general overview of stretching,its principles,types,indication,contraindications

1. STRETCHING

2. INTRODUCTION:
 Stretching is a general term used to
describe any therapeutic maneuver
designed to increase the extensibility
of soft tissues, thereby improving
flexibility by elongating (lengthening)
structures that have adaptively
shortened and have become
hypomobile over time.

3. STRETCH REFLEX:
The stretch reflex (myotatic reflex), or more
accurately "muscle stretch reflex", is
a muscle contraction in response to stretching
within the muscle.

4. RECIPROCAL INHIBITION:
 Reciprocal inhibition describes the
relaxation of muscles on one side of a joint
to accommodate contraction on the other
side.

5. AUTOGENIC INHIBITION:
When the GTO inhibits the (agonist)
muscle's contraction and allows the
antagonist muscle to contract more
readily, the muscle can be stretched
further and easier.

6. INDICATION FOR
STRETCHING:
 ROM is limited because soft tissues
have lost their extensibility as the result
of adhesions, contractures, and scar
tissue formation causing functional
limitations or disabilities.
 May be used as part of a total fitness
program designed to prevent
musculoskeletal injuries.
 May be used prior to and after vigorous
exercise potentially to minimize post
exercise muscle soreness.

7. CONTRAINDICATIONS FOR
STRETCHING:
Recent fracture
Hematoma or other tissue trauma
There is a evidence of acute
inflammatory or infectious process
Hypermobility already exist

8. PRINCIPLE OF
STRETCHING:
1. Alignment
2. Stabilization
3. Intensity of stretch
4. Duration of stretch
5. Speed of stretch
6. Frequency of stretch
7. Mode of stretch

9. 1. Alignment
 Proper alignment or positioning of the
patient and the specific muscles and joints
to be stretched is necessary for patient
comfort and stability during stretching
• For example, To stretch the rectus femoris (
crosses two joints) effectively, as the knee
is flexed and the hip extended, the lumbar
spine and pelvis should be aligned in a
neutral position. The pelvis should not tilt
anteriorly nor should the low back
hyperextend; the hip should not abduct or
remain flexed.

10. 2. Stabilization
 To achieve an effective stretch of a specific
muscle or muscle group and associated
periarticular structures, it is necessory to
stabilize (fixate) either the proximal or distal
attachment site of the muscle-tendon unit
being elongated.
 For example, when stretching the iliopsoas,
the pelvis and lumbar spine must maintain
a neutral position as the hip is extended to
avoid stress to the low back region.

11. 3. Intensity of stretch:
 The intensity (magnitude) of a stretch
force is determined by the load placed
on soft tissue to elongate it.
 Low-intensity stretching has also been
shown to elongate dense connective
tissue, a significant component of
chronic contractures, more effectively
and with less soft tissue damage and
post-exercise soreness than a high-
intensity stretch.

12. 4.Duration of stretch:
 In general, the shorter the duration of
a single stretch cycle, the greater the
number of repetitions applied during a
stretching session.
 In a study by Cipriani et al., two
repetitions of 30-second hamstring
stretches were found to be equally
effective compared to six repetitions of
10-second stretches.

13. TYPES OF STRETCHING:
1. Static stretching
2. Cyclic stretching
3. Ballistic stretching
4. PNF stretching
5. Manual stretching
6. Mechanical stretching
7. Self stretching
8. Active stretching

14. PRECAUTIONS FOR STRETCHING:
 Don’t passively force beyond its
normal ROM.
 Avoid vigorous stretching of muscles
and connective tissues that have been
immobilized for an extended period of
time.
 Avoid stretching edematous tissue, as
it is more susceptible to injury than
normal tissue.