Benefits of Stretching for Occupational Therapy
Overall, stretching has many benefits for the patient. Regular stretching increases flexibility and range of motion, making movements easier and enhancing performance in physical activities and sports. It improves muscle function, coordination, and balance, reducing the risk of injuries. Stretching also helps in reducing muscle soreness and stiffness after workouts, promotes better posture by lengthening tight muscles, and provides stress relief. Additionally, it improves circulation, delivering oxygen and nutrients to muscles.
In terms of occupational therapy, stretching plays a role in enhancing task performance, as therapists incorporate task-oriented stretches that mimic the movements required for specific self-care tasks, work activities, or recreational pursuits. These targeted stretches aim to optimize muscle length and joint mobility, enabling individuals to achieve smoother, more coordinated movements during functional tasks.
Contraindications for Stretching in Occupational Therapy
However, stretching may not be appropriate in all cases. The following are contradictions to stretching for occupational therapy:
- A recent fracture
- Acute inflammation
- Infection
- Tissue trauma, e.g., hematoma
- Pain with joint movement
- Bony block
- Joint hypermobility is already present
- Stretching leads to joint instability
- Compromises function
Recent fracture: Stretching exercises are contraindicated for individuals with a recent fracture that is still in the process of healing and has not yet achieved bony union. Stretching in this stage can disrupt the healing process, delay bone union, and potentially cause further damage. For example, in occupational therapy, a client who has recently undergone a wrist fracture would not be prescribed stretching exercises until the fracture has sufficiently healed and bony union is confirmed through medical imaging.
Acute inflammation: Stretching should be avoided when there is evidence of acute inflammation in the tissues. Inflammation is a natural response to injury or infection and is characterized by heat, swelling, and redness. Stretching during this stage can exacerbate the inflammatory response, impede healing, and cause increased pain. An example in occupational therapy would be refraining from stretching exercises for a client with acute inflammation in their shoulder joint due to a recent rotator cuff injury.
Infection: Stretching exercises are contradicted when there is an active infection in the tissues. The presence of an infection requires immediate medical attention and appropriate treatment, and stretching during this time can spread the infection, worsen symptoms, and hinder the healing process. In occupational therapy, if a client has an infected wound in their leg, stretching exercises would not be implemented until the infection has been effectively treated and resolved.
Tissue trauma: Stretching is not recommended when there is tissue trauma, such as a hematoma (collection of blood) in the affected area. Stretching can disrupt the healing of damaged tissues, increase pain, and potentially lead to further complications. For example, in occupational therapy, if a client has a large hematoma in their thigh due to a sports injury, stretching exercises would be avoided until the hematoma has resolved and the tissues have healed sufficiently.
Pain with joint movement: Stretching exercises should be avoided when joint movement causes sharp or acute pain. Pain during stretching indicates an underlying issue that requires further assessment and appropriate treatment. Continuing to stretch in the presence of pain can exacerbate the condition, lead to tissue damage, and impede recovery. For instance, in occupational therapy, if a client experiences severe pain in their knee when performing stretching exercises, alternative interventions would be explored until the cause of the pain is identified and addressed.
Bony block: Stretching is contraindicated when there is a bony block that limits joint motion. A bony block refers to a structural obstruction or abnormality in the joint that restricts its range of motion. Stretching in this situation can be ineffective and potentially cause harm or further limitations. In occupational therapy, if a client has a bony block in their elbow joint due to a congenital condition, stretching exercises would not be suitable for improving joint mobility in that specific area.
Joint hypermobility is already present: Stretching exercises should be approached with caution or avoided when joint hypermobility already exists. Joint hypermobility refers to excessive joint mobility beyond the normal range. Stretching in individuals with hypermobile joints can further destabilize the joints, increase the risk of injury, and compromise their function. In occupational therapy, if a client has hypermobile joints in their fingers, stretching exercises would be modified or minimized to avoid overextending the already hypermobile joints.
Stretching leads to joint instability: Stretching exercises should be avoided if they contribute to joint instability. Stretching excessively or inappropriately can result in excessive joint laxity, leading to instability and a decreased ability to maintain proper joint alignment and control. Engaging in stretching that overly stresses the ligaments and joint structures without providing sufficient stability can increase the risk of joint dislocation, subluxation, or further joint damage. In occupational therapy, if a client has a history of joint instability in their ankle, stretching exercises that excessively stress the joint would not be recommended to prevent exacerbating the instability and potential injury.
Compromises function: Stretching exercises should be approached with caution if they compromise an individual’s function or performance in daily activities. While stretching aims to improve flexibility and range of motion, it should not impede an individual’s ability to carry out their functional tasks effectively and safely. If stretching excessively restricts muscle strength, stability, or coordination, it may hinder functional movements and compromise overall function. In occupational therapy, if a client experiences a significant decrease in functional abilities or experiences difficulty performing specific work-related tasks after stretching exercises, modifications or alternative approaches would be explored to ensure that the stretching routine does not compromise their occupational performance.
Conclusion
In summary, there are various situations in which stretching exercises may be contraindicated within the context of occupational therapy. These include recent fractures that are still healing, acute inflammation, active infections, tissue trauma such as hematomas, pain with joint movement, the presence of a bony block limiting joint motion, joint hypermobility, stretching leading to joint instability, or compromising an individual’s functional abilities. In each case, stretching exercises may hinder the healing process, exacerbate symptoms, spread infections, cause further tissue damage, increase pain, or compromise joint stability and functional performance. It is important for occupational therapists to carefully assess individual circumstances and consult with healthcare professionals to determine appropriate interventions and alternatives that align with the client’s specific needs and goals.
Yoga
The considerations regarding stretching exercises and contraindications mentioned earlier can also apply to yoga practice. While yoga incorporates various stretching poses and movements, it is important to approach yoga with mindfulness and adapt the practice to individual circumstances.
Sources
Johnson, J. (2012). Therapeutic stretching. Human Kinetics.
Kisner, C., Colby, L. A., & Borstad, J. (2017). Therapeutic exercise: foundations and techniques. Fa Davis.