fw190 flexibility
TRANSCRIPT
Chapter
5
Flexibility and Low-Back Health
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 1
Flexibility and Low-Back Health (1)
Ahead: Types of Flexibility What Determines Flexibility? Benefits of Flexibility Assessing Flexibility Creating a Successful Program to
Develop Flexibility Preventing and Managing Low-Back Pain
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 2
Types of Flexibility
Flexibility, the ability of a joint to move through its normal, full range of motion, is important for general fitness and wellness
Range of motion: the full motion possible in a joint Static flexibility: ability to hold an extended position
at one end or point in a joint’s range of motion Dynamic flexibility: ability to move a joint through its
range of motion with little resistance
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 3
What Determines Flexibility?Joint Structure Flexibility of a joint depends
partly on the nature and structure of the joint Hinge joints Ball-and-socket joints Joint capsules: semi-elastic
structures composed primarily of connective tissues; surround major joints
© Andres Rodriguez / Alamy RF
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 4
FIGURE 5.1Basic joint structures
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 5
What Determines Flexibility? Muscle Elasticity and Length (1)
Soft tissues: tissues of the human body that include skin, fat, linings of internal organs and blood vessels, connective tissues, tendons, ligaments, muscles, and nerves
Collagen: white fibers that provide structure and support in connective tissue
Elastin: yellow fibers that make connective tissue flexible
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 6
What Determines Flexibility? Muscle Elasticity and Length (2)
Elastic elongation: temporary change in the length of muscles, tendons, and supporting connective tissues
Plastic elongation: long-term change in the length of muscles, tendons, and supporting connective tissues
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 7
What Determines Flexibility? Nervous System Regulation (1)
Proprioceptor: nerve that sends information about the muscular and skeletal systems to the nervous system
When proprioceptors detect changes in position
or force of muscles and joints, they send signals to the spine and brain The brain sends signals back to coordinate muscle
action to protect muscles and tendons from injury
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 8
What Determines Flexibility? Nervous System Regulation (2)
Proprioceptors control speed, strength, and coordination of muscle contractions Small movements that only slightly stimulate
these receptors cause small reflex actions Rapid, powerful, and sudden changes in muscle
length stimulate receptors and can cause powerful reflex muscle contractions▪ Proprioceptive neuromuscular facilitation (PNF) stretching
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 9
Benefits of Flexibility:Joint Health
When muscles and other tissues supporting a joint are tight, the joint is subject to stresses that can cause deterioration
Poor joint flexibility can cause abnormalities in joint lubrication, leading to deterioration of the cartilage cells lining the joint
© Image Source / Alamy RF
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 10
Benefits of Flexibility: Prevention of Low-Back Pain and Injuries Poor spinal stability puts pressure on the
nerves leading out from the spinal column and can lead to low-back pain Good hip and knee flexibility protects the spine People with either high or low flexibility seem to have
an increased risk of injury Stretching programs are important for older adults,
people who play high-power sports, workers involved in brief bouts of intense exertion, and those and who sit for long periods
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 11
Additional Potential Benefits of Flexibility
Relief of aches and pains Relief of muscle cramps Improved body position and
strength for sports and life Maintenance of good
posture and balance Relaxation Improving impaired mobility
© Dougal Waters/Getty Images RF
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 12
Assessing Flexibility
There are no tests of general flexibility The sit-and-reach test rates the flexibility of
muscles in the lower back and hamstrings
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 13
Creating a Successful Program to Develop Flexibility Should include safe exercises and most
effective techniques Goal of attaining normal flexibility in major joints Balanced flexibility provides for joint stability
and smooth movement
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 14
Applying the FITT Principle (1)
Frequency ACSM recommends stretching exercises be
performed a minimum of two or three days a week Intensity and time (duration)
Slowly apply the stretch to your muscles to the point of slight tension or mild discomfort▪ Hold the stretch for 10 to 30 seconds▪ As tension subsides, stretch a bit farther▪ Rest 30 to 60 seconds; do 2 to 4 repetitions for a total of
60 seconds per exercise
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 15
FIGURE 5.2The FITT principle for a flexibility program
Perform the following stretching exercises as a warm-up for 5-10 minutes or following an endurance or strength training workout: Head turns and tilts: Stretches neck Towel stretch: Stretches triceps, shoulders, chest Across-the-body and overhead: Stretches shoulders, upper back, back of arm Upper-back stretch: Stretches upper back Lateral stretch: Stretches trunk muscles Step Stretch: Stretches hip, front of thigh Side lunge: Stretches inner thigh, hip, calf Inner-thigh stretch: Stretches inner thigh, hip Hip and trunk stretch: Stretches trunk, outer thigh, hip, buttocks, lower back Modified hurdler stretch: Stretches back of thigh, lower back Alternate leg stretcher: Stretches back of thigh, hip, knee, ankle, buttocks Lower-leg stretch: Stretches calf, soleus, Achilles tendon
Frequency: 2-3 days per week (minimum); 5-7 days per week (ideal)Intensity/Resistance: Stretch to the point of mild discomfort, not painTime: All stretches should be held for 10-30 seconds and performed 2-4 times, for a total of 60 seconds per exercise.Type of activity: Stretching exercises that focus on major joints
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 16
Applying the FITT Principle (2)
Types of stretching techniques Static stretching: technique in which a muscle is
slowly and gently stretched and then held in the stretched position
Ballistic stretching: technique in which muscles are stretched by the force generated as a body part is repeatedly bounced, swung, or jerked
Dynamic stretching: technique in which muscles are stretched by moving joints slowly and fluidly through their range of motion in a controlled manner; also called functional stretching
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 17
Applying the FITT Principle (3)
Types of stretching techniques Proprioceptive neuromuscular facilitation (PNF):
uses reflexes initiated by both muscle and joint nerves to achieve greater training effects
Passive stretching: technique in which muscles are stretched by force applied by an outside source
Active stretching: technique in which muscles are stretched by the contraction of the opposing muscles
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 18
Making Progress
Judge progress by noting body position while stretching Should see some improvement after two to three
weeks of stretching May take two months to attain significant
improvements
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 19
Exercises to Improve Flexibility: A Sample Program Flexibility program should include exercises to
work major joints of the body by stretching associated muscle groups Hold each position 10 to 30 seconds for 2 to 4
repetitions Use proper technique
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 20
Flexibility Exercises
Head turns and tilts Towel stretch Across-the-body and
overhead stretches Upper-back stretch Lateral stretch Step stretch Side lunge
Inner-thigh stretch Hip and trunk stretch Modified hurdler
stretch (seated single-leg hamstring)
Leg stretcher Lower-leg stretch Single-leg deadlift
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 21
Preventing and Managing Low-Back Pain Low-back pain afflicts more than 85% of
Americans by age 50 Second-most common ailment in the U.S.
Often the result of weak and inflexible muscles, poor posture, or poor body mechanics when lifting or carrying
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 22
Function and Structure of the Spine (1)
Spine provides structural support for the body Surrounds and protects the spinal cord Supports much of the body’s weight Serves as attachment site for muscles, tendons,
and ligaments Allows movement of the neck and back in all
directions
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 23
Function and Structure of the Spine (2)
Spinal column has 7 cervical, 12 thoracic, 5 lumbar vertebrae Vertebrae: bony segments of the spinal column that
provide structural support for the body and protect the spinal cord
The 9 vertebrae at the bottom are fused into sections that form the sacrum and coccyx
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 24
Function and Structure of the Spine (3)
Intervertebral disk: elastic disk located between adjoining vertebrae, consisting of a gel- and water-filled nucleus surrounded by fibrous rings; serves as a shock absorber for the spinal column
Nerve roots: bases of the 31 pairs of spinal nerves that branch off the spinal cord through spaces between vertebrae
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 25
FIGURE 5.3The spinal column
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 26
FIGURE 5.4Vertebrae and an intervertebral disk
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 27
FIGURE 5.5Major core muscles (front)
Jump to long image description
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 28
FIGURE 5.5Major core muscles (back)
Jump to long image description
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 29
Core Muscle Fitness (1)
Core muscles: trunk muscles extending from the hips to the upper back Attach to ribs, hips, spine and other bones in the
trunk of the body Core muscles stabilize the spine and help transfer
force between the upper body and lower body
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 30
Core Muscle Fitness (2)
During any dynamic movement, core muscles work together Some shorten to cause movement; others contract
and hold to provide stability, lengthen to brake movement, or send signals to the brain about the movements and positions of the muscles and bones▪ Best exercises for low-back health care are whole-body
exercises that force core muscles to stabilize the spine in many different directions
© Wavebreakmedia Ltd/ Getty Images RF
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 31
Causes of Back Pain
Lumbar area is the most common area of pain Poor muscle endurance and strength in the core
muscles Excess body weight Poor posture or body position Poor body mechanics Physical stress can cause disks to break down and
lose some of their ability to absorb shock
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 32
Preventing Low-Back Pain
Maintain a healthy weight Stop smoking and reduce stress Avoid sitting, standing, or working in the same
position for too long Use a supportive seat and a medium-firm
mattress Use lumbar support when driving Warm up thoroughly before exercising Progress gradually when attempting to improve
strength or fitnessCopyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 33
Managing Acute Back Pain
Sudden back pain usually involves tissue injury Applying cold and then heat may reduce pain and
inflammation Bed rest immediately following the onset of pain
may help▪ See physician if acute back pain doesn’t resolve within
a short time Back pain that lasts more than 3 months is
considered chronic
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 34
Managing Chronic Back Pain
Different people benefit from different treatment strategies Medications Exercise Physical therapy, massage, yoga, chiropractic care Acupuncture PENS Education and advice Surgery
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 35
Exercises for the Prevention and Management of Low-Back Pain Perform low-back exercises (3 days per week) Emphasize muscular endurance Don’t do full-range-of-motion spine exercises
early in the morning
Engage in regular endurance exercise Be patient and stick with your program Forget the adage “no pain, no gain” Emphasize stabilization exercises
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 36
Low-Back Exercises
Cat stretch Step stretch Leg stretcher Trunk twist Curl-up Isometric side bridge Spine extensions
(bird dogs)
Wall squat (phantom chair)
Pelvic tilt Back bridge Stir the pot Kettlebell or
dumbbell carry
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 37
Appendix: Long Descriptions for Visuals
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 38
Long Description for FIGURE 5.5
Major core muscles (front)
Deep Muscles include the following:• Abdominal muscles: internal obliques and transversus
abdominis• Hip muscles: adductor brevis, adductor magnus, gemellus
superior, gemellus inferior, obturator internus, and periformis
Superficial Muscles include the following:• Abdominal muscles: rectus abdominis and external
obliques• Hip muscles: rectus femoris, Iliopsoas, tensor fascia lata,
sartorius, pectineus, adductor longus, and gracilis
Jump back to slide containing original image
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 39
Long Description for FIGURE 5.5
Major core muscles (back)
Deep Muscles include the following:• Spinal muscles: quadratus lumborum, paraspinals, and rotatores• Hip muscles: quadratus femoris, obturator externus, gluteus
medius, and gluteus minimusSuperficial Muscles include the following:• Spinal muscles: erector spinae, iliocostalis thoracis, iliocostalis
lumborum, latissimus dorsi, trapezius, and serratus anterior• Hip muscles: gluteus maximus and hamstrings (biceps femoris,
semimembranosus, semitendinosus)
Jump back to slide containing original image
Copyright © 2017 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 40