flexibility and stability are important for effective/efficient movement
stability vs mobility
joints typically favor one over the other. ex: lumbar spine more stable than mobile. lack of flexibility typically causes and overcompensation of mobility into another muscle area. Hip extension with tight hip flexors causes hips to rotate into transverse plane
when people cannot perform exercises the way they are meant to be performed due to mobility and flexibility compensations and imbalances.
r'ship bt the contractile proteins (actin and myosin) of a sacromere in a myofibril and their force-generating capacity. stretching: inc sacromere alignment and resting alignment shortening: overlap of contractile fibers, reduces muscles force-generating capacity.
immobilization, trauma and aging all shorten muscles. This causes a potential for greater force in the shorten position but less force in lengthened or resting positions due to a loss of sacromeres (500,000 in one muscle myofibril) passive stretching and elongation of tightened muscles will help put sacromeres back in place to restore normal length and resting relationship
happens on the opposing side of a muscle that is shortening of a joint. sacromeres are added and inc force in lengthened position but dec in resting or short position. to fix: must strengthen muscle from resting or shortening position. ex: shoulders protract, full ROM back rows not recommend, but isometric or shortened rows recommended.
force couple relationships
many muscle groups act on the skeletal muscles to keep them in place during rest and during movement. ex: pelvic bone held in place by hip flexors, rectus abdominis, hamstrings and erector spinae ex 2: shoulder abduction uses delts as prime mover but rotator cuff keeps humeral head from impinging.
co-contraction helps in antagonist muscle to help control joints during movement. when a muscle shortens, it inc tonicity (muscle req less nerve impulse to contract). Then when trying to work the antagonist, the agonist could premature inhibit this movement due to it's inc tonicity. ex: hip flexors inhibiting glutes during hip extension.
this happens as a results of neural control in shortened muscles. ex: hip flexors inhibits glutes from being used in hip extension. There fore, the synergist muscles (in this ex: hamstrings) kick in to aid the joint movement. However, this is not the function of the hamstring and cause the joint and muscle to be injured overtime as they are not functioning properly
Phase 1: stability and mobility training
of functional movement and resistance training, should focus on the proximal lumbar spine bc this is where the COG is. Once stable and mobile, pt can focus on more distal parts of the body. Lumbo-pelvic, thoracic and shoulders--- then distal
stabilizer muscles vs mobilizing muscles
stabilizers: more type 1 muscle fibers for endurance and duration mobilzers: more type II fibers for power movements and higher intensity
small, continuous, back and forth movements on a foam roller covering 2 to 6 in over tender region for 30-60s. -realigns elastic muscle fibers from bundled position -preceeds static stretching -reduces hypertonicity/tension in muscles used pre exercise for conditioned and deconditioned clients to restore and maintain flexibility
taken to point of tension and held for 15-60s atleast 4 times performed pre exercise after warm up in deconditioned inds also post exercise for all clients
proprioceptive neuromuscular facilitation
PNF. ex: hamstring stretch with client lying down and leg at 90 degrees. Flexing the knee flexes the quad which releases the hamstrings and can then be further stretched. hold contraction for min 6s then follow with 10-30s passive or assisted static stretch can be done post exercise for all clients
active isolated stretches
AIS. one or two sets of 5-10 reps at controlled tempo holding end ROM for 1 or 2 s at a time. pre exercise for conditioned clients during exercise for unconditioned clients
dynamic and ballistic stretches
1 or 2 sets of 10 reps pre exercise for athletes and conditioned clients during exercise for conditioned clients
begin with low grade isometric contractrions 2-4 reps of 5-10s each in a controlled environment (floor, chair, wall). then progress to dynamic, controlled ROM exercises 1-3 sets of 12-15 reps this improves endurance of the type I stability muscles. Remember, lengthened muscles shouldnt use full ROM to strengthen them at first. loads can be gradually added to improve strength and endurance
proximal stability: activating the core
core encompasses lumbo-pelvic region, hips, abdoment and lower back deep/innermost= vertebral bones and discs, spinal ligaments and small muscles that stabilize each vertabra (interspinali) middle= fasciae, transverse abdominis, multifidi, and others outer= powerful muscles that span more vertebrae: rectus abdominis, erector spinae, ext and int obliques, iliopsoas and latissiumus dorsi
hoop tension effect
activation of the TVA is the key muscle of the neural system reflexivity of posture. Pulls other muscles and vertabrae in place. weak TVA is associated with low back pain and can cause other injuries if it calls on the synergist muscles to function in ways they were not meant to.
co-contraction of core or "bracing"
when tva contracts and "braces", core and abdominal muscles activate to provide a wider base of support for spinal stabilization. clients should practice "bracing" when performing load exercises.
COM (center of mass) and (BOS) base of support are critical to balance training. core conditioning and balance training are essentially the same thing. stage 1: core function. stage 2: static balance stage 3: dynamic balance
proximal stability: core function
exercise 1: drawing in. supine w knees bent, fingers medial to ASIS. TVA contracts without moving ribs, pelvis or lowback
exercise 2: quadruped drawing in w extremity movement- stabilize lumbar spine during min loading of spine in hip and shoulder movements. on all fours, lift one hand and one leg off 1 in off floor and hold.
Proximal mobility: hips and thoracic spine
this area is prone to poor mobility. static stretching should precede dynamic mobilization exercises. avoid overcompensating at successive joints.
bi articulate= muscle stretches over two joints
start in one plane of movement before adding other planes of movement to the stretches
supine 90-90 neutral back
goal: relax muscles of low back
how: lie on floor with legs on a chair at 90 degrees of flex in knees and hips. toes should be in line with hips and a pillow or yoga block should be place to avoid int or ext rotation of hips. Lay back, arms out away from sides with palms up. relax in this position for 3-10 min
goal: improve extensibility within the lumbar extensor muscles
how: quadruped on all fours, inhale belly button to spine and hold for 15s then exhale to camel and hold for 15s
goal: hip mobility in sagittal plane
how: supine, knees bent, arms out, palms up, push pelvis posteriorly and anteriorly for 1-2 sets of 5-10 controlled reps holding position for 1-2s
pelvic tilt progressions: bent knee march
goal: hip mobility in sagittal plane without compromising lumbar spine during lower movement
how: pelvic tilt position, bring one leg toward chest til parallel with floor. hold position briefly then do next leg. 1-2 sets 5-10 reps 1-2s holding
pelvic tilt progressions: modified dead bug with reverse bent-knee marches
introduce after pelvic tilt marches. goal: hip mobility w/out compromising lumbar spine stability during movement
how: pelvic tilt position with towel under low back to monitor movement. raise legs to 90 degrees. slowly lower one, bring back then lower the other to the floor and bring back. Can add arm movements of arm on same side as leg as an option too.
hip flexor mobility: lying hip flexor stretch
goal: imp flex of hip flexors in s plane w/out compromising lumbar stability
how: pelvic tilt starting position. bring one knee to chest with two hands and slowly extend other to floor or until lumbar stability is compromised and hold.
half kneeling triplanar stretch
goal: mobility of hip flexors without compromise of lumbar spine stability
how: half kneeling lunge position with rear leg directly under pelvis on floor. lean forward to stretch hips without lordosis of spine.
progressions: can flex or rotate trunk in other planes
lying hamstring stretch
goal: improve mobility of the hamstrings in s plane w/out compromising lumbar stability
how: supine, knees bent, one leg extended to 90 on a table or door jam with plantarflexion in toe to avoid gastrocnemius inhibition. extend leg to stretch hammies
progressions: anterior pelvic tilt or extend bent leg out.
shoulder bridge (glute bridge)
goal: improve hip mobility and stability and core stability by activating the glute muscle groups
supine 90-90 hip rotator stretch
goal: imp hip mobility in transverse plane
how: supine, arms out, feet on wall, cross leg over knee. push crossed leg away while pulling other foot off wall.
table top kneeling lat stretch
goal: imp flex of latissimus dorsi to facilitate mobility between hips and shoulders
how: quadruped, arms on a chair, push head and chest toward floor, hold for 15s then perform pelvic tilts
spinal extensions and twists
extension: lie on floor, knees bent, arms at side and extend arms over head
spinal twists: same as yoga move
goal: thoracic spine mobility in transverse plane
how: upright on knees, hands locked behind head, rotate to one side then laterally flex elbow to floor and then flex the other direction then return to upright (reminds me of the spongy things in zelda that are so annoying)
goal: hip and thoracic mobility while maintaining lumbar spine stability
how: all fours in front of a mirror, rock back and forth to control ROM using mirror
scapulothoracic region and g/h joint
g/h joint one of most mobile in body but cannot be as mobile without scapulothoracic stability. Stability here often is determines by mobility of the thoracic spine.
muscles in this area (including rotator cuff muscles and parascapular muscles) aid the gliding motion between the humeral head and the gleno fossa rather than impingement.
stretches for shoulder muscles
inferior: overhead tricep
posterior: arm across body
anterior: pec stretch against wall
superior: towel at elbow against body and pulling elbow downward and inward with other hand.
in closed chain kinetic movements this muscle is responsible for moving thorax toward a more fixed, stable scapulae
in open chain kinetic movements, SA works to fix scapulae against rib cage
OKC vs CKC for shoulder stability
open chain kinetic movements are better because CKC (pull ups and push ups) are for more fit inds.
at first, use the floor for CKC if using them but OKC is better when the client has a "packed" shoulder position.
goal: imp awareness of good scapular position, imp flexibility and strength of key parascapular muscles
how: lay on floor, knees bent, arms at side, palms up and hold scapular depression (down) and retraction (back) for 5-10s. then with opp arm, gently push shoulder down w/o losing lumbar stability.
int and ext humeral rotation
goal: imp rotator cuff function while maintaining good scapular position
how: line on floor, knees bent, arms abduct at 90 degrees with forearms perpendicular. rotate externally backward and rest. repeat 2-4 more times. Rotate internally (forearms 20/30 deg above floor) and repeat
make harder: use bands
goal: imp rotator cuff function with 4 integrated movements at gh and scapulothoracic joints
how: 1. lay on floor with knees bent and arm across body (like drawing a sword) and pull back across body (like raising a sword). repeat
2. start with hand on hip, bring across body like you are going to slap yourself.
warm up with this then add cable resistance.
reverse flys with supine 90-90
goal: strength post. shoulder muscles
how: get in supine 90-90 position with arms abducted and 90 degrees with forearms perpendicular to the floor. push against the floor with less than 50% max effort w/o altering position of lumbar spine. 2-4 reps holding for 10s. build up to 3 sets of 12-15 reps.
prone arm lifts
goal: strengthen parascapular muscles
how: lay face down on mat, use muscles to make an "I" shape, "Y" shape, "W" shape and "O" Shape (hands behind hips) with arms.
perform 2-4 reps of each holding 5-10s
CKC weight shifts
goal: stabilize s/t joint and lumbar spin in CKC position
how: face down, hands next to shoulders on floor, press up into straight knee or bent knee press up and shift forward, backward, side to side 3-6 inches. 2-4 reps holding each for 5-10s
goal: promote scapular stabilization during dynamic movement
how: lie on side with hips and knees slightly flexed, bring a light dumbbell up with arm abducted perpendicularly to the floor and the other arm abducted on floor. roll front of body toward mat while maintaining arm in vertical position. 2-4 sets of 5-10 reps on each side holding end position for 1-2s
gastrocnemiusand soleus (triceps surae) are often tight bc people stand with pronation more often than not.
this causes problems in bend and lift movements (like a squat) because the heel comes off the floor
when someone is stretching a calf muscle, be sure they aren't "stretching" further by compensating with another movement (further pronation) by internally rotating the food.
Want to see the other 49 Flashcards in TM Chapter 9?JOIN TODAY FOR FREE!