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Proprioceptive Neuromuscular Facilitation (PNF)

Proprioceptive Neuromuscular Facilitation (PNF):  PNF takes advantage of Autogenic Inhibition.  There are three phases of a PNF stretch.  An initial static stretch is held for 10 seconds.  This is the first phase.  The second phase involves a contraction of the muscle being stretched (about 6 seconds).  The 3rd phase is another static stretch held for 30 seconds.  Essentially following a “hold-relax” pattern.

The most basic PNF stretch is the “Hold-Relax” which starts with a static stretch.  The second step is a contraction stage, followed by the third step of another static stretch.

The next PNF stretch is termed, the “Contract-Relax” stretch.  Step one is the static stretch.  The second step is a contraction of the muscle being stretch within its full ROM (range of motion) of about 6 seconds.  The 3rd step is a 30 second static stretch.

The third PNF stretch is termed “Hold-Relax with Agonist Contraction” and takes advantage of autogenic and reciprocal inhibition.  As always, start with a static stretch for about 10 seconds.  Now, contract with no movement for 6 seconds, then immediately contract the opposite muscle while your partner stretches the muscle being stretched.  (If you are stretching your quads, flex and contract the hamstrings.)

Now, you can add another version of these PNF stretches termed, “Hold-Relax-Repeat”.  You can guess by now what this is, right?  Static stretch for 10 seconds, contract for 6 seconds, static stretch for 10 seconds, contract for 6 seconds, static stretch for 10 seconds, contract for 6 seconds and complete the stretch with a 30 second static stretch.


Chapter 7: An NASM Focus on Flexibility

Dynamic Flexibility: optimal control of movement through the joint’s entire ROM (range of motion).

Think about your legs and their ability to move relatively freely when only using one side.  Now, attempt to move both legs at the same time in the same manner and ROM and you will find it much more difficult.

Neuromuscular Efficiency (much like neuromuscular coordination):  ability of the neuromuscular system to allow agonists, antagonists, stabilizers, to work synergistically to produce, reduce, and dynamically stabilized the entire kinetic chain in all 3 planes of motion.

NASM focuses on flexibility due to their belief that inflexibility leads to injuries.  Following a pattern of inflexibility, also referred to as postural distortions, can lead to predictable patterns of muscular imbalances.  In other words, poor posture leads to improper movement and that… leads to injury.

Altered Reciprocal Inhibition:   (things not functioning exactly the way we want) tight agonist muscle decreases neural drive to its functional antagonist. (hip flexor is tight causing glutes to be loose)  This means that the body thinks it is working, even though it isn’t.  The tightened muscle is shortened and tends to lose flexibility.  This tends to happen when we are in one position for extended periods of time (sitting for hours).  NASM quite often recommends foam rolling tight and shortened muscles.  The optimal time to stretch and roll-out the tight muscles (muscle activation technique) is just before activity or gym time.

Synergistic Dominance:  (related to altered reciprocal inhibition)  the synergists take over for a weak or inhibited agonist/prime mover.  This means you’ll be using your erectors (lower back) to reach your pen on the floor, instead of properly using your glutes to bend/squat.

All of these lead to…

Arthrokinetic Dysfunction:  biomechanical and neuromuscular dysfunction leading to altered joint motion.  Things just aren’t working correctly.  If you train through dysfunction, you will “learn” how to function with the dysfunction.  This is not an optimal scenario.

How does this happen?  Let’s say you experience some sort of trauma, like a car accident, and then you experience inflammation.  Next, we’ll consider you are in pain.  Pain leads to tension and resistance.  Your body’s muscle spindles are activated (stretch reflex) and contract causing “micro spasms”.  When the muscles are tight for an extended period of time adhesions will develop.  When these adhesions are formed (knots), they cause altered reciprocal inhibition and synergistic dominance.  Your form and function is now altered, not normal.  You are walking, or moving in a strange manner.  Continuing this altered joint motion will cause your body to make permanent changes.  You already know this is not an optimal scenario.   Optimally, you will get treatment for the injury when you first experience the altered reciprocal inhibition.  Consider Davis’ Law.  Davis’ law is used in anatomy to describe how soft tissue models along imposed demands. It is the corollary to Wolff’s law, which applies to osseous tissue.  Davis’ Law states that soft tissue remodels along the lines of stress.  An injury will cause the body to strengthen along the line of an injury.  In other healthy scenario like when working out, your body will grow and adapt to the specific exercise.

NASM’s Phase 1 for Corrective Flexibility:

–       Stabilization Phase

–       Tools to use:  Self Myofascial Release Massage and Static Stretching

–       Purpose:  Increase Joint ROM, Improve Muscular Imbalances, Correct Altered Joint Motion

NASM’s Phase 2, 3, 4 for Active Flexibility:

–       Strength Phase

–       Tools to use:  Reciprocal Inhibition, Self Myofascial Release

–       Purpose:  Increase soft tissue extensibility, Increase Neuromuscular Efficiency

NASM’s Phase 5 for Functional Flexibility:

–       Power Phase

–       Tools to use:  Self Myofascial Release, Dynamic Stretching

–       Purpose:  Improve soft tissue extensibility, Improve motor control during higher speed, multiplanar movements  (combination of sagittal plane, transverse/horizontal plane, frontal plane)

* Active Isolated Stretching:  using your muscles to stretch another muscle.  This is accomplished when you use your chest muscles to stretch your back muscles.

2 Types of flexibility: Static (holding) and Dynamic (changing)

(Flexibility:  NSCA gives a nice overview ~  NASM gets into depth)

There are a variety of factors that affect flexibility.  Some we can control, some we cannot.  Joint structure is an uncontrollable factor.  The shoulder is the most flexible joint and is a ball and socket joint.  The other ball and socket joint is at your hip.  Hinge joints perform extension and flexion, like your knee and elbow joint.  Other factors to consider are age and gender.  As we get older, we tend to become more fibrous in our joints limiting our range of motion (ROM).  The connective tissue is naturally elastic and plastic.  It stretches and returns to its original shape and we call this elasticity.  Something that is plastic will stretch and maintain the “new” shape.  Weight training will increase your flexibility if you are inflexible.  If you are flexible already, then resistance training will decrease your flexibility.  The growth of muscle can decrease your flexibility.  However, your activity level will increase your flexibility and delay a loss of flexibility.

Knowing how and when to stretch is important.  Stretching before an activity will serve as a test of your ROM before your sport.  Some say this will help prevent injury.  Others say it may injury your “cold” body and may make you weaker.  It is assumed that static stretching may cause a decrease in strength and power (not jumping as high as an example).  It is also worth noting that “cold stretching” is necessary for “normal” activity.  This is often the argument of martial artists who need to be flexible to use their advanced techniques.  Often people will stretch during an activity (and after) to promote recovery.  Gym goers may stretch between exercises to save time.  However, stretching a fatigued muscle should be done carefully and gently.

Proprioceptors are special cells in the body that sense body position.  They are involved in stretching.  Golgi Tendon Organs (GTO) are located in the tendons (tendons attach muscle to bone).  GTOs detect a load on a muscle.  You experience this when you pick up something and are able to guess its weight.  When the GTO is activated as a safety mechanism, the GTO shuts down/turns off the muscle.  You experience this when you are performing an action and suddenly lose all strength.  Another proprioceptor is a Muscle Spindle.  These are located within the muscles and detect a stretch (speed and ROM) on the muscle.   When you stretch to your limit (Yoga class) and start shaking a bit, this is the muscle spindle activating.

Autogenic inhibition is when the muscle is most flexible (relaxed) and is immediately after the same muscle contracts. (Massage therapists will use this to “turn off” a tight muscle.)  Reciprocal Inhibition is contracting a muscle, forcing the antagonist muscle to relax.  (Personal Trainers will use this to help you gain more ROM during a stretch.)  GTOs, Autogenic and Reciprocal Inhibition are explained here:

Proprioceptive Neuromuscular Facilitation (PNF) :  PNF stretches are usually performed with a partner in a “contract then relax” routine.  PNF takes advantage of the aforementioned proprioceptors to increase the ROM.  🙂

Read more about the different types of stretching techniques here:

Special Populations: Older Adults ~ 65+

Strength, power, muscular endurance, cardio, and metabolism naturally decrease as we age once we pass about 30 years of age.  Not everything goes down however; body fat increases.  We’ll also likely need to get a medical clearance to workout with a trainer or in a gym setting.  Also, beneficial to older adults is a thorough, longer warm-up (perhaps include some stretching) almost doubling the warm-up time of a 25-year-old.  Exercise is beneficial for a lifetime.  The focus for older adults will be maintaining current health or a steady progression.  The emphasis will be on balance in order to prevent falls.  And, exercise will strengthen bones by increase or maintaining bone density.  Most of the activities of daily living, cooking, cleaning, bathing, will be much easier to perform when exercise is also part of a regular routine.  This will mean at least and normally about 2 training sessions per week.  Again, nutrition is often an overlooked area.  Protein intake is important and often protein foods require a lot of chewing making them a less desirable food choice.  This is within the realm of comfort.  Considering comfort, performing exercises in a manner within a comfortable position are most preferred.  This also means that exercises that may increase intracranial pressure should be avoided (blood pressure) for safety.  (Do not perform “head below hips” or Valsalva techniques.)

–       Light Stretching

–       Progressive overload (start light)

–       Beginner’s Workout (total body, 2 * a week, 10-15 reps at a 2:4 tempo)

–       Stable Exercises, progress to standing & weight-bearing exercises

–       Monitor RPE (Rate of Perceived Exertion)  Take a break if needed.

–       Limit soreness (negatives, volume (total reps), intensity techniques (drop sets), and new exercises all cause soreness)

You can be an older adult and perform physically better than some 25 year olds.  These are general guidelines for older adults and a general good place to start for most.  When an exercise is difficult to perform, find a way to make the resistance easier.  If you find the exercise is still difficult, performing partial range of motion is acceptable.  However, there should never be pain and exercises should be fun.  The reason most people do anything is that it’s fun.  If it’s not fun, we won’t likely continue.  Something to consider especially if you’re an older adult and don’t enjoy living.  … Find something to be passionate about, something that moves your mind and body.  This could be interacting with grandchildren, vacations, language exchanges with new friends, and other life activities.

Women ~ A Special Group? A Training Enigma?

It’s common to separate our general healthy population into what is called special populations.  The special populations are children, older adults and women.  While there are valid age considerations, it’s sometimes a bit ridiculous to call females a special group.  You see, human cells are human cells.  Muscle cells are not sex specific.  So, women are not “special” when considering training groups.  There is a difference in hormones between men and women, specifically Testosterone, and Estrogen, and hormones will be considered.  But, there is also a difference in the amount of hormones even among different men.  Now being sensitive to one of the common fears of some women of waking up one morning to find themselves looking manly big (and hairy!)  This isn’t going to happen, to a woman or a man.  Progression and muscle growth is slow.   At any point you decide you’re happy with your results, adjust your program respectively.

A nutritional consideration for males but, sometimes ignored by females, is adequate protein intake.  Often females, unlike males, will eat plenty of vegetables while skipping the protein rich foods (perhaps due to higher calories).   Protein is necessary for recovery and repair for general health and is even more important to an athlete.

Developing a base strength through bench presses, squats and, dead lifts, is important to women, and men.  But, men are stronger, right?  Well, relative to lean mass, there is less of a difference between men and women.  This means that once only muscle mass (muscle weight) is considered, women are much closer in strength (more so lower body than upper) to men.  Something to consider however is that women are more prone to knee injury.  It is theorized that due to joint flexibility, hip joint (femur angle to knee) women experience more injuries.  This should direct workouts to pay attention on strengthening the quads, hamstrings, adductors and abductors on women.  Essentially, calling for a 360 degree primary exercise focus on ensuring the supporting structures are strong for female athletes and therefore less likely to be injured.  A female working within their bodyweight during all exercises is generally a good idea.  There are exceptions of course and mostly due to thorough training and training experience.  But bodyweight is a good place to start.  This brings up another common criticized action called “partials”.  A partial is performing an exercise in less than the exercise’s full range of motion.  Performing partials are okay.  The goal is to reach full range of motion however.

Gluteus Medius ~ It’s Visible! Glute Minimus ~ It’s Not!

Gluteus Medius starts on the middle gluteal line of the Ilium.  If you can see someone’s “butt” from the front, you are seeing the Glute Medius.  The insertion is at the Greater Trochanter of the femur (the part you bump into door knobs).  Gluteus Medius works for you while you abduct your femur, and on your opposite, supporting leg it helps stabilizes.  Glute Medius works hard while doing a one-legged squat.

Gluteus Minimus originates on the inferior gluteal line of the Ilium and also goes to the Greater Trochanter of the Femur.  It also performs abduction of the Femur (horizontal and vertical).  When muscles start and/or end in the same place, they will have same and similar actions.  The Glute Minimus is the weakest, smallest and deepest Glute muscle.

These two muscles are primarily used to stabilize leg movement.  To focus on these muscles you will perform a lateral leg raise, an X-Band side-walk (lateral), abduction machine, pistols (single-leg squat), penguin walks, fire hydrant (on all fours), or any single-leg movement.  All good exercises for men considering it’s more common to find muscle weakness in these two muscles in males.

A)  Medius B) Maximus C) Minimus

Gluteus Maximus ~ Largest Thickest Human Muscle

Glutes start on the Posterior Sacrum, just below your waistline (and follow your plumber’s line).  Glute Max starts on the Posterior Ilium at the Superior Gluteal Line of the Ilium and runs to the Gluteal Tuberosity of the Femur.  Some of the Glutes attach to the Iliotibial Band (IT Band or IT Track).  The Glutes pull the Femur back into hip extension.  Hip extension is the main action of the Glutes.  The hip is a hinge joint, dividing the body into two sections.  With the feet stable, while the Glutes contract, the trunk extends.  Hip/Leg extension happens while doing a leg press, squat, lunges, and step ups (high).  Trunk extension is demonstrated while performing hyper-extensions,  as well as, good mornings and dead lifts.

Link to some great glutes!

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