According to Carolyn Kisner and Lynn Allen Colby. physical therapists, stretching is, “A general term to describe any therapeutic maneuver designed to lengthen, elongate, pathologically shortened soft tissue structures and thereby to increase range of motion.” Whether in a wheelchair. or relatively active, it is common for brain injury survivors to experience stiff, or tight, muscles as a result of spasticity, lack of mobility, and many other contributing factors. Flexibility is the ability to relax and receive a force to achieve a stretch, With that said, stretching exercises are designed to increase range of motion. Overall mobility and functionality of a patient has the potential to improve if the appropriate stretching and range of motion techniques are applied to properly selected joints. Additionally, stretching increases blood flow to the muscles and encourages tissue elasticity. More specifically, PNF stretching techniques, used for treating neuromuscular conditions such as multiple sclerosis, stroke, and traumatic brain injury, can decrease the abnormally high muscle tone and stiffness of affected muscle groups. According to Healthline, “PNF techniques have since gained popularity with physical therapists and other fitness professionals. It’s easy to understand why. According to researchTrusted Source from the University of Queensland, PNF stretching may be the most effective stretching technique for increasing range of motion.” Stretching may improve flexibility and thereby potentially increasing range of motion. There are many many benefits to stretching such as the potential to prevent irreversible contractures, increase flexibility and function, and relieve spasticity.
The definition of contracture is, “Shortening of muscle or other tissues that cross a joint which results in limited range of motion.” In some cases, contracture is inevitable however, proper stretching techniques can be applied to prevent muscle or tendon shortening. You can imagine muscle tissue as an elastic substance that is supposed to extend and contract like a rubber band. If the rubber band freezes, it becomes shortened and no longer has the ability to elongate. NCBI says, “Although previous studies found differences regarding stretching application time, they commonly stressed the importance of stretching for the prevention of joint contracture.” With that said, stretching is a very important aspect of brain injury recovery as joint and muscular preservation is crucial. According to a research article, pertaining to traumatic brain injury and spasticity, “The aims of stretching in spasticity may be to normalize muscle tone, to maintain or increase soft-tissue extensibility, to reduce pain and to improve function.” Stretching is not only required for improving tissue health, it is also required for mobility and function.
In regards of putting shorts on, Michelle Agbayani, occupational therapist said, “Practice pulling your leg up and resting it on your other knee. This stretch is one way you can practice getting dressed.” Whether you are reauching for an object, enjoying a recreational activity, or grooming, stretching is required for mobility and function. It is important to stretch because it keeps the muscles flexible, strong, and healthy, and stretching maintains a range of motion in the joints. Working towards flexibility is important so when you call on the muscles for activity they can respond. According to the Mayo Clinic, “Flexible muscles can improve your daily performance. Tasks such as lifting packages, bending to tie your shoes or hurrying to catch a bus become easier and less tiring.” Stretching improves functionality of how we can use our bodies, as it makes us more mobile, Additionally, the general consensus among physical therapists is that stretching is an effort to normalize muscle tone that is affected by spasticity.
According to spasticity related research, “The aims of stretching in spasticity may be to
normalize muscle tone, to maintain or increase soft-tissue extensibility, to reduce pain and to improve function.” Not enough research has not been conducted to either confirm or eliminate the possibility of stretching improving spasticity however, stretching does loosen up and improve the range of motion in muscles suffering from spasticity. Spasticity causes tight muscles, and joints that in some causes do not bend, and by stretching, lengthening, and holding stretched positions, on a consistent basis, the stiff and tight muscles find the opportunity to elongate and loosen up. Additionally, when preformed over a long period of time, the neuromuscular system becomes conditioned and attempts to calm down the spasticity and get it under control. According to Barnabas Lazarus, massage therapist, “The function of the parasympathetic nervous system is calm the nerves, comfort the body, and slow the heart rate.” When stretching, combined with deep breathing, the end goal is to balance the nervous system, the part of the body where spastcity resides. With spasticity the challenge is relaxing an over-stressed and overworked nervous system that is on hyper alert due to anxiety and trauma. With that said, the more time spent activating the parasympathetic nervous system, and stretching, the more chances the central nervous system has to reset and re-balance itself.