Stretching Exercises for Muscle Conditioning: A Comprehensive Guide, Exams of Yoga

Download Stretching Exercises for Muscle Conditioning: A Comprehensive Guide and more Exams Yoga in PDF only on Docsity! 6 STRETCHING When muscles are trained through conditioning exercises they can become tight . Stretching extends the muscles, helping them relax and maintain flexi- bility. It also relieves stress and contributes to men- tal as well as physical health . Stretching exercises should always be included in warm-up and cool- down routines for muscle conditioning or sports. There are two basic kinds of stretches : static and dynamic . A static stretch is one in which a position or a posture is extended and held for a period of time . Yoga is an example of static stretch exercise . Most of the stretches included in this book are static exercise. Dynamic stretching involves range of motion, such as in calisthenics and aerobic dance. Some of the calisthenics in Chapter 5 involve dynamic stretching. People just beginning an exer- cise program should concentrate on static stretching, adding dynamic stretches as they develop flexibility. Flexible joints and a limber body reduce the risk of injury in physical activities . The most effective and the safest way to develop flexibility is through slow, steady, and regular progress. Before beginning your program, work out a routine that is suited to your own level with your rehabilitation team or with experienced exercise therapists . How to Stretch Correctly The stretch should be held for approximately 10 to 30 seconds, and only to the point where mild tension is felt in the muscle . Relax as the stretch is held . Mild tension in the muscle should subside as the position is held . If it does not subside, ease tension on the muscle to a comfortable degree of tension where the stretch can be held . After the first stretch has been held, come back to the resting position completely before the next stretch. The second stretch for the same muscle group is called the "developmental stretch" In this stretch, try to move a fraction of an inch further than the first stretch, creating a mild tension of the muscles while holding the stretch for the same number of seconds as the first one. Prostheses may restrict the natural range of motion. For example, the person with a below-knee amputation will be restricted when flexing the knee, while someone with an above-knee amputation will be restricted when flexing the hip . Modified trim lines and flexible brim sockets are helpful in increasing flexibility. 50 51 Conditioning Exercises : Stretching STRETCHING EXERCISES Muscle Exercise Title Shoulder/Upper Body 10 Overhead Stretch Shoulder/Upper Body 1 1 Overhead Bent-Arm Stretch Shoulder/Upper Body 1 2 Shoulder/Arm Stretch Gastroc/Soleus 1 3 Standing Calf Stretch Hamstrings 1 4 Standing Toe Touch Hamstrings 1 5 Seated Toe Touch Hamstrings 1 6 Hurdler's Stretch Quadriceps 1 7 Anterior Thigh Stretch Quadriceps 1 8 Standing Quadriceps Stretch Quadriceps 1 9 Double Quadriceps Stretch Gluteus Maximus/Hip 20 Seated Hip and Upper Hamstring Stretch Inner Thigh/Groin 21 Standing Split Lower Back/Abdomen 22 Prone Trunk Extension/ Low Back Arch 54 RRDS Clinical Guide . Physical Fitness : A Guide for Individuals with Lower Limb Loss EXERCISE 12 . SHOULDER/ARM STRETCH PURPOSE Warm-up and cool-down for the shoulders, arms, chest, and upper back muscles. PROCEDURE ▪ Stand with feet comfortably apart and hands down at the sides. M Raise both arms out from the body to shoulder height . With the arms parallel to the floor and at shoulder height, bring the fingers of both hands as close together as possible . Bring your hands together behind the back and keep the head up, the back straight, and do not bend at the knees. ▪ Bring both arms back out to the sides before repeating the exercise. 10 This exercise may be done from a seated position. VARIATION When done without an assistant, this exercise requires great flexibility in order to make the hands meet behind the back . However, it is an effective stretch exercise even if the hands do not touch in the back. With the assistance of Richard Hughes, Greg Mannino is able to make his hands meet behind his back . 55 Conditioning Exercises : Stretching EXERCISE 13 . STANDING CALF STRETCH PURPOSE Stretches the gastrocnemius and soleus muscles. PROCEDURE II Stand about 3 feet away from the wall . Step forward with one foot but keep the knee of the back leg straight. II Lean forward as far as is comfortable, trying to touch the chest to the wall . Keep the heel of the back foot on the floor . Hold the position for about 15 seconds. II As flexibility is developed, step further away from the wall to increase the stretch. VARIATION To stretch the lower calf and Achilles tendon, bend the knee of the back leg during the lean forward. Be certain to keep the heel of the back leg on the floor. Greg Mannino uses a wall for support while doing this stretch . An exercise bar may also be used . 56 RRDS Clinical Guide . Physical Fitness: A Guide for Individuals with Lower Limb Loss EXERCISE 14. STANDING TOE TOUCH PURPOSE Improve balance and develop flexibility in the hamstring muscles. MODIFICATIONS If needed, use a wall for support and balance . The anterior trim lines of the AK socket may restrict range of motion . They can be lowered or a flexible brim socket can be used. PROCEDURE This exercise may be done with the knees slightly bent or with the legs held straight for greater stretch of the hamstring muscles . Three variations are shown. VARIATION 1 n As shown below, bend from the waist as if to touch one toe . It may not be possible without practice, but reach as far as is comfortable. n Hold the position for a few seconds and round the back to help relax the muscles of the lower back if necessary. n Return to an upright position before alternating sides. Samantha Ellis uses a wall to help maintain balance. CAUTION The stretch should be performed in a smooth manner . Do not bounce . 59 Conditioning Exercises : Stretching VARIATION 2 n Spread legs apart as far as is comfortable. n Reach with both arms straight out from the body as far as possible . Hold the position for 10-30 seconds, allowing the back muscles to relax. n Slowly return to the starting position before repeating the exercise. Ellis stretches arms forward with legs apart. VARIATION 3 n Keep the legs as far apart as possible. n Reach to touch the toes of one foot with both hands . The opposite hip may pull up from the floor slightly . Hold the position for a few seconds and allow the back muscles to relax. n Slowly return to the starting position and repeat the exercise on the other leg. n For more stretch and greater range of motion, try to touch your forehead to your knee. Ellis demonstrates the basic stretch . 60 RRDS Clinical Guide. Physical Fitness : A Guide for Individuals with Lower Limb Loss EXERCISE 16. HURDLER'S STRETCH PURPOSE Stretches the hamstring muscles. PROCEDURE n Sit on the floor with legs spread apart . Keep one leg straight and flex the other one at the knee. (The flexed position may be difficult at first .) n Lean forward to touch the toes on the outstretched leg . Keep the head up and back straight, bending only at the waist. n Do not bounce, but stretch gradually, holding the furthest position for at least 20 seconds. n Stretch a little further on each repetition. n Avoid stressing the medial ligaments of the bent leg by proper positioning. MODIFICATIONS AK flexible brim A person with an above-knee amputation may benefit from a flexible brim socket in stretching on the prosthetic side with the leg extended. If flexing the AK prosthesis at the knee is too difficult, do only the Seated Toe Touches to stretch the hamstrings with the prosthesis straight (Exercise 15). BK suspension sleeve When the BK prosthetic side is extended, a cuff strap suspension may prevent a full stretch by holding the knee in flexion . Using a suspension sleeve will allow the knee to achieve a full range of motion . When flexing the BK prosthesis, the ActivSleeve suspension sleeve worn by Albert Rappoport allows the residual limb to pull out of the socket, relieving any hamstring impingement. Lowered BK trim line The degree of flexibility on the BK prosthetic side will depend on the height of the trim lines . While lowered medial and lateral trim lines are very helpful, lowering the posterior trim lines will best improve knee flexion . 61 Conditioning Exercises : Stretching Linda Pedersen demonstrates the Hurdler's Stretch to stretch the hamstrings of her residual limb. Albert Rappoport stretches the hamstrings of his sound leg . 64 RRDS Clinical Guide . Physical Fitness : A Guide for Individuals with Lower Limb Loss EXERCISE 19 . DOUBLE QUADRICEPS STRETCH PURPOSE Stretches the quadriceps muscles. PROCEDURE n Kneel down on both knees and sit down on your legs. n Move your legs outside the width of the hips and turn the prosthetic foot outward while keeping the toes of the sound foot straight back. n Slowly lean backward, moving your hands on the floor for support and to control the movement. n Allow the residual limb to slide out of the socket as necessary. n Lean back as far as is comfortable . Hold for 20 seconds and then return to the kneeling position . Try to lower the body a bit farther back each time. n The goal is to lean back until the shoulders are on the floor, as shown in the photo, but do not overstretch at first. MODIFICATIONS — To relieve stress on the knees when in the supine position of the exercise, move them closer to the midline of the body . The sound side foot should be pointed straight back. The prosthetic foot cannot bend straight back but can be positioned to the side as pictured. — The ActivSleeve suspension sleeve allows the knee to pull out of the prosthesis and then go back into the socket without special adjustment. — The posterior trim line may be normal height, equal to the patellar bar, but can be modified to a lower position on those with longer residual limbs without causing any problems while walking. Medial/lateral trim lines are lowered . CAUTION This is a very demanding stretch exercise and recommended only for those with well-devel- oped flexibility . For best results, 9K-level exer- cisers should use the ActivSleeve suspension sleeve . This stretch is not recommended for persons with chronic knee problems or back problems. Albert Rappoport demonstrates this difficult and advanced stretch . 65 Conditioning Exercises : Stretching EXERCISE 20. SEATED HIP AND UPPER HAMSTRING STRETCH PURPOSE Stretches the gluteus maximus and other hip muscles and hamstrings. PROCEDURE n Sit on the floor with your back against a wall. n Keeping one leg straight out in front, flex the other knee and gently pull the entire leg toward the chest until tension is felt at the back of the upper leg . Be sure the leg is pulled to the chest as one unit, from the ankle and knee, so that undue stress is not placed on the knee. n Hold the stretch for 20 seconds before slowly putting the leg flat on the floor again. Try to pull the leg up a bit further with each repetition. CAUTION Socket impingement and suspension may re- strict completion of this exercise for the AK prosthetic side. Greg Mannino demonstrates this exercise by balanc- ing against the wall for support and using two hands to make the stretch complete . He holds his leg on the outside of the ankle with the one hand while the other hand supports the bent knee . Albert Rappoport demonstrates a variation of this exercise . He balances his body with one arm while lifting his prosthetic leg for the stretch . This position may be used for both legs . The above stretch using two hands is preferable, but it there is no wall or back support available, try this technique . 66 RRDS Clinical Guide . Physical Fitness: A Guide for Individuals with Lower Limb Loss EXERCISE 21 . STANDING SPLIT PURPOSE Stretches the inner thigh and groin. PROCEDURE nl Stand with your legs slightly apart on a non-slip surface or lie flat in the supine position. II Work your legs apart as far as you are able, moving them out one at a time in line with your hips . Keep the back and legs straight, if possible. El Hold the stretch for 20-30 seconds and slowly return to the starting position. IN Hands may be positioned on the knees to gain stability and push legs outward. VARIATION Beginners may need to bend forward and balance themselves by holding on to a railing or other fixed object. Albert Rappoport demonstrates the exercise wearing an exoskeletal prosthesis, ActivSleeve suspension sleeve, and a DAS Foot, which has excellent inversion/eversion capabilities so it can remain flat on the floor .