Active Isolated Stretching for the Head, Neck and Shoulders

I’ve had several clients with neck pain and ‘stiffness.’ Some have been unable to move their head, neck and shoulders – which throughout the day could be inconvenient. The Active Isolated Stretching (AIS) method of muscle lengthening and fascial release allows me to use a type of Athletic Stretching Technique to provide dynamic and effective self-care and facilitated stretching of major muscle groups for my clients in pain. I have expanded into this area of Kinesiotherapy to provide better results for my clients, and more importantly AIS provides functional muscle balance and physiological restoration of superficial and deep fascial planes Range of Motion.

As I recently learned, over the past few decades many experts have advocated that stretching should last up to 60 seconds. Physical Therapists have published studies comparing, 15-60 seconds of static stretching on improving muscle length. For years, this prolonged static stretching technique was the gold standard. However, prolonged static stretching decreases the blood flow within the tissue creating localized ischemia and lactic acid buildup. This can cause potential irritation or injury of local muscular, tendinous, lymphatic, as well as neural tissues. These are similar to the effects and consequences of trauma and overuse syndromes.

The AIS Technique – Performs Functional Muscle Release for Deep, Superficial Fascial Lines throughout the body.

Using an Active Isolated Stretch program, either active or assisted, performs a series of stretches in the functional muscle group – each repetition should last no longer than two seconds per repetition. This movement, and assisted movement, allows the target muscles to optimally lengthen without triggering the protective stretch reflex and subsequent reciprocal antagonistic muscle contraction of the joint or movement. The isolated muscle achieves a state of relaxation, and with subsequent repetitions these stretches provide maximum benefit, more lengthening and can be accomplished without opposing tension or resulting trauma.

Myofascial Release to Achieve Optimal Flexibility

Aaron Mattes' myofascial release technique, which also incorporates Active Isolated Stretching and Strengthening uses active movement and reciprocal inhibition to achieve optimal flexibility. Using a 2.0 second stretch he has been proven there is key to avoiding reflexive contraction of the antagonistic muscle and regain length throughout the functional muscle group. The sequence of repetitions allows increased circulation, warmth to the muscle and lengthening to the End-of-the-Range-of-Motion, without activating muscle group contraction, restoration of full range of motion and flexibility can be successfully achieved.

Many rehabilitation clinics use AIS after surgery with excellent outcomes. But, using AIS for re-conditioning to bring movement to limbs and digits damaged by stroke, nervous system disorders and surgical procedures. Hypermobility patients benefit from strengthening areas that are strained from compensation patterns. Some of the most impressive results are using AIS as ‘pre-habilitation’ or preparation for upcoming events. Using AIS to prepare for surgery, many patients have realized substantial benefits:

-         Reducing recovery time after surgery by 50% of predicted time frame

-         Preventative ‘flexibility’ facilitates alleviation of pain symptoms,

-         Improve conditions in the musculoskeletal condition, that surgery may not be necessary.

Since flexibility is not a general body situation, but it is specific to each joint in the body- there can be work or exercise to undo the movements or effort that produces repeated overuse of the same muscles each day - that leads to a restriction in the Range of Motion and reduced flexibility. Eventually this reduced flexibility may exhibit pain patterns in many ways, because the muscles have to work harder still to produce normal results.

 

I.    Standardized Stretch and Strengthen Format - Shoulder

List of muscles and stretches

a.      SCM – head and neck stretch

b.      Scalenes – head and neck stretch

c.      Rotator Cuff: Supraspinatus, Infraspinatus, Subscapularis and Teres Minor– shoulder and upper strengthening

d.      Trapezius, all fibers

e.      Latissimus Dorsi

f.       Pectoralis Major/Minor

g.       Biceps Brachii

  1.  Frozen Shoulder/Adhesive Capsulitis Treatment with Summary Treatment – with Active Isolated Stretching

There is usually consistent irritation in the subacromial region, which will increase the tension in the scapular thoracic region. Extrinsic causes such as an acromial spur, tendon calcification, a curved or hooked acromion, or acromioclavicular osteophytes may be present. Most frequently impingement involves the musculotendinous portion of the supraspinatus, the infraspinatus, the subscapularis, or the long head of the biceps.

Benefits of AIS on Condition: The program should include the entire shoulder AIS stretching program and emphasizing shoulder sideward elevation, having the palm of the hand facing backward. The strength program should include the rotator cuff muscles, shoulder stabilization exercises, and posterior shoulder adduction using a band or pulley and pulling downward toward the buttock, having the body face away from the mechanism of overload.

2. Medial Epicondylitis (Golfer’s Elbow) Summary Treatment with Active Isolated Stretching

Summary of Condition: Medial epicondylitis is also called “little league” elbow.  Medial epicondylitis illustrates a snapping motion of the elbow in pronation or a motion such as throwing breaking balls in baseball causing stress on the medial side of the elbow. This may result in Inflamation and Edema that make movement of the olecranon difficult, extremely painful. This results in an injuring of the radioulnar pronator cuff muscle inserting on the inner condylar ridge of the humerus.

Benefits of AIS on Condition: After the elbow is healed and free movement is permitted by the physician, restore the range of motion with gentle AIS stretching. If the injury is mild, begin stretching of the elbows, radioulnar, wrists and hands. Strengthen the elbow flexors and extensors, radioulnar pronators and supinators with small weights. Progression to stretching bands or surgical tubing is permitted when the subject is pain free. Incorporate the use of a rubber band and a soft ball for the hands and fingers. Ice massage and stretch the muscles frequently. An ace wrap for gentle support is helpful.

Wrist Flexion

The wrists are a complex joint full of bone, ligaments, connective tissue, muscles and nerves. Muscles stretched are over the wrist and into forearm - either extensor or flexor muscles. The Arm Lines are, posturally speaking, a bit different from the other myofascial meridians. The Deep Front Arm Line is a stabilizing line; in poses like the yoga plank, it manages side to side movement of the upper body. In the open movement of the arm, the DFAL controls the angle of the hand, generally through the thumb, as well as the thumb's grip. So they are active at all times - both agonist and antagonist muscles - depending on the movement. Stretching these vital muscles is imperative.

You begin the stretch by extending the elbow, slowly flexing the wrist downward by contracting the wrist flexor muscles. Apply a gentle stretch across the posterior (dorsal) hand with the opposite hand. (Excerpt from Active Isolated Stretching: The Mattes Method. Pg. 33)It also has multiple ranges of movement—flexion and extension (moving the palm backward or forward relative to the forearm), adduction and abduction (moving the hand from side to side). Compare this to the movement of, for example, the knee joint, which only has flexion and extension. It also marks the area of transition between the forearm and the hand—so the health of the wrist can directly impact your grip strength and dexterity in the hand.

Another thing to consider is that if we lack motion at the wrist, we’ll try to make the motion up at the shoulder and elbow. Conversely, if we lack shoulder mobility, we’ll try to make it up at the elbow and wrists. It is therefore just as important to focus on scapular and shoulder mobility as it is on the wrist, as the two are interconnected and focusing on one may not alleviate the problem for the other. As an example, in the catch phase of a clean, we need to have adequate wrist extension, forearm pronation and external rotation of the shoulder to allow us to receive the bar on the front of the shoulders and fingertips dorsal) hand with the opposite hand. (Excerpt from Active Isolated Stretching: The Mattes Method. Pg. 33)

 Upper back and chest stretch-Mattes Method

Upper back and chest stretch-Mattes Method

 Pectoralis, Trapezius and Lat Stretch - Mattes Method (AIS)

Pectoralis, Trapezius and Lat Stretch - Mattes Method (AIS)