ADAPTIVE SHORTENING

ADAPTIVE SHORTENING

Adaptive shortening is the tension that results from keeping the muscle in a shortened position. Unless the opposite muscle is unable to pull the back into a neutral position or external force is exerted to stretch the short muscle, the muscle in question will remain in a shortened condition. Shortening represents a mild to moderate decrease in muscle length and results in a corresponding restriction of range of motion. It is considered reversible, but the stretching movements must be done gradually to avoid damaging the tissue structures. It usually takes several weeks to restore mobility to moderately stiff muscles. People who have to spend most of the day in a wheelchair or sitting in sedentary positions may develop adaptive shortening of the hip flexors of a joint (iliopsoas). Long sitting with the knees partially extended places the foot in a plantar flexion position and can cause adaptive shortening of the soleus. Women who wear high heels most of the time may also develop adaptive shortening of the soleus. Such brevity can affect both balance and standing alignment.

STRETCH WEAKNESS

Stretch weakness is defined as weakness that results from the muscles remaining in a stretched, albeit mild, condition beyond the neutral physiological resting position, but not beyond the normal range of muscle length. The concept refers to the duration rather than the severity of the misalignment. (It does not refer to excessive stretching, which means beyond the normal range of muscle length.) Many cases of stretch weakness have responded to treatment that kept the muscles in a favorable position, even if the muscles were weak or partially paralyzed. long since. time, even several years after the initial problem began. The return of force in these cases indicates that the damage to the muscles was not irreparable. A familiar example of stretch weakness superimposed on a normal muscle is foot drop which can develop in a bedridden patient due to the bed supporting the foot.

foot in plantar flexion. The weakness of the dorsiflexors is due to the continuous stretching of these muscles, although there is no neurological involvement. Stretch weakness superimposed on the affected muscles by involvement of the anterior horn cells has been observed numerous times in patients with poliomyelitis. Stretch weakness superimposed on a central nervous system lesion has been observed in patients with multiple sclerosis, particularly in the wrist extensors and ankle dorsiflexors. Stretch the opposite muscles that have been shortened and apply a brace in the form of a wrist splint or ankle brace resulted in an improvement strength and functional capacity. Stretch weakness of a less dramatic nature is frequently seen in cases of occupational and postural stress. The muscles most affected were the monoarticulars: gluteus medius and minor, iliopsoas, external rotators of the hip, abdominal muscles and middle and lower trapezius. Muscles that exhibit stretch weakness should not be treated by stretching or moving through the full range of motion of the joint in the direction of stretching the weak muscles. The condition is the result of continuous stretching and responds to immobilization in a physiological position of rest for a period of time sufficient to allow for recovery. Realigning the part, bringing it to a neutral position, and the use of supportive measures to help restore and maintain this alignment until weak muscles regain strength are important factors in treatment. Any opposing contractions that tend to keep the part out of alignment should be corrected to relieve strain on the weak muscles. Defective work positions that continuously stress certain muscles also need to be adjusted or corrected.

Care must be taken not to overload a muscle that has been subjected to prolonged traction stress. As muscles improve in strength and become able to sustain gain, the patient is expected to use working muscles to maintain proper muscle balance and good alignment.

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