Flexibility and Range of Motion

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Flexibility and Range of Motion

• Tim Takahashi
• M.Kin., CAT(C), RK, CSCS

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Introduction

• Who is this guy?
• Education B.A.(P.E.), M.Kin., CAT(C), RK, CSCS
• Background - Working, teaching.
• My Job

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What is Flexibility?

• The ability of a joint to move freely through its
  full range of motion
• or
• The range of possible movement in a joint and its
  surrounding muscles (1)

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Range of Motion (ROM)

• The ability to go through the full range of
  possible movement about a joint.

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What Limits ROM?

• Joint Structure - shape of bone and cartilage
• Muscle Bulk - ROM
• Muscle Power and Tone
• Age and Gender - young vs. old, male vs. female,
  fibrosis
• Ligaments and Joint Capsule

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What Limits ROM?

• Extensibility of skin and subcutaneous tissue
• Dominant vs. Non-Dominant limb
• Injury and Pain

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Hypomobility vs. Hypermobility

• 5 Tests of Hypomobility
• Thumb to forearm
• DIII to dorsal aspect of forearm
• Elbow H.ext to10 degrees
• Knee H.ext to 10 degrees
• PROM DF/Eversion foot

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Hypomobility vs. Hypermobility

• 5 Tests of Hypomobility
• Palms to floor, knees bent
• Lotus position
• lt 20 degrees of knee hyperextension prone
• 180 degrees with knees at 15 - 30 bent
• U/E limb laxity with shoulder flexion, elbow
  hyperextension, forearm hypersupination

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Active vs. Passive ROM

• Active movements are actively performed by the
  patients voluntary muscles.
• Assess joint range, control, muscle power and
  willingness to perform movement
• Aid in determining problem structure

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Active vs. Passive ROM

• Passive movement is when the joint is put through
  its ROM by the examiner while the patient is
  relaxed.
• Differences in AROM and PROM may be caused by
  muscle contractions or spasm, muscle deficiency,
  neurological deficit, contracture or pain.

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Practical Applications of ROM and Flexibility

• Prevention of Injury - chance and severity
• Increased Sport Performance - Physical and Mental
• Homo Sedatus - Homo Monotonous - Homo inactivus

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Contra - Indicated Stretches and Movements?

• Full Squat - to be done or not to be done?
• Hurdler Stretch - for everyone?
• Sport Specific Stretches - i.e. Gymnastics

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Conditions Relating to ROM and Flexibility

• Hamstrings
• Ax
• M.O.I. overstretch vs. rapid contraction
• flexibility
• tripod sign
• contractures
• muscle strength ratios
• 6 degrees and 10.

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Back Health

• Changes in Work Pattern
• Manual to Sedentary
• Large Movt patterns to Static Work
• Lots of Aerobic work to Little Aerobic

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Back Health

• Majority of doctors visits are for MSK disorders
• 1985 Norway Survey 17.8 MSK, 10.8 CV, 7
  Neurological Cases of Disease per 1000
  inhabitants.
• Working days lost in UK in 1985 was 30 M. In
  1995 over 80 M d/t LBP.

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Back Health

• 3-5 of the population get LBP (WCB) each year.
  Of those injured, 95 account for 10 of the
  total costs. The other 4-6 with LBP never go
  back to work or who go on LTD account for 90 of
  the total costs!!!
• Reports of a Clinical Standards Advisory Group
  committee on back pain. H.M.S.O., London 1994.

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Back Health

• 33 vertebrae from base of skull to tailbone
• double S formed
• vertebrae separated by discs/capsules made from
  water

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Proper Posture - Standing
Incorrect
Correct

• lift with legs
• elevated footrest
• hold heavy objects close to your body
• when standing, chin in, head up, back flattened,
  pelvis held straight

Fig. 7.2
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Proper Posture - Sitting

• Flatten back and cross legs elevated footrest

Incorrect
Correct
Fig. 7.2
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Proper Posture - Sitting

• Flatten back and cross legs elevated footrest

Drive close to pedals
Incorrect
Correct
Fig. 7.2
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Proper Posture - Sitting

• Flatten back and cross legs elevated footrest

Drive close to pedals
Avoid slumping - Dowagers Hump
Incorrect
Incorrect
Fig. 7.2
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Proper Posture - Lying Down

• Dont
• sleep on stomach or back with too high or no
  pillow

Fig. 7.2
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Proper Posture - Lying Down

• Do
• sleep on side with a flat pillow
• sleep on back pillow/cushion under knees

Fig. 7.2
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Poor back healthis usually caused by a
sedentary lifestylethat means that it can be
avoided.
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Who is most Susceptible to Dysfunction and LBP?

• Those with a very low or very high level of
  activity.
• Inverted U

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11 Risk Factors of LBP

• History
• Flexibility
• AB/Back Strength
• Fitness Level
• Activity Pattern
• Obesity
• Fatigue / Stress

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Risk Factors of LBP

• Age (30-40 and Male)
• Posture
• Ergonomics
• Nutrition (OA etc.)