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Chapter Goals:
- Know the difference between flexibility and mobility and their relevance to performance.
- Be able to explain the consequences that come with being inflexible and hypermobile.
- Find the elastic and plastic properties of soft tissues.
- Find the main factors that impact our joint range of motion.
- Know the usefulness of myofascial release techniques.
- Explain the common techniques for assessing flexibility.
Introduction to Flexibility
Flexibility uses many definitions depending on the point of reference in the discussion.
Range of motion means the full movement potential of a joint measured with the linear or angular distance between two limits.
Flexibility is defined as the range of motion of a joint achieved in a single direction.
Mobility is the range of motion achieved during a multi-joint action where several groups of connective tissue structures interplay to effect movement.
Flexibility is going to be assessed before mobility.
There can be many differences in bilateral joint movement ability, which may be determined by genetics, strength, connective tissue discrepancy, joint injuries, participation in activity, activation issues, and alignments of resting posture.
Flexibility and mobility are both inherent components of movement ability, and therefore they will play major roles in human function and our health and fitness in activity, exercise, and sport.
Due to flexibility training having almost no role in aesthetics, it is often forgotten about.
The benefits of flexibility:
- Muscle relaxation
- Reduced incidence of muscle cramps
- Increased movement range
- Reduction in the rate of functional decline
- Reduced tension
- Reduced risk of injury
- Relief of muscle pain
- Improved quality of life
- Postural symmetry
- Stress reduction
The Importance of ROM
Range of motion will affect the joint’s performance and functionality.
A functional range is the minimum range of motion that is needed for the comfortable and effective performance of the activities of daily living.
Lacking flexibility is often seen with musculoskeletal injuries. Both as the cause and as a result of these injuries.
The activities emphasizing flexibility will reduce the stress on the musculoskeletal system by alleviating tension, reducing psychomotor distraction, and improving the state of overall body relaxation.
Hypermobility is when the movement ability of a joint is beyond the normal range of motion and it will actually compromise joint stability.
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Properties of Soft Tissue
The soft tissues of the body include the categories:
- Muscle and fascia
- Tendons and ligaments
- Skin, fat, and collagen
- Synovial membranes
- Nerves and blood vessels
Elasticity relates to the stretch quality or the potential for deformation.
Elasticity allows the tissue to be stretched and then return to the normal pre-stretch levels. It returns easily to the original position.
Plasticity is the property of tissue to become permanently deformed or attain a new length after it is stretched. The tight stretching levels being used over time will cause the connective tissues to assume a chronic plastic state or new length.
Viscosity is a property where the soft tissue has variable fluid resistance. The tissue has some form of resistance to change.
Factors Affecting Joint Range of Motion
There are muscle factors such as the number of sarcomeres or their own ability to lengthen. These sarcomeres also play a role in the passive stretching ability.
The muscle’s ability to relax when it is stretched is a factor of extensibility.
The connective tissues play a role in lengthening muscles and going through a proper range of motion.
For example, the more collagen a person has in an area, the more resistant the area will be to stretch.
The existence of more elastic fibers will adhere well to being more easily stretched.
Connective fascia makes up a third of the body’s muscle mass and gives the muscles their shape and connective framework. These may tighten up and restrict movement to some degree.
Restriction and trigger points may be alleviated through the use of stretching, manual massage, thermotherapy, electrotherapy, acupressure, and pressure roll.
Some neural factors affect the range of motion we have in our joints. These include the muscle spindles, Golgi tendon organs, and joint mechanoreceptors.
Muscle spindles are parallel to the muscle fibers in the belly of the muscle. They are our main source of stretch receptors and show stretch length and velocity.
The GTOs are in the musculotendinous junction and they work to protect the muscles from excessive force. They can be manipulated through the use of autogenic inhibition and reciprocal inhibition,
Autogenic inhibition is the reduction in excitability of a muscle upon the development of high tension levels.
Reciprocal inhibition is the relaxation of the muscles on one side of the joint for the accommodation of contracting the opposing muscles.
Age is a factor in flexibility since the musculature will experience a decline with aging. This decline occurs in the quality and quantity of muscle.
Sex is a differentiator in flexibility, as the bodies are built somewhat differently and allow for more or less range of motion.
High body mass is a limiter of flexibility as the joints may have some things in the way as they stretch.
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Immobility is a significant reason for negative effects on the mobility of joints. There will be significant losses in flexibility in a short time with a lack of movement.
Pain and discomfort in other areas will often influence the range in which we feel we should stretch.
Injuries lay a role in our ability to stretch muscles and body parts. Oftentimes scar tissue and other things in recovery are not dealt with, and this causes problems in the future.
Three common diseases are seen affecting our flexibility levels. These are osteoarthritis, rheumatoid arthritis, and gout.
Testing Flexibility
There are many ways we can test client flexibility. We have tools such as the goniometer, inclinometer, and flexometer. We also can test it without the use of tools.
Direct measurement with tools like a goniometer is quite effective in assessment, but they require more expertise than other methods.
Some of the common assessments for the general population include the following:
- Apley back scratch test
- Single straight-leg hip flexion test
- Thomas test
- Trunk flexion/extension tests
- Overhead squat assessment
Types of Flexibility Training
Implementing flexibility into programs will require the organization of aggregate factors into a structured and premeditated format.
The goal of flexibility training is to achieve chronic changes in the tissue’s ability to lengthen with the use of stretching techniques.
The styles of stretching can first be put into two categories: active and passive.
Active stretching involves the use of force the client produces to apply the stretch.
Passive stretching uses external force like a partner, gravity, or device to apply a stretch to a flaccid body segment.
Static flexibility includes the modalities of active stretching, active-assisted stretching, PNF, and active isolation stretching.
Dynamic flexibility includes the modalities of dynamic-performance stretching, slow-speed dynamic stretching, and ballistic stretching.
Static stretching is the most well-known form of flexibility training and it has the client lengthen their tissue n a slow, controlled way to the end of the range of motion and then hold that position for a set time.
This is done slowly to avoid the stretch reflex, which causes a backward contraction.
Active-assisted stretching is the same as static stretching but has added force to help reach a greater end range.
The duration is usually held the same, just with this potentially greater end range.
Active isolation is a hybrid that uses active stretching along with neural factors. It has contraction of the antagonist’s muscle to assist with the stretch.
Proprioceptive neuromuscular facilitation, or PNF stretching, is a hybrid between static and dynamic flexibility as it uses different aspects of these two.
This uses a partner to help attain these greater ranges of motion and is primarily used in rehab settings.
Dynamic flexibility is the act of briefly achieving the full range of motion through the use of controlled muscle contractions. This is often more of a warm-up method.
Dynamic stretches allow for a range of motion gains related to specific movements to be used in training, they are popular in sports as a warm-up method, and they allow for both a warm-up and improved range of motion long-term.
The dynamic performance stretches use many sport-specific movements to stretch the musculature and their movements often exaggerate to extend the range of motion.
Slow-speed dynamic stretches allow for slower and more isolated movements to be done, and the designated time for each rep ensures controlled contractions and no stretch reflex response.
Ballistic stretching is considered risky and has the body segments moving through full ranges of motion with some momentum with the movements.
Flexibility training protocols:
Explain the techniques and protocol well to the client and establish open and easy communication
Perform a warm-up before flexibility training
Select one activity per major muscle group or joint action
Order deficient areas first and perform others in the sequence of need
Perform 2 – 4 sets of 30-second holds or accumulate that duration with many sets
Use multiple planes of movement with each muscle group
Require strict adherence to the protocol
Use dynamic flexibility before static
Establish static stretching proficiency before any use of PNF
Stretch to levels of tolerable discomfort
Use controlled breathing in rhythmic patterns
Record any pain that happens
Tyler Read
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