fw190 flexibility

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


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


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


FIGURE 5.1Basic joint structures


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


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


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


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


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


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


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


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


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


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


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



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



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


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


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


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


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


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



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



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


FIGURE 5.3The spinal column


FIGURE 5.4Vertebrae and an intervertebral disk


FIGURE 5.5Major core muscles (front)

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FIGURE 5.5Major core muscles (back)

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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


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


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


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


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


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


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


Appendix: Long Descriptions for Visuals


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

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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)

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