1. Stretching as Rx Implications to Muscle, Joint and Neural

2. It Feels Good!!! STRETCHING as we know it can not prevent injury

3. There is plenty of research showing that stretching as we know it — the typical stretching that the average person does at the gym, or even the kind of stretching that most athletes do — is mostly a waste of time for most commonly identified goals. Herbert et al. British Medical Journal. 2002 For instance, articles published in recent years, reviewing hundreds of studies, have concluded that there isn’t much evidence that any widely practice form of stretching prevents injury or muscle soreness. Shrier. Clinical Journal of Sports Medicine. 1999. — Which is in sport arguably the single most common goal of stretching. Adding significantly to the credibility of those reviews, a major clinical study of many hundreds of soldiers showed no sign of benefit from and even some risks to stretching. Pope et al. Medicine Science in Sports Exercise. 2000

4. Does stretching increase ankle dorsiflexion range of motion? A systematic review. To determine the effect of static calf muscle stretching on ankle joint dorsiflexion range of motion. Calf muscle stretching provides a small and statistically significant increase in ankle dorsiflexion. However, it is unclear whether the change is clinically important. Radford JA, Burns J, Buchbinder R, Landorf KB, Cook C. Br J Sports Med. 2006 Aug 22. Source School of Biomedical and Health Sciences, University of Western Sydney, Campbelltown, Australia.

5. Effect of static stretching on the muscle-tendon tissue properties. The findings provided evidence that static stretching had different effects on passive resistive torque and tendon stiffness, and stretching should be considered for training and rehabilitation programs. Mahieu NN,McNair P, De Muynck M, Stevens V 2007 March. Source Department of Rehabilitation Sciences and Physiotherapy; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

6. PASSIVE STATIC STRETCHING "No pain, No Gain" ? "No Pain, No Pain." Edward R. Laskowski, M.D., co-director of the Mayo Clinic Sports Medicine Centre, Rochester, Minn. (1997)

7. JOINT IMPLICATIONS Bio mechanics will impact on your stretch. The body will move into its easiest plane of movement.

8. Cx Facet Joint Compression?

9. Hip Joint Impingement?

10. Tissue Stretch Induces Nuclear Remodelling in Connective Tissue Fibroblasts We also have shown that stretching of the whole tissue causes fibroblasts to respond rapidly (i.e. within minutes) with extensive cell spreading and peri nuclear actin redistribution. Helene M. Langevin., 2005

11. NEURAL IMPLICATIONS Peripheral nerves have a predetermined ROM THINK MOBILITY !

12. Neuromobilization is aimed at reconstructing normal neuromechanical condition, i.e. adapting the nervous system to constantly changing loads and mechanical tension. Neuromobilization techniques restore normal neuromechanical function of both peripheral nerves and the central nervous system. Neuromechanical disorders result the inability of the nervous system to adapt to movement and mechanical loading Principles of neuromobilization for treating musculoskeletal disease (2007) Micha Dwornik, Dariusz Bia oszewski, Izabela Korabiewska, Zbigniew Wroñski Zak Rehabilitacji Oddzia Fizjoterapii II WL, Akademia Medyczna, Warszawa Instytutu Reumatologii, Warszawa Division of Rehabilitation, Department of Physiotherapy, 2nd Faculty of Medicine, Warsaw Medical University, Poland 2 Division of Rehabilitation. Institute of Rheumatology, Warsaw, Poland

13. SLUMP Mobilising

14. Median Nerve Mobilising

15. 3 Areas to Consider Each patient is individual needs! Question your technique!

16. GENERAL RULES What am I really effecting? We are not all gymnasts Be specific to you or your patient Stretch ‘warm' muscles (post) Start slowly Hold your stretch Do not bounce! Think equality

17. In-depth Ax knowledge of the anatomy is a must to create an effective Rx plan for your patient.