Chapter 14 - Flexibility Training Concepts

flexibility

the normal extensibility of soft tissues that allows for full range of motion of a joint

extensibility

capability to be elongated or stretched

range of motion (ROM)

the degree to which specific joints or body segments can move; often measured in degrees

mobility

optimal flexibility and joint range of motion; ability to move freely

myofascial

the body’s connective tissue that includes muscles and fascia

relative flexibility

the process in which the body seeks the path of least resistance during functional movements

human movement system (HMS)

the collective components and structures that work together to move the body: muscular, skeletal, and nervous systems

soft tissue

tissue connecting, supporting, and surrounding bodily structures and organs

which portion of a client’s exercise program should be designed **first**?

the flexibility portion

postural distortion imbalances

predictable patterns of muscle imbalances

muscle imbalances

when muscles on each side of a joint have altered length-tension relationships

force-couple relationships

the synergistic action of multiple muscles working together to produce movement around a joint

osteokinematic

movement of a limb that is visible

arthrokinematics

the description of joint surface movement; consists of three major types: roll, slide, and spin

reciprocal inhibition

when an agonist receives a signal to contract, its functional antagonist also receives an inhibitory signal allowing it to lengthen

altered reciprocal inhibition

occurs when an overactive agonist muscle decreases the neural drive to its functional antagonist

overactive

when elevated neural drive causes a muscle to be held in a chronic state of contraction

underactive

when a muscle is experiencing neural inhibition and limited neuromuscular recruitment

synergistic dominance

the neuromuscular phenomenon that occurs when synergists take over function for a weak or inhibited prime mover (agonist)

altered length-tension relationship

when a muscle’s resting length is too short or too long, reducing the amount of force it can produce

neuromuscular effciency

the ability of the nervous system to recruit the correct muscles to produce force, reduce force, and dynamically stabilize the body’s structure in all three planes of motion

muscle spindle

sensory receptors sensitive to change in length of the muscle and the rate of that change

central nervous system

a division of the nervous system that includes the brain and spinal cord

stretch reflex

neurological signal from the muscle spindle that causes a muscle to contract to prevent excessive lengthening

golgi tendon organ (GTO)

a specialized sensory receptor located at the point where skeletal muscle fibers insert into the tendons of skeletal muscle; sensitive to changes in muscular tension and rate of tension change

autogenic inhibition

the process by which neural impulses that sense tension are greater than the impulses that cause muscles to contract, providing an inhibitory effect to the muscle spindles

lengthening reaction

when a muscle is lengthened, a cascade of neurological reactions occur that allows the muscle to be stretched

static stretching

a type of stretch where the muscle is passively lengthened to the point of tension and held for a sustained amount of time

pattern overload

consistently repeating the same pattern of motion over long periods of time that can lead to dysfunction or injury

cumulative injury cycle

a cycle whereby tissue trauma will induce inflammation, muscle spasm, adhesions, altered neuromuscular control, and muscle imbalances

nociceptors

pain receptors located in the skin and fascial connective tissues

davis’s law

states that soft tissue models along the line of stress

collagen matrix

a complex meshwork of connective tissue, including collagen proteins

with regard to the cumulative injury cycle, current theory supports the idea that repetitive movements, such as long periods of poor posture, are believed to lead to which of the following?

tissue trauma and inflammation

self-myofascial techniques

techniques used for treating and breaking up adhesions of the fascia and the surrounding muscle tissues; examples include foam rolling or self-massage

fascial system

a web of connecting fibers made of connective tissues that are found just under the skin

mechanical effect

having a physical effect

neurophysiological effect

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having an effect on the nervous system

delayed-onset muscle soreness (DOMS)

pain or discomfort often felt 24 to 72 hours after intense exercise or unaccustomed physical activity

SMR: calves

crossing one leg on top of the other is optional and is used to increase pressure to the calf

roll along the length of the calf muscles

SMR: peroneals

stacking the legs is optional and is used to increase pressure on the peroneals

roll along the length of the muscle. Avoid rolling over the knee joint

SMR: hamstrings

while sitting, the target leg is straight with the roller underneath the posterior thigh, and the opposite knee is flexed

roll along the length of the muscle

avoid rolling over the knee joint

using a massage ball instead of a foam roller is a progression for this exercise and can help pinpoint tender areas

SMR: quadriceps

the client is in the plank position with knees straight and roller under the quadriceps

roll along the length of the muscle

this exercise can be performed bilaterally (both legs) or unilaterally (one leg at a time)

avoid rolling over the knee joint

SMR: adductors

to perform this technique correctly, the foam roller should be placed perpendicular to the inner thigh

roll the length of the muscle

avoid rolling over the knee joint

SMR: lateral thigh

the client is side-lying with the roller under the lateral thigh

the opposite hip and knee are bent with foot flat on the floor

roll along the length of the lateral thigh. Avoid rolling over the hip or knee joint

this exercise can be too painful for some individuals

if this occurs, opt for a handheld roller instead

SMR: tensor fascia latae

the tensor fascia latae (TFL) is a small muscle, so this technique does not require lots of movement

to target the TFL, roll along the front and slightly lateral (outside) part of the upper thigh (just below the pelvis)

avoid rolling over the hip bone

SMR: piriformis

the piriformis is a small muscle of the posterior hip that runs horizontally across the pelvis

to target the piriformis, sit on top of the foam roll, positioned on the back of the hip

cross one foot to the opposite knee and lean into the hip of the crossed leg. Roll back and forth over the muscle

avoid rolling over the hip bone

SMR: thoracic spine

the client keeps the bridge position and rolls along the thoracic spine

the client can choose to support their head in their hands (as shown) or cross their arms in front of their chest

this is a good technique to gain thoracic extension of the spine

avoid rolling over the low-back (lumbar spine) and neck (cervical spine)

SMR: latissimus dorsi

to target the latissimus dorsi, lie on the floor on one side with the arm closest to the floor outstretched and thumb facing upward

place the foam roller under the armpit area (axillary region) and slowly roll until a tender spot is identified

medical precautions

any medical conditions that could be potentially unsafe for a client

hypertension, osteopenia, pregnancy, diabetes, varicose veins, rolling over bony prominences or regions, abnormal sensations, sensitivity to pressure, recent injury or surgery, etc.

contraindications

a specific situation where a medication, procedure, or exercise should be avoided because it may prove to be harmful to the individual

skin rash, open wounds, blisters, local tissue inflammation, bruises, or tumors, deep vein thrombosis, osteomyelitis, osteoporosis, bone fracture of myositis ossificans, cancer/malignancy, hypertension (uncontrolled), etc.

TRUE OR FALSE: the mechanical effect of direct roller compression is the relaxation of the local myofascia by increasing local blood flow and reducing myofascial restriction and adhesions

true

stretch tolerance

the ability to experience the physical sensations of stretching to reduce the discomfort felt at the end range of motion

static gastrocnemius stretch

stand in a lunge position with both feet pointing straight forward

make sure to keep the rear foot flat on the ground

do not let the heel rise

shift weight forward until a stretch is felt in the rear calf muscle

static soleus stretch

stand in a lunge position with both feet pointing straight forward and back knee slightly flexed

make sure to keep the rear foot flat on the ground

do not let the heel rise up

shift weight forward until a stretch is felt in the rear calf muscle

static 90/90 hamstring stretch

lie supine with one hip flexed 90 degrees (target leg) and the opposite leg straight and flat on the floor

straighten the target leg until a mild stretch is felt in the hamstrings

the use of a rope or band is suggested

the stretch should not cause pain or extreme discomfort

static supine bicep femoris stretch

lie supine with one hip flexed 90 degrees (target leg) and the opposite leg straight and flat on the floor

next, adduct the target leg across the body and extend the knee until a mild stretch is felt in the lateral hamstrings

the stretch should not cause pain or extreme discomfort

keep both shoulders flat on the ground during this stretch

avoid rotating the torso toward the stretched leg

static standing bicep femoris stretch

use a low box or step to perform this stretch

place one leg on top of the box in an adducted and internally rotated position

then, locking the hands together, slowly rotate the torso in the opposite direction

the stretched leg does not need to be elevated above hip height

this stretch emphasizes the lateral hamstring

static seated ball adductor stretch

sit on a stability ball in a lateral lunge position until a stretch is felt in the inner thigh area

posteriorly rotate the pelvis and draw in the abdominals when performing this stretch

static standing adductor stretch

stand with legs apart and shift weight to one side (lateral lunge position) until a stretch is felt in the inner thigh of the target leg

posteriorly rotate the pelvis and draw in the abdominals when performing this stretch

static adductor magnus stretch

while standing with one foot on a bench or plyo box, reach down to a comfortable position without excessively rounding the spine until a stretch is felt

static standing TFL stretch

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stand in a staggered stance with the front leg slightly bent and rear leg straight

externally rotate the rear foot, draw in the navel, and posteriorly rotate the pelvis

squeeze the gluteal muscles of the side being stretched

as a progression, raise the arm (on the same side as the back leg) up and over to the opposite side while maintaining pelvis position

hold side bend position as illustrated

static kneeling hip flexor stretch

kneel with front and back legs flexed at a 90-degree angle

draw in the navel and posteriorly rotate the pelvis

squeeze the gluteal muscles of the side being stretched

as a progression, raise the arm (on the same side as the back leg) up and over to the opposite side while maintaining pelvis position

hold side bend position and slowly rotate posteriorly as illustrated

to emphasize the TFL, externally rotate the rear leg, whereas to emphasize the psoas, internally rotate the rear leg

static supine piriformis stretch

lie supine and cross one leg over the opposite leg that is straight

keep the low-back in a neutral position while bringing the knee toward the opposite shoulder

stati erector spinae stretch

sit with one leg crossed over the other and opposite knee straight

rotate the torso to the right when the right leg is crossed over the left leg

rotate to the left when the left leg is crossed over the right leg

static ball latissimus dorsi stretch

in the quadruped position, put one arm on top of a stability ball and roll forward until a stretch is felt

posteriorly rotate the pelvis, point the thumb up toward the sky, and draw in the abdominals when performing this stretch

static pectoral stretch

standing with one arm in a 90/90 arm position, lean forward until a stretch is felt in the anterior shoulder and chest area

do not allow the shoulders to elevate (shrug) during this stretch

static upper trapezius/scalene stretch

grasp the top of the head with one hand and laterally flex toward the same shoulder

do not allow the chin to jut forward or shoulders to shrug during this stretch

static levator scapulae stretch

grasp the top of the head with one hand and laterally flex toward the same shoulder

next, slightly rotate the head to look in the axillary (armpit) region as shown

do not allow the chin to jut forward or shoulders to shrug during this stretch

static sternocleidomastoid stretch

grasp the top of the head with one hand and laterally flex toward the same shoulder

rotate the head up and away as shown

only perform this stretch to the point of mild tension

do not allow the chin to jut forward or shoulders to shrug during this stretch

what is the **minimum** duration for which a static stretch should be held?

30 seconds

TRUE OR FALSE: static stretching, when performed for 30 seconds or less prior to every workout and followed by dynamic activities, impairs athletic performance

false

active stretching

a type of stretching that uses agonists and synergists to dynamically move the joint into a range of motion; includes holding the stretched position for 1–2 seconds and repeating for 5–10 repetitions

active gastrocnemius stretch

stand with back hip and knee straight (target leg)

the opposite hip and knee are flexed and swing back and forth across the body

this motion causes rotation at the back knee and eversion and inversion of the foot and ankle

repeat for the desired number of repetitions

active soleus stretch

stand with back hip and knee slightly flexed (target leg)

the opposite hip and knee are flexed and swing back and forth across the body

this motion causes rotation at the back knee and eversion and inversion of the foot and ankle

repeat for the desired number of repetitions

active 90/90 hamstring stretch

lie supine with one hip flexed 90 degrees (target leg)

straighten the target leg until a mild stretch is felt in the hamstrings

the stretch should not cause pain or extreme discomfort

repeat for the desired number of repetitions

active supine bicep femoris stretch

lie supine with one hip flexed 90 degrees (target leg) and the opposite leg straight and flat on the floor

next, adduct the target leg across the body and extend the knee until a mild stretch is felt in the lateral hamstrings

the stretch should not cause pain or extreme discomfort

keep both shoulders flat on the ground during this stretch

avoid rotating the torso toward the stretched leg

repeat for the desired number of repetitions

active standing adductor stretch

stand with legs spread apart and shift weight to one side (lateral lunge position) until a stretch is felt in the inner thigh area

posteriorly rotate the pelvis and draw in the abdominals when performing this stretch

repeat for the desired number of repetitions

active ball adductor stretch

sit on a stability ball in a lateral lunge position until a stretch is felt in the inner thigh area

posteriorly rotate the pelvis and draw in the abdominals when performing this stretch

repeat for the desired number of repetitions

active adductor magnus stretch

while standing with one foot on a bench or plyo box, reach down to a comfortable position without excessively rounding the spine until a stretch is felt

repeat for the desired number of repetitions

active standing TFL stretch

stand in a staggered stance with the front leg slightly bent and rear leg straight

externally rotate the rear foot, draw in the navel, and posteriorly rotate the pelvis

squeeze the gluteal muscles of the side being stretched

as a progression, raise the arm (on the same side as the back leg) up and over to the opposite side while maintaining pelvis position

hold side bend position and repeat for the desired number of repetitions

active kneeling hip flexor stretch

kneel with front and back legs flexed at a 90-degree angle

draw in the navel and posteriorly rotate the pelvis. Squeeze the gluteal muscles of the side being stretched

as a progression, raise the arm (on the same side as the back leg) up and over to the opposite side while maintaining pelvis position

hold side bend position and slowly rotate posteriorly as illustrated

to emphasize the TFL, externally rotate the rear leg, whereas to emphasize the psoas, internally rotate the rear leg

repeat for the desired number of repetitions

active latissimus dorsi ball stretch

in the quadruped position, put one arm on top of a stability ball and roll forward until a stretch is felt

posteriorly rotate the pelvis, point the thumb up toward the sky, and draw in the abdominals when performing this stretch

repeat for the desired number of repetitions

active pectoral stretch

standing with one arm in a 90/90 arm position, lean forward until a stretch is felt in the anterior shoulder and chest area

do not allow the shoulders to elevate (shrug) during this stretch

repeat for the desired number of repetitions

active upper trapezius/scalene stretch

grasp the top of the head with one hand and laterally flex toward the same shoulder

do not allow the chin to jut forward or shoulders to shrug during this stretch

repeat for the desired number of repetitions

active levator scapulae stretch

grasp the top of the head with one hand and laterally flex toward the same shoulder

next, slightly rotate the head to look in the axillary (armpit) region as shown

do not allow the chin to jut forward or shoulders to shrug during this stretch

repeat for the desired number of repetitions

active sternocleidomastoid stretch

grasp the top of the head with one hand and laterally flex toward the same shoulder

rotate the head up and away as shown

only perform this stretch to the point of mild tension

do not allow the chin to jut forward or shoulders to shrug during this stretch

repeat for the desired number of repetitions

dynamic stretching

a type of stretching that uses the force production of a muscle and the body’s momentum to take a joint through the full available range of motion

prisoner squat

with arms behind the head and feet approximately shoulder-width apart, perform a bodyweight squat

as a progression to this exercise, add a calf raise at the top position after performing the squat

mutliplanar lunge with reach

perform the lunge in all three planes of motion: sagittal, frontal, and transverse

in other words, perform a forward lunge, lateral lunge, and turning lunge

lunge with rotation

perform a forward lunge with trunk rotation toward the outside portion of the forward leg

this exercise can be performed with or without an external load, such as a medicine ball

tube walking: side to side

place elastic tubing around the knees, maintain a quarter squat position, and sidestep for the desired number of repetitions in each direction

make sure the knees are tracking in line with the second and third toes

do not allow the knees to cave inward

this exercise primarily targets the hip abductors, such as the gluteus medius

the band can also be placed around the ankles (as shown) as a progression to this exercise

leg swings: front to back

in standing position, swing one leg in a controlled pendulum fashion to the front and back, only lifting the leg as high as can safely be controlled

keep a tall, upright posture with the abdominals drawn in during the duration of the exercise

leg swings: side to side

in standing position, swing one leg in a controlled pendulum fashion from side to side

like front to back hip swings, keep a tall, upright posture with the abdominals drawn in during the duration of the exercise

frankenstein

this technique is performed while walking forward with arms stretched out away from the body

only lift each leg as high as can be safely controlled while maintaining ideal posture

keep a neutral back without leaning to the left or right

this exercise helps stretch the hamstrings

high knee

this technique is performed while walking forward

with each step, flex the hip as high as can be controlled, grasping the knee at the top with both hands

be sure to pause at the top and switch legs with each step

push-up with rotation

perform a bodyweight push-up with a trunk rotation at the top

keep the abdominals drawn in, chin tucked, and spine in a neutral position throughout the exercise

ball russian twist

while bridging on a stability ball, perform trunk rotation

this exercise targets the internal and external obliques in addition to the gluteus maximus because it requires the participant to maintain a bridged position

the exercise can be performed with or without external load, such as using a medicine ball

arm circles

perform arm circles in both directions using a slow to moderate speed

jumping jacks

when performing jumping jacks as a dynamic warm-up, the goal is to slightly elevate heart and respiration rates without causing undue fatigue