PNF Stretching Techniques and Principles

Exercise Stretching Practical

• Learning outcomes for exercise stretching practical include: demonstrating various stretches, teaching stretches for major muscle groups, assisting patients/models with stretching, and identifying suitable stretches for warm-up and cool-down portions of an exercise session.

PNF (Proprioceptive Neuromuscular Facilitation) Stretch

• PNF stretches induce relaxation in target muscles by stimulating muscle proprioceptors.
• This can occur through either autogenic inhibition of the Golgi tendon organ (GTO) in the stretched muscle or reciprocal inhibition through voluntary contraction of the opposing muscle.
• Muscle spindles lie parallel to muscle fibers, detecting sudden stretches and causing contraction in the same muscle while inhibiting contraction in the opposing muscle.
• Voluntary muscle contraction mimics muscle spindle action.
• Golgi tendon organs (GTO) are located in the musculotendinous junction, detecting excessive muscle contraction and inhibiting it to prevent injuries.

Reciprocal Inhibition

• Reciprocal inhibition involves the inhibitory effect on a muscle from activating its opposing muscle.
• Descending inputs are involved in the transmission of the signals.

Autogenic Inhibition

• Golgi tendon organs (GTOs) are located at the musculotendinous junction.
• GTOs detect excessive voluntary muscle contraction, inhibiting it.
• Maximum isometric muscle contraction produces autogenic inhibition.

Task 2: PNF Stretching

• Students should practice PNF stretching techniques, including contract-relax (CR) and contract-relax-agonist-contract (CRAC).
• Specific muscle groups to practice on include hamstrings, gastrocnemius, and triceps.

Active Inhibition Technique

• Contract-relax (hold-relax), originally associated with proprioceptive neuromuscular facilitation (PNF), is a technique widely used in rehabilitation and training programs.
• Contract-relax-contract (hold-relax-hold) is another active inhibition technique.
• Agonist contraction is a third active inhibition technique.

Active Inhibition Techniques - Procedures for Application (Contract-Relax)

• Begin by positioning the tight muscle in a comfortably lengthened position.
• Ask the patient to isometrically contract the tight muscle against resistance for 5-10 seconds until fatigue.
• Have the patient relax the muscle voluntarily.
• The therapist then passively stretches the extremity through the increased range.
• Repeat procedure after a brief rest.

Example: Tight Ankle Planter Flexors

• Dorsiflex the ankle to a comfortable position
• Place your hand on the plantar surface of the patient's foot.
• Have the patient isometrically contract the plantar flexors against your resistance for 5–10 seconds.
• Allow the patient to relax and passively dorsiflex the patient’s ankle.

Contract-Relax / Hamstrings

• This describes the technique applied to the hamstring muscle group.

2. Contract – Relax – Contract (Hold-Relax-Hold)

• Follow the same initial steps as the contract-relax technique.
• After the patient relaxes the tight muscle, the patient should concentrically contract the muscle opposite the tight muscle.
• The patient actively moves the extremity through the increased range.

Example: Tight Ankle Planter Flexors

• Dorsiflex the ankle to a comfortable position.
• Position your hand on the affected foot.
• The patient isometrically contracts the plantar flexors while you resist the movement for 5-10 seconds.
• Instruct the patient to relax and passively dorsiflex the ankle.

3. Agonist Contraction

• Passively lengthen the tight muscle to a comfortable position.
• Have the patient perform a dynamic (shortening) contraction of the opposing muscle.
• Apply mild resistance to the contracting muscle and allow the movement (increased range).
• The opposing muscle will relax due to reciprocal inhibition.

Example: Tight Ankle Planter Flexors

• Dorsiflex the ankle for a comfortable stretch.
• Apply mild resistance as the patient contracts the dorsiflexors.
• Allow the joint movement (increased range of dorsiflexion).

Task 3: Dynamic Stretching

• Teach models to perform dynamic stretches for deltoids, triceps, oblique abdominal muscles, quadriceps, hip flexors, hamstrings, gluteal muscles, and calf muscles.
• Important considerations include safety, individual capabilities, achieving goals, starting position, posture, type of instructions, range of the stretch and the repetitions.

Dynamic Stretch - Arm Swings, Overhead/Down and back, Side/Front Crossover

• Specific instructions for dynamic stretches targeting the shoulders and trapezius muscles.

Dynamic Stretch - Hip Circles and Twists, Twisting Movement

• Instructions specific to hip circles and twisting movements, targeting oblique abdominal muscles.

Dynamic Stretch - Running High Knees, Running Bottom Kicks, Walking Lunges, Ankle Bounce

• Instructions for dynamic stretches targeting various lower body/leg muscles.

Stretching as part of a warm-up and cool-down

• Stretching can be beneficial for warm up routine and is important for a cool down routine.
• Suggest to include stretching at the end of the warm up.
• Suggest potentially longer stretching routines during the cool down.

Task 5: Tennis Stretching

• Design 3 stretches for a warm-up and 3 stretches for a cool down for tennis players returning after a long break, focusing on upper limb range of motion.

Warm-up Stretches, Cool-down Stretches for Pectoralis muscles

• Illustrations of specific stretches focusing on the pectoralis major (upper, mid, and lower fibers).

References

• A list of relevant research articles on stretching, muscle performance, and exercise physiology (see original document).

This quiz focuses on Proprioceptive Neuromuscular Facilitation (PNF) stretching methods, the role of Golgi Tendon Organs, and various inhibition techniques used in muscle stretching. Explore essential concepts such as autogenic inhibition and the contract-relax methods to enhance your understanding of effective stretching practices.