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Fit & Well:

Core Concepts and Labs in Physical Fitness and Wellness
PRESENT BY MB Ntjana

5: Flexibility and Low-Back Health

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 Looking Ahead...
After reading this chapter, you should be able to:
• Identify the potential benefits of flexibility and
stretching exercises.
• List the factors that affect a joint’s flexibility.
• Describe the types of stretching exercises and how
they affect muscles.
• Describe the frequency, intensity, and duration for
a successful flexibility program.
• List safe stretching exercises for major joints.
• Explain how low-back pain can be prevented and
managed.

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 Types of Flexibility
Flexibility—the ability of a joint to move through
its normal, full range of motion—is important for
general fitness and wellness.
Range of motion: the full motion possible in a
joint.
Static flexibility is the ability to hold an extended
position at one end or point in a joint’s range of
motion.
Dynamic flexibility is the ability to move a joint
through its range of motion with little resistance.

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 What Determines Flexibility?
Joint Structure
The flexibility of a joint depends partly on the
nature and structure of the joint.
• Hinge joints, such as those in your fingers and
knees, lock when fully extended.
• Ball-and-socket joints like the hip enable
movement in many directions.
• Joint capsules: semielastic structures,
composed primarily of connective tissue, that
surround major joints.
• Arthritis: a disorder of the joints characterized
by joint pain, stiffness, and inflammation.

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 Figure 5.1 Basic joint structures
Access the text alternative for slide images.

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 What Determines Flexibility?
Muscle Elasticity and Length
Soft tissues: tissues of the human body that
include skin, fat, linings of internal organs and
blood vessels, connective tissues, tendons,
ligaments, muscles, and nerves.
Collagen: white fibers that provide structure
and support in connective tissue.
Elastin: yellow fibers that make connective
tissue flexible.
Elastic elongation: temporary change in the
length of muscles, tendons, and supporting
connective tissues.
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 What Determines Flexibility?
Nervous System Regulation 1
Proprioceptor: a nerve that sends information
about the muscular and skeletal systems to the
nervous system.
• When a muscle is stretched (lengthened),
proprioceptors detect the amount and rate of the
change in muscle length and send a signal to the
spinal cord.
• The spinal cord sends a signal back, triggering a
muscle contraction that resists the change.
• Another signal is sent to the opposing muscle
(antagonist), causing it to relax and facilitate
contraction of the stretched (agonist) muscle.

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 What Determines Flexibility?
Nervous System Regulation 2
Small movements that only slightly stimulate
the nerves cause small reflex actions.
Rapid, powerful, and sudden changes in muscle
length strongly stimulate receptors and can
cause large and powerful reflex muscle
contractions.
• Thus, stretches that involve rapid, bouncy
movements can cause injury.

Proprioceptive neuromuscular facilitation (PNF)

is a stretching technique that takes advantage
of nerve activity to improve flexibility.
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 Benefits of Flexibility: Joint Health
When muscles and other tissues supporting a
joint are tight, the joint is subject to stresses
that can cause deterioration.
Poor joint flexibility can also cause
abnormalities in joint lubrication, leading to
deterioration of the cartilage cells lining the
joint.

Access the text alternative for slide images.

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 Benefits of Flexibility: Prevention of
Low-Back Pain and Injuries
Poor spinal stability puts pressure on the nerves
leading out from the spinal column and can lead
to low-back pain.
• Good hip and knee flexibility protects the spine.
• People with either high or low flexibility seem to
have an increased risk of injury.
• Stretching programs are important for older
adults, people who play high-power sports,
workers involved in brief bouts of intense
exertion, and those who sit for prolonged periods.

Note that static stretching before a high-

intensity activity may increase the risk of injury.
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 Additional Potential Benefits of Flexibility
Relief of aches and pains
Relief of muscle cramps
Improved blood vessel health
Improved body position and strength for sports
(and life)
Maintenance of good posture and balance
Relaxation
Improving impaired mobility

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 Assessing Flexibility
Because flexibility is specific to each joint, there
are no tests of general flexibility.
The most commonly used flexibility test is the
sit-and-reach test, which rates the flexibility of
muscles in the lower back and hamstrings.

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 Creating a Successful Program
to Develop Flexibility
A successful program includes safe exercises
executed with the most effective techniques.
Your goal should be attaining normal flexibility
in the major joints.
Balanced flexibility provides for joint stability
and facilitates smooth, economical movement.
Perform stretching exercises regularly, and use
a variety of stretches and techniques.

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 Applying the FITT Principle 1
Frequency:
• The American College of Sports Medicine
recommends stretching exercises be performed a
minimum of two or three days a week; more often
is better.
• It’s best to stretch when muscles are warm.

Intensity and time (duration):

• Slowly stretch your muscles to the point of slight
tension or mild discomfort.
• Hold the stretch for 10–30 seconds.
• As tension subsides, try to stretch a bit farther.
• Rest for 30–60 seconds between each stretch,
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and do multiple repetitions for a total of 90 14
 Figure 5.2 The FITT principle for a
flexibility program
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 Applying the FITT Principle 2
Types of stretching techniques:
• Static stretching: a technique in which a muscle is slowly and
gently stretched and then held in the stretched position.
• Ballistic stretching: a technique in which muscles are
stretched by the force generated as a body part is repeatedly
bounced, swung, or jerked.
• Dynamic stretching: a technique in which muscles are
stretched by moving joints slowly and fluidly through their
range of motion in a controlled manner; also called functional
stretching.

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 Static and dynamic stretching

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 Static stretching

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 Dynamic stretching

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 Ballistic Stretching

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 Applying the FITT Principle 3
Types of stretching techniques, continued:
• Proprioceptive neuromuscular facilitation
(PNF): techniques that use reflexes initiated by
both muscle and joint nerves to achieve greater
training effects.
• Passive stretching: a technique in which
muscles are stretched by force applied by an
outside source.
• Active stretching: a technique in which muscles
are stretched by the contraction of the opposing
muscles.

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 PNF Stretch

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 Passive and active stretching

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 Making Progress

You will make progress and improve your flexibility

if you stick with your program.

Judge your progress by One example of progress is how far you can
lean forward.

noting your body position You will likely notice some improvement after
only two to three weeks of stretching.

while stretching. It may take two months to attain significant

improvements.

Don’t continue to try to increase flexibility after you

have achieved a normal range of motion—excessive
flexibility can cause joint instability.

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 Exercises to Improve Flexibility:
A Sample Program
Your program should include exercises that
work all the major joints of the body by
stretching their associated muscle groups.
• Hold each position for 10–30 seconds, and
perform multiple repetitions.
• Use proper technique.

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 Flexibility Exercises
Head turns and tilts Inner-thigh stretch
Towel stretch Hip and trunk stretch
Across-the-body and Modified hurdler
overhead stretches stretch (seated
single-leg hamstring)
Upper-back stretch
Leg stretcher
Lateral stretch
Lower-leg stretch
Step stretch
Single-leg deadlift
Side lunge

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 Preventing and Managing Low-Back
Pain

Low-back pain is the second most common ailment in the United States and the
second most common reason for absences from work study
A cross-sectional and visits to a physician.
by Major-Helsloot (2014) on
More than 85% of Americans experience back pain by the management of LBP at primary care levels in
age 50. South Africa reported a lifetime prevalence of LBP of
73.2% with 26.3% suffering from CLBP.

Often, it is the result of weak and inflexible muscles, poor posture, or poor body
mechanics when lifting or carrying.

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 Function and Structure of the Spine 1
The spinal column performs many important
functions in the body:
• It provides structural support for the body,
especially the thorax (upper-body cavity).
• It surrounds and protects the spinal cord.
• It supports much of the body’s weight.
• It serves as an attachment site for a large
number of muscles, tendons, and ligaments.
• It allows movement of the neck and back in all
directions.

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 Function and Structure of the Spine 2
Vertebrae: bony segments
composing the spinal column
that provide structural
support for the body and
protect the spinal cord.

• seven cervical vertebrae in the neck;

The spine consists of: • 12 thoracic vertebrae in the upper back; and
• five lumbar vertebrae in the lower back.

The nine vertebrae at the

bottom are fused into sections
that form the sacrum and
coccyx.

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 Figure 5.3 The spinal column
The spine is made up of five separate regions
and has four distinct curves. An
intervertebral disk is located between
adjoining vertebrae.

Access the text alternative for slide images.

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Image Source/Photodisc/Getty Images 30
 Function and Structure of the Spine
3

Intervertebral disk: an elastic disk located between adjoining

vertebrae consisting of a gel- and water-filled nucleus
surrounded by fibrous rings; serves as a shock absorber for the
spinal column.

Nerve roots: the bases of the 31 pairs of spinal nerves that

branch off the spinal cord through spaces between vertebrae.

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 Figure 5.4 Vertebrae and an
intervertebral disk
Access the text alternative for slide images.

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 Core Muscle Fitness 1
Core muscles: the trunk muscles extending
from the hips to the upper back.
• They include those in the abdomen, pelvic floor,
sides of the trunk, back, buttocks, hip, and pelvis.
• These muscles are attached to the ribs, hips,
spine, and other bones in the trunk of the body.
• They stabilize the spine and help transfer force
between the upper body and lower body.

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 Figure 5.5 Major core muscles (front)

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 Figure 5.5 Major core muscles (back)

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 Core Muscle Fitness 2
During any dynamic movement, core muscles
work together.
• Some shorten to cause movement.
• Others contract and hold to provide stability,
lengthen to brake the movement, or send
signals to the brain about the movements and
positions of the muscles and bones
(proprioception).
• The best exercises for low-back health are
whole-body exercises that force core muscles to
stabilize the spine in many different directions.

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 Causes of Back Pain
The lumbar area is the most common site of
pain.
Underlying causes of back pain include:
• Poor muscle endurance and strength in the core
muscles;
• Excess body weight;
• Poor posture or body position when standing,
sitting, or sleeping; and
• Poor body mechanics when performing actions
such as lifting and carrying or sports movements.

Physical stress can cause disks to break down

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and lose some of their ability to absorb shock. 37
 Preventing Low-Back Pain
Maintain a healthy weight.
Stop smoking and reduce stress.
Avoid sitting, standing, or working in the
same position for too long.
Use a supportive seat and a medium-firm
mattress.
Use lumbar support when driving.
Warm up thoroughly before exercising.
Progress gradually when attempting to
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improve strength or fitness. 38
 Managing Acute Back Pain
Sudden (acute) back pain usually involves
tissue injury.
• Applying cold and then heat may reduce pain and
inflammation.
• An over-the-counter nonsteroidal anti-
inflammatory medication such as ibuprofen may
be helpful.
• Bed rest immediately following the onset of pain
may make you feel better, but it should be of
short duration.
• See a physician if acute back pain doesn’t resolve
within a short time.

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 Managing Chronic Back Pain
Low-back pain is considered chronic if it
persists over three months.
• Symptoms vary, and therefore people benefit
from different treatment strategies.

Potential treatments include medications;

exercise;
physical therapy, massage, yoga, or
chiropractic care; acupuncture; percutaneous
electrical nerve stimulation (PENS); education
and advice about posture, exercise, and body
mechanics; and surgery.
Psychological therapy may also be beneficial
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 Exercises for the Prevention and
Management of Low-Back Pain
Do low-back exercises at least three days per
week.
Emphasize muscular endurance.
Don’t do spine exercises involving a full range of
motion early in the morning.
Engage in regular endurance exercise.
Be patient and stick with your program.
Forget the adage “no pain, no gain.”
Build core stiffness through stabilization
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exercises. 41
 Low-Back Exercises
Cat stretch Wall squat (phantom
chair)
Step stretch
Pelvic tilt
Leg stretcher
Back bridge
Trunk twist
Stir the pot
McGill curl-up
Kettlebell or dumbbell
Isometric side bridge
carry (“suitcase
Spine extensions carry”)
(“bird dogs”)

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 Example of Exercise

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 Test Your Knowledge

When should static exercises be performed?

If you injure your back, it’s usually best to rest in

bed until the pain is completely gone. True or false?

Is it better to hold a stretch for a short time than to

“bounce” while stretching? Explain.

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