Flexibility/ROM Flashcards
1
Q
Flexibility vs. ROM
A
- Flexibility
~ Musculotendinous unit’s ability to
elongate with application of force - ROM
~ Amount of mobility of a joint
~ Determined by soft tissues and bony
structures - ROM may be limited due to a lack of
flexibility
2
Q
Flexibility/ROM Importance
A
- Allows for proper quantity and quality of
movement
~ Decreases compensations in the
Kinetic Chain
> Allows all links to contribute to the
activity
~ Allows for greater “forgiveness” in
prevention of injury
3
Q
Flexibility/ROM Limiting Factors
A
- Muscle spasm
~ Natural reaction to pain/injury
~ Part of the pain/spasm/stasis cycle
~ Body’s way of bracing the area to
protect the injured structures - Scar tissue
~ Both positive and negative
~ Scar tissue is less flexible than other
tissue = limiting
~ Can be modified with stress to avoid
limitation
~ Adhesion
> Scar tissue formation between
layers of soft tissue
~ Joint Contracture
> Loss of ROM typically due to scar
tissue formation or lack of
flexibility in joint capsule - Neural Factors
~ Nervous system is continuous
> Impingement at any site can cause
tension throughout the system - Tension
~ Nervous system is enclosed in Fascia
that can be injured or tightened with
immobilization - Effects of Immobilization
4
Q
Flexibility/ROM Limiting Factors: Effects of Immobilization
A
- Connective Tissues
~ Tissue Composition
> Collagen
> Elastin
> Fibroblasts
> Ground Substance
• Organic gel that lubricates and
maintains space between fibers
~ Immobilization decreases the amount
of Ground Substance decreasing
space and lubrication
> CT becomes tight - Muscle
~ Fibers and bundles are wrapped in
CT that can tighten
> Due to decreased Ground
Substance
~ Muscle will adapt to immobilized
position by changing its resting
length
5
Q
Techniques to Increase Flexibility/ROM
A
- ROM Exercise
~ PROM
> Causes scar tissue to be laid down
in a more organized way
> Moves synovial fluid to nourish
cartilage
> No output
> Must use care to not disrupt
healing~ Once done, AROM > Causes scar tissue to be laid down in an even more organized way > Moves synovial fluid to nourish cartilage > Output occurs > Must use care to not disrupt healing ~ Once done, RROM and or Functional Activity
6
Q
Stretching Techniques: Static
A
- Lengthening or decreasing tone of a
muscle by placing it in a position of
stretch (tension) and holding it for an
extended amount of time
~ Holding it activates the GTO causing
the muscle to relax
~ Causes habituation of the MS,
decreasing their activation due to
repeated or prolonged stimulation
~ Duration of Hold Time: 15-30 seconds
is optimal - Can’t be done too early, it can disrupt
healing if a muscle strain is present
7
Q
Stretching Techniques: Balistic
A
- Repetitive bouncing motions
~ Antagonist is inhibited by contraction
of the agonist allowing for greater
degree of movement
> Reciprocal Inhibition (RS)
> Retraining/Neurological Effects
• Closely mimics the way muscles
function during activity: Muscles
are eccentrically loaded before
contracting concentrically during
functional activity - does not
contribute to lengthening, but
prepares muscles to work
efficiently
8
Q
Stretching Techniques: Proprioceptive Neuromuscular Facilitation (PNF)
A
- Techniques use the GTO, MS, and RS to
increase flexibility
9
Q
PNF Contract Relax Technique: GTO
A
- Limb is passively moved to a position
where resistance is sensed - Pt. is instructed to perform an isotonic
contraction against resistance for
5-10 seconds - The muscle being treated is relaxed and
the limb is passively moved to a new
point of resistance - This process is repeated a total of 3 times
10
Q
PNF Hold Relax Technique: GTO
A
- Limb is passively moved to a position
where resistance is sensed - Pt. is instructed to perform an isometric
contraction (GTO) against resistance for
5-10 seconds - The muscle being treated is relaxed and
the limb is passively moved to a new
point of resistance - This process is repeated a total of 3 times
11
Q
PNF Slow Reversal Hold Relax Technique: RI & GTO
A
- Limb is actively moved to a position
where resistance is sensed - Pt. is instructed to perform an isometric
contraction (GTO) against resistance for
5-10 seconds - The muscle being treated is relaxed and
the limb is actively (RI) moved to a new
point of resistance - This process is repeated a total of 3 times
12
Q
Active Isolated Stretching: RI
A
- Limb is moved to the end ROM by one
muscle group and a 2 second stretch is
applied with external assistance - Increases flexibility by stretching CT and
lengthening it to a new length
13
Q
Joint Mobilization
A
- Used when limitation for Flexibility/ROM
is associated with the CT of the joint
~ Joint capsule
~ Ligaments
~ Caused by tight CT due to inactivity
and or scar tissue - Can also be used to reduce pain
14
Q
Joint Mobilization Characteristics
A
- Passive
- Technique may be oscillatory or a
sustained stretch - Techniques typically uses accessory
movements to enhance physiological
movement
~ Physiological
> Movements the pt. can do
voluntarily (In/Ex rotation of
shoulder)
~ Accessory
> Movements that are necessary for
normal ROM but can’t be
performed by pt.
> Occurs during physiological
movements (Ex rotation and
translation of humeral head
during Ex rotation of shoulder)
15
Q
Joint Shapes
A
- Ovoid
~ One surface is convex and the other is
concave
~ Tibiofemoral Joint - Sellar/Saddle
~ One surface is concave in one
direction and convex in the other with
the other bone being convex and
concave, respectively
~ Articulation between thumb and
trapezium carpal bone
16
Q
Joint Mobilization: Accessory Motions
A
- Rolling
~ New points of one surface meet new
points on the opposing surface
~ Never alone - Sliding
~ Same point on one surface comes into
contact with new points on the
opposing surface
~ Gets taken of advantage of during
Joint Mobilization
~ Never alone - Spinning
~ Rotation around a stationary axis
~ Same point on the moving surface
creates an arc on the opposing
surface
~ Never alone - Compression and Distraction
17
Q
Concave - Convex Rule: Concave on Convex Movement
A
- Key to knowing in which direction to
mobilize a joint - Concave surface moving on convex
surface moves in in the same direction as
the moving bone
~ Slide occurs in the same direction as
the physiological movement
> Posterior rolling = posterior
sliding
> Ex: Open chain knee extension to
flexion
18
Q
Concave - Convex Rule: Convex on Concave Movement
A
- Convex surface moving on concave
surface - Convex surface moves in the different
direction as the moving bone - Slide occurs in the opposite direction as
the physiological movement
~ Inferior sliding = superior rolling
~ Ex: shoulder abduction/adduction
