Stretching Exercises: Recommendations for Home Care

WSCC Clinics Protocol

Adopted 10/99 Reviewed 10/02

This protocol is intended for 1) rehabilitation of injured tissue, 2) increasing flexibility, and 3) helps reduce or prevent symptoms associated with postural syndromes and inefficient movement patterns.

Be sure patients know what to do. It is Instruct patients to warm up the area to important that they know the number of be stretched. This can be done by jog- repetitions, the number of sets, when to ging in place or moving the upper extremi- do the exercises, and reasons for discon- ties for at least five minutes before doing tinuing (e.g., worsens symptoms). Provid- the stretches. Warm-up activity may be ing pictures and/or written information is useful in preventing injuries during a helpful. stretching program. In the case of dorsi- flexors, pre-heating may hasten improve- Have patients do up to 5 repetitions of ment in flexibility. the stretch in a single set once a day. Some studies suggest that stretching a Patients may enhance the stretch with muscle once a day is as effective at in- a form of self-administered post- creasing flexibility as stretching three isometric relaxation. This can be done times a day. by isometrically contracting the target muscle for 5 seconds before each stretch Stretches should be held for about 30 seconds. Longer stretches (e.g., 60 sec- Contracting the antagonist during the onds) do not appear to be any more effec- stretch also enhances the exercise. tive at increasing flexibility. For example, contract the gluteus maxi- mus during a psoas stretch. When teaching stretching exercises, have patients perform them to verify Have patients demonstrate the exer- that it is working the targeted area. cises at the next visit. Very often the patient is no longer do the stretch cor- Instruct patients to relax and breathe rectly and will need to be re-directed. slowly while holding a stretch and to avoid bouncing in the stretch. Inform patients that stretching after ac- tivities is thought be more effective Make sure patients maintain good pos- than before the activity. Brief, gentle ture and that their joints are not stretching can be done before participat- loaded. For example, the patient should ing in a sport. But a longer stretching avoid hyper-extending while doing a program should be reserved until after the psoas or quadriceps stretch. patient has finished the activity.

PAGE 1 OF 2 STRETCHING EXERCISES: RECOMMENDATIONS FOR HOME CARE Primary Author References - Ronald LeFebvre Bandy W, Irion J, et al. The effect of time and Reviewed by CSPE Committee frequency of static stretching on flexibility of the - Laura Baffes, DC hamstring muscles. Physical Therapy. 1997; - Owen Conway, DC 77(10):1090-6. - Lorraine Ginter, DC - Ronald LeFebvre, DC Geraci MC. Rehabilitation of Pelvis, Hip, and - Owen T. Lynch, DC Thigh Injuries in Sports in Physical Medicine and - Karen E. Petzing, DC Rehabilitation Clinics of North America. Phila- - Anita Roberts, DC delphia, PA: WB Saunders; 1994.

Other Reviewers Kibler WB, Herring SA, et al. Functional Reha- - Joel Agresta, DC, PT bilitation of Sports and Musculoskeletal Injuries. - Mike Carnes, DC Gaithersburg, MD: Aspen Publishers; 1998. - Cathy Cummins, DC - Charles Novak, DC

STRETCHING EXERCISES: RECOMMENDATIONS FOR HOME CARE PAGE 2 OF 2