PART ONE Stretching Fundamentals

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1 Contents Preface vii Acknowledgments xiii Reviewers xv PART ONE Stretching Fundamentals CHAPTER 1 Introduction to Stretching 3 WHY STRETCH: THE BENEFITS OF STRETCHING 3 Maintains and Improves Range of Motion 3 Prevention of Injuries 5 Injury Rehabilitation 5 Posture 6 Counteracts Sedentary Lifestyle 6 Relaxation 7 Treatment and Prevention of Lower Back Pain 7 Related Declines in Health and Fitness 8 SITUATIONS IN WHICH STRETCHING IS NOT ADVISED 8 Pre-activity to Prevent Injury 8 Pre-event to Improve Performance 9 To Reduce Delayed-onset Muscle Soreness 9 TYPES OF STRETCHING 10 Static 10 Active 10 Proprioceptive Neuromuscular Facilitation (PNF) 11 Ballistic 11 Self-stretching Versus Partner or Clinician Stretching 11 MECHANICS OF STRETCHING 12 Tissues Involved in Stretching 12 Possible Mechanisms Contributing to Tissue Lengthening 13 WHAT HAPPENS DURING A STATIC STRETCH? 15 COMPLETE FITNESS 16 Strength Training 16 Training for Cardiovascular Fitness 17 CHAPTER 2 General Principles for Safe and Effective Stretching 21 TERMINOLOGY OF MOVEMENT: A BRIEF REVIEW 21 Reference Directions 21 Reference Planes for Description of Movement 23 Terms Describing Functional Relationships 23 Movements Allowed by Joints 24 xvii

2 xviii SETTING GOALS 27 FACTORS TO CONSIDER FOR SAFE AND EFFECTIVE STRETCHING 28 Cautions and Contraindications 28 When to Stretch 28 Warming Up 29 Intensity 29 Rate and Application of Tension 30 Duration of Stretch 31 Frequency 31 Cooling Down 32 EVALUATING PROGRESS 33 Duration of Stretching Program 33 CHAPTER 3 Assessing Flexibility 36 ASSESSING POSTURE 37 ASSESSING RANGE OF MOTION 38 Cervical Spine 39 Shoulder 42 Elbow 44 Wrist, Hand, and Fingers 45 Thoracic and Lumbar Spine 47 Hip 51 Knee 54 Ankle, Foot, and Toes 56 PART TWO Basic Stretches and Stretching Programs CHAPTER 4 Stretches for Individual Muscles 63 ORGANIZATION OF STRETCHES FOR INDIVIDUAL MUSCLES 64 HEAD AND NECK 64 Cervical Flexors 65 Cervical Extensors 66 Cervical Side-benders 68 Cervical Rotators 69 SHOULDER 70 Shoulder Flexors 70 Shoulder Flexors Acting on the Scapula 71 Shoulder Extensors 72 Shoulder Extensors Acting on the Scapula 71 Shoulder Abductors 72 Shoulder Abductors Acting on the Scapula 73 Shoulder Adductors 74 Shoulder Adductors Acting on the Scapula 75 Rotator Cuff 76 ELBOW 77 Elbow Flexors 77 Elbow Extensors 79 WRIST AND HAND 80 Flexors of the Wrist, Hand, and Fingers 81 Extensors and Abductors of the Wrist, Hand, and Fingers 82 Pronators and Supinators of the Forearm 85 INTRINSIC HAND MUSCLES 86 Finger Flexors 86 Finger Adductors and Opposers 87 Finger Extensors 88 Finger Abductors 89 TRUNK 90 Trunk Flexors 90 Trunk Extensors 91 Trunk Rotators 93 Trunk Stabilizers 95

3 xix HIP 95 Hip Flexors 95 Hip Extensors 97 Hip Abductors 98 Hip Adductors 98 Hip External Rotators 100 Hip Internal Rotators 100 KNEE 101 Knee Extensors 101 Knee Flexors 102 ANKLE AND FOOT 105 Ankle Plantarflexors 105 Ankle Dorsiflexors 106 Ankle Invertors 107 Ankle Evertors 108 Toe Flexors 111 Toe Extensors 110 INTRINSIC FOOT MUSCLES 111 Toe Flexors 111 Toe Extensors 112 Toe Abductors 113 Toe Adductors 115 CHAPTER 5 Stretches for Major Muscle Groups 117 UPPER BODY 118 Neck 118 Shoulder 120 Elbow 125 Wrist and Hand 127 Fingers 128 TRUNK 129 LOWER BODY 133 Hip 133 Knee 136 Ankle and Foot 137 Toes 139 CHAPTER 6 Stretching Programs for the Whole Body 141 TEN-MINUTE PROGRAM 141 Upper Body 143 Lower Body 145 TWENTY-MINUTE PROGRAM 146 Upper Body 147 Lower Body 153 THIRTY-MINUTE PROGRAM 157 Upper Body 157 Lower Body 165 CHAPTER 7 Improving Posture Through Flexibility 171 GOOD POSTURE 171 POSTURE-FUNCTION RELATIONSHIPS 171 Factors Affecting Posture 172 Effects of Posture on Function 174 ABNORMAL POSTURES 176 Sagittal Plane Deviations 177 Frontal Plane Deviations 177 Transverse Plane Deviations 178 ASSESSING POSTURE 180 INTERVENTIONS TO IMPROVE POSTURE 180 Education 181 Strengthening 181 Stretching 182

4 xx PART THREE Special Stretches and Stretching Programs CHAPTER 8 Workplace Stretching Programs 187 TYPES OF WORK AND WORK-RELATED INJURIES 187 Static Work Injuries 188 Dynamic Work Injuries 188 GENERAL APPROACH TO INDIVIDUALS WITH WORK-RELATED PAIN 189 Assessment 189 Education in Posture and Body Mechanics 190 Conditioning 196 STRETCHES FOR STATIC WORK 198 Seated Work 198 Standing Work 200 STRETCHES FOR DYNAMIC WORK 202 Work Requiring Repetitive Movements 202 Work Requiring Lifting 202 WHOLE-BODY WORKPLACE STRETCHING PROGRAM 203 CHAPTER 9 Stretching for Sports 205 BASEBALL 206 BASKETBALL 207 BICYCLING 207 FOOTBALL 208 GOLF 209 GYMNASTICS 209 HIKING 210 HOCKEY 211 KAYAKING 211 ROCK CLIMBING 212 RUNNING 213 SKATING 213 SKIING (ALPINE) 214 SKIING (NORDIC) 214 SNOWBOARDING 215 SOCCER 216 SWIMMING 216 TENNIS 217 TRACK AND FIELD 217 VOLLEYBALL 218 WEIGHTLIFTING 219 CHAPTER 10 Stretching for Rehabilitation of Injuries 221 INITIAL APPROACH TO INJURY 222 Addressing the Mechanism of Injury 222 Stretching Injured Tissue 223 Applying Rest Ice Compression Elevation (RICE) 223 LONG-TERM REHABILITATION OF INJURY 224 Increasing Range of Motion and Flexibility 225 Regaining Strength 227 Conditioning 231 Development of Functional Skills and Balance 232 CHAPTER 11 Advanced Stretching 235 COMBINATION STRETCHES 235 Benefits of Combination Stretching 236 Examples of Combination Stretches 236

5 xxi STRETCHING NON-MUSCULAR STRUCTURES 237 Benefits of Stretching Non-muscular Structures 239 Examples of Non-muscular Stretches 239 USE OF STRETCHING AIDS 241 Physiotherapy Ball 241 Belts, Bands, Straps, and Bolsters 242 PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF) 243 Benefits and Risks of PNF Stretching 246 Examples of PNF Stretches 246 HATHA YOGA 247 Benefits of Hatha Yoga 248 Examples of Yoga Stretches 248 Some Thoughts on Yoga 250 Guidelines for Individuals Considering Yoga or Other Movement Arts 253 Appendix A: Recommended Resources 255 Index 259