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Frequency of Stretching

The document discusses different modes of stretching including manual, mechanical, and self stretching. Manual stretching is performed by a clinician and involves applying force to lengthen tissues beyond resistance. Self stretching is done independently by a patient after instruction. Mechanical stretching uses devices to apply low force over long periods to permanently lengthen tissues.

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13 views2 pages

Frequency of Stretching

The document discusses different modes of stretching including manual, mechanical, and self stretching. Manual stretching is performed by a clinician and involves applying force to lengthen tissues beyond resistance. Self stretching is done independently by a patient after instruction. Mechanical stretching uses devices to apply low force over long periods to permanently lengthen tissues.

Uploaded by

palaroankheisleemymarie
Copyright
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We take content rights seriously. If you suspect this is your content, claim it here.
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Mode of stretch: Stretching exercises can be executed in a variety of ways.

Categories include,
but are not limited to, manual and mechanical stretching or self-stretching, as well as passive,
assisted, or active stretching
Manual stretch - clinician or caregiver applies an external force that lengthens the targeted
tissue beyond the point of tissue resistance. The therapist manually controls the site of
stabilization and the direction, rate of application, intensity, and duration of stretch. Manual
stretching can be performed passively, with assistance from the patient, or even independently by
the patient. Manual stretching typically employs a controlled, static stretch applied at an intensity
consistent with the patient’s comfort level. It is held for 15 to 60 seconds and repeated for at least
several repetitions. The intensity is often increased as tolerated for subsequent repetitions in an
effort to achieve progressive lengthening.
Self stretching – (also referred to as flexibility exercises or active stretching) is a type of
stretching procedure done independently by the patient after careful instruction and supervised
practice. Self-stretching enables the patient to maintain or increase the extensibility gained as the
result of direct intervention by a therapist. This form of stretching is often an integral component
of a home exercise program and is necessary for long-term self-management of many
musculoskeletal and neuromuscular disorders.
To facilitate effectiveness, the patient must be taught to perform self-stretching procedures
correctly and
Mechanical stretching - Mechanical stretching devices apply a very low-intensity stretch force
over a prolonged period of time to create relatively permanent lengthening of soft tissues,
presumably due to plastic deformation. There are many ways to use equipment to stretch
shortened tissues and increase ROM. The equipment can be as simple as a cuff weight or weight-
pulley system or as sophisticated as some adjustable orthotic devices or automated stretching
machines.

Preparation for stretching:


Review the goals and desired outcomes of the stretching program with the patient. Obtain the
patient’s consent to initiate treatment.
■ Select the stretching techniques that will be most effective and efficient.
Warm up the soft tissues to be stretched by the application of local heat or by active, low-
intensity exercises. Warming up tight structures may increase their extensibility and decrease the
risk of injury from stretching.
■ Have the patient assume a comfortable, stable position that allows the correct plane of motion
for the stretching procedure. The direction of stretch is exactly opposite the direction of the joint
or muscle restriction.
■ Explain the procedure to the patient and be certain he or she understands.
■ Free the area to be stretched of any restrictive clothing, bandages, or orthotics.
■ Explain to the patient that it is important to be as relaxed as possible and that the stretching
procedures are meant to remain within his or her tolerance level.

After stretching:
■ Apply cold to the soft tissues that have been stretched and allow these structures to cool in a
lengthened position. Cold may minimize poststretch muscle soreness that can occur as the result
of microtrauma during stretching. When soft tissues are cooled in a lengthened position,
increases in ROM are more readily maintained.73,102
■ Have the patient perform active ROM and strengthening exercises through the gained range
immediately after stretching. With your supervision and feedback, have the patient use the
gained range by performing simulated functional movement patterns that are part of daily living,
occupational, or recreational tasks.
■ Strengthen the antagonistic muscles in the newly gained range to ensure adequate
neuromuscular control and stability as flexibility increases.

Manual Stretch:
Shoulder flexion & extension - NOTE: For normal motion, the scapula should be free to rotate
upward as the shoulder flexes. If motion of only the glenohumeral joint is desired, the scapula is
stabilized as described in the chapter on stretching (see Chapter 4).
Shoulder hyperextention
Shoulder abduction & adduction - NOTE: To reach full range of abduction, there must be
external rotation of the humerus and upward rotation of the scapula
Shoulder external rotation & IR - If possible, the arm is abducted to 90°, the elbow is flexed to
90°, and the forearm is held in neutral position. Rotation may also be performed with the
patient’s arm at the side of the thorax, but full internal rotation is not possible in this position.

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