Interventions to Increase Mobility of Soft Tissues

Manual or Mechanical/Passive or Assisted Stretching Self-Stretching Neuromuscular Facilitation and Inhibition Techniques Muscle Energy Techniques Joint Mobilization/Manipulation Soft Tissue Mobilization and Manipulation Neural Tissue Mobilization

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Manual or Mechanical/Passive or Assisted Stretching

A sustained or intermittent external, end-range stretch force, applied with overpressure and by manual contact or a mechanical device

◦Elongates a shortened muscle-tendon unit and periarticular connective tissues by moving a restricted joint just past the available ROM.

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Self-Stretching

Any stretching exercise that is carried out independently by a patient after instruction and supervision by a therapist

self-stretching is same as flexibility exercises ◦some practitioners prefer to limit the definition of

flexibility exercises to ROM exercises that are part of a general conditioning and fitness program carried out by individuals without mobility impairment.

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Neuromuscular Facilitation and Inhibition Techniques

Relaxation of tension in shortened muscles reflexively prior to or during muscle elongation.

Combined inhibition/muscle lengthening procedures referred to as PNF stretching, active inhibition, active stretching, or facilitated stretching.

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Muscle Energy Techniques Manipulative procedures that have evolved out of

osteopathic medicine and are designed to lengthen muscle and fascia and to mobilize joints.

Employ voluntary muscle contractions by the patient in a precisely controlled direction and intensity against a counterforce applied by the practitioner.

Because principles of neuromuscular inhibition are incorporated into this approach, another term used to describe these techniques is post isometric relaxation.

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Joint Mobilization/Manipulation

Manual therapy techniques specifically applied to joint structures and are used to stretch capsular restrictions or reposition a subluxed or dislocated joint.

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Soft Tissue Mobilization and Manipulation

the application of specific and progressive manual forces to effect change in the myofascial structures that can bind soft tissues and impair mobility. ◦ friction massage◦myofascial release◦Acupressure◦ trigger point therapy,

improve tissue mobility by mobilizing and manipulating connective tissue that binds soft tissues.

Very useful adjuncts to manual stretching procedures

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Neural Tissue Mobilization Mobilization of adhesions or scar tissue that was

formed around the meninges and nerve roots or at the site of injury at the plexus or peripheral nerves, after trauma or surgical procedures

Tension placed on the adhesions or scar tissue leads to pain or neurological symptoms.

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Selective Stretching

A process whereby the overall function of a patient may be improved by applying stretching techniques selectively to some muscles and joints but allowing limitation of motion to develop in other muscles or joints.

always keep in mind the functional needs

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Overstretching and Hypermobility

Overstretching◦ a stretch well beyond the normal length of muscle and ROM

of a joint and the surrounding soft tissues, resulting in hypermobility (excessive mobility).

Hypermobility by overstretching may be necessary for certain healthy individuals

Overstretching becomes detrimental and creates joint instability

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