1. Flexibility and Proprioception n Reading assignment: n Read pp 125-136 of text n Take quiz for Chapter 5 on text website n Self-study problems : -Introductory problems, p 136: 3,5,7,10; -Additional problems, p 137: 7

2. Objectives n Identify factors contributing to joint stability and flexibility. n Discuss role of proprioceptors in increasing flexibility (both acute and long-term) n Discuss characteristics of effective flexibility exercises, including PNF n Review common joint injuries

3. Joint flexibility – Range of Motion (ROM) n Static vs dynamic n Active vs passive n Measuring joint range of motion -Direct measurement – Goniometer (Fig 5.9, p 127) Leighton flexometer (Fig 5.10, p 127) -Indirect & composite – e.g., sit and reach n Factors influencing joint flexibility -Shape of articulating bone surfaces (ex.: forearm extension) -Intervening muscle and fat (ex. : forearm flexion) -Length of ligaments and musculotendinous units crossing joint n Flexibility and injury – -Increased potential for injury when ROM is high, low, or imbalanced

4. Measurement of Flexibility Direct Indirect, or composite

5. Normal ROM Values n Knee flexion 130-150 deg n Hip flexion 115-125 deg n Hip extension 25-35 deg (20% decrease in aged) n Arm flexion 160-180 n Arm extension 40-60 deg n General considerations -10% deviation is considered normal -Small age and gender differences Source: ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription (4 th ed). Pp 381-390)

6. Techniques for increasing joint flexibility n Focus is on increasing length of musculotendinous units crossing the joint n Neuromuscular response to stretch -The sensory unit Consists of receptors, sensory neuron Role is to provide feedback to provide body position and muscle- tendon condition sense & to enable motor control -Proprioceptors Tendon receptors (stretch-sensitive golgi tendon organ, or GTO) –Stimulation inhibits contraction of host muscle and tendon Muscle receptors (stretch-sensitive muscle spindle) –Excitation facilitates contraction of host muscle -Role of proprioception in skilled movement & flexibility Goal of proprioceptive neuromuscular facilitation (PNF) stretching technique is to minimize spindle effect and maximize GTO effect.

7. Muscle spindle

8. Reciprocal inhibition

12. Increasing flexibility n Active and passive stretching n Ballistic and static stretching n Proprioceptive Neuromuscular Facilitation:

13. Proprioceptive Neuromuscular Facilitation (PNF) n A group of stretching procedures involving alternating contraction and relaxation of the muscles being stretched. n Done to take advantage of GTO and muscle spindle response. n Many of the techniques require partner or clinician -Contract-relax-antagonist-contract technique (CRAC) -Contract-relax and hold-relax methods (CR) n Can significantly increase joint ROM over single stretching session.

14. Example of PNF Stretching using hamstrings (CRAC) n Passive stretch of hams by partner n Contract hams against partner resistance (inhibits hams via GTO excitation) -Isometricly or concentricly n Relax hams, contract quads (inhibits hams further through reciprocal inhibition via spindle excitation) -Isometricly or concentricly n Passively stretch hams n Both methods involve 4-8 reps of 10-15 seconds duration or longer

15. Common jt injuries and pathologies n Sprains- stretching or tearing of ligaments, tendons, and connective tissues crossing a joint n Dislocations – displacement of the articulating bones at a joint n Bursitis – inflammation of bursae n Arthritis – inflammation with pain and swelling -Rheumatoid arthritis autoimmune system disorder -Osteoarthritis Joint-specific, due to wear and tear