Interventions to Increase Mobility of Soft
Tissues
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Manual or Mechanical/Passive or Assisted Stretching
Self-Stretching
Neuromuscular Facilitation and Inhibition Techniques
Muscle Energy Techniques
Joint Mobilization/Manipulation
Soft Tissue Mobilization and Manipulation
Neural Tissue Mobilization
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Manual or Mechanical/Passive or Assisted
Stretching
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A sustained or intermittent external, end-range stretch
force, applied with overpressure and by manual
contact or a mechanical device
◦ Elongates a shortened muscle-tendon unit and
periarticular connective tissues by moving a
restricted joint just past the available ROM.
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Self-Stretching
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Any stretching exercise that is carried out
independently by a patient after instruction and
supervision by a therapist
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self-stretching is same as flexibility exercises
◦ some practitioners prefer to limit the definition of
flexibility exercises to ROM exercises that are part
of a general conditioning and fitness program
carried out by individuals without mobility
impairment.
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Neuromuscular Facilitation and Inhibition
Techniques
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Relaxation of tension in shortened muscles
reflexively prior to or during muscle elongation.
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Combined inhibition/muscle lengthening procedures
referred to as PNF stretching, active inhibition, active
stretching, or facilitated stretching.
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Muscle Energy Techniques
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Manipulative procedures that have evolved out of
osteopathic medicine and are designed to lengthen
muscle and fascia and to mobilize joints.
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Employ voluntary muscle contractions by the patient
in a precisely controlled direction and intensity
against a counterforce applied by the practitioner.
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Because principles of neuromuscular inhibition are
incorporated into this approach, another term used to
describe these techniques is post isometric relaxation.
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Joint Mobilization/Manipulation
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Manual therapy techniques specifically applied to
joint structures and are used to stretch capsular
restrictions or reposition a subluxed or dislocated
joint.
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Soft Tissue Mobilization and
Manipulation
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the application of specific and progressive manual
forces to effect change in the myofascial structures
that can bind soft tissues and impair mobility.
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friction massage
myofascial release
Acupressure
trigger point therapy,
improve tissue mobility by mobilizing and
manipulating connective tissue that binds soft tissues.
Very useful adjuncts to manual stretching procedures
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Neural Tissue Mobilization
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Mobilization of adhesions or scar tissue that was
formed around the meninges and nerve roots or at the
site of injury at the plexus or peripheral nerves, after
trauma or surgical procedures
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Tension placed on the adhesions or scar tissue leads
to pain or neurological symptoms.
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Selective Stretching
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A process whereby the overall function of a patient
may be improved by applying stretching techniques
selectively to some muscles and joints but allowing
limitation of motion to develop in other muscles or
joints.
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always keep in mind the functional needs
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Overstretching and Hypermobility
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Overstretching
◦ a stretch well beyond the normal length of muscle and ROM
of a joint and the surrounding soft tissues, resulting in
hypermobility (excessive mobility).
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Hypermobility by overstretching may be necessary
for certain healthy individuals
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Overstretching becomes detrimental and creates joint
instability
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