 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

35. 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

36. Protecting Your Back When walking When lifting
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

37. Managing Acute Back Pain
Sudden back pain usually involves tissue injury
Symptoms
Pain
Muscle spasms
Stiffness
Inflammation

38. Managing Acute Back Pain
Treatment
Ice, then heat
OTC medication (ibuprofen or naproxen)
Moderate exercise

39. 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

40. Managing Chronic Back Pain
Treatment
Medication
Exercise
Physical therapy
Massage
Acupuncture
Education
Surgery

41. 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

42. Exercises for the Prevention and Management of Low - Back Pain
Engage in regular endurance exercise
Be patient and stick with your program