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PNF Stretching

PNF stretching is considered to be the most effective way to increase static flexibility and is a combination of static passive stretching and isometric stretching. PNF stands for Proprioceptive Neuromuscular Facilitation and was first developed as a treatment for paralysis patients.

PNF stretching is usually carried out with a partner who provides the resistance for the isometric contraction although it can be done without a partner (but generally will be less effective). If using a partner, then it is important that the partner be attentive and focused.

Pnf StretchingThe most commonly used PNF technique is the “Hold-Relax” which is sometimes referred to as the “Contract-Relax”. The muscle is stretched passively towards the limit of its range of motion and then the muscle being stretched is isometrically contracted for 5-15 seconds after which the muscle is relaxed for a couple of seconds before being subjected to a passive stretch which should be greater than the initial passive stretch. This stretch is held for around 10-15 seconds before repeating the PNF stretch one or two more times.

PNF Stretching Examples: Hamstring Stretch
For an example of a PNF stretch, then the person being stretched lies flat on their back with one leg bent at 45 degrees and the other leg extended straight. The partner lifts the straight leg until a comfortable stretch is felt through the hamstring (nb partner just supports the stretched leg and does not push). This stretch is held for 15 seconds.

The stretchee should then isometrically contract the hamstring against partner’s resistance for 5-15 seconds, relaxes and the partner gently guides the hamstring to a deeper stretch. This is repeated a few more times until there is no further increase in range of motion.

Brief PNF Physiology of Stretching
Muscles spindles cells located within the muscles, protect the muscle from injury. They sense how far and fast a muscle is being stretched and when activated produce a stretch reflex. This reflex causes the muscles to contract to prevent overstretching the muscle.

Located within the muscle tendon is another sensor called the golgi tendon which senses how much tension is being put upon the tendon. When the golgi tendon is activated then it relaxes the muscles (unlike the muscle spindle).

A voluntary contraction during a stretch increases the tension on the muscle, activating the golgi tendon organs more than the stretch alone. So when the voluntary contraction is stopped the muscle is inhibited from contracting against a subsequent stretch. PNF stretches uses this to take advantage of the sudden vulnerability of the muscle and its increased range of motion by using the period immediately following the isometric contraction to train the stretch receptors to get used to this new, increased, muscle length. This is accomplished by the final passive stretch.

Some General Recommendations for PNF Stretching

•Leave 48 hours between PNF stretching routines
•For each muscle group complete 2-5 sets of the chosen exercise
•Each set should consist of one stretch held for 10-15 seconds after the contracting and relaxing phases
•PNF is not recommended for anyone under 18 years old
•A 5-10 minute thorough warm up is recommended before performing PNF stretching as a separate exercise session.

While most of us could obtain benefit from the improvement in flexbility that PNF stretching can bring, there is some conjecture amongst sports professionals about the effective of stretching in general to reduce the risk of injuries and to improve performance. Although there is some conflicting evidence reported, on balance research literature reviews such as reported by Thacker et al (1) support the hypothesis that routine stretching has little impact on reducing total injuries amongst competitive or recreational athletes.

  
However, research has also found that pnf stretching may lead to improvements in running mechanics. Caplan et al (2) concluded from studying rubgy league players that stretch training at the end of regular training is effective in improving running mechanics during high velocity running.

As with all stretches, only take a PNF to the limit of what feels comfortable. Pain is an indication that you are overstretching.

In addition, there are advantages and disadvantages of PNF stretching and it may be worthwhile discussing these with a suitably qualified sports therapist.

(1) Thacker SB, Gilchrist J, Stroup DF, Kimsey CD., Jr. “The impact of stretching on sports injury risk: a systematic review of the literature”. Med Sci Sports Exerc. 2004;36:371-378
(2) Caplan N, Roggers R, Parr MK, Hayes PR. “The effect of proprioceptive neuromuscular facilitation and static stretch training on running mechanics.” J Strength Cond Res, 2009, 23: 1175-1180

By Richard Lane

Do you cheat when you stretch your quads?

Many people “cheat” when they stretch their quads. The standard stretch for the quads that you will see many people doing is to stand on one leg and bring their foot to your butt.

However, the chances are that their alignment is such that they are not actually stretching the quads at all, but merely compensating by hip or trunk rotation.

(If you can cope with the sound of young children) The following video explains how best to perform a genuine quad stretch.

Positional Release

Most people who have regular remedial or therapeutic massage in Sydney would probably prefer to have the therapist to get stuck into the muscles and the soft tissues. Certainly with our Sydney mobile massage business, deep tissue and deep pressure massage are more popular than Swedish or relaxation massage.
However, not all clients necessarily respond best to a stronger massage and recently I’ve some good results with incorporating positional release techniques within a session (particularly when the deep tissue techniques have not yielded the benefits that I would like to have seen).

Therapeutic relief through positional release techniquesPositional release is a gentle and relatively non-invasive technique that allows for pain relief effectively by the body healing itself. It relies on the use of placing the body or painful part of the body in a comfortable position so that myofascial trigger points can release.

Positional release can be incorporated into a remedial massage bodywork session to assist with reducing the pain for particularly stubborn area or it can be considered as a standalone session. In addition, once you have experienced pain relief from using positional release then it is possible to perform some level of self-positional release.
In order to perform positional release, then a therapist will locate the areas of dysfunction (most often affected by trigger points) and then they will manoeuvre the client’s body into such a position that the pain experienced from the trigger point is eliminated (or at least minimised). The client will stay in this position for up to 2-3 minutes (which may be assisted by the therapist supporting an arm, a leg or the head for example).

The philosophy behind of positional release is that painful muscles when put into such a position that they are shortened (without contraction) then the pain sensors within the muscle can in effect be “switched off”. The muscle may then be in a more relaxed state when the passive support is removed and the level of pain and discomfort can be decreased.

Self-Positional Release
If you are having problems with soreness in your neck then lie on your side on a pillow and using your fingers or thumb find a spot that is particularly tender. Often these points are just below the occiput (ie just under the bone of the skull at the back of the neck). Now very slowly and very easily move your head in different directions whilst monitoring the pain you are experiencing. You may need to tilt your head backwards, forwards or to the side or even rotate it in one direction. Hopefully you will move into such positions that the pain will be reducing – if you find that it is actually increasing then move in the opposite direction.

  
Once you have found a position such that the pain is minimised then support your head as much as possible in that position and just stay there for a couple of minutes (no need to keep monitoring the pain with your fingers at this time). Gradually ease yourself back into a normal position and hopefully your pain will be less. If you need to work on the opposite side then simply turn over and repeat.

Obviously never force your head into uncomfortable or strained positions whilst you are attempting to perform self-positional release and if you have any concerns regarding the pain and discomfort you are feeling, always consult a health care professional.

By Richard Lane

Why Does My Neck Hurt?

Regardless of where a problem may originate in the body, the neck and shoulders are very often the manifestation of the issue.  This is true of both physical and emotional dysfunctions.

On top of the cervical vertebrae is a large roundish object which is virtually always in motion in an attempt to stay balanced and to keep the eyes horizontal.   If this object, also known as the head, is well balanced on the vertebrae then the loads on the muscles of the neck and shoulders are relatively low.   However, physical disturbances all down the body to the feet can interfere with this dynamic leading to greater loads on and tension in the muscles.  For example, a shortening of calf muscles from, say, wearing high heels, tilts the pelvis forward which alters the curvature of the spine which will impact on how the head sits.

In addition, our necks are always adjusting to any imbalances in our body.  If we sidebend to one side then there is a tendency for our neck to counteract this movement in order to keep our eyes level with the ground.

Chickens are often used to demonstrate this to great effect!

Our emotions often arise in our stomachs and we are all familiar with the sensation of butterflies or tightening in our bellies.  From there they will wind up again to our necks where the emotions can often be expressed in the form of tightening of the muscles of the neck and shoulders.  If this becomes a near constant state of tension then we can lose a degree of flexibility in our spine to create a bottleneck in the area.

  
Furthermore the complicated movements and requirements on the cervical spine and muscles can lead to problems more easily than elsewhere in the body where there is more protection and less mobility demands.

For these reasons, whenever you book in for a massage, then your therapist is likely to find restrictions and painful areas in your neck that you may not even have been aware of.  However, if you do present with a neck problem then it may very well be the case that your therapist could spend significant time working on parts of the body other than the neck if they consider that the root cause of the neck issues may not actually be with the neck.

By Richard Lane


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