UNIT 2: Week 1
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Physiological adaptations associated with hypomobility from connective tissue
Collagen - cross-linking - adhesions - disorganized orientation
What is collagen cross-linking?
• imp for increasing the stiffness and strength of tissues • lack of movement reduces water intake by GAGs, weakening the cross-links
Collagen adhesions
accumulation of restrictive, non-functional collagenous scar tissue that binds tissues together, limiting their ability to move freely
Disorganized orientation of collagen
• weakens connective tissues • reduces joint stability • increased laxity and risk of injury
Physiological adaptations associated with hypomobility from muscle
• change in the number of sacromeres in series • muscle tone
Why do muscles change the number of sarcomeres in series?
• to adapt their overall length and optimize the range of motion at which they can generate the most force
What is muscle tone?
• ongoing, low-level tension in muscles, even when relaxed, which maintains posture and resists passive movement • determined by muscle spindles and GTO
Two main causes of hypomobility
• Joint mobility • Muscle flexibility
What is poor joint mobility limited by ?
• inert tissues
What is poor joint mobility due to?
• structural changes (changes to collagen
What is poor joint mobility usually complained as?
• stiffness
What is poor muscle flexibility limited by?
• contractile tissues
What is poor muscle flexibility due to?
• neural control (changes to muscle tone)
What is poor muscle flexibility complained as being?
• tightness
What is the response of connective tissue to tension dependent on?
• rate • time
What is the concept of the elastic deformation phase?
• loaded tissues return to their shape in a linear fashion after the force causing the deformation is removed
Elastic deformation phase: stages
• Stress relaxation (toe): fibres at rest • Creep (linear): load applied • Temporary change in mobility until load is removed
What is the concept of the plastic deformation phase?
• the force applied to the collagen causes a permanent (irreversible) change in the tissue structure • BUT If this force continues beyond the elastic limit, the tissue can tear at its ultimate failure point
Plastic deformation phase: steps
• microscopic failure • macroscopic failure • permanent change in mobility
Best practice interventions to improve mobility of connective tissue
• low load prolonged stretching • progressive TERT
What is low load prolonged stretching?
• allows stress-relaxation and creep to occur • minimal risk of macroscopic damage
Total end range time (TERT)
• spend more time in end range of movement to cause permanent tissue change without macroscopic damage
FITVP for low load prolonged stretch
F: >3 x day I: into stiffness (not pain) T: position of tension V: 5–>20 min/session P: increase volume (TERT>60min/day), then increase intensity (gravity or external load)
FITVP for mobility
F: >3 x day I: into stiffness (not pain) T: Slow PROM/ AAROM/ AROM into position of tension V: 5–> 10 reps, hold 10–>30s, 1-3 sets P: increase volume (TERT), progress from PROM to AAROM to AROM