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Len Kravitz, Ph.D. and Vivian H. Heyward, Ph.D.
Introduction Interest in flexibility training has its roots in the early 1900's due to increased orthopedic cases resulting from World War I. Public attention was heightened with the 1950's publication by Kraus and colleagues that American children were unable to successfully execute some flexibility and muscular strength tasks (Kraus & Hirschland, 1954). Those who now proclaim the worth of proper flexibility training include coaches, personal trainers, fitness instructors, medical doctors, physical therapists, and health promotion specialists. The following review is designed to synthesize information, based on past and current flexibility research, for practitioners. The Nature of Flexibility Flexibility refers to the total range of motion of a joint or group of joints. Flexibility, which differs from person to person and from joint to joint, encompasses all components of the musculoskeletal system as well as specific neuromuscular pathways of the body. The structural characteristics of the joints and the mechanical properties of the connective tissues of the muscle-tendon structures largely affect the extent of movement around a given joint. The specificity of movement that a person performs in regular physical activities and stretching methods often define the development and improvement of the body's range of motion. The goal of all stretching programs is to optimize joint mobility while maintaining joint stability. Concern should always be focused on the systematic, safe and effective application of the range of motion techniques utilized. The Benefits of Stretching An examination of the reported research and empirical evidence support the following benefits of stretching: 1) An increase in functional range of motion (Taylor, Dalton, Seaber, &
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many health practitioners are using flexibility training as a vehicle to facilitate mental and physical relaxation as well as stress reduction. meditation and self-evaluation (Alter. 1961). & Ribbeck. 1988). 1990). 1973). 1985. Wiswell. 10) Personal enjoyment and gratification. 1972). 9) An opportunity for spiritual growth. 5) Delay in the onset of muscular fatigue (DeVries & Adams. 1980). Taking a similar approach to the harmony of the mind. body and spirit. 1988). 1981). Glisson.com/Articles/flexibility. & Jensen. 6) Prevention and alleviation of muscle soreness after exercise (DeVries. 8) Promotion of mental relaxation (DeVries.drlenkravitz.Flexibility training http://www. Joint Considerations With Flexibility 2 of 12 20/07/2012 3:06 PM . Flexibility training has more recently been recognized amongst the other components of fitness as a means to better unify one's mind. Farfan. Seaber. 3) Reduction in the incidence and severity of injury (Safran. 7) Increase in the level of certain skills and muscular efficiency (Beaulieu. 2) Reduction of low back pain and injury (Bach. & Moritani.html Garrett. body and spirit in yoga techniques. 1980). Green. Bulbulion. Garrett. 4) Improvement in posture and muscle symmetry (Corbin & Noble.
The adjacent ends of the bones are covered with a weight-bearing or articular surface known as the articular cartilage. ligaments serve to prevent dislocation. The diarthrodial or synovial joints function is to hold bones securely together while permitting considerable movement. and reflex mechanisms minimally involved. and diarthrodial joints allow considerable movement (such as in the arms and legs). and limit some ranges of movement. This cartilage absorbs shock and prevents direct wear on the bone. This synovial fluid provides nourishment to the articular cartilage and serves as a lubricant to the joint.drlenkravitz. muscles and their fascial sheaths (41%). The composition characteristic of the articular cartilage is something between a solid and a liquid.Flexibility training http://www. It also converts the compression stress placed upon the joint from physical activity to a hydrostatic stress which limits the potential dangers to the joint. Factors that Influence Flexibility Distinctive connective tissues associated with any joint contribute to joint flexibility. tendons (10%). Johns and Wright (1962) have found the relative contributions of soft tissue to joint stiffness to be the following: joint capsule. Other factors which influence flexibility are: 1) Age. The ligamentous sleeve called the capsular ligament is attached firmly to both bones of the joint. including ligaments (47%). enclosing the joint entirely. The ligaments are strong fibrous bands which are made from the same tissue found in the joint capsule.html The points in your body where two or more bones meet are called joints or articulations. The diathrodial joints are of greatest concern in flexibility training. Besides helping to bind the bones. The capsular ligament is lined with a thin synovial membrane which secretes a synovial fluid into the joint cavity. In addition to the capsular ligament. With the muscles relaxed. and the skin (2%).com/Articles/flexibility. There are three types of joints: synarthrodial joints allow no movements (such as in the skull). There tends to be a decrease in flexibility with aging (Chapman. 3 of 12 20/07/2012 3:06 PM . each joint typically has several other ligaments which serve to help bond the bones together. amphiarthrodial joints allow limited movement (such as in the spine).
arm span. condyloid) and the type of movement that the joint exhibits (i.g. and weight do not significantly affect range of motion (Alter. Regular exercise.drlenkravitz. Resistance trainingin which exercises are executed through a full range of motion may help to improve a person's flexibility 4 of 12 20/07/2012 3:06 PM . including stretching exercises. height.. ball and socket. flexion-extension. It is very well established that flexibility is specific to each joint. Participation in regular exercise involving full range of motion generally enhances flexibility. 4) Exercise history. rotation. 2) Gender.. 1980). 1988). a sedentary lifestyle often results in diminished flexibility (Beaulieu. For example. older persons are more susceptible to injury from vigorous physical activity. hinge. An increase in body temperature via a warm-up or the participation in physical activity will increase range of motion (Sapega. 1981). protraction-retraction and circumduction). trained dancers demonstrate superior flexibility of the ankle and legs but only moderate flexibility in their upper torsos.e. The evidence leads one to conclude that factors including arm and leg length.related decrease in range of motion. 7) Resistance training. can minimize the effect of this age. adduction-abduction. This difference is generally attributed to anatomical variations in joint structures. Moyer. 3) Type of joint. Due to this loss of joint mobility.Flexibility training http://www. pronationsupination. 6) Body build. Quendenfild. This is largely attributed to a loss in elasticity in the connective tissues surrounding the muscles which go through a normal shortening process resulting from a lack of physical activity.com/Articles/flexibility. A lowering in body temperature is associated with a decrease in flexibility.html 1971). 5) Temperature. & Butler. The degree of range of motion at the joint is also affected by joint structure (e. on the other hand. 1968). Females tend to be more flexible than males of the same age throughout life (Holland.
1981).Flexibility training http://www. 1988). but not so demanding as to lead to fatigue. Ballistic stretching was quite popular in the 1970's. Wickstrom. are best presented after the cardiovascular cool-down or after the muscle toning section of class. Warm-up vs. to increase range of motion.. Often included after this full-body movement phase of the warm-up are some stretching exercises that go through a functional range of motion. muscles.html (Massey & Chaudet. relaxin production decreases and the ligaments tighten up. This segment. walking or jogging. making this time in the workout ideal for increasing flexibility. approximately 5 minutes in length.com/Articles/flexibility. The warm-up is physical activity that raises the temperature of the blood. tendons and ligaments. After pregnancy. During pregnancy. The hormone responsible for this change in range of motion is relaxin. Partner stretching requires close communication between partners. static and proprioceptive neuromuscular facilitation (PNF). should be intense enough to increase body temperature. Stretching exercises. Calguneri. The goal is to prepare the body's freely moveable joint structures for vigorous physical activity while reducing the risk of injury (Safran et al. stationary cycling. 1956. Methods of Stretching The types of stretching programs commonly used are classified in four general categories: passive. and the slow application of the stretch in order to prevent injuries due to rigid or forceful manipulation of the body segment. holding positions usually no longer than 10 seconds. Stretching The warm-up and stretching portion of a class should not be confused. 8) Pregnancy. the pelvic joints and ligaments are relaxed and capable of greater range of motion (Bird. but is used primarily by athletes 5 of 12 20/07/2012 3:06 PM . Wright. Passive stretching techniques are usually performed with an outside force such as a towel or partner who applies a stretch to a relaxed joint.drlenkravitz. 1963). ballistic. The warm-up is best accomplished with a full-body rhythmic activity such as low-to-moderate intensity aerobics. The temperature of the soft tissues is most likely elevated.
Flexibility training http://www. and then typically held in that position for a period of 15 to 30 seconds. The next phase involves a less than maximal voluntary contraction in the pre-stretched muscle group for 4 to 6 seconds.com/Articles/flexibility. Holt introduced modifications of Kabat's work that were adopted by several athletic teams (Holt..html due to a greater risk of injury and lesser efficiency compared with other stretching techniques. Travis. neither technique has been demonstrated to be superior for improving range of motion. To date. In the third phase of this technique. is probably the most commonly used flexibility technique and is very safe and effective. when carefully introduced. With proper instruction. With ballistic and passive stretching there is a need to control numerous factors to insure safety. Herman Kabat in the 1950's as part of his therapeutic work with patients suffering from paralysis and muscular diseases. At present.drlenkravitz. the target muscle group is placed on stretch. Taylor (Taylor et al. the two most accepted methods of improving flexibility are the static and PNF techniques. 1980). the PNF techniques have also been shown to be safely implemented with students (Kravitz. and then stretched 6 of 12 20/07/2012 3:06 PM . contract-relax and contract-relax agonist contract. may be readily modified and used either individually or with a skilled partner. a muscle or muscle group is gradually stretched to the point of limitation. Two commonly used PNF stretching techniques. The contraction is "isometric" because movement of the body segment is resisted by the individual or partner. have been applied by many personal trainers and fitness instructors with their students. & Okita. the muscle being stretched should be as relaxed as possible. Static. Each method operates on the premise that to increase flexibility and prevent risk of injury. In the early 1970's. Over the years these PNF concepts and modifications. the contracted muscle group is first relaxed. In the first phase of both techniques. The PNF techniques were developed by Dr. 1990) reported significant improvement in flexibility using four sets of 15-20 seconds per stretch. With this technique. 1970). PNF stretching techniques are also very effective for increasing flexibility. limiting the applications of these techniques. or hold stretching.
or stretched too fast. This is a basic protective mechanism.drlenkravitz. the client now contracts the opposing muscle(s) for 4 to 6 seconds against a resistance. Thus. and send a message to the spinal cord that the muscle is being extended. referred to as the stretch reflex. the spinal cord sends a reflex message to the muscle to contract. When excessive tension (force) is created in the muscle from either a deep stretch or a muscle contraction. to help prevent over-stretching and injury. the golgi tendon organ is part of a defense mechanism which prevents the muscle from developing too much tension. This reflex inhibits muscle contraction and relaxes the muscle. leading to strain in the musculotendinous area and microscopic tearing of muscle fibers.html to a new point of limitation. known as muscle spindles are stimulated. which may otherwise lead to injury. In the final step.com/Articles/flexibility. Sensory Response to Stretching When a muscle is stretched. the muscle's sensory receptors (muscle spindle and golgi tendon organ) provide a means of monitoring and maintaining an optimal and safe operating range of motion for the muscles. With the contract-relax agonist contract technique. 1988). receptors within the muscle. while the golgi tendon organ produces an inverse stretch reflex which relaxes the muscle when too much tension is being produced. The muscle spindle causes a stretch reflex making the muscle contract when too much stretch or too fast of a stretch is initiated. Research has noted that the stretch reflex can be inhibited in muscles that 7 of 12 20/07/2012 3:06 PM . Located in the musculotendon junction is another sensory receptor called the golgi tendon organ. the golgi tendon organ triggers a reflex known as the inverse stretch reflex. If the muscle is overstretched. In short. The speed of bouncing during ballistic stretching may elicit an equally responsive contraction of the muscle. Researchers have found the contract-relax agonist contract technique to be superior to the contract-relax technique for improving range of motion (Etnyre & Lawrence. This reflex helps to explain the risk in ballistic stretching.Flexibility training http://www. the agonist contraction is released and the target muscle group is taken to a final stretch.
anterior pelvic tilt vs. in a hamstring stretch significantly affected the range of motion at the hip joint. is that any form of stretching that exerts pressure on the soles of the feet or palms of the hands will produce a strong reflex extension of the limb(s) concerned. is necessary. Technique in Stretching The results of a recent study demonstrate the importance of technique in a stretch. instructors may help students stretch by encouraging them to focus on relaxing the muscles before and during a stretch. Instructors who are knowledgeable in anatomy and kinesiology of muscle attachments and joint movements may have greater success in designing flexibility programs for their students. and number of repetitions of any given stretching technique. It is certain that for flexibility to increase. and it serves to stabilize the limb. according to Siff (1992). 1985). careful application of a slow and progressively increasing stretch just past the point of limitation. This reaction is one neurological reason to avoid forward unsupported stretches. (The anterior pelvic tilt proved to be the preferred anatomical position.com/Articles/flexibility.) The implications of this research are clear.e. the posterior pelvic tilt. A little-known factor about stretching. Depending on a client's fitness level. This is known as a positive supportive reaction. an individualized flexibility program can be designed using the following guidelines: 8 of 12 20/07/2012 3:06 PM . (1992) found that the effect of the pelvic position. goals. Sullivan et al. Although stretching techniques are continually evolving. limiting factors of flexibility. deliberate and regular program of exercises that can progressively and permanently increase the usable range of motion of a joint or set of joints. presently there are no universally agreed upon guidelines to follow for prescribing the type.drlenkravitz. Thus. i. over a period of time.html are passively stretched (Basmajian.. Flexibility Guidelines Alter (1988) defines a flexibility training program as a planned. Subjects have been able to relax muscles consciously when normal stretch reflexes would be expected to occur.Flexibility training http://www. and other exercise program participation. but not to the point of pain. duration.
minimizing the movement of other body parts. Stretch to the limit of movement..Flexibility training http://www. Assess your client's flexibility in orderto pinpoint strengths and weaknesses. as stretching in different planes may enhance muscle relaxation and improve overall range of motion at the joint.html 1. 5. Stretch the muscles in various positions. 3. Keep the breathing slow and rhythmical while holding the stretches. 6. Hold stretches between 15 and 30 seconds.drlenkravitz. Research suggests that four sets of 15 to 20 seconds per stretch will result in optimal gains (Taylor et al. 12. This is referred to as the "endpoint" of the stretch. 9.com/Articles/flexibility. 10. 8. Attempt to relax the target muscle before going into the stretch. Stretch all the major muscle groups as well as opposing muscle groups. 7. 2. Stretch after each vigorous workout to reduce the potential of delayed-onset muscle soreness and to encourage mind and body 9 of 12 20/07/2012 3:06 PM .1990). 4. Warm-up before stretching to increase the body temperature and range of motion. not to the point of pain. Perform stretching exercises daily. 11. Focus on the muscles involved in the stretch. Design a program that stretches the specific muscles used by the client during physical activity or sport participation.
57-60. 51.html relaxation. K.. Bach. (1981). B. University of Southern California. Effects of exercise upon joint mobility of young and old men. Muscles alive. C. 6. Pasadena: Athletic Press. 16. Calguneri. J. Chapman. (1985). 315-323.drlenkravitz. References: Alter. & Wright. Annals of the Rheumatic Diseases.com/Articles/flexibility. (1980). S. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Beaulieu.. DeVries. A. 13. E. H. back off the movement and make sure the stretching technique is correct. & Noble. M. A comparison of muscular tightness in runners and non-runners and the relation of muscular tightness to low back pain in runners. 23-24. Corbin. Armstrong. (1984). 529-538. (1988).. It may be necessary to try another position or a different stretching exercise for the target muscles. (1971). R. A. Champaign: Human Kinetics Books. M. Electromyographic observations of the effects of static 10 of 12 20/07/2012 3:06 PM . (1980). L. Green. & Jensen. D. 40. J. Science of stretching. Baltimore: Williams and Wilkins. G. M. (1985). E. A.Flexibility training http://www.. The Journal of Physical Education and Recreation. (1961). If the stretch yields pain in the joint area. Doctoral Dissertation. 209-212. B. Medicine and Science in Sports and Exercise. Basmajian. Journal of Orthopedic Sports Physical Therapy. J. Bird. B. Flexibility: A major component of physical fitness.. Stretching for all sports. Changes in joint laxity occurring during pregnancy. H. V.
Medicine and Science in Sports and Exercise. (1973). (1980)... J. (1972). L. J. R.html stretching upon muscular distress. A. & Adams. H. Johns. & Chaudet. (1956). Holt. American Journal of Physical Medicine.. (1968). 31. & Hirschland. L D. H. 611-616. & Abraham. M. & Moritani. A.. 20. E.com/Articles/flexibility. Mechanical disorders of the low back. 824-828. L. H. Antagonist muscle activity during stretching: a paradox re-assessed. R. The physiology of flexibility: A review of the literature.. G.drlenkravitz. G. 60. Perceptual and Motor Skills. DeVries. T. American Journal of Physical Medicine. Effects of systematic. Bulbulion. P. A comparative analysis of variable time-controlled proprioceptive neuromuscular facilitation slow reversal-hold-relax stretching to active assistive stretching. Wiswell. 468-479. R. N. V. (1988). Tranquilizer effect of exercise. T. Masters Thesis. & Okita. (1962).. Philadelphia: Lea and Febiger. San Jose State University. 285-289. & Wright. Farfan. L. M. Research Quarterly. B. Travis. 178-188. R. (1970). 130-141. DeVries. 51. 17. F. Kraus. 49-62. Massey. T. Minimum muscular fitness tests in school children. Relative importance of various tissues in joint stiffness. Holland. 25. (1954). Journal of Applied Physiology. (1981). Kravitz. Etnyre. A. 32.. H.. Comparative study of three stretching techniques. R.Flexibility training http://www. A. B. R. Kinesiology Review. heavy resistance exercise on range of movement in young adults.. EMG comparison of single doses of exercise and meprobamate as to effects of muscular relaxation. 57-66. Research Quarterly. Research 11 of 12 20/07/2012 3:06 PM ..
T. W.html Quarterly.com/Articles/flexibility. M. 9. A. 300-309. Las Vegas. E. & Worrell. R. 61-62. R. Physical Education and Recreation.. & Garrett. J. D. & Butler. (1992). Biophysical factors in range-of-motion exercises. 12 of 12 20/07/2012 3:06 PM . M. Wickstrom. Weight training and flexibility. Sullivan. & Ribbeck. D. American Journal of Sports Medicine. R. J. C.. 123-129. R. 18. R. G. Glisson. A. M.. (1963). Moyer. L. (1990). Taylor. V. A. 16.the biomechanical effects of stretching. R. The role of warmup in muscular injury prevention. (1981). The Physician and Sportsmedicine. Medicine and Science in Sports and Exercise. M. 1383-1389..drlenkravitz. V. W. Biomechanical analysis and modeling of components of flexibility and exercise stretching. T. Safran. 57-65. International IDEA Research Symposium.. Garrett. Journal of Health. 41-51. A. C. Seaber.. J. Seaber... (1992). Siff. (1988). The American Journal of Sports Medicine.. 27. A. B. 34. Viscoelastic properties of muscle tendon units . NV. 24. Dejulia. Quendenfild. Sapega. Effect of pelvic position and stretching method on hamstring muscle flexibility.. E. Dalton. A..Flexibility training http://www.. W.