Upper and Lower Extremity Exercise

Question 1

static stretching

Answer 1

stretch is held in a challenging but comfortable position for a period of time, usually somewhere between 10 to 30 seconds
most common form of stretching
considered safe and effective for improving overall flexibility
May be much less beneficial than dynamic stretching for improving range of motion for functional movement

Question 2

dynamic stretching

Answer 2

stretch is performed by moving through a challenging but comfortable range of motion repeatedly, usually 10 to 12 times.
requires more thoughtful coordination than static stretching (because of the movement involved
more benefits in improving functional range of motion and mobility in sports and activities for daily living.
Not the same as old-fashioned ballistic stretching

Question 3

passive stretching

Answer 3

using some sort of outside assistance to help achieve a stretch
your body weight
a strap
leverage
gravity
another person
a stretching device
the muscle to be stretched is relaxed and relies on the external force to hold person in place
risk that the external force will be stronger than muscle is flexible

Question 4

active stretching

Answer 4

stretching a muscle by actively contracting the muscle in opposition to the one being stretched
do not use your body weight, a strap, leverage, gravity, another person, or a stretching device
relax the muscle that’s being stretched and rely on the opposing muscle to initiate the stretch
can be challenging because of the muscular force required to generate the stretch
frequently requires assistance from another person to direct the motion or create muscle awareness
generally considered lower risk because the stretch force is controlled with person’s own strength rather than an external force

Question 5

what is the use of toe lifts

Answer 5

Good for forefoot pronation or pes planus, plantar fasciitis, lower extremity dysfunction
Strengthens intrinsic muscles of the foot
Stand with neutral pelvic rotation (tail tucked) and neutral position of femur on tibia (knees soft)
Lift heels off floor 1 inch keeping all 10 toes on the floor
Hold for up to 30 seconds
Toes that lift up indicate specific muscle dysfunction

Question 6

pigeon pose

Answer 6

active

stretching piriformis

Question 7

passive hamstring stretch

Answer 7

just simply putting your leg up and bending over to stretch it

Question 8

dynamic hamstring stretch

Answer 8

Bend hips to 90 degrees and flex knees
Keep pelvis in anterior tilt
Extend knees and push ischial tuberosities up to the ceiling

Question 9

active psoas stretch

Answer 9

Start by kneeling on floor with one leg flexed at knee.
Invert foot on floor. Keep torso erect with neutral pelvic
rotation. Contract gluteus maximi muscles and
advance into lunge. Hold for 30 seconds.

Question 10

alpha motor neuron.

what happens with lengthening versus shortening of muscle

Answer 10

Control of muscle length by muscle spindle
Stretching muscle causes spindle to discharge more = muscle is lengthening
Contracting muscle causes spindle to be silent = muscle is shortening

Question 11

what does the golgi tendon organ do

Answer 11

Golgi tendon organ responds to stretch and contraction & initiates inhibitory reflex arc to prevent overloading the muscle

Question 12

reciprocal innervation and inhibiiton

Answer 12

Stimulating limb flexor and extensor muscles = joint stabilization
Joint flexes, flexor contracts, extensor lengthens
Joint extends, flexor lengthens, extensor contracts
Occurs ipsilaterally & contralaterally
Ipsilateral flexor contracts, contralateral flexor lengthens

Question 13

slow twitch fibers

Answer 13

Function is tonic/postural
Uses oxidative metabolism
High capillary density
Twitch speed is slow
Type I myosin heavy chain (MHC) isoform

Question 14

fast twitch muscle fibers

Answer 14

Function is phasic, muscles react by shortening and tightening
Uses glycolytic metabolism
Fatigue rapidly
Low capillary density
Twitch speed is fast
Type II MHC isoform

Question 15

psoas muscle distribution of type I and type II fibers

Answer 15

Type I muscle fibers have the largest cross-sectional area over Type II fibers

Fiber types differ in level of the muscle with Type I mostly in the cephalad portion starting from L1 to L4***

Therefore, more postural and stabilizes the lumbar spine, controls disc space anterolaterally

Type II fibers are more predominant in the caudal portion of the muscle
Therefore, more dynamic as main flexor of the hip

Question 16

what is the sumo exercise

Answer 16

dynamic stretch of the psoas

Stand with feet 18” apart
Flex knees and hips
Round spine, particularly lumbars
Use glut max to push pubes anteriorly
Keeping pubes anterior, extend knees, hips
Straighten spine by rotating at hip joints
Keep lordotic curve minimal
Repeat 3 more times

Question 17

pelvic clock

Answer 17

Naval is center of clock
Using multifides, rotatores, erector spinae, move naval to each position on clock
Do not use legs to push pelvis
Monitor via ASIS

Question 18

when there is muscle dysfunction, what happens to postural muscles and dynamic phasic muscles

Answer 18

Postural/tonic muscles become facilitated, hypertonic, shortened, tight***

• iliopsoas, rectus femoris, piriformis, adductors, TFL
• erector spinae

Dynamic/phasic muscles become inhibited, hypotonic, weak***

• glut med and max
• abdominals

Question 19

when you have muscle dysfunction of the shoulder region , what muscles are weak and what muscles are tight

Answer 19

tight
-levator scap, upper traps, pectorals

weak
-supra and infraspinatous 
-deltoid
rhomboids
lower traps
serratous anterior 
longus colli

Question 20

what is lower crossed syndrome

Answer 20

Weak gluteus maximus and tight hip flexors

Weak abdominals and short/tight lumbar erector spinae

Weak gluteus medius and minimus and short tensor fascia latae and quadratus lumborum

Anterior pelvic tilt and increased lumbar lordosis
Hypermobility in the lowest lumbar levels

Question 21

what is upper crossed syndrome

Answer 21

tight upper trapezius and levator scap

weaak deep cervical flexors

tight pectoralis and SCM

weak lower trap and serratous anterior

Question 22

how do you treat lower crossed syndrome

Answer 22

Strengthening glut max & med
Lengthens iliopsoas, rectus femoris
Engages abdominals
Causes pelvis to move into neutral tilt

Question 23

in what type of muscles do trigger points, pain and tendonitis develop

Answer 23

muscles that are weak and inhibited

Question 24

tears and ruptures develop in what type of muscles

Answer 24

tight muscles

Question 25

short and tight muscles

Answer 25

fast twitch dysfunction

Question 26

tonic/postural muscles

Answer 26

type I slow twitch

become facilitated, hypertonic, shortened

Question 27

what postural muscles of the upper extremity can become hypertonic and facilitated

Answer 27

Scalenes
Latissimus dorsi
Subscapularis
Flexors of the upper extremity
Levator scapulae
Upper trapezius
Sternocleidomastoid
Pectorals

Question 28

what dynamic muscles of the upper extremity can become weak and hypotonic

Answer 28

Middle and lower trapezius.
Serratus anterior.
Rhomboids.
Supraspinatus.
Infraspinatus.
Deltoid.
Deep neck flexors.
Extensors of the upper extremity.

Question 29

what is the upper crossed syndrome

Answer 29

Forward head posture.
Straightening of the lower cervical lordosis.
Extension of the upper cervical spine.
Increased kyphosis of the cervico-thoracic junction.
Internal rotation of the shoulder girdles

Question 30

how do you stretch the upper trap and SCM

Answer 30

hold head like football
rotate toward
side bend away from the shoulder

Question 31

how can one strengthen the lower traps

Answer 31

Sit with pelvis in neutral
Contract lower traps
If weak, strengthen by holding arms with elbows at your side, palms up.
Contract lower traps.
Pull Theraband taut by moving fists away.
Maintain contraction while releasing tension on the Theraband.
Repeat 5 more times.

Question 32

how does one retrain the longus colli

Answer 32

Hold SCMs to ensure that they do not fire during this exercise. Tuck chin to throat as far as possible. Hold for 10 seconds and repeat 3-5 times. Work up to holding tuck for 30 seconds.