STIFFNESS

 inability to move easily and

without pain
DEFINITION:
Inactivity and illness can both or singularly cause joint and
muscle stiffness.  

INTRODUCTION:
Stiffness, or the loss of joint mobility is a complaint of the
elderly. Stiffness limits numerous functional activities in the
daily life of an individual by interfering with the initiation and
completion of movement patterns.
 Decreased activity increases the incidence of frailty(the
state of being weak in health or body especially from old
age).

 Frail individuals are clinically identified from those

individuals having three of the five attributes of frailty:
unintentional weight loss, muscle weakness, slow
walking speed, exhaustion & low physical activity.
COMMON CAUSES OF STIFFNESS:

The clinician has accepted stiffness to be a natural part of the

aging process.
four common causes of stiffness are:

 Biomechanical changes in connective tissue and related

structures.
 Hypokinesis
 Arthritis
 Trauma.
CONNECTIVE TISSUE & STRECTHING TECHNIQUES

The unique qualities of deformation of connective tissues

are referred to as

 viscous(permanent deformation of CT after stretch or

mobilzation,part of the length or extensibility gained
remains even after a period of time
 elastic as a (temporary deformation characteristic when
subject to stretch in which all the length or extensibility
gained during stretch or mobilization is lost over short
period of time.
Treatment and stretching techniques:

 Physiotherapist can help you return to your regular

activities, with no pain or discomfort, and give you the
confidence to manage and prevent future problems.
They help you in overcome joint and muscle stiffness,
and may use  a variety of treatment, depending on your
specific situation.  

 when force is applied in a affected part intermittently as

in progressive stretching, a progressive elongation may
be achieved.
 Manual techniques, including soft tissue massage,
specific joint mobilizations, myofascial releases and
active stretches, traction, mobilizations with movement,
deep friction massage.   
 
 Pain Treatment Modalities to decrease pain and stiffness,
like electrotherapy, Ultrasound, Laser, heat, ice.
Correction of Posture and mobility:

 A common and often preventable postural change in the

elderly is the forward-flexed posture. This posture causes
forward thrust head and shoulders. Decreased chest and
rib cage mobility, increased kyphosis,decreased mobility
of hip & knee joint.

There are different areas of body where the elderly

commonly repot stiffness & discomfort of joint and their
muscles that limit functional activities and movements
and these are :
Areas of stiffness & discomfort and the
muscles involved
Areas of stiffness & discomfort Key muscles involved

 Pelvic girdle and trunk --  Psoas,iliacus,quadratus

 Hip-------------------------- 
 Knee---------------------- 
 Ankle-------------------- 
lumborum.
 Rectus/hamstrings,internal/
external rotators.
 Quadriceps, hamstring
 Dorsi & planter
flexors,gastrocnemius,
soleus,tibialis ant, planter fascia.

 Shoulder--------------   Pectoralis major & minor.

 Neck-------------------   Suboccipitals,scaleni
 Stiffness a frequent symptom in geriatric patients is
caused by factors leading to functional declines in
posture and mobility resulting in frailty.

 Therefore Close instruction on a therapeutic exercise

program, including range of movement, flexibility,
strengthening, core stability, proprioceptive, and
balance.  Education on body awareness, tips on
recovery and healing, sleeping, proper posture,
ergonomics at work, and how to identify and avoid
aggravating factors.