PNF ECCENTRIC/DECELERATION TECHNIQUES
FWATA: APRIL 16, 2015
Proprioceptive Neuromuscular Facilitation (PNF)
Definition:
A concept of treatment based on the philosophy that all human beings, including
those with disabilities have untapped existing potential. PNF is a hands-on,
aggressive and progressive approach to rehabilitation. It uses the sensory receptors
that give information concerning movement and position of the body. It is a
technique that promotes/hastens the response of normal neuromuscular
mechanisms. The goal of PNF is to achieve a desired response. PNF employs several
facilitation procedures and treatment techniques which allows earlier initiation of
rehabilitation based on facilitation of normal neuro-muscular mechanical
parameters.
Basic Principles and Procedures of PNF are applied to all PNF
techniques to elicit desired responses.
 Manual Pressure: the ATC’s hands are placed on the surface toward the
direction of the desired movement.
 Auditory Stimulation: use of appropriate words to convey the movements
required. Appropriate volume and use of action words will help prepare and
facilitate the action.
 Visual Stimulation: the patient observes themselves performing a
movement and the head motion facilitates trunk motion
 Optimal Resistance: PNF utilizes various forms of resistance. Resistance is
accommodating throughout the range of motion.
 Use of Joint and Muscle Neural Receptors: stimulation of articular,
external and muscle neural receptors for motor control: Traction and
Approximation.
 Stretch Elongation: used to elicit stretch stimulus response by MS
 Use of Functional Patterns of Facilitation: Diagonal and spiral in nature,
these functional patterns are related to normal functional activities. Each
extremity pattern of motion consists of a foundation pivot, proximal pivot,
distal pivot and intermediate pivot.
 Normal Timing: refers to the sequence of muscle activation in a movement
pattern. Normal timing occurs distal to proximal.
 Body Position/Mechanics: maintain good patient and ATC mechanics. Use
your body (leverage) as resistance
 Irradiation: the spread of excitation through the nervous system. Example
is using a distal component to facilitate proximal response.
Techniques of PNF utilize isometric and isotonic contractions.
Techniques
that use isometric contractions are Hold Relax, Contract Relax, Rhythmic
Stabilization, and Combination Isotonics. Techniques that utilize isotonic
contractions (concentric and eccentric) are Slow Reversals, Repeated Contractions,
Agonist Reversals, and Combination of Isotonics.
 Hold Relax: isometric resistance performed at the limitation or restriction
of motion or at the point of pain or tightness.
 Contract Relax: Used to increase range of motion. Performed as a hold
relax but before the “relax” command appropriate rotation of resisted
concentrically
 Rhythmic Stabilization: multiple use technique that utilizes alternating
agonist-antagonist isometric contractions.
 Slow Reversals: isotonic alternating rhythmic concentric contractions in a
movement diagonal.
 Repeated Contractions: Concentric contraction into one pattern of motion,
can be short or full range
 Agonist Reversals: the use of eccentric contractions in one pattern of
motion, can be short or full range
 Combination of Isotonics: use of isometric, concentric, and eccentric
techniques in a movement pattern.
Lab Activities (patterns of motion will be reviewed):
Upper Extremity:
 Flexion Abduction UE:
o Slow Reversals (SR)
o Repeated Contractions (RC) w/hold full range
o RC w/hold short range
o Combination Isotonic (CI): Repeated Stretch through range
o Agonist Reversal (AR) w/RC /HR full range
o AR w/RC/HR short range
 Flexion Adduction UE:
o SR
o RC w/hold full range
o Repeated Stretch through range
o AR full/short range
 Supine Rotation (internal and external) at 0° and 90°
o HR
o RC
o RC w/HR-AR
 Supine Wrist (in neutral with elbow flexed to 90° and shoulder 90° elbow
extended
o RC
o AR



Seated
o Rotation RC/AR
o Flexion Abduction RC-HR-AR
Kneeling
o Flexion Abduction RC-HR-AR
Standing
o Flexion Abduction RC-HR-AR
Lower Extremity:
 Ankle (hip and knee fixed)
o SR
o RC
o RC-HR-AR
 Prone hamstring
o RC
o RC-HR-AR
o Resisted stretch through range
 Supine Hip Flexion-Adduction
o SR
o RC
o RC-HR-AR
 Supine Knee extension-hip flexion/adduction
o RC
o RC-HR-AR
 Seated (knee pivots): review SR first
o Hamstring (flexion)
 RC-HR full range
 RC-HR short range
 Repeated stretch through range
 RC-HR-AR
 AR CI: hip extension to knee flexion
o Quads (extension)
 RC-HR
 RC-HR-AR
 TKE: RC-HR-AR
 CI: RC-HR-PNF SLR-AR
Carolyn Greer MA ATC; Joseph Parry MA ATC
Paul Signorelli MA ATC; Coliflores, Justine MA ATC; Daniel Melara MA ATC; Tyler Arford MA ATC;
Katina Kartalias ATC; Carolyn Peters MA ATC; Sue Lalicker MA ATC
PNF: ECCENTRIC/DECELERATION TECHNIQUES
REFERENCES
Adler, Susan S.; Beckers, Dominick; Buck, Math: PNF in Practice. Berlin: SpringerVerlag. Third Edition: 2008; Fourth Edition: 2014
Knott, Margaret; Voss, Dorothy: Proprioceptive Neuromuscular Facilitation (second
edition). New York: Harper & Row. 1968
Moore, Robert J., Gottshall, Kim: PNF Principles and Techniques of Proprioceptive
Neuromuscular Facilitation for Rehabilitation of Sports Injuries. SDSU: 2006.
Hoppeler, Hans: Eccentric Exercise. New York: Routledge, 2015.
Frizziero, Antonio; Trainito, Sabina et al: “The Role of Eccentric Exercise in Sports
Injuries Rehabilitation”. British Medical Bulletin, 2014, 110:47-75.
Lorenz, Daniel: “Use of Eccentric Exercise for Prevention and Rehab”. Lower
Extremity Review Magazine, February 2012.
Lindstedt, S. L. ; LaStayo, P.C.; and Reich, T.E.; “When Active Muscles Lengthen:
Properties and Consequences of Eccentric Contraction”. News Physiology Science,
Volume 16, December 2001.
Lorenz, Daniel and Reiman, Michael: “The Role and Implementation of Eccentric
Training in Athletic Rehabilitation: Tendinopathy, Hamstring Strains, and ACL
Reconstruction”. International Journal of Sports Physical Therapy, March 2011:
6(1): 27-44.