Definition of Stretching
Stretching is a general term used to describe any
therapeutic maneuver designed to increase the
extensibility of soft tissues.
After gaining desired ROM, Stretching must be
supported by an appropriate level of strength and
endurance to become permanent.
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Mobility.
Hypomobility.
Flexibility.
Contracture.
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• the ability of structures or segments of the
body to move to allow range of motion for
functional activities (functional ROM).
• OR
• the ability of an individual to initiate, control,
or sustain active movements of the body to
perform simple to complex motor skills
(functional mobility)
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Decreased mobility or restricted motion
Caused by adaptive shortening of soft tissues can occur
as the result of many disorders or situations.
Factors affect mobility:
◦ Prolonged immobilization of a body segment
◦ Sedentary lifestyle
◦ Postural malalignment: congenital or acquired
deformities.
◦ Paralysis, tonal abnormality, Muscle imbalance.
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Flexibility is the ability to move a single joint or series of
joints smoothly and easily through an unrestricted, painfree ROM.
Dynamic flexibility. (active mobility/active ROM)
the degree to which an active muscle contraction moves a body
segment through the available ROM of a joint.
Passive flexibility. (passive mobility/passive ROM)
the degree to which a joint can be passively moved through the
available ROM
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• Contracture is the adaptive shortening of the muscle-tendon unit
and other soft tissues that cross or surround a joint
• Contracture is defined as an almost complete loss of motion,
whereas the term shortness is used to denote partial loss of
motion.
Contracture Versus Contraction
• Contraction: the process of tension developing in a muscle
during shortening or lengthening
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Precautions for Stretching
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Do not passively force a joint beyond its normal ROM
Patients with known or suspected osteoporosis
Protect newly united fractures
Avoid vigorous stretching of tissues that have been
immobilized for an extended period of time
• Progress gradually
• Avoid stretching edematous tissue
• Avoid overstretching weak muscles
Indications for Stretching
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Limited ROM .
Muscle shortening.
Part of a total fitness program designed to prevent
musculoskeletal injuries.
Prior to and after vigorous exercise potentially to
minimize post-exercise muscle soreness.
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Contraindications to Stretching
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A bony block limits joint motion.
Recent fracture, and incomplete bony union
acute inflammatory or infectious process
sharp, acute pain with joint movement or muscle
elongation.
A hematoma or other indication of tissue trauma.
Hypermobility already exists.
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Guidelines for Application of Stretching
• Perform appropriate Examination and Evaluation
for joint that you will apply stretching for its
surrounding soft structures.
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Explain the procedure to the patient
Review the goals and desired outcomes & obtain consent
Select effective and efficient stretching techniques
Warm up the soft tissues to be stretched
The direction of stretch is exactly opposite the direction
of the joint or muscle restriction.
Remove any restrictive clothing, bandages, or splints.
Explain to the patient that it is important to be as relaxed
as possible or assist when requested.
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After Stretching
• Apply Cold packs in the lengthened position.
• Perform active ROM for shorted group of muscles
and strengthening exercises for antagonist muscle
group through the gained range immediately after
stretching.
Follow with functional movement patterns