1. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Flexibility and Low-Back Health Chapter 5

2. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Flexibility The range of motion in a joint or group of joints Important for general fitness and wellness Static versus dynamic flexibility

3. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. What Determines Flexibility? Joint structure—joints vary in direction and range of movement –Joint capsules = semielastic structures that give joints strength and stability but limit movement Muscle elasticity and length –Collagen = white fibers that provide structure and support –Elastin = yellow fibers that are elastic and flexible –Titin = muscle filament with elastic properties

4. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Nervous System Activity Proprioceptors send information about the muscle and skeletal systems to the nervous system –Stretch receptors (muscle spindles) –Golgi tendon organs If a muscle is stretched, signals between the stretch receptors and nervous system control muscle length and movement and protect muscles from injury

5. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Nervous System Activity Proprioceptive neuromuscular facilitation (PNF) = a technique for stretching muscles that relies on neuromuscular reflexes to stimulate training effects Regular stretching trains all of the proprioceptors Proprioceptors adapt very quickly to stretching and lack of stretching

6. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Benefits of Flexibility and Stretching Exercises Joint health Prevention of low-back pain and injuries Other potential benefits: –Relief of aches and pains –Relief of muscle cramps –Improved body position and strength for sports –Maintenance of good posture and balance –Relaxation Lifetime wellness benefits

7. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Creating a Successful Program to Develop Flexibility Applying the FITT principle –F requency—how often to stretch –I ntensity—how far to stretch –T ime—how long to stretch –T ype—which stretching exercises to perform

8. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Frequency of Exercise The American College of Sports Medicine (ACSM) recommends that stretching exercises be performed a minimum of 2–3 days per week; ideally 5-7 days per week Stretch when muscles are warm, either after a workout or after the active part of a warm-up Do not stretch before a high-performance activity

9. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Intensity and Time (Duration) of Exercise Stretch to the point of slight tension or mild discomfort Hold each stretch for 15–30 seconds Do 2–4 repetitions of each exercise Rest for 30–60 seconds between stretches

10. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Types of Stretching Techniques Static stretching = slowly stretching a muscle and holding the stretched position Ballistic stretching = suddenly stretching a muscle through a bouncing or swinging movement Dynamic stretching = stretching by moving joints slowly through their range of motions in a controlled manner Proprioceptive neuromuscular facilitation = obtaining a greater training effect by using neuromuscular reflexes; for example, contracting a muscle before it is stretched

11. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Types of Stretching Techniques Passive stretching = muscles are stretched by force applied by an outside source Active stretching = muscles are stretched by a contraction of the opposing muscles Safest technique is active static stretching, with an occasional passive assist

12. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Low-Back Health Function of the spine –Provides structural support for the body –Surrounds and protects the spinal cord –Supports body weight –Serves as attachment site for muscles, tendons, ligaments –Allows movement of neck and back in all directions

13. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Structure of the Spine 7 cervical vertebrae in the neck 12 thoracic vertebrae in the upper back 5 lumbar vertebrae in the lower back 9 vertebrae at the base of the spine fused into the sacrum and the coccyx (tailbone)

14. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Vertebrae Vertebrae consist of a body, an arch, and several bony processes Intervertebral disks = elastic disks located between adjoining vertebrae; consist of a gel- and water-filled nucleus surrounded by fibrous rings; serve as shock absorbers Nerve roots = base of pairs of spinal nerves that branch off the spinal cord

15. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Core Muscle Fitness Core muscles include those in the abdomen, pelvic floor, sides of the trunk, back, buttocks, hip, and pelvis Core muscles stabilize the spine and help transfer force between the upper body and lower body Lack of core muscle fitness can create an unstable spine and stress muscles and joints Whole body exercises and exercises using free weights or stability balls all build core muscle fitness

16. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Causes of Back Pain Any movement that causes excessive stress Risk factors: –Age greater than 34 years –Degenerative diseases –Family or personal history of back trauma –Sedentary lifestyle, overweight –Low job satisfaction, certain occupations –Low socioeconomic status –Smoking –Psychological stress or depression

17. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Underlying Causes of Back Pain Poor muscle endurance and strength Poor posture Poor body mechanics

18. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Preventing Low-Back Pain Lose weight, stop smoking, and reduce emotional stress Avoid sitting, standing, or working in the same position for too long Use a supportive seat and a medium-firm mattress Warm up thoroughly before exercise Progress gradually when improving strength and fitness

19. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Protecting Your Back An exercise program designed to increase flexibility and strengthen the legs, abdomen, and lower back can hep prevent low-back pain. When sleeping: Lie on your side with your knees and hips bent. If you like on your back, place a pillow under your knees. When sitting: Sit with your lower back slightly rounded, knees bent and feet flat on the floor. Alternate crossing your legs or use a footrest to keep your knees higher than your hips

20. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Protecting Your Back When standing: Keep your weight mainly on your heels, with one or both knees slightly bent. Try to keep your lower back flat (not arched) by placing one foot on a stool. When walking: Keep your toes pointed straight ahead, your back flat, head up and chin in. When lifting: Bend at the knees and hips rather than at the waist and lift gradually using your leg muscles.

21. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Managing Acute Back Pain Sudden back pain usually involves tissue injury Symptoms: Pain, muscle spasms, stiffness, inflammation Treatment: –Ice, then heat –OTC medication (ibuprofen or naproxen) –Moderate exercise

22. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Managing Chronic Back Pain Considered chronic if lasts longer than 3 months Symptoms: Stabbing or shooting pain, steady ache accompanied by stiffness, pain that is localized or that radiates to other parts of the body Treatment: Many options, including medication, exercise, physical therapy, massage, acupuncture, education, and surgery

23. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Exercises for the Prevention and Management of Low-Back Pain Do low-back exercises at least 3 days per week Emphasize muscular endurance Do not do full range of motion spine exercises early in the morning Engage in regular endurance exercise Be patient and stick with your program

24. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 5 © 2007 McGraw-Hill Higher Education. All rights reserved. Flexibility and Low-Back Health Chapter 5