Transcript Proprioceptive Neuromuscular Facilitation (PNF)

Proprioceptive
Neuromuscular
Facilitation (PNF)
Dr. Michael P. Gillespie
When To Use PNF
 PNF stretches are most often used by athletes and
individuals who have a range of motion that is less than
normal.
 The two types of PNF to be discussed are as follows:
 Contract-relax technique
 Antagonistic contract-relax technique
Contract-Relax Technique
 1. Passively take a muscle through a range of motion that
produces a mild (not painful) stretch tension.
 2. Contract the muscle (with about the same force as a
closed fist) for 4-5 seconds. 60-60 percent strength
isometric contraction. Breathe.
 3. Relax the muscle momentarily.
 4. Perform a mild static stretch again for 5-15 seconds.
 5. Repeat this process several times.
Contract-Relax Technique
Isotonic and Isometric
Contractions
 Concentric isotonic contraction – a muscle shortens
and pulls on another structure.
 Eccentric isotonic contraction – the length of a muscle
increases during contraction.
 Isometric contraction – muscle tension is created;
however, the muscle doesn’t shorten or lengthen.
Post Isometric Relaxation
 1. Bring the muscle to its maximum length without
stretching, taking up the slack. There should be only
minimal or no pain.
 2. The patient is asked to resist with only minimal force
(isometrically) and to breathe in for 10 seconds.
 3. The patient is then told to ‘let go’ (relax) and exhale
slowly. It is important for the doctor to wait and feel the
relaxation. The doctor could wait 10 to 20 seconds or longer
as relaxation is taking place. Due to pure relaxation there
should be an increase in the range of motion.
Post Isometric Relaxation
 4. If the patient has difficulty relaxing, hold the
isometric phase for 30 seconds before having the
patient ‘let go’.
 5. Usually three to five times is all that is necessary to
obtain spontaneous stretch each session.
 6. Along with breathing, have the patient look up (eyes
only). This helps facilitate the inspiration, which
facilitates the muscle. Have the patient look down
during expiration to aid in relaxation.
Post Isometric Relaxation
 This technique can be used with the force of gravity
substituting for isometric resistance.
Antagonist Contract-Relax
Technique
 This technique uses the principle of contracting and
relaxing opposing muscles (i.e. quadriceps and
hamstring).
 You contract your quadriceps to relax the hamstrings
and then stretch the hamstrings.
 This utilizes a principle of neurology known as
reciprocal inhibition (A biomechanical Yin Yang).
Coordination Within Muscle
Groups
 Movements are typically the result of several skeletal
muscles acting as a group.
 Most skeletal muscles are arranged in opposing
(antagonistic) pairs at joints:
 Flexors – extensors, abductors – adductors, etc.
 One muscles is called the prime mover (agonist) which
contracts to cause an action and the other muscle is
called the antagonist which stretches and yields to the
effects of the prime mover.
Coordination Within Muscle
Groups
 Synergists work with agonists to stabilize intermediate
joints and assist the prime mover.
 Fixators stabilize the origin of the prime mover so that
it can operate more efficiently.
 In limbs, a compartment is a group of skeletal
muscles, with their associated blood vessels and
nerves, that have a common function.
 i.e. In the upper limbs we have flexor compartments and
extensor compartments.
Example of Antagonist
Contract-Relax Technique
 Start in a standing position and slowly bend forward from the
hips (keeping the knees slightly flexed), until you reach a
comfortable stretch.
 Note how far you are able to go.
 Return to a standing position, keeping your knees slightly
flexed.
 Assume a flexed knee position. Hold for 15-20 seconds.
This position contracts your quadriceps and relaxes your
hamstrings.
 Stand up and go back into the first stretch. Hold for 5-15
seconds.
 You should be able to stretch further with the same effort.
Antagonist Contract-Relax
Technique