Presentation for WAFIC 2011 by Max Martin AEP, Director of Corrective Exercise Australia. This workshop will equip you as an exercise professional to understand the impact, relevance and correct application of flexibility, stretching and self myofascial release (SMFR) on musculoskeletal health, function and performance. At the workshop you will establish a strategic approach to dealing with muscle tightness affecting injury, posture and movement, based on clinical evidence and current research, theories and practices.

1. Flexibility: stretching vs SMFR PRESENTED BY: Max MARTIN BAppSc (Hons) AEP

2. Please keep your phone ON!! & This is a Friendly session! @ iNformMaxMartin Corrective Exercise Australia

5. Why do people stretch Overall flexibility Muscle lengthening - Joint mobility Release tension Prevent delayed onset muscle soreness (DOMS) Injury prevention Performance preparation

6. Stretching: To elongate, increase in length. The implied meaning is that the muscle is not beyond its normal length Kendall et al. 2005

8. tighter muscles greatest measured improvements.

10. 4 min run

11. passive stretch

12. run & stretch

13. run, stretch & practice jumpsResult: 1. run 1b. run, stretch & jump 3. Run & stretch 4. control 5. Passive stretch

15. found no effects of acute stretching,

16. but positive effects of regular stretching away from event on strength, jump height and running speed.Stretching and Performance cont.

18. Need very high intensity to produce risk of injuryMost conducted studies suggest no change in injury rates Different sports require different joint flexibility leading to inconclusive results in literature

20. Dynamic warm ups increase performance in children and athletes compared to static stretching alone

22. The Physiology of Tightness Joint ROM can be limited by the following factors (Hutton, 1992): Joint constraints Subcutaneous connective tissue. Neurogenic constraints (voluntary and reflexive) Myogenic constraints

23. Muscle Fibres (myogenic effect) Can stretch to at least 50% greater length that resting (last cross bridges intact). Magnesium deficiency can cause tightness (cramping) as magnesium facilitates actin-myosin release.

24. Muscle Spindles (neurogenic effect) Primary stretch receptors in the muscles. reflexive capabilities via alpha-motoneuron. Strong phasic contraction upon detection of stretch, followed by controlled tonic contraction. Regular stretching may decrease sensitivity of muscle spindles This may explain acute performance decreases post-passive stretch

25. Continuous structure that surrounds and integrates tissues and structures Can affect relationship amongst structures Composed of collagen and elastin, providing tensile and elastic properties. Fascia

26. Contributes >40% of resistance to movement Immobilisation decreases space between collagen fibres- causing a sticking together Muscle overactivity can result in increased fibroblast activity (>collagen deposition). Interconnectedness of fascia can result in patterns of tightness in muscle slings. Fascia cont’d

27. Myofascial restriction: Restriction in normal muscle function due to injury or biomechanical force imbalance

28. Trigger points Discrete, focal, hyperirritable spot in taut band of muscle Occurring in all patients with musculoskeletal pain Can be active or latent Symptoms: Painful on compression Referred pain/tenderness Motor dysfunction No evidence for development mechanism of Trigger Points Acute and chronic trauma, chronic lengthening, sleep disturbance, anxiety

29. Myofascialrelease – the alternative Similar to massage Uses palpation, pressure and tissue stretch to relieve tension and improve: Muscle tone, Length, Timing, Strength, Endurance, Control Can be used on various soft tissue abnormalities: Local increased muscle tone Trigger points Muscle shortness Fascial tightness Deficits in motor activity or control Can result in pro-inflammatory effect and decreased fibroblast activity (short-term).

30. Exercise and myofascial release Exercise is vital for myofascial release treatment Resets neurological programming Both needed for permanent change

31. Self Myo-Fascial and Trigger Point Release Interactive soft tissue release requiring feedback from patient to determine correct position, amount of pressure and duration of stretch Uses body weight on tool i.e. foam roller or tennis ball Penetrates into muscle and or fascia Easy and effective Releases tightness and trigger points Can be painful Research to prove efficacy is poor and inherently difficult to achieve.

33. Activation exercises

34. Dynamic warm up with progressive loading

36. Slow dynamic stretching movements

37. SMFR