Stretching Concepts

Ted Nissen Copyright December 2003

Table of Contents

1.1 An Overview of Flexibility. 1

1.2 Contractile Components of Muscle: Limiting Factors of Flexibility. 2

1.3 Connective Tissue as a Limiting Factor of Flexibility. 4

1.4 Mechanical and Dynamic Properties of Soft Tissues. 6

1.5 The Neurophysiology of Flexibility: Neural Anatomy and Neural Transmission. 8

1.6 Osteology and Arthrology. 9

1.7 Social Facilitation and Psychology in Relation to Stretching. 9

1.8 Potpourri 10

1.9 Relaxation. 10

1.10 Muscular Soreness: Its Etiology and Consequences. 12

1.11 Types and Varieties of Stretching. 12

1.12 Stretching Concepts. 15

2 Functional Anatomy. 16

2.1 The Lower Extremity and Pelvic Girdle. 16

2.2 The Vertebral Column. 20

2.3 The Upper Extremity. 22

1 Factors Related to Flexibility and Stretching

1.1 An Overview of Flexibility

Back Table of Contents References Chapter Illustrations

1.1.1 1.1.2 The Nature of Flexibility

1.1.2.1

1.1.3 Flexibility Training Program

1.1.3.1

1.1.4 Benefits of a Flexibility Training Program

1.1.4.1 1.1.4.2 Union of the Body, Mind, and Spirit

1.1.4.2.1

1.1.4.3 Relaxation of Stress and Tension

1.1.4.3.1

1.1.4.4 Muscular Relaxation

1.1.4.4.1

1.1.4.5 Self-Discipline

1.1.4.5.1

1.1.4.6 Body Fitness, Posture, and Symmetry

1.1.4.6.1

1.1.4.7 Flexibility and Low Back Pain

1.1.4.7.1

1.1.4.8 Relief of Muscular Soreness

1.1.4.8.1

1.1.4.9 Enhancement of Physical and Athletic Skills

1.1.4.9.1

1.1.4.10 Injury Prevention

1.1.4.10.1

1.1.4.11 Enjoyment

1.1.4.11.1

1.1.5 Potential Disadvantages of Flexibility Training

1.1.5.1

1.1.6 Summary

1.1.6.1

1.1.7 Test Your Knowledge

1.1.7.1

1.2 Contractile Components of Muscle: Limiting Factors of Flexibility

1.2.1 1.2.2 Composition of Myofibrils and Their Constituents

1.2.2.1 The Ultrastructure of the Myofibrils

1.2.2.1.1

1.2.2.2 The Sarcotubular System

1.2.2.2.1

1.2.3 Muscular Contraction, Relaxation, and Elongation

1.2.3.1 1.2.3.2 The Theory of Contraction

1.2.3.2.1 1.2.3.2.2 The Ultrastructural (Physical) Basis of Contraction

1.2.3.2.2.1

1.2.3.2.3 The Molecular (Chemical) Basis of Contraction

1.2.3.2.3.1

1.2.3.3 The Theory of Muscular Relaxation

1.2.3.3.1 1.2.3.3.2 The Ultrastructural (Physical) Basis of Relaxation

1.2.3.3.2.1

1.2.3.3.3 The Molecular (Chemical) Basis of Relaxation

1.2.3.3.3.1

1.2.3.4 The Theory of Muscular Elongation

1.2.3.4.1

1.2.4 Ultrastructural Limitations of Sarcomere Elongation

1.2.4.1

1.2.5 Improper Muscle Balance as a Limiting Factor

1.2.5.1

1.2.6 Inadequate Muscle Control as a Limiting Factor

1.2.6.1

1.2.7 The Effects of Aging on Muscle

1.2.7.1

1.2.8 The Effects of Immobilization

1.2.8.1

1.2.9 Summary

1.2.9.1

1.2.10 Test Your Knowledge

1.2.10.1

1.3 Connective Tissue as a Limiting Factor of Flexibility

1.3.1 1.3.2 Collagen

1.3.2.1 1.3.2.2 The Ultrastructure of Collagen

1.3.2.2.1

1.3.2.3 Cross-Links

1.3.2.3.1

1.3.2.4 The Biochemical Composition of Collagen

1.3.2.4.1

1.3.2.5 Groundsubstances

1.3.2.5.1

1.3.2.6 The Effects of Aging on Collagen

1.3.2.6.1

1.3.2.7 The Ultrastructural Basis of Elongation and the Physiological Limit of Elongation

1.3.2.7.1

1.3.3 Elastic Tissue

1.3.3.1 1.3.3.2 The Composition of Elastic Fibers

1.3.3.2.1

1.3.3.3 Cross-Links

1.3.3.3.1

1.3.3.4 Elastin

1.3.3.4.1

1.3.3.5 The Relationship between Collagen and Elastin

1.3.3.5.1

1.3.3.6 The Effects of Aging on Elastic Fibers

1.3.3.6.1

1.3.3.7 The Ultrastructural Basis and the Physiological Limit of Elongation

1.3.3.7.1

1.3.4 Tissues Composed of Connective Tissue

1.3.4.1 1.3.4.2 Tendons

1.3.4.2.1

1.3.4.3 Ligaments

1.3.4.3.1

1.3.4.4 Fascia

1.3.4.4.1

1.3.4.5 The Effects of Immobilization on Connective Tissues

1.3.4.5.1

1.3.5 Summary

1.3.5.1

1.3.6 Test Your Knowledge

1.3.6.1

1.4 Mechanical and Dynamic Properties of Soft Tissues

1.4.1 1.4.2 Definitions and Terminology

1.4.2.1 1.4.2.2 Deformations

1.4.2.2.1

1.4.2.3 Elasticity

1.4.2.3.1

1.4.2.4 Stress

1.4.2.4.1

1.4.2.5 Strain

1.4.2.5.1

1.4.2.6 Hooke’s Law and the Modulus of Elasticity

1.4.2.6.1

1.4.2.7 Elastic Limit, Permanent Set or Sprain, Yield Point, and Ultimate Strength

1.4.2.7.1

1.4.3 Soft Tissues

1.4.3.1 1.4.3.2 Properties of Soft Tissues

1.4.3.2.1

1.4.3.3 The Relationship and Significance of the Mechanical Properties of Soft Tissues to Stretching

1.4.3.3.1

1.4.4 Mechanical Components/ Elements of Muscle

1.4.4.1 1.4.4.2 The Parallel Elastic Component (PEC)

1.4.4.2.1

1.4.4.3 The Series Elastic Component (SEC)

1.4.4.3.1

1.4.4.4 The Contractile Component (CC)

1.4.4.4.1

1.4.4.5 Total Tension of Active Muscle During Stretch

1.4.4.5.1

1.4.4.6 The Force-Length Relationship

1.4.4.6.1

1.4.4.7 Stress-Relaxation and Creep during Passive Tension

1.4.4.7.1

1.4.4.8 Stretches Applied during Contraction at and beyond 1.5 Lo

1.4.4.8.1

1.4.5 Research Findings

1.4.5.1

1.4.6 An Analysis of the Factors Affecting the Mechanical Properties of Connective Tissues and Muscles

1.4.7 1.4.8 Summary

1.4.8.1

1.4.9 Test Your Knowledge

1.4.10

1.5 The Neurophysiology of Flexibility: Neural Anatomy and Neural Transmission

1.5.1 1.5.2 Nerves

1.5.2.1

1.5.3 Resting Potential

1.5.3.1

1.5.4 The All-or-None Law

1.5.4.1

1.5.5 CNS Feedback on Intensity of Stretching

1.5.5.1

1.5.6 Sensory Adaptation

1.5.6.1

1.5.7 Muscle Spindles

1.5.7.1

1.5.8 The Process of Muscle Spindle Excitation

1.5.8.1

1.5.9 The Myotatic or Stretch Reflex

1.5.9.1

1.5.10 Reciprocal Innervation

1.5.10.1

1.5.11 The Golgi Tendon Organs

1.5.11.1

1.5.12 The Inverse Myotatic Reflex or the Autogenic Inhibition

1.5.12.1

1.5.13 Summary

1.5.13.1

1.5.14 Test your Knowledge

1.5.14.1

1.6 Osteology and Arthrology

1.6.1 1.6.2 Structural Limitations

1.6.2.1

1.6.3 Classification of Joints and their Influence on Motion

1.6.3.1

1.6.4 Types of Motion

1.6.4.1

1.6.5 Growth of Bones as a Factor of Flexibility

1.6.5.1

1.6.6 Close-Packing as a Limiting Factor of Flexibility

1.6.6.1

1.6.7 Osteoporosis

1.6.7.1

1.6.8 Summary

1.6.8.1

1.6.9 Test you Knowledge

1.6.9.1

1.7 Social Facilitation and Psychology in Relation to Stretching

1.7.1 1.7.2 The Effect of an Audience on Developing Flexibility

1.7.2.1

1.7.3 The Effect of Coaction on Developing Flexibility

1.7.3.1

1.7.4 Summary

1.7.4.1

1.7.5 Test your Knowledge

1.7.5.1

1.8 Potpourri

1.8.1 1.8.2 Ate and Flexibility Development

1.8.2.1

1.8.3 Critical Periods of Flexibility Development

1.8.3.1

1.8.4 Sex Differences in Flexibility

1.8.4.1

1.8.5 Body Build and Flexibility

1.8.5.1

1.8.6 Viscosity’s Effect on Flexibility

1.8.6.1

1.8.7 Warming Up and Cooling Down (Warming Down)

1.8.7.1

1.8.8 Strength Training

1.8.8.1

1.8.9 Summary

1.8.9.1

1.8.10 Test your Knowledge

1.8.10.1

1.9 Relaxation

1.9.1 1.9.2 Defining Relaxation

1.9.2.1

1.9.3 Methodologies of Muscular Relaxation

1.9.3.1

1.9.4 Stretching

1.9.4.1

1.9.5 Special Modalities, Drugs, or Aids

1.9.5.1 1.9.5.2 Heat

1.9.5.2.1

1.9.5.3 Diathermy

1.9.5.3.1

1.9.5.4 Cold

1.9.5.4.1

1.9.5.5 Massage

1.9.5.5.1

1.9.5.6 Analgesic/Counterirritant Balms and Liniments

1.9.5.6.1

1.9.5.7 Muscle Relaxant Drugs

1.9.5.7.1

1.9.5.8 Biofeedback

1.9.5.8.1

1.9.5.9 Progressive Relaxation

1.9.5.9.1

1.9.5.10 The Relaxation Response

1.9.5.10.1

1.9.5.11 Breathing and Imagery

1.9.5.11.1

1.9.6 Summary

1.9.6.1

1.9.7 Test your Knowledge

1.9.7.1

1.10 Muscular Soreness: Its Etiology and Consequences

1.10.1 1.10.2 The Torn Tissue and Connective Tissue Damage Hypotheses

1.10.2.1

1.10.3 Etiology

1.10.3.1

1.10.4 The Inflammatory Response and Consequences

1.10.4.1

1.10.5 Stretching and Scar Tissue

1.10.5.1

1.10.6 The Metabolic Accumulation or Osmotic Pressure and Swelling Hypothesis

1.10.6.1

1.10.7 The Localized Spasm of Motor Units Hypothesis

1.10.7.1

1.10.8 Summary

1.10.8.1

1.10.9 Test your Knowledge

1.10.9.1

1.11 Types and Varieties of Stretching

1.11.1 Traditional Classifications

1.11.1.1 1.11.1.2 Arguments Supporting Ballistic Stretching

1.11.1.2.1

1.11.1.3 Arguments Against Ballistic Stretching

1.11.1.3.1

1.11.1.4 Arguments Supporting Static Stretching

1.11.1.4.1

1.11.1.5 Arguments Against Static Stretching

1.11.1.5.1

1.11.2 Additional Classifications

1.11.2.1 1.11.2.2 Passive Stretching

1.11.2.2.1

1.11.2.3 Passive-Active Stretching

1.11.2.3.1

1.11.2.4 Active-Assisted Stretching

1.11.2.4.1

1.11.2.5 Active Stretching

1.11.2.5.1

1.11.3 Proprioceptive Neuromuscular Facilitation (PNF)

1.11.3.1 1.11.3.2 The Neurophysiological Basis of PNF

1.11.3.2.1

1.11.3.3 Advantages and Benefits of PNF Techniques

1.11.3.3.1

1.11.3.4 Arguments and Controversy against PNF Techniques

1.11.3.5 PNF Techniques

1.11.3.5.1 1.11.3.5.2 Repeated Contractions (RC)

1.11.3.5.2.1

1.11.3.5.3 Rhythmic Initiation (RI)

1.11.3.5.3.1

1.11.3.5.4 Slow Reversal (SR)

1.11.3.5.4.1

1.11.3.5.5 Slow Reversal-Hold (SRH)

1.11.3.5.5.1

1.11.3.5.6 Rhythmic Stabilization (RS)

1.11.3.5.6.1

1.11.3.5.7 Contract-Relax (CR)

1.11.3.5.7.1

1.11.3.5.8 Hold-Relax (HR)

1.11.3.5.8.1

1.11.3.5.9 Slow Reversal-Hold-Relax (SRHR)

1.11.3.5.9.1

1.11.3.5.10 Agonistic Reversal (AR)

1.11.3.5.10.1

1.11.3.6 Manipulation

1.11.3.6.1

1.11.3.7 Traction

1.11.3.7.1

1.11.3.8 Summary

1.11.3.8.1

1.11.3.9 Test your Knowledge

1.11.3.9.1

1.12 Stretching Concepts

1.12.1 1.12.2 Homeostasis

1.12.2.1

1.12.3 The Overstretching Principle

1.12.4 1.12.5 Requisites

1.12.6 1.12.7 Knowledge of Limitations

1.12.8 1.12.9 Principles of Stretching

1.12.9.1 1.12.9.2 Safety

1.12.9.3 1.12.9.4 Medical Exam

1.12.9.5 1.12.9.6 Identifiable Goals

1.12.9.7 1.12.9.8 Individualized Program

1.12.9.9 1.12.9.10 Keep Accurate Records

1.12.9.11 1.12.9.12 Gradualism

1.12.9.13 1.12.9.14 Comparing and Competing

1.12.9.15 1.12.9.16 Clothes and Positioning

1.12.9.17 1.12.9.18 Mental Set

1.12.9.19 1.12.9.20 Relaxation

1.12.9.21 1.12.9.22 Warm-up and Cool-Down (Warm-Down)

1.12.9.23 1.12.9.24 Isolate the Muscle

1.12.9.25 1.12.9.26 Application of the S.A.I.D. Principle

1.12.9.27 1.12.9.28 Application of the Overstretching Principle

1.12.9.29 1.12.9.30 Mechanics

1.12.9.31 1.12.9.32 Stretch Reflex

1.12.9.33 1.12.9.34 Anticipation and Communication

1.12.9.35 1.12.9.36 Appropriate Use of Medical Resources

1.12.9.37 1.12.9.38 Enjoyment

1.12.9.39

1.12.10 Summary

1.12.11 1.12.12 Test Your Knowledge

1.12.13

2 Functional Anatomy

2.1 The Lower Extremity and Pelvic Girdle

2.1.1 2.1.2 The Foot

2.1.2.1 2.1.2.2 The Significance of a Flexible Foot and Ankle

2.1.2.2.1

2.1.2.3 The Significance of Exercise

2.1.2.3.1

2.1.2.4 Limits on Range of Motion

2.1.2.4.1

2.1.2.5 Extension of the Interphalangeal and Metatarsophalangeal Joints of the Toes

2.1.2.5.1

2.1.3 The Ankle or Talocrural Joint

2.1.3.1 2.1.3.2 The Effects of Excessive Stress

2.1.3.2.1

2.1.3.3 Limits on Range of Motion

2.1.3.3.1 2.1.3.3.2 Eversion

2.1.3.3.2.1

2.1.3.3.3 Inversion

2.1.3.3.3.1

2.1.3.3.4 Plantar Flexion

2.1.3.3.4.1

2.1.3.3.5 Ankle Dorsiflexion

2.1.3.3.5.1

2.1.3.3.6 Injury Prevention

2.1.3.3.6.1

2.1.4 The Lower Leg

2.1.4.1 2.1.4.2 The Posterior Muscles

2.1.4.2.1 2.1.4.2.2 Injuries to the Posterior Muscles and Tendo Calcaneus

2.1.4.2.2.1

2.1.4.2.3 Stretching the Posterior Crural Muscles and Tendo Calcaneus

2.1.4.2.3.1

2.1.4.3 The Anterior and Lateral Crural Muscles

2.1.4.3.1 2.1.4.3.2 Injuries

2.1.4.3.2.1

2.1.4.3.3 Stretching

2.1.4.3.3.1

2.1.5 The Genual or Knee Joint

2.1.5.1 2.1.5.2 Limits on Range of Motion

2.1.5.2.1 2.1.5.2.2 Flexion

2.1.5.2.2.1

2.1.5.2.3 Extension

2.1.5.2.3.1

2.1.5.2.4 The Mechanical and Structural Disadvantages of the Knee

2.1.5.2.4.1

2.1.5.3 The Upper Leg

2.1.5.3.1 2.1.5.3.2 The Posterior Femoral Muscles

2.1.5.3.2.1

2.1.5.3.2.2 Causes and Mechanisms of Injury

2.1.5.3.2.2.1

2.1.5.3.2.3 Stretching

2.1.5.3.2.3.1

2.1.5.3.3 The Medial Femoral Muscles

2.1.5.3.3.1

2.1.5.3.3.2 Causes and Mechanisms of Injury

2.1.5.3.3.2.1

2.1.5.3.3.3 Stretching

2.1.5.3.3.3.1

2.1.5.3.4 The Anterior Femoral Muscles

2.1.5.3.4.1

2.1.5.3.4.2 Causes and Mechanisms of Injury

2.1.5.3.4.2.1

2.1.5.3.4.3 Stretching

2.1.5.3.4.3.1

2.1.5.4 The Iliac Region

2.1.5.4.1

2.1.5.5 The Gluteal Region

2.1.5.5.1 2.1.5.5.2 Causes and Mechanisms of Injury

2.1.5.5.2.1

2.1.5.5.3 Stretching

2.1.5.5.3.1

2.1.5.6 The Coxal or Hip Joint

2.1.5.6.1 2.1.5.6.2 Factors Affecting Stability and Range of Motion

2.1.5.6.2.1

2.1.5.6.2.2 The Acetabulum

2.1.5.6.2.2.1

2.1.5.6.2.3 The Shape of the Pelvis

2.1.5.6.2.3.1

2.1.5.6.2.4 The Angle of Inclination and Declination

2.1.5.6.2.4.1

2.1.5.6.2.5 The Articular Capsule and Ligaments

2.1.5.6.2.5.1

2.1.5.6.2.6 Muscular Reinforcement and Coordination

2.1.5.6.2.6.1

2.1.5.6.3 Limits on Range of Motion

2.1.5.6.3.1

2.1.5.6.3.2 Flexion

2.1.5.6.3.2.1

2.1.5.6.3.3 Extension

2.1.5.6.3.3.1

2.1.5.6.3.4 Abduction

2.1.5.6.3.4.1

2.1.5.6.3.5 Adduction

2.1.5.6.3.5.1

2.1.5.6.3.6 Medial Rotation

2.1.5.6.3.6.1

2.1.5.6.3.7 Lateral Rotation

2.1.5.6.3.7.1

2.1.6 Test Your Knowledge

2.1.6.1

2.2 The Vertebral Column

2.2.1 2.2.2 Gross Anatomy

2.2.2.1

2.2.3 Function

2.2.3.1

2.2.4 The Vertebrae

2.2.4.1

2.2.5 The Disks

2.2.5.1 2.2.5.2 The Nucleus Pulposus

2.2.5.2.1

2.2.5.3 The Annulus Fibrosus

2.2.5.3.1

2.2.6 The Vertebral Ligaments

2.2.6.1 2.2.6.2 Flexion and Extension

2.2.6.2.1

2.2.6.3 Lateral Flexion

2.2.6.3.1

2.2.7 Limits on Range of Motion of the Thoracic=Lumbar Region

2.2.7.1 2.2.7.2 Trunk Flexion

2.2.7.2.1

2.2.7.3 Trunk Extension

2.2.7.3.1

2.2.7.4 Lateral Trunk Flexion

2.2.7.4.1

2.2.8 The Interrelationship of Stretching the Lower Back, Pelvis, and Hamstrings

2.2.8.1

2.2.9 The Cervical Vertebrae

2.2.9.1 2.2.9.2 Movements of the Neck

2.2.9.2.1

2.2.9.3 Limits to Range of Motion

2.2.9.3.1 2.2.9.3.2 Flexion

2.2.9.3.2.1

2.2.9.3.3 Extension

2.2.9.3.3.1

2.2.9.3.4 Lateral Flexion

2.2.9.3.4.1

2.2.9.3.5 Dangerous Stretching

2.2.9.3.5.1

2.2.10 Test Your Knowledge

2.2.10.1

2.3 The Upper Extremity

2.3.1 2.3.2 The Shoulder Girdle and Arm-Complex

2.3.2.1 2.3.2.2 Gross Anatomy

2.3.2.2.1

2.3.2.3 Analysis of Movement

2.3.2.3.1 2.3.2.3.2 Extension and Backward Extension

2.3.2.3.2.1

2.3.2.3.3 Abduction

2.3.2.3.3.1

2.3.2.3.4 Internal (Inward) or Medial Rotation

2.3.2.3.4.1

2.3.2.3.5 External (Outward) or Lateral Rotation

2.3.2.3.5.1

2.3.2.3.6 Horizontal Transverse Abduction (Extension)

2.3.2.3.6.1

2.3.2.3.7 Horizontal Transverse Adduction (Flexion)

2.3.2.3.7.1

2.3.2.3.8 Elevation of the Scapula

2.3.2.3.8.1

2.3.2.3.9 Depression of the Scapula

2.3.2.3.9.1

2.3.2.3.10 Protraction (Flexion) of the Scapula

2.3.2.3.10.1

2.3.2.3.11 Retraction (Extension) of the Scapula

2.3.2.3.11.1

2.3.2.4 Injuries, Stretching, and Testing

2.3.2.4.1

2.3.3 The Elbow Joint

2.3.3.1 2.3.3.2 Analysis of Movement

2.3.3.2.1 2.3.3.2.2 Flexion

2.3.3.2.2.1

2.3.3.2.3 Extension

2.3.3.2.3.1

2.3.3.2.4 Pronation

2.3.3.2.4.1

2.3.3.2.5 Supination

2.3.3.2.5.1

2.3.3.3 Injuries

2.3.3.3.1

2.3.4 The Radiocarpal or Wrist Joint

2.3.4.1 2.3.4.2 Stability

2.3.4.2.1

2.3.4.3 Analysis of Movement

2.3.4.3.1 2.3.4.3.2 Flexion

2.3.4.3.2.1

2.3.4.3.3 Extension

2.3.4.3.3.1

2.3.4.3.4 Abduction (Radial Deviation)

2.3.4.3.4.1

2.3.4.3.5 Adduction (Ulnar Deviation)

2.3.4.3.5.1

2.3.4.4 Test Your Knowledge

2.3.4.4.1