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1

Ch 4

Flexibility

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Flexibility – Definitions & Types

Flexibility: the ability of a joint to move through its full range of motion (ROM)

80% of all low back problems are caused by improper alignment of the spine & pelvic girdle – i.e. due to a lack of flexibility and weak abdominal muscles (core).

Over $1 BILLION dollars lost by businesses because of employees suffering from

low-back problems.

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Flexibility – Definitions & Types

Two types of flexibility: 1) Static: The ability to assume and maintain an

extended position at one end or point in a joint’s ROM;

Dependent upon structure of a joint & tightness of muscles, tendons, & ligaments that are attached

2) Dynamic: The ability to move a joint through its ROM with little resistance

Dependent upon static flexibility and strength, coordination, and resistance to movement

Can be important in daily activities & sport

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Major Benefits of Flexibility

Promotes good joint health

Slows joint deterioration

Can improve the elasticity in tissue making it easier to move

Improves quality of life - especially as you age

Problem can be made worse by arthritis

May prevent low-back pain and injuries

Reduces frequency and severity of injuries

Overstretching can decrease the stability of the joint

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Other Benefits of Flexibility Reduced soreness (Delayed Onset of Muscle

Soreness) - injury to muscle fibers and surrounding tissue; action causes inflammation - causes release of proteases {enzymes that break down proteins} & causes pain/discomfort - muscles will produce proteins that prevent soreness in future workouts - you will become sore again if not regularly working out)

Improves performance in sports and other activities

Contributes to good posture

Promotes relaxation

Contraindicated Exercises •Most strength and flexibility exercises are relatively safe to perform •Some exercises (contraindicated) can be hazardous if performed incorrectly •Contraindicated exercises may cause harm because of excessive strain on muscles and joints; in particular the spine, lower back, knees, neck, or shoulders •A list of contraindicated exercises are provided in the textbook (e.g. plow, bridge, double leg lift, deep knee bend, hurdler’s stretch, hero stretch, quad stretch, ballistic bar stretch)

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7 From: HPS Faculty at Kennesaw State University (2009) Fitness for Living. Dubuque, IA. Kendall Hunt. (www.khwebcom.com) p. 78. 8

From: HPS Faculty at Kennesaw State University (2009) Fitness for Living. Dubuque, IA. Kendall Hunt. (www.khwebcom.com) p. 79.

9

From: HPS Faculty at Kennesaw State University (2009) Fitness for Living. Dubuque, IA. Kendall Hunt. (www.khwebcom.com) p. 80.

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What Determines Flexibility? Joint structure - Different for joint types (hinge – finger

& knee; ball & socket - shoulder & hip)

primary determinant - can be limited by heredity

Muscle tissue’s elasticity and length can be lengthened if stretched regularly

Important for connective tissue to stretch

Nervous system activity

stretch receptors control the length of muscles

proprioceptive neuromuscular facilitation (PNF) technique may improve flexibility

Factors Affecting Flexibility

• Genetics

• Physical inactivity

• Joint structure

• Joint specific

• Ligaments - connects bones to other bones

• Tendons - connects muscle to bone

• Muscles

• Skin

• Tissue injury

• Adipose tissue (fat)

• Body temperature

• Age

• Gender

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Muscle Tissue and Flexibility

Muscle tissue can be stretched to increase flexibility

Connective tissue is most important part of muscle tissue for flexibility – can rupture if “overstretched”

Types of connective tissue:

collagen (white fibers) for structure and support

elastin (yellow fibers) are elastic and flexible

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Stretching Techniques

Static stretching (slow, sustained)

should “warm-up” before stretching each muscle is gradually stretched and held for 15-30

seconds; repeated 2-4 times; at least 3 times/week Should experience a sensation of “tightness” - but not pain Can be active (done by one’s self) or passive (with a partner)

Ballistic stretching sudden stretching in a bouncing movement sometimes used in sport specific training, but can/will cause

problems (e.g. muscle damage & delayed muscle soreness) Could increase risk of partial or full joint dislocation due to

loosening of the ligaments NOT recommended for improving overall range of motion

(ROM)

Stretching Techniques Active Isolated Stretching (AIS)

Isolate muscle to be stretched Actively contract muscle opposite one being stretched (e.g. quads & hamstrings) Stretch targeted muscle for no more than 2 sec. Release stretch before muscle reacts to being stretched Repeat 2-3 times

Proprioceptive Neuromuscular Facilitation (PNF) Contract-and-Relax method; performed with a partner The range of motion is slowly increased muscle is isometrically contracted (4-5 sec.), then

stretched (10-30 sec.) The isometric type of contraction helps muscle to relax May cause soreness, requires partner; takes more

time/session

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Alternative Methods of Stretching • Pilates: incorporated yoga, martial arts, and

calisthenics into light resistance exercises using machines with springs or elastic cables to work the entire body.

• Yoga: Stimulates the mind/body relationship to enhance one’s well-being. Incorporates breathing techniques and body alignment movements that increase blood flow and energy to body tissues.

• Tai Chi: slow-moving form of martial arts – Stresses suppleness and elasticity vs. hardness & force

– Improves balance, strength, and improved ROM

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Low Back Pain

85% of Americans have low back problems

Most common site for injury - lumbar area – since it carries most of the body’s weight

Underlying causes: weak muscles; excess body weight; poor posture; poor bio-mechanics

“Slipped” disk – a damaged intervertebral disk – may bulge out between vertebrae against a nerve causing pain, numbness, loss of muscle function, muscle spasms

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Low Back Pain - Prevention

Maintain correct posture in all activities – including warm-ups & exercise

Warm up properly using mild stretches before engaging in physical activity

Use proper weight lifting techniques

Lift heavy objects by bending at the knees and carrying them close to the body

Lose weight

Reduce stress 20

Low Back Pain - Prevention • Be physically active • Strengthen muscles in abdomen, along spine

(erector spinae) and sides, hips, and thighs • Stretch often using spinal exercises through a

functional range of motion • Regularly strengthen the core of the body • Avoid sitting (over 50 minutes) or standing in one

position for lengthy periods of time • Use a firm mattress • Sleep on your back with a pillow under the knees

or sideways with the knees drawn up and a small pillow between the knees

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Developing A Flexibility Program

Active and passive stretching safest technique is active static stretching add occasional passive assist

Intensity and duration hold each stretch for 10-30 seconds Only to the point of mild discomfort or tightness There should be NO pain at least 2-4 repetitions of each stretch rest for 30-60 seconds between stretches

Frequency minimum of 2-3 days per week Ideal is daily

Flexibility Fitness Tests Labs 4.2 & 4.3

LAB 4.2

• Rating Your Posture

LAB 4.3

• Modified sit-and-reach test

• Total body rotation test

• Shoulder flexibility Test

• * Shoulder rotation test (Alt. version)

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Modified Sit and Reach Test

Starting position for the modified sit-and-reach test

Measures hip and trunk flexibility. Modified protocol accounts for arm/leg length discrepancies.

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Modified Sit and Reach Test

Modified Sit-and-Reach Test

Hold the final reach for two seconds

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Total Body Rotation Test

Measures body rotation. Test is performed on either right or left side.

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Shoulder Flexibility Test • While standing, raise your left arm and reach down your back as far as

possible. Move your right arm behind your back and upward as high as possible. Try to overlap your fingers and/or hands as much as possible. Estimate the overlap of fingers in inches or centimeters. Repeat with the right arm up and left arm down.

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Shoulder Rotation Test (Alt. Test) • Measures shoulder flexibility

Measuring

biacromial width

Starting position

for the shoulder

rotation test

Shoulder rotation test

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Age Category - Men

Percentile

Rank ≤18

19

-

35

36

-

49

≥50

in. in. in. in.

90 18.5 15

.5

20

.8

27.

9

High

Phys. Fit.

Std. 80 20.7

18

.4

23

.3

28.

5

70 23.0 20

.5

24

.7

29.

4

60 24.2 22

.9

26

.6

29.

9

Health

Fitness Std.

50 25.4 24

.4

28

.0

30.

5

40 26.3 25

.7

30

.0

31.

0

30 28.2 27

.3

31

.9

31.

7

20 30.0 30

.1

33

.3

33.

1

10 33.5 31

.8

36

.1

37.

2

5 34.7 33

.5

37

.8

38.

7

1 40.8 42

.6

43

.0

44.

1

Age Category - Women

Percentile

Rank ≤18

19

-

35

36

-

49

≥50

in. in. in. in.

90 10.7 9.

7

16

.8 20.9

High

Phys. Fit.

Std.

80 14.5 14

.5

19

.2 22.5

70 16.1 17

.2

21

.5 24.3

60 19.2 18

.7

23

.1 25.1

Health

Fitness

Std

50 21.0 20

.0

23

.5 26.2

40 22.2 21

.4

24

.4 28.1

30 23.2 24

.0

25

.9 29.9

20 25.0 25

.9

29

.8 31.5

10 27.2 29

.1

31

.1 33.1

5 28.0 31

.3

33

.4 34.1

1 32.5 37

.1

34

.9 35.4

Name: _________________

Percentile Ranks for Shoulder Rotation Test

Biacromial width (nearest ¼ inch): __________

Distance between little fingers: ____________

(Distance between fingers) – (Biacromial width) = _________

28 From: Hoeger, W.W.K. and Hoeger, Sharon A. (2010) Principles and Labs for Fitness and Wellness (10th Ed.). Belmont, CA:

Wadsworth/Thomson Learning. (p, 295)

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Ch 5

Nutrition

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Dietary Analysis Dietary analysis may be completed using the

USDA Super Tracker program that is available on the WWW or from your home computer at:

https://www.choosemyplate.gov/SuperTracker/default.aspx

or Calories Per Hour site

http://www.caloriesperhour.com/index_food.html

or Dietary Approaches to Stop Hypertension

http://dashdiet.org/default.asp

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Old Food Pyramid

https://www.choosemyplate.gov/supertracker/

Orange = Grains

6 oz/day

Green = Vegetables

2-3 cups/day

Figure

represents

the

importance of

daily physical

activity

Red = Fruits

1 ½ - 2

cups/day

Yellow = Oils

5-7 TBLs/day

Blue = Milk

3 cups/day

Purple = Meats &

Beans

5 - 6 oz/day

Colors

represent

food groups

& oils, widths

of the bands

offer a guide

to portions

Replacement for Food Pyramid

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My Plate (Replaces the Food Pyramid)

Dairy How Much? (@ 3 cups)

• Fruits Grains • How Much? How Much?

(@1.5 – 2 cups) (@3 – 4 oz.)

• Vegetables Protein • How Much? How Much?

• (@2 – 3 cups) (@5 – 6.5 oz.) • Exercise • How Much?

• (@2.5 hrs./week) MyPlate.gov

2010 Dietary Guidelines

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Essential Nutrients

Nutrients the body cannot produce in sufficient quantity for its needs

Energy providing nutrients

Proteins - (4 calories/gram) Form important parts of muscle, bone, blood, enzymes, repair tissue, regulate water balance & acid-base balance, help in growth, supply energy

Fats - (9 calories/gram) supply energy, insulate/ cushion organs, provide medium for absorption of fat-soluble vitamins

Carbohydrates - (4 calories/gram) supply energy to muscles and cells in brain, nervous system, & blood

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Essential Nutrients - Continued

Non-energy providing

Vitamins – Promote specific chemical reactions within cells

Minerals – Help regulate body functions; aid in growth & maintenance of body tissues; act as catalysts for the release of energy

Water – Makes up 50% - 70% of body weight; provides a medium for chemical reactions; transports chemicals; regulates body temperature; removes waste products

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Sources of Energy

Measured by number of kilocalories (calories)

Average male requires around 2200-3500 calories per day (depending on activity level);

Average female requires about 1600-2500 calories/day (depending on activity level)

Excess calories stored by the body as fat

protein and carbohydrates provide 4 cal/gram

fats provide 9 cal/gram

alcohol provides 7 cal/gram

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Protein

12% - 15% of total calories should come from protein

Important component of muscle, bone, blood, enzymes, cell membranes, hormones

Amino acids (20) are building blocks of protein

9 are essential/required for normal health; 11 can be produced by the body if necessary ingredients are supplied by foods

Sources: meat, fish, poultry, eggs, milk, cheese, legumes, nuts

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Protein - Continued

“Complete” protein (i.e. meat, fish, poultry, milk, eggs, cheese) supplies all 9 essential amino acids;

“Incomplete” protein (i.e. plant sources: legumes & nuts) usually low in 1-2 essential amino acids

About 2/3 of protein intake comes from animal sources

Plant source protein is incomplete because it does not contain all 9 essential amino acids

Most of us consume more than necessary

Excess protein is synthesized into fat for energy

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Fats 25% - 30% of total calories should come from fat

Best in form of fish, nuts, and vegetable oils

Most concentrated source of energy for the body

Provide insulation and support for organs

Help absorb fat-soluble vitamins

3 main types of fats from foods

1) Saturated – animal flesh, whole milk, cheese, lunch meats, hot dogs - solid at room temperature

2) Monounsaturated – olive, canola, safflower & peanut oils – liquid at room temp.

3) Polyunsaturated – corn, soybean, & cottenseed oils – liquid at room temperature

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Fat Facts Fats make up 33% of average American diet

Need only 1 tablespoon of vegetable oil (15 grams) to supply essential fats

Saturated and trans fats raise blood levels of LDL (“bad” cholesterol)

Unsaturated fats lower LDL and raise HDL (“good” cholesterol)

Cholesterol Levels:

Desirable - <200 mg/dl

Concern - 200 - 240 mg/dl

High - >240 mg/dl

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Carbohydrates

@ 60% of total calories should come from carbohydrates (≤ 10% simple and @ 50% complex)

Supply energy to cells, especially during high-intensity exercise

Simple carbohydrates (table sugar, honey, malt sugar, milk sugar, fructose, sucrose, etc.) provide sweetness.

Found naturally in fruits & milk; added to fruit drinks, candy

No evidence that one type of simple sugar is “better” than any other

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Carbohydrates – continued

Complex carbohydrates (i.e. wheat, rye, rice, barley, potatoes, yams, legumes) provide starch and most dietary fiber.

Excess carbohydrate intake can make weight control difficult – should be balanced with/by physical activity

Unrefined carbohydrates (brown rice, whole wheat breads) are better than refined (white rice, white breads)

Americans need to consume more unrefined complex carbohydrates – Should be @ 50% of the calories in out diets

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Benefits of Unrefined

Carbohydrates 1) Retain fiber, vitamins, minerals 2) Low in fat and cholesterol free 3) Take longer to chew and enter blood stream

more slowly 4) Slower digestive process makes you feel full

sooner and longer 5) Lessens likelihood of overeating & gaining

weight 6) Keeps blood sugar and insulin levels low –

may decrease risk of diabetes

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Dietary Fiber Carbohydrate plant substances that are difficult or

impossible for humans to digest

National Institute of Health (NIH) recommends

20-35 grams/day

Two types:

1. “soluble” (dissolves in H2O; lowers blood cholesterol; reduce risk of CV disease) and

2. “insoluble” (binds H2O; aids in elimination; can reduce risk of constipation, hemorrhoids, some types of digestive tract cancer, and diverticulitis – formation of abnormal pouches in walls of intestine that become inflamed)

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Dietary Fiber - Continued

Contributes to disease prevention; prevents conditions arising in the intestinal tract; manage diabetes and high blood cholesterol

Foods highest in dietary fiber: fruits, legumes, oats, barley, wheat bran, cereals, grains, and vegetables

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How to Increase Dietary Fiber Look for breads, crackers, etc. that list “whole grains”

first on ingredient list (e.g. whole-wheat flour (not wheat flour), whole-grain oats)

Eat whole, unpeeled fruit – rather than fruit juices

Include beans in soups/salads; eat raw vegetables with pasta, rice

Substitute bean dip for cheese dip or sour cream dips; use raw vegetables, not chips, for dipping

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Vitamins Vitamins - organic substances (carbon containing)

Required in very small amounts to help chemical reactions in cells

Release energy stored in carbs, fats, and proteins.

Act as antioxidants (e.g. Vit. C & E) by rendering free radicals harmless and preserving body’s healthy cells

Most must be obtained from foods

Humans need 13 vitamins 50

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Vitamins Fat-soluble (absorbed only in presence of fat)

vitamins (4): require more complex digestive process; carried in blood by special proteins; stored in fat tissues rather than excreted

1) Vitamin A – Important for vision, skin, linings of nose, mouth, digestive & urinary tracts; immune function

2) Vitamin D – Important for bones & teeth, promotion of calcium absorption

3) Vitamin E – Protection & maintenance of cellular membranes

4) Vitamin K – Essential for blood clotting

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Vitamins - Continued

Water soluble vitamins (9): absorbed directly into blood stream; excess excreted in urine

1. Vitamin C – Maintains/repairs connective tissue, bones, teeth, cartilage; promotes healing; aids in iron absorption

2. Thiamin - Converts carbohydrates into usable forms of energy; maintains appetite & nervous system functions

3. Riboflavin – energy metabolism, maintains skin, mucous membranes, & nervous system structures

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Vitamins - Continued

4. Niacin – Converts carbohydrates, fats, proteins into usable forms of energy

5. Vitamin B-6 – Protein & neurotransmitter metabolism; red blood cell synthesis

6. Folate – amino acid metabolism; synthesis of DNA; new cell synthesis

7. Vitamin B-12 – synthesis of red & white blood cells

8. Biotin – metabolism of fats, proteins, & carbohydrates

9. Pantohenic Acid - metabolism of fats, proteins, & carbohydrates

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Minerals Minerals - inorganic compounds (non-carbon

containing)

Help regulate body functions

Needed in small amounts

Aid in growth

Aid in tissue & cell maintenance

Trigger release of energy

17 essential minerals

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Minerals

Most common missing: iron (anemia), calcium (osteoporosis), zinc (growth failure, poor wound healing), magnesium (neurological disturbances, CV problems, kidney disorders)

Iron & zinc – available in lean meats; calcium is in low-fat or non-fat dairy products; magnesium is in green vegetables, grains; nuts

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Water

Most important component in food & human body

Used in digestion & absorption of food

Medium where most chemical reactions take place

H2O based fluids (blood) aid in transport of substances throughout body

Serves as lubricants, cushions

Helps to regulate body temperature

Need at least 8 cups/day; more if active or in hot environment

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Water Found in all tissues, blood, lymph and synovial fluids Found in almost all foods, especially liquids, fruit and

vegetables 80 - 90% of daily water intake comes from eating &

drinking Should drink before you are thirsty Thirst is body’s first sign of dehydration Hydrate BEFORE an activity Caffeinated beverages act as diuretics, increasing water

output and raising the need for water Sugar & sodium require water to be dissolved, used,

and excreted

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Other Substances in Food • Antioxidants – Can help protect the body by blocking

the formation & action of free radicals – by-products of cell oxidation (implicated as factor in aging, cancer, CV disease)

• Phytochemicals – may help to prevent chronic disease (e.g. cancer, diabetes, hypertension, c-v disease) found in variety of foods (e.g. fruits & vegetables).

• Soy products may help lower cholesterol; cruciferous vegetables (broccoli) may render cancer-causing compounds harmless; garlic & onions seem to boost cancer fighting cells

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Supplements?

No substitute for a healthy diet

Excess could lead to problems

May lack the phytochemicals found in whole food

More research needed regarding the potential disease-fighting properties (e.g. Vit. E)

Large doses of some nutrients can effect the absorption of other vitamins & minerals

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Supplements?

Pregnant women should have folic acid to reduce chance of birth defects

People over 50 may need Vitamin B-12 – trouble absorbing the vitamin

Women with heavy menstrual flow may need iron to prevent iron-deficiency anemia

Newborns may need dose of Vitamin K

If taken - look for a balanced formulation that contains 50%-100% of daily values

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Dietary Challenges Vegetarians – Need to plan their diet to avoid

problems – Need to eat wide variety of foods – may need to consult registered dietitian

Women – Smaller/weigh less/eat less – may miss essential nutrients (iron & calcium)

Men – tend to overeat meat and need more fruits, vegetables, grains in their diet

College Students – eat on the run; make poor choices

Older Adults – less active, need fewer calories, need fiber in diet

Athletes – need fluids, carbohydrates for energy, protein for muscle development, careful of “special” supplements

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Fast Food & Eating Out Challenges • Think small vs. “supersized”

• Limit “add-ons” (Cheese, butter, sour cream)

• Avoid the fried foods (can significantly increase fat/calories of the food)

• Limit biscuits/croissants

• Limit desserts/beverages

• Seek out the nutritional information 64

Fast Food & Eating Out Challenges

• Look for the “low fat” or “heart healthy” items

• Order a nutrient dense side dish (steamed rice/lightly stir fried vegetables)

• Share an entrée • Take some home • Eat slowly – fast eaters eat more • Snacks – think healthy or with

moderation

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How to read a food label

The 5 - 20 Rule

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Dietary Guidelines – ABC’s Aim for fitness

Aim for a healthy weight Be physically active every day

Build a healthy base Let the food pyramid guide your food choices Eat a variety of grains, fruits, and vegetables Keep food safe to eat (proper heat & refrigeration)

Choose sensibly Choose a diet low in saturated fat and cholesterol and

moderate in total fat Limit your intake of sugars Prepare foods with less salt If you drink alcohol, do so in moderation