ADJUNCTS TO
ST RET CHING
KRIPA AGARWAL
232102042
ADJUNCTS
 Relaxation Training
 Heat
 Cold
 Massage
 Biofeedback
 Joint Traction or Oscillation
RELAXATION TRAINING
• Relaxation training, using methods of general relaxation, helps
patients learn to relieve or reduce pain, muscle tension, anxiety or
stress, headaches, high blood pressure, and respiratory distress.
• Common Elements of Relaxation Training : Involves reduction in muscle tension that is painful or restricted by
conscious effort and thought.
 Training occurs in a quiet environment with low lighting and
soothing music or an auditory cue on which the patient may focus.
 The patient performs deep breathing exercises or visualizes a
peaceful scene.
 When giving instructions the therapist uses a soft tone of voice.
EXAMPLES OF APPROACHES
• Autogenic training: It involves conscious
relaxation through autosuggestion and a
progression of exercises as well as meditation.
• Progressive relaxation: This technique,
developed by Jacobson, uses systematic, distal
to proximal progression of voluntary contraction
and relaxation of muscles.
• Awareness through movement: It combines
sensory awareness, movements of the limbs and
trunk, deep breathing, conscious relaxation
procedures, and self-massage.
JACOBSON TECHNIQUE
SEQUENCE OF PROGRESSIVE
RELAXATION TECHNIQUE
• Place the patient in a quiet area and in a comfortable position and be
sure that restrictive clothing is loosened. Have the patient breathe in a
deep, relaxed manner.
• Ask the patient to contract the distal musculature in the hands or feet
voluntarily for 5 to 7 seconds and then consciously relax those muscles
for 20 to 30 seconds.
•
Suggest that the patient try to feel a sense of heaviness in the hands or
feet and a sense of warmth in the muscles just relaxed.
• Progress to a more proximal area of the body and have the patient
actively contract and actively relax the more proximal musculature.
HEAT
• Warming up prior to stretching is a common practice in
rehabilitation and fitness programs.
• As the intramuscular temperature increases, the extensibility of
soft tissues increases. In addition, the amount of force required
and the time of stretch force decreases.
• When tissues relax it is easier to lengthen them.
• Warming up also reduces postexercise muscle soreness and
the risk of injury to soft tissues.
• Heat combined with stretching produces greater long-term
gains in tissue length than stretching alone.
METHODS OF WARM - UP
• Superficial heat or deep-heating modalities
are used primarily to heat small areas such as
individual joints, muscle groups, or tendons and
may be applied prior to or during the stretching
procedure.
• Low-intensity, active exercises, which
generally increase circulation and core body
temperature, also have been used as a
mechanism to warm up large muscle groups
prior to stretching.
• Some common warm-up exercises are a brief
walk, non-fatiguing cycling on a stationary
bicycle, use of a stair-stepping machine, active
heel raises, or a few minutes of active arm
HOT PACKS
PARAFFIN
WAX
ULTRASOUND
SHORTWAVE
DIATHERMY
COLD
• The application of cold prior to stretching (Cryostretching) decrease
muscle tone and make the muscle less sensitive during stretch in
healthy subjects and in patients with spasticity or rigidity.
• After stretching, cold should be applied to soft tissues held in a
lengthened position to minimize post stretch muscle soreness and to
promote longer-lasting gains in ROM.
• Cold be applied to injured soft tissues during the first 24 to 48 hours
after injury to minimize swelling, muscle spasm, and pain.
MASSAGE AND SOFT TISSUE
MOBILIZATION TECHNIQUES
MASSAGE FOR RELAXATION
• In some approaches to stress and anxiety or
pain management, self-massage, using light
stroking techniques (effleurage) is performed
during the relaxation process.
• Massage has been used for general relaxation
purposes or to enhance recovery after strenuous
physical activity.
• As it increase circulation to muscles and
decrease muscle spasm, it is a useful adjunct to
stretching exercises.
MASSAGE AND SOFT TISSUE
MOBILIZATION TECHNIQUES
SOFT TISSUE MOBILIZATION AND MANIPULATION
TECHNIQUES
•
The primary purpose of these techniques is increasing the
mobility of shortened connective tissues including fascia,
tendons, and ligaments.
•
Stresses are applied long enough for creep and stress-relaxation
of tissues to occur.
•
With myofascial massage, stretch forces are applied across
fascial planes or between muscle and septae.
•
With friction massage, deep circular or cross-fiber massage is
applied to break up adhesions. It is also used to increase the
mobility of scar tissue in muscle as it heals.
• Biofeedback is another tool to help a patient
BIOFEEDBACK
learn and practice the process of relaxation.
• A patient, if properly trained, can
electronically monitor and learn to reduce
the amount of tension in muscles, through
biofeedback instrumentation.
• Through visual or auditory feedback, a
patient can begin to sense or feel what
muscle relaxation is.
• It is also a useful means to help a patient
learn how to activate a muscle, rather than
relax it.
JOINT TRACTION OR
OSCILLATION
• Slight manual distraction of joint surfaces prior to or in
conjunction with joint mobilization techniques can be
used to inhibit joint pain and spasm of muscles.
•
Pendular motions of a joint use the weight of the limb to
distract the joint surfaces and simultaneously oscillate
and relax the limb.
• The joint may be further distracted by adding a 1- or 2-lb
weight to the extremity, which causes a stretch force on
joint tissues.
REFERENCES
• Therapeutic Exercise 5 th ed., by
Carolyn Kisner and Lynn Allen
Colby
T H A N K YO U
BEYONCE