b) Ballistic stretching
Ballistic stretching uses repeated movement and momentum to gain range . The drawbacks to using this type of exercise with most individuals encountered in the hospital setting are that patients are typically not conditioned to use ballistic stretching effectively or without sustaining further injury.
During ballistic stretching, the stretch reflex is initiated to resist the change in muscle length and to protect the muscle from injury.This occurs due to stimulation of the non-contractile elements of muscle spindles , which send afferent information about the length of muscles to spinal cord level. This in turn causes stimulation of the extra fusal fibres via the alpha motor neurone , resulting in a muscle contraction . Should this muscle contraction coincide with the next ballistic movement, a muscle unconditioned to cope with that stress may become injured.
c) Static stretching
As the name suggests, this involves maintaining a position for a sustained period to gain the desired effect -it is widely suggested that an effective time to hold a static stretch is 30 seconds.
Static stretching is a controlled , slow movement with emphasis on correct bodily alignment. Static stretching protocols are commonly used and, for example, have been shown to be effective in terms of improving flexibilitly of muscle . An element of fine motor control and postural awareness is important during static stretching exercises and this can be enhanced by the use of feedback and correction from the physiotherapist, as Well as mirrors. Exercise forms such as Pilates, Tai Chi and Yoga employ many of these principles and can be used effectively within a patient's exercise programme.
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