Flexibility Practical

• Non-Modifiable Factors:

• Joint Laxity: Joint laxity is produced by such extreme stretching it can lead to anterior dislocation, especially in the backstroke turn when the hand contacts the wall.

• Age: Pre-adolescents are generally more flexible than adults.

• Gender: Females are generally more flexible than males.

• How to measure flexibility:

-Goniometry: used in rehabilitation.

-Computer based tests.

-Isokinetic machine: measures range of motion.

-Field tests: e.g. sit and reach test.

• How to improve flexibility:

-Stretching is a means by which flexibility is improved and maintained and freedom of movement is increased. It reduces muscle tension and the risk of muscle and tendon injuries.

-“Stretches can be categorized as either active or passive. Active stretching occurs when the person stretching supplies the force of the stretch. Passive stretching occurs when a partner or device provides the force of the stretch. ()

• There are four commonly recognised groups of stretching techniques:

1. Static
2. Dynamic
3. Ballistic
4. Proprioceptive Neuromuscular Facilitation (PNF)

• Static Stretch

• “It is constant and the end position is held for 10-30 seconds and includes passive relaxation. There are several advantages to this type of stretching, it’s easy to learn, doesn’t elicit a stretch reflex, helps relieves soreness. Although injury can result if intensity is carried too far, there are no real disadvantages to static stretching.”()

• Many people use the term “passive stretching” and “static stretching” interchangeably. But according to M. Alter “Static stretching consists of stretching a muscle (or group of muscles) to its farthest point and then maintaining or holding that position, whereas: Passive stretching consists of a relaxed person who is relaxed (passive) while some external force (either a person or an apparatus) brings the joint through it’s range of motion.” ()

• The sitting toe touch is a good example of a static stretch.

• Dynamic Stretch

• “Involves flexibility through the use of specific sports movements and its often used as a specific warm-up. The movements mimic the actual competitive sport movement patterns, e.g., track high knees, diving twist and approach.” ()

• Dynamic stretching is similar to ballistic stretching in that it utilizes speed of movement, but dynamic stretching avoids bouncing and includes movements’ specific to a sport or movement pattern.

• According to Kurz dynamic stretching “involves moving parts of your body and gradually increasing reach, speed of movement, or both.”()

• According to Kurz, dynamic stretching exercises should be performed in sets of 8-12 repetitions.

• “An example of dynamic stretching would be a track sprinter performing long walking strides, which emphasize hip extension, while maintaining a posterior pelvic tilt. This dynamically stretches the hip flexors, providing the flexibility about the hip joints necessary for competition.” (Lab. Manual)

• Ballistic Stretch

• “Ballistic stretching uses the momentum of a moving body or a limb in an attempt to force it beyond its normal range of motion. This is stretching, or “warming-up”, by bouncing into (or out of) a stretched position, using the stretched muscles as a spring, which pulls you out of the stretched position. (E.g. bouncing down repeatedly to touch your toes). This type of stretching is not considered useful and can lead to injury. It does not allow your muscles to adjust to, and relax in, the stretched position. It may instead cause them to tighten up by repeatedly activating the stretch reflex.” ()

• Proprioceptive Neuromuscular Facilitation (PNF)

• “Proprioceptive neuromuscular facilitation (PNF) stretching was originally developed as part of a neuromuscular rehabilitation program designed to relax muscles with increased tone or activity. It has since expanded to the conditioning of athletes, as a method of increasing muscular flexibility.” (Lab. Manual)
• It is currently the fastest and effective way known to increase static-passive flexibility. It isn’t really a type of stretching but a combination of passive stretching and isometric stretching to achieve maximum static flexibility.
• “PNF refers to any of several post-isometric relaxation stretching techniques in which a muscle group is passively stretched, then contracts isometrically against a resistance while in the stretched position, and then is passively stretched again through the resulting increased range of motion. NF stretching usually employs the use of a partner to provide resistance against the isometric contraction and then later to passively take the joint through its increased range of motion. It may be performed, however without a partner, although it is usually more effective with a partner’s assistance.

                               Most PNF stretching techniques employ isometric agonist contraction/relaxation where the stretched muscles are contracted isometrically and then relaxed. Some PNF techniques also employ isometric antagonist contraction where the antagonists of the stretched muscles are contracted. In all cases it is important to note that the stretched muscle should be rested (and relaxed) for at least 20 seconds before performing another PNF technique. The most common PNF stretching techniques are:” ()

• Hold-relax/Contract relax technique:

After assuming an initial passive stretch, the muscle being stretched is isometrically contracted for 7-15 seconds, after which the muscle is briefly relaxed for 2-3 seconds, and the immediately subjected to a passive stretch which stretches the muscle even further than the initial passive stretch. This final passive stretch is held for 10-15 seconds. The muscle is then relaxed for 20 seconds before performing another PNF technique.

• Hold-relax-contract/contract-relax-contract/contract-relax-antagonist-contract (CRAC) technique:

It involves performing two isometric contractions: 1st of the agonists, then of the antagonists. The 1st part is similar to the hold-relax where, after assuming an initial passive stretch, the stretched muscle is isometrically contracted for 7-15 seconds. Then the muscle is relaxed while its antagonist immediately performs an isometric contraction that is held for 7-15 seconds. The muscles are then relaxed for 20 seconds before performing another PNF technique.

• Hold-relax-swing technique:

This technique actually involves the use of dynamic or ballistic stretches in conjunction with static and isometric stretches. It is very risky, and is successfully used only by the most advanced of athletes and dancers that have managed to achieve a high level of control over their muscle stretch reflex. It is similar to the hold-relax technique except that a dynamic or ballistic stretch is employed in place of the final passive stretch.

“PNF Stretching is not recommended for children and people whose bones are still growing. PNF stretching helps strengthen the muscles that are contracted and therefore is good for increasing active flexibility as well as passive flexibility. PNF stretching is very strenuous and should be performed for a given muscle group no more than once per day (ideally, no more than once per 36 hour period). The initial recommended procedure for PNF stretching is to perform the desired PNF technique 3-5 times for a given muscle group (resting 20 seconds between each repetition).” (www.bath.ac.uk)

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• Correct stretching technique:

• Static stretching should always be used. This involves assuming the stretch position slowly and gently, placing the muscle in a lengthened position for a number of seconds.
• Only begin to stretch after the muscles are warmed up.
• Each stretching exercise should be performed statically and progressively.
• There should be no bouncing in an attempt to increase the range of motion at a joint.
• Only stretch to the point where mild discomfort is felt. There should be no pain.
• Stretching exercises should relate to the other components in the exercise session.
• During the warm-up component of an exercise session, the stretches should be held for approximately 6-10 seconds.
• During the cool down component, the stretches can be held for approximately 6-10 seconds to maintain flexibility or approximately 30 seconds to develop flexibility. This is the ideal time to spend developing and improving flexibility.

()

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• Elements of a good stretch:

1. Isolation:

“Ideally, a particular stretch should work only the muscles you are trying to stretch. Isolating the muscles worked by a given stretch means that you don’t have to worry about having to overcome the resistance offered by more than one group of muscle. In general, the fewer muscles you try to stretch at once, the better. For example, you are better off trying to stretch one hamstring at a time than both hamstrings at once. By isolating the muscle you are stretching, you experience resistance from fewer muscle groups, which gives you greater control over the stretch and allows you to more easily change its intensity.” ()

2. Leverage:

“Having leverage during a stretch means having sufficient control over how intense the stretch becomes, and how fast. If you have good leverage, not only are you better able to achieve the desired intensity of the stretch, but also you do not need to apply as much force to your outstretched limb in order to effectively increases the intensity of the stretch. This gives you greater control.” ()

3. Risk:

“Although a stretch may be very effective in terms of providing the athlete with ample leverage and isolation, the potential risk of injury from performing the stretch must be taken into consideration.” ()

• Stretching to Increase Flexibility:

“When stretching for the purpose of increasing overall flexibility, a stretching routine should accomplish, at the very least, two goals;

1.To train your stretch receptors to become accustomed too greater muscle length.

2.To reduce the resistance of connective tissues to muscle elongation.” ()

If you are attempting to increase active flexibility you also want to strengthen the muscles responsible for holding the stretched limbs in their extended positions.

Before composing a particular stretching routine, you must first decide which types of flexibility you wish to increase, and then which stretching methods are best for achieving them. The best way to increase flexibility is by performing dynamic stretches, supplemented with static stretches. The best way to increase active flexibility is by performing active stretches, supplemented with static stretches. The fastest and most effective way currently known to increase passive flexibility is by performing PNF stretches.

Overall, you should expect to increase flexibility gradually. Don’t try to increase flexibility too quickly by forcing yourself. Stretch no further than the muscles will go without pain.

               

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• Contraindications:

• Joint:

• “Immediately post-injury as this may increase the inflammatory process.”
• “Early fractures where movement may cause disruption of a fracture site.”
• “Where pain may be beyond a persons tolerance.”
• “Muscle or ligament incomplete tears where further damage may occur.”
• “Where the circulation may be comprised.”

 (Trew and Everett, 1997)

• If a bone blocks motion.

• If one has had a recent fracture of bone.

• An acute inflammatory or infectious process in or around a joint is suspected or known.

• Osteoporosis is suspected or known.

• There is sharp, acute pain with joint movement or muscle elongation.

• One has had a recent sprain or strain.

• One suffers from certain vascular or skin diseases.

• There is a loss of function resulting in a decrease of range of motion.