Flexibility: Achieving Great Movement

PRESENTED BY:Max MARTIN BAppSc (Hons) AEP

TODAY’S AGENDA

Why flexibility?The physiological basis of tightnessWhat does the research say?Flexibility assessmentFloor to ceiling flexibility specifics

Prescription Paradigms

Movement is a behaviourDeveloped, learned and adapted.

Faulty Posture or Movement is a SYMPTOM of dysfunction

Stabilisers typically become hypotonic/inhibited (weak) – ‘allowing’ faulty posture

Gross movers typically become hypertonic/facilitated (tight) – ‘driving’ faulty posture

Why weakness?

Muscle inhibition due to pain/injury

Muscle susceptibility – eg. VMO vs VL atrophy post surgery

Muscle inactivity in chronic postures – eg. Sedentary behaviours

CNS driven protection

Why do people get tight?

Sedentary lifestyleInjury and painRepetitious movementPoor nutrition and hydrationAge (accumulation of behaviours)Altered neuromuscular function

Why anatomical tightness?

Joint ROM can be limited by the following factors

1. Joint constraints

2. connective tissue (40%) – protective, inactivity,

hypertonicity

3. Neurogenic constraints (voluntary and reflexive) -

protective

4. Myogenic constraints – overload protective

tightness?

Or

gaining stability??

tightness weakness

antagonist

synergist

Upper Cross Syndrome

Lower Cross Syndrome

tightness weakness

antagonist

synergist

Clinical/Practical findings

Downward rotators of scaps!

Pec MinorLevator ScapulaRhomboids

Serratus AnteriorTraps

Upward rotators of scaps!

tightness weakness

antagonist

synergist

Hamstrings

Glute max

Hip Flexors• Psoas• Iliacus• TFL• Rec femLumbar Erectors

Glute max

TrA (+core)

Clinical/Practical findings

Pronation

Weakness!!

Stretching for Joint ROM

Harvey, Herbert & Crosbie (2002)13 studies of poor to moderate scientific qualityVarious stretching methods used• Range Of Motion (ROM) gains on average of 8%• tighter muscles greatest measured improvements.• Consistency of >3weeks for ‘plastic’ changes.

Stretching and Performance

Pre Exercise Stretching:•Detrimental to isometric force, isokinetic torque and jumping height•One study found benefits for running economy•Of four studies related to running speed:

–1 was found to be positive– 1 found stretching detrimental –two showed no effect

Regular Stretching•7/9 studies showed positive effects upon various performance parameters, with none showing detrimental effects

Shrier 2004

Let’s think about the design

• Stretching as part of warm up (Young & Behm 2003) prior to jumping tests - concentric & drop jump

• Five groups:1. control (no stretch)2. 4 min run3. passive stretch4. run & stretch5. run, stretch & practice jumps

Result:1. run 1.b) run, stretch & jump3. Run & stretch4. control5. Passive stretch

Effects of Stretching on DOMS:

Herbert & Gabriel (2002)• Pre or Post-exercise

stretching found to be ineffective in reducing DOMS

Injury prevention?Difficult to study – unreliable results

Hard to controlNeed very high intensity to produce risk of injury

Weldon (2003)• Pre-exercise stretching shown to be ineffective for reducing

injury risk• Highest quality studies showed poorest results

Massage & DOMS

Ernst (1998)• Post-exercise massage

shown to be effective in reducing DOMS

• Poor study quality

Massage & Performance

Hennings (2001) Improvements to muscle

endurance and power No effect upon MVC, stride

length, submax running No effect when massaged

between exercise bouts

Massage & Joint ROM

Moraska (2005) • Pre-exercise massage

shown to improve ROM• Results short term

Self-Myofascial Release Reviews

None!

Superficial Front Line

Superficial Back Line

Spiral Line

Functional Front & Back Lines

Exercise and myofascial release

Exercise/movement is vital for myofascial release treatment

Resets neurological programming (ideal 30-60 secs post)

Both needed for permanent change

Practical programming

Look at what is short-tight and facilitated (assess!!)

Address Right/left and front/back imbalances

Consider performance effect of chosen modality

Stretch if trying to ‘relax’ certain muscle

Stretch for the ‘stiff’ post SMFR > tissue and joint

mobility

SMFR to low-tone, ‘floppy’ client

Trigger point release will reset muscle function

Warm up: Self-myofascial release Activation exercises (+ mobilisers) Dynamic warm up with progressive loading

(jog, add speed and direction change, dynamic stretch, agility, skill)

Cool Down Decrease metabolic load for waste product clearance Slow dynamic stretching movements SMFR Static stretching later

Practical programming

Prescription Paradigms

Joint by joint approach

Ankle

Foot

Knee

Hip

Lx Spine

Tx Spine

Scapula

GH Joint

Mobile

Stable

Stable

Mobile

Stable

Mobile

Stable

Mobile

Stiff

unstable

unstable

Stiff

unstable

Stiff

unstable

Stiff

Western Foot!!

PRESENTED BY:Max MARTIN BAppSc (Hons)AEP

max@correctiveexerciseaustralia.com

@iNformMaxMartin Corrective Exercise Australia