Proprioceptive Neuromuscular Facilitation (PNF)

1
Proprioceptive Neuromuscular Facilitation (PNF)

• Dr. Michael P. Gillespie

2
When To Use PNF

• PNF stretches are most often used by athletes and
  individuals who have a range of motion that is
  less than normal.
• The two types of PNF to be discussed are as
  follows
• Contract-relax technique
• Antagonistic contract-relax technique

3
Contract-Relax Technique

• 1. Passively take a muscle through a range of
  motion that produces a mild (not painful) stretch
  tension.
• 2. Contract the muscle (with about the same
  force as a closed fist) for 4-5 seconds. 60-60
  percent strength isometric contraction. Breathe.
• 3. Relax the muscle momentarily.
• 4. Perform a mild static stretch again for 5-15
  seconds.
• 5. Repeat this process several times.

4
Contract-Relax Technique
5
Isotonic and Isometric Contractions

• Concentric isotonic contraction a muscle
  shortens and pulls on another structure.
• Eccentric isotonic contraction the length of a
  muscle increases during contraction.
• Isometric contraction muscle tension is
  created however, the muscle doesnt shorten or
  lengthen.

6
Post Isometric Relaxation

• 1. Bring the muscle to its maximum length
  without stretching, taking up the slack. There
  should be only minimal or no pain.
• 2. The patient is asked to resist with only
  minimal force (isometrically) and to breathe in
  for 10 seconds.
• 3. The patient is then told to let go (relax)
  and exhale slowly. It is important for the
  doctor to wait and feel the relaxation. The
  doctor could wait 10 to 20 seconds or longer as
  relaxation is taking place. Due to pure
  relaxation there should be an increase in the
  range of motion.

7
Post Isometric Relaxation

• 4. If the patient has difficulty relaxing, hold
  the isometric phase for 30 seconds before having
  the patient let go.
• 5. Usually three to five times is all that is
  necessary to obtain spontaneous stretch each
  session.
• 6. Along with breathing, have the patient look
  up (eyes only). This helps facilitate the
  inspiration, which facilitates the muscle. Have
  the patient look down during expiration to aid in
  relaxation.

8
Post Isometric Relaxation

• This technique can be used with the force of
  gravity substituting for isometric resistance.

9
Antagonist Contract-Relax Technique

• This technique uses the principle of contracting
  and relaxing opposing muscles (i.e. quadriceps
  and hamstring).
• You contract your quadriceps to relax the
  hamstrings and then stretch the hamstrings.
• This utilizes a principle of neurology known as
  reciprocal inhibition (A biomechanical Yin Yang).

10
Coordination Within Muscle Groups

• Movements are typically the result of several
  skeletal muscles acting as a group.
• Most skeletal muscles are arranged in opposing
  (antagonistic) pairs at joints
• Flexors extensors, abductors adductors, etc.
• One muscles is called the prime mover (agonist)
  which contracts to cause an action and the other
  muscle is called the antagonist which stretches
  and yields to the effects of the prime mover.

11
Coordination Within Muscle Groups

• Synergists work with agonists to stabilize
  intermediate joints and assist the prime mover.
• Fixators stabilize the origin of the prime mover
  so that it can operate more efficiently.
• In limbs, a compartment is a group of skeletal
  muscles, with their associated blood vessels and
  nerves, that have a common function.
• i.e. In the upper limbs we have flexor
  compartments and extensor compartments.

12
Example of Antagonist Contract-Relax Technique

• Start in a standing position and slowly bend
  forward from the hips (keeping the knees slightly
  flexed), until you reach a comfortable stretch.
• Note how far you are able to go.
• Return to a standing position, keeping your knees
  slightly flexed.
• Assume a flexed knee position. Hold for 15-20
  seconds. This position contracts your quadriceps
  and relaxes your hamstrings.
• Stand up and go back into the first stretch.
  Hold for 5-15 seconds.
• You should be able to stretch further with the
  same effort.

13
Antagonist Contract-Relax Technique