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WHAT IS IT?
Flexibility is the range of motion at any particular joint. Each person has a somewhat genetically determined range of flexibility that can be changed
through stretching, strengthening exercises or shear neglect. Flexibility is a spectrum of mobility from stiffness to hypermobility or those people more commonly referred to as "double-jointed".
Although stretching and flexibility are often used synonymously, they are not the same thing.
One athlete may be flexible without ever stretching while another may stretch appropriately without gaining flexibility. With proper stretching, maximal functional flexibility can be attained or conversely with proper strengthening exercises decreased flexibility and increased stability can be attained within the spectrum of genetically pre-determined flexibility that you possess.
Every sport has its own flexibility requirements. Some sports, such as gymnastics and wrestling, require extensive flexibility for successful
participation and avoidance of injury. Other sports require joint specific flexibility. Swimming; for example, requires shoulder flexibility. Still other sports require more stability rather than
flexibility for optimum participation like a tennis player with respect to the serving shoulder. Some athletes are successful despite flexibility problems; but adequate flexibility permits better technique
and decreased risk of injury - - which should lead to better performance!
STRUCTURES THAT DETERMINE FLEXIBILITY
Flexibility is determined by the bony configuration of a joint and the soft tissue surrounding it. Soft tissues include any ligaments, joint capsule,
tendons and muscles crossing the joint as well any subcutaneous fat and skin overlying the joint.
Figure 1 - Shoulder joint
Figure 2 - Elbow and radioulnar joints
Figure 3 - Cervical vertebrae
Certain joints permit more motion because of its bony construction. Ball and socket joints (Figure 1), like the shoulder
and hip, permit the most motion. Hinge joints (Figure 2, Elbow joint), such as the elbow or fingers, permit motion only in one direction. Some joints pivot one bone around another (Figure 2,
Radioulnar joint). The small joints of the vertebral column, individually allow small sliding-type motions, but several joints combined produce larger motions like bending your chin towards your chest (Figure 3).
The joint capsule and ligaments support the joint and permit motion determined by the anatomical construction of these soft
tissues. These structures oppose any abnormal motion and check normal joint range of motion. If these tissues are injured, increased motion, motion in inappropriate directions and/or
limited motion secondary to scar tissue may result.
Tendons and muscles crossing a joint also limit its range of motion. If the muscles and tendons are tight, joint motion is
limited. These are the soft tissue most addressed with stretching activities. Any tightness of these tissues is alleviated through a consistent stretching program.
If the skin over a joint has been injured, it may lose its elastic properties and not move/stretch appropriately with joint motion.
For example, a scar from "road rash" or a burn may not stretch as the joint moves, limiting the motion of that joint. Stretching activities and more specifically scar mobilization techniques will
help alleviate this restriction.
Lastly, if a person is overweight or a female athlete is pregnant, motion may be limited by two body parts running into each other.
For example, hip motion may be limited by a large abdomen hitting the thighs rather than hamstring muscle tightness.
TYPES OF STRETCHING
Three types of stretching are commonly used:
1. Ballistic Stretching uses a bounding motion to increase joint range of motion. This type of stretching should be limited
to very specific instances since it causes a protective muscular reflex, to fire and actually shorten the muscle while it is being stretched. This type of stretching increases the chance of injury
while stretching if not used appropriately and supervised.
2. Static Stretching applies a slow, ocntrolled lengthening force to the muscle. A muscle is gradually put under tension
until a comfortable streching sensation is felt in the muscle. This position is held for 20 - 30 seconds. As the stretching sensation diminishes, tension is increased to re-establish the original
stretching sensation. The stretch and hold patterm is repeated 2-4 times for maximum results.
3. Contract-Relax stretching uses neuromuscular reflexes to stretch more effectively. A muscle is first contracted
isometrically, without joint motion, for 3 - 5 seconds ten stretched statically for 15 - 30 seconds. This contract-relax stretch pattern is repeated 3 -5 times to achieve maximal results. This stretching
usually requires a partner to apply the resistance and then stretch.
These three types of stretching all increase joint range of motion. Some techniques are easier to perform then others; some take
more time; and some have greater risk of injury. ALL stretching must be done in a controlled manner, consistently and following a proper warm-up to maximize results. If a stretching sensation is
felt anywhere other than the intended muscle or tendon, the position is wrong and needs to be re-evaluated. Stretching should increase the length of muscles and tendons and not stress joints or ligaments.
For more specific information regarding stretching techniques and recommended stretches for a specific sport, please refer to
accompanying handouts/articles throughout this website. For further information about this or other sports medicine topics, please feel free to contact the medical professionals at Skyline
Hospital's Physical Therapy and Sports Medicine Clinic at (509)493-1101 from White Salmon/Bingen, (541)386-5348 from Hood River, (509)427-2083 from Stevenson or pt@skylinehospital.com
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