Transcript What is Facilitated Stretching?

CFP 2012
Session 2013
Using Facilitated Stretching
in the Gym
Stay for the book giveaway!
Presented by
Bob McAtee, CSCS, C-PT, RMT
Pro-Active Massage Therapy
Colorado Springs, CO USA
www.stretchman.com
Learning Objectives
1. Clearly understand the theoretical basis and
principles underlying the development and use of
Facilitated Stretching.
2. Be able to perform effective facilitated stretches for
the muscle groups covered in class.
3. Be confident in using partner-stretching techniques
with clients and self-stretching techniques to teach
them to use at home.
4. Understand safety factors in the use of facilitated
stretches.
5. Be able to demonstrate proper biomechanics for
the practitioner.
What is Flexibility ?
• Flexibility can be
defined as the range of
motion about a joint or
series of joints.
• Flexibility is specific to
the joint and plane of
movement.
Flexibility<<< >>>> Stability
• Increased flexibility results
in decreased stability.
• A certain minimum range is
required to safely and
optimally carry out a given
activity.
• Training goal: develop
flexibility within the needs
and abilities of the client.
A Brief Review:
Types of Stretching
• Passive
Static or Ballistic
• Active
Ballistic
Dynamic
• Active-Assisted
AIS
Facilitated Stretching
What is
Facilitated Stretching?
• Based on PNF, a Physiotherapy modality developed in
the 1950’s.
• PNF is designed for rehabilitating function rather
than individual muscles.
• PNF is designed to integrate the neuromuscular
system:
• Employs active, active-assisted, and passive
techniques.
• Teaches complex movement patterns.
How is Facilitated Stretching Different?
• Facilitated Stretching is an activeassisted technique based on PNF
principles
• Uses an isometric contraction of the
target muscle to prepare it to
stretch.
• Encourages active stretching on the
part of the athlete, avoiding
additional passive stretching when
possible.
• Can be done with a partner or
alone.
Facilitated Stretching in
Three Easy Steps
• Step 1.
Stretcher actively moves the limb to lengthen the
target muscle to the end of range.
• Step 2.
Stretcher isometrically contracts the target muscle
for 6 seconds.
• Step 3.
Stretcher actively stretches to a new range of
motion.
Rhomboids Self-Stretch
•Stretch by reaching
across your chest, feeling
the stretch in your upper
back.
•Keep your low-back flat.
•Isometrically contract
rhomboids (pull your
scapula toward your
spine).
Abductors/Low Back Self-Stretch 2
• Cross left knee over right.
• Keep sacrum on the floor
and drop the inside of the
right knee toward the floor.
• Resist isometric abduction
of the right leg with left leg.
• To stretch the low back,
allow sacrum to roll up off
the floor.
Facilitated Stretching in
Three Easy Steps
• Step 1.
Stretcher actively moves the limb to lengthen the
target muscle to the end of range.
• Step 2.
Stretcher isometrically contracts the target muscle
for 6 seconds.
• Step 3.
Stretcher actively stretches to a new range of
motion.
Facilitated Stretching
Three-Step Protocol
• The protocol has evolved over many years of
clinical practice.
• In client sessions, repeat each stretch up to
three times. In today’s seminar, just do two
reps.
• Use proper biomechanics for the partner and
the stretcher to isolate the target muscles, to
avoid injury, and to prevent compensation.
Classic Physiological Explanation
• The success of PNF is based on eliciting:
• Reciprocal Inhibition during active
movement (muscle spindles).
• and
• Autogenic Inhibition as a result of the
isometric contraction (Golgi tendon
organs).
Reciprocal Inhibition
• Voluntary contraction
of the opposing muscle
results in an inhibition
of the motor neurons
of the target muscle.
• Reciprocal inhibition
can depress the
amplitude of stretch
reflex.
Autogenic Inhibition
• Refers to reduction in excitability of
a contracting or stretched muscle.
• Often attributed to increased
inhibitory input from Golgi Tendon
Organ (GTO)
– Located in tendons and
tendinous junctions of muscle.
– Provides sensory info about
changes in muscle tension.
– Responds to overload by
relaxing (inhibiting) the muscle.
Theory
Reality
• "There is nothing so sad as the
destruction of a beautiful theory by an
ugly fact.”
Thomas Henry Huxley.
Does Reciprocal Inhibition Play a Role?
•Conflicting research results.
•This reflex is not as automatic as once believed,
but is task-related.
•It may be at work in facilitated stretching.
Does Autogenic Inhibition Play a Role?
•In some cases the GTO can excite the same muscle
and inhibit or excite opposing muscle.
•GTOs cease or significantly decrease firing as soon as
muscle relaxes after contraction.
•Unclear to what extent GTO is involved in relaxation
response.
•We have clinical evidence of a “post-isometric
relaxation” effect, but currently do not have an accepted
physiological explanation for why it occurs.
Current Thinking about Stretching
• Stretch Tolerance Improves:
• Stretching is believed to alter the point at which stretch is
perceived or tolerated.
– Inhibition of stretch reflex?
• Sensory perception may diminish, allowing the stretch to go
farther before reaching a soft-tissue barrier.
• Growing support for the contention that PNF may influence
stretch tolerance to a greater extent than other stretching
methods (Sharman et al., 2006).
Working With a Partner
Hamstrings Stretch
•Client keeps both hips on the mat.
•Maintain straight knee during isometric.
•Actively stretch pain-free.
Bent Knee Hamstring 1
•Client keeps the thigh vertical throughout the
sequence.
•During the isometric contraction, client pushes the
heel toward the buttocks as if bending the knee.
Bent Knee Hamstring 2
• Client holds thigh close to chest throughout the
sequence.
• During the isometric contraction, client pushes the
heel toward the buttocks as if bending the knee.
Hamstrings, Self-Stretch
•Use the strap only to resist the
isometric contraction, never to lift
the leg.
Quadriceps
•Keep the lower leg in good alignment to avoid
stressing the knee. Passively stretch the quad.
•Client keeps the low back flat; use a pillow under the
hips if necessary.
Hip Flexors
Client keeps both hips flat on the mat.
Watch for lumbar hypermobility.
Glutes relax during the isometric contraction of
the hip flexors.
Quadriceps Self-Stretch
•Keep the back flat & the weight-bearing knee slightly bent.
•Phase one: focus on heel to buttocks.
•Phase two: focus on hip extension.
Hip Flexors Self-Stretch
•Keep the low back
flat.
•Feel the stretch
high on the front of
the thigh.
•Relax the glutes
during the
isometric phase.
So Many Stretches,
So Little Time!
Pectoralis Major
•Prevent trunk rotation.
•Stretcher relaxes rhomboids
and contracts pecs, leading
from the elbow (Butterfly).
•Changing the angle of
abduction of the arm
emphasizes different fibers of
the pectoralis major.
Triceps
•Client stretches by
touching the scapula on
the same side.
•Trainer stabilizes
posterior shoulder during
the isometric phase.
Subscapularis
•This stretch is used to
improve external rotation.
•Client focuses on pure
rotation of the arm.
•Verbal cue for isometric: “Try
to roll your wrist toward the
floor.”
Pec Major Self-Stretch
•Keep low-back flat by using a
lunge stance.
•Use the post for resistance
during the isometric phase,
but stretch the pecs actively.
Triceps Self-Stretch
•Reach toward the shoulder
blade to stretch.
•Keep the upper arm close to
the ear.
•Don’t arch your back.
Subscapularis Self-Stretch
•Elbow stays against side.
•During the isometric, press
toward the belly as if swinging a
gate closed.
•Stretch actively by externally
rotating the humerus.
Oblique Abdominals
Client sits tall, breathes and rotates to increase
ROM
Trainers hands are placed to emphasize trunk
motion, not shoulder motion.
QL/Obliques on a Stability Ball
• Stabilize yourself
sidelying on left side on
the ball.
• Sidebend with arm
overhead to stretch QL.
• Raise up slightly to
isometrically contract
QL.
• To target obliques, add a
forward rotation to the
sidebend.
Hip Abductors
One leg crossed to
move it out of the
way.
Athlete stretches by
adducting straight leg
as far as possible.
Resist isometric
abduction by holding
across the lateral
knee, counterbalance
the opposite hip.
p. 48
Adductors
Both hips stay flat. Knee points toward the ceiling to prevent
leg rotation. Place hand/foot across inside of knee joint to
provide resistance.
p. 52
Gastrocnemius Stretch
Client keeps knee
straight and heel on the
floor.
Trainer resists isometric
plantarflexion by holding
across the ball of the
foot.
Adductors, Self-Stretch
Hip Abductors
Self-Stretch
Calf Self-Stretch
Soleus
Gastrocnemius
Further Reading
• Facilitated Stretching, 3rd
edition
– PNF Stretching and
Strengthening Made Easy
• McAtee and Charland
• Human Kinetics Publishers
2007
Abductors/Low Back Self-Stretch
• Place left ankle outside
right knee, keeping
sacrum on the floor.
• Resist isometric
abduction with right
hand on left knee.
• To stretch the low
back, allow sacrum to
roll up off the floor.