what type of adaptation should we consider hypomobility to be?
a physiological adaptation (the body is trying to get better at what it is doing)
what is mechanotransduction?
the process by which the body converts mechanical loading into cellular responses which promote structural change
what are the 3 ways collagen contributes to adaptations for hypomobility?
cross-linking
adhesions (change in lubrication, harder to move in its sheath - less movement)
disorganized orientation (layed down randomly where there is no movement due to immobilization)
what is the physiological adaptation of the muscle when it is immobilized?
there is a reduced number of sarcomeres in series when a muscle is immobilized, to adapt to the shortened length of the muscle
why would the body add or remove sarcomeres to a muscle?
it does this to adapt to a muscle’s length, the muscle wants to make sure that sarcomeres are sitting in their optimal positions
what is tone and where is it common?
tone is the passive state of muscle contraction or a muscles’ resistance to passive tension at rest (it is common close to an area that has recently been injured)
what is muscle hypomobility largely due to?
neural control (e.g. changes in muscle tone)
what is the theory of connective tissue mobility prescription?
it explains the connective tissue response to tension (viscoelastic) which is rate dependant and time dependant
- in the elastic deformation phase, there will be no lasting change in the tissues (will cause stress relaxation, creep, and temporary change in mobility)
- in the plastic deformation phase, you want to cause just enough microscopic failure to create permanent change, but not enough to create macroscopic change (will cause microscopic failure, macroscopic failure, and permanent change in mobility)
what is the practical application of the connective tissue mobility prescription theory?
think PUDDY
- you want to do a low load prolonged stretch with total end range time (TERT)
- we want to LIMIT force, but increase TIME to avoid damage
what is the best practice for connective tissue mobility?
low load prolonged stretch
low load prolonged stretch
greater than 3x per day
into stiffness, not pain
position of TENSION
5-20 mins per session
increase volume and intensity to progress (often seen with post-surgery ACLs and TKRs)
what is the best practice for connective tissue mobility?
mobility
greater than 3x per day
into stiffness not pain
slow PROM, AROM, AAROM into position of tension
5-10 reps for 10-30 secs for 1-3 sets
increase volume (TERT) to progress
what is the theory of muscle flexibility prescription?
explains the muscle’s response to tension (stretching) - explaining how there is an activation of the muscle spindle, leading to stimulation of myotactic/stretch reflex, stimulating the alpha neuron, and leading to a muscle contraction
- this theory explains in short how the feeling of muscle tension should fade as you hold the muscle in it’s extended contracted position
what is the sensory theory portion of the muscle flexibility prescription theory?
it states that there are no lasting changes seen in muscle length following static stretching and that temporary increases in muscle flexibility following static stretching may be due to an increased TOLERANCE of tension and pain
what is the golgi tendon reflex?
it explain the tendon’s response to tension, the golgi tendon organ will be activated when a muscle nearly is contracted - this will cause stimulation of the golgi tendon reflex which tells the muscle to relax and helps to reset the body
what is the neuromuscular relaxation theory?
it explains autogenic inhibition (aka PNF stretching) and how the golgi tendon is responsible for telling the muscle to relax - this a action helps facilitate an additional stretch
what are the 3 types of muscle stretching
static
dynamic
pre-contraction (proprioceptive neuromuscular facilitation PNF)
what does dynamic stretching increase?
range of motion
performance (if immediately before activity)
what is the impact of static stretching on ROM and performance?
increase ROM
decrease performance (if immediately before)
* this activity gets you ready to relax rather than perform
what is the best practice for dynamic stretching?
3x per week
into tightness not pain
controlled concentric contraction of opposing muscle into position of tension of target muscle
volume is 1-3 sets of 5-10 reps
what is the best practice for static stretching?
2-3 per week
into tightness
slowly and passively assume position of tension in target muscle
10-30 seconds or 30-69 for OA
1-3 reps or 60 seconds total
what are the effects of eccentric training on mobility?
comparable to static stretching
increases fascicle length (more sarcomeres)
does foam rolling improve mobility?
yes there is a temporary change in the tone of tissues, comparable to static stretching, best when followed by static stretching
due to sensory & neuromuscular mechanisms (not structural)
can unilateral stretching improve mobility in contralateral non-stretched joints
yes, there are temporary sensory changes to the body
what are the benefits of resisted exercise in rehabilitation?
increase strength, improve function, reduce pain
