Hold-relax Stretch Steps
Passive stretch 10s --> Relax 2-4s --> Isometric contraction 6s -->Relax 2-4s -->Passive stretch
10s--> Back to natural position
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| Term | Definition |
|---|---|
Hold-relax Stretch Steps | Passive stretch 10s --> Relax 2-4s --> Isometric contraction 6s -->Relax 2-4s -->Passive stretch
10s--> Back to natural position |
Contract-relax Stretch Steps | Passive stretch 10s --> Relax 2-4s --> Isotonic contraction to nature position 6s --> Relax 2-4s --> Passive stretch 10s--> Back to natural position |
Hold-relax with Antagonist Contraction | Passive stretch 10s --> Relax 2-4s --> Isometric contraction 6s --> Relax 2-4s --> Active stretch 10s--> Back to natural position |
PNF techniques | -Hold-relax (isometric).
-Contract-relax (isotonic).
- Hold-relax with antagonist contraction (isometric)
|
Manual flexibility components | -Body positions - Client - Assistant.
-Demonstration.
-Hand Placement - Stabilizing hand - Working hand.
-Communication.
-Eye contact.
-Degree of Motion. |
Stretching cautions | -Posture is important.
-Stretch slowly.
-Do not stretch to the point of the pain.
-Do not stretch through the onset of muscle spasm.
-Do not hold breath.
-Flexibility is joint specific. |
Stretching protocol | -Assistant must: - constantly remind client to inform them if at any time during the stretch they can move further into the ROM.
-Assistant starts moving the joint through the ROM to the point of stretch or until the client tells you to hold/stop. At this point, hold your position and start your count ( 1-1000, 2-1000, 3-1000, etc.)
-Ask the client if you can go further.
-If yes, move further into the ROM until the client tells you to stop or hold. At this point, hold your position and start counting where you left off.
-If no, hold the same position and continue count. |
Wrist Flexors Client Position | seated with stable base posture, elbow bent at 90°, forearm supported by armrest, and palm in supine position. |
Wrist Flexors Assistant Position | seated to the side being stretched. |
Wrist Flexors Hand Placement A | stabilizing hand: grasp forearm slight above wrist joint. |
Wrist Flexors Hand Placement B | working hand: across palm. |
Wrist Flexors Direction of stretch | moving into wrist extensions up to 70°. |
Wrist Extensors Client Position | seated with stable base posture, elbow bent at 90°, forearm supported by armrest, and palm in prone position. |
Wrist Extensors Assistant Position | seated close to and facing client. |
Wrist Extensors Hand Placement A | stabilizing hand: grasp forearm slight above wrist joint. |
Wrist Extensors Hand Placement B | working hand: on backside of hand. |
Wrist Extensors Direction of stretch | moving into wrist flexion up to 80°. |
Supinators Client Position | seated with stable base posture, elbow bent at 90°, forearm supported by armrest, and palm in neutral position halfway between supination and pronation. |
Supinators Assistant Position | seated close to and facing client. |
Supinators Hand Placement A | stabilizing hand: grasping elbow. |
Supinators Hand Placement B | working hand: interlocking thumbs and palms with fingers reaching to the backside of client’s hand and wrist in what is sometimes referred to as the “cool hand shake” position. |
Supinators Direction of stretch | moving into pronation up to 90°. |
Pronators Client Position | seated with stable base posture, elbow bent at 90°, forearm supported by armrest, and palm in neutral position halfway between supination and pronation. |
Pronators Assistant Position | seated close to and facing client. |
Pronators Hand Placement A | stabilizing hand: grasping elbow. |
Pronators Hand Placement B | working hand: interlocking thumbs and palms with fingers reaching to the backside of client’s hand and wrist in what is sometimes referred to as the “cool hand shake” position. |
Pronators Direction of stretch | moving into supination up to 90°. |
Shoulder Abductors Client Position | seated with stable base posture and upper arm down at side, and hand in lap. |
Shoulder Abductors Assistant Position | standing in back and to the side being stretched. |
Shoulder Abductors Hand Placement A | stabilizing hand: cupping shoulder joint. |
Shoulder Abductors Hand Placement B | working hand: grasp backside of upper arm slightly above elbow joint. |
Shoulder Abductors Direction of stretch | moving into shoulder adduction up to 45°. |
Shoulder Adductors Client Position | seated with stable base posture and involved arm hanging down at side with palm towards body. |
Shoulder Adductors Assistant Position | standing in back and to the side being stretched. |
Shoulder Adductors Hand Placement A | stabilizing hand: cupping shoulder joint. |
Shoulder Adductors Hand Placement B | working hand: grasp inside of upper arm slightly above elbow joint. |
Shoulder Adductors Direction of stretch | moving into shoulder abduction up to 180°. |
Shoulder Horizontal Flexors Client Position | seated with stable base posture and involved arm parallel to floor with elbow bent at 90°. |
Shoulder Horizontal Flexors Assistant Position | standing behind and slightly to the side being stretched. |
Shoulder Horizontal Flexors Hand Placement A | stabilizing hand: fingers on top of shoulder with heel of hand pressing into scapula. |
Shoulder Horizontal Flexors Hand Placement B | working hand: grasp under upper arm with fingers on biceps slightly above elbow joint. |
Shoulder Horizontal Flexors Direction of stretch | moving into shoulder horizontal extension up to 45°. |
Shoulder Horizontal Extensors Client Position | seated with stable base posture and involved arm parallel to floor with elbow bent at 90°. |
Shoulder Horizontal Extensors Assistant Position | standing behind and slightly to the side being stretched. |
Shoulder Horizontal Extensors Hand Placement A | stabilizing hand: cupping shoulder joint. |
Shoulder Horizontal Extensors Hand Placement B | working hand: grasp under upper arm with heel of hand on triceps. |
Shoulder Horizontal Extensors Direction of stretch | moving into shoulder horizontal flexion up to 150°. |
Shoulder Internal Rotators Client Position | seated with stable base posture, elbow bent at 90° pressing against body, and palm in neutral position halfway between supination and pronation. |
Shoulder Internal Rotators Assistant Position | seated to the side being stretched. |
Shoulder Internal Rotators Hand Placement A | stabilizing hand: grasp upper arm slightly above elbow and press into body. |
Shoulder Internal Rotators Hand Placement B | working hand: grasp forearm slightly above wrist joint. |
Shoulder Internal Rotators Direction of stretch | moving into shoulder external rotation up to 45°. |
Shoulder External Rotators Client Position | seated with stable base posture, elbow bent at 90° pressing against body, and palm in neutral position halfway between supination and pronation. |
Shoulder External Rotators Assistant Position | seated to the side being stretched. |
Shoulder External Rotators Hand Placement A | stabilizing hand: grasp upper arm slightly above elbow and press into body. |
Shoulder External Rotators Hand Placement B | working hand: grasp forearm slightly above wrist joint. |
Shoulder External Rotators Direction of stretch | moving into shoulder internal rotation up to 55°. |
Cervical Flexors Client Position | seated with stable base posture. |
Cervical Lateral Flexors Client Position | seated with stable base posture. |
Cervical Lateral Flexors Assistant Position | standing in back and slightly to the side being stretched. |
Cervical Lateral Flexors Hand Placement A | stabilizing hand: grasp top of shoulder. |
Cervical Lateral Flexors Hand Placement B | working hand: on side of head slightly above ear. |
Cervical Lateral Flexors Notes | Be aware of sensitive spots where you are applying pressure. |
Cervical Lateral Flexors Direction of stretch | moving into cervical lateral flexion up to 45°. |
Cervical Rotators Client Position | seated with stable base posture. |
Cervical Rotators Assistant Position | standing directly in back of client. |
Cervical Rotators Hand Placement A | stabilizing hand: on right side of head slight above ear. |
Cervical Rotators Hand Placement B | working hand: on left side of head slight above ear. |
Cervical Rotators Notes | Be aware of sensitive spots where you are applying pressure. |
Cervical Rotators Direction of stretch | moving into cervical rotation up to 90°. |
Spinal Lateral Flexors Client Position | seated with stable base posture and arms hanging down at sides. |
Spinal Lateral Flexors Assistant Position | standing in back and slightly to the side being stretched. |
Spinal Lateral Flexors Hand Placement A | stabilizing hand: on top of thigh near hip joint holding pelvis down. |
Spinal Lateral Flexors Hand Placement B | working hand: grasp upper arm slightly below shoulder joint. |
Spinal Lateral Flexors Direction of stretch | moving into spinal lateral flexion up to 20°. |
Spinal Rotators Client Position | seated with stable base posture and arms crossed over chest, and hands tucked under arms. |
Spinal Rotators Assistant Position | standing directly in back of client. |
Spinal Rotators Hand Placement A | working hand: on scapula of side being stretched. |
Spinal Rotators Hand Placement B | working hand: on upper chest of opposite side. |
Spinal Rotators Notes | Both hands are considered working hands when doing this exercise. |
Spinal Rotators Direction of stretch | moving into spinal rotation up to 80°. |
Hip Flexors Client Position | supine lying with uninvolved hip and knee flexed at 90°. |
Hip Flexors Assistant Position | standing opposite of the side being stretched. |
Hip Flexors Hand Placement A | stabilizing hand: grasp back of thigh slightly above knee and push leg up towards chest until involved leg rises of table up to 90°. |
Hip Flexors Hand Placement B | working hand: grasp top of thigh slightly above knee only after involved leg has risen off table up to 30°. |
Hip Flexors Direction of stretch | pressing leg down into hip extension up to 30° while making sure uninvolved leg stays in fixed position. |
Hip Extensors Client Position | supine lying with involved hip and knee flexed 90°. |
Hip Extensors Assistant Position | standing to the side being stretched. |
Hip Extensors Hand Placement A | stabilizing hand: grasp top of uninvolved leg slightly above knee keeping leg flat on table. |
Hip Extensors Hand Placement B | working hand: grasp back of thigh slightly above knee. |
Hip Extensors Direction of stretch | moving into hip flexion up to 135° while making sure uninvolved leg is held flat on table. |
Hip Adductors Client Position | supine lying. |
Hip Adductors Assistant Position | standing to the side being stretched. |
Hip Adductors Hand Placement A | stabilizing hand: grasp under lower leg slightly above ankle to support leg. |
Hip Adductors Hand Placement B | working hand: grasp inside of thigh slightly above knee. |
Hip Adductors Direction of stretch | moving into hip abduction up to 45-50° (make sure to pull only with working hand to avoid stressing knee joint). |
Hip Abductors Client Position | supine lying. |
Hip Abductors Assistant Position | standing opposite of the side being stretched. |
Hip Abductors Hand Placement A | stabilizing hand: grasp under lower leg slightly above ankle to support leg. |
Hip Abductors Hand Placement B | working hand: grasp outside of thigh slightly above knee. |
Hip Abductors Direction of stretch | moving into hip abduction up to 20-30° (make sure to pull only with working hand to avoid stressing knee joint). |