Stretching Techniques for Tight/Stiff Muscles

This is usually best brought about by the patient attempting to stretch the tissues himself.There are several techniques which may be used.The patient may make repeated efforts ar achieving the difficult movement by working the muscle which would bring about the desired movement,e.g. if abduction is limited by tight medial structures the patient works the abductors, or if the last few degrees of elevation of the arm are lost then the patient should make repeated resisted attempts to gain the last few degree of elevation.The resistance could push a weight ( sandbag) up the wall.



A second techniques which may be used is pendular swinging in which the alternations of the pendulum will carry the limb past the limitation of movement and apply repeated minute stretch to the tight structure.The addition of a weight to the end of the limb will both distract the joint surfaces and increase the tendency of the pendulum to swing past the point of limitation.This techniques is most commonly used for the shoulder and hip joints,but is equally valuable as a method for the smaller joints such as the wrist and ankle.At these joints rapidly alternating movements are performed and ,although the limb of the pendulum is short,the effect of rapid alternations of direction will be to increase momentum in each direction and bring about stretch on tight structure and increase in range.The use of this techniques for stiffness of the vertebral region is usually confined to movements of the lumbar spine by swinging the pelvis and legs in suspension,thus avoiding dizziness due to alternations in head movement.


A third techniques which may be used is that of an auto-pulley circuit,in which the patient may perform rapid alternations of the two limbs and so carry the stiff joint a little past its limitation each time.Or the patient may apply deliberate slight stretch to the tight structure by an added pull with the contralateral limb.

The fourth technique which is occasionally used is one of self-mobilizing by stretching tight structure using body weight.For example,to stretch a tight tendocalcaneous which is liliting full dorsi-flexion of the ankle joint,the patient may be put into step standing and lean forwards over the bent knee.If both hells are kept on their support the tendocalcaneous is stretched on both legs.The procedure should never be used unless the muscle acting over the joint being mobilized are already sufficiently strong to maintain the stability of the joint.

Following the relief of spasm or the regaining of range,any objective exercise may be used which will increase joint range,while interesting the patient and allowing him to forget his lilitations.

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