Proprioceptive Neuromuscular Facilitation (PNF) Hold Relax (HR) - Thoracic Spine (Midback)

Proprioceptive Neuromuscular Facilitation (PNF)
Several Types:
Hold Relax (HR): Isometric contraction of stretching muscle followed by static stretch
Contract Relax (CR): Isotonic contraction of stretching muscle followed by static stretch
Hold Relax, Agonist Contract (HRAC): Isometric contraction of stretching muscle followed by a static stretch with simultaneous isotonic contraction of antagonist muscle

Hold Relax (HR): (Isometriccontraction of stretching muscle followed by static stretch )
Thoracic Spine
Patient quadruped with posterior distal upper arm resting on treatment table. Elbows flexed maximum amount.
Doctor kneeling on patient’s side. Doctor places their hands on patient’s thoracic spine.
Doctor instructs patient to inform them when a mild stretch is felt.
Doctor asks patient to exhale and instructs patient to slowly lower their upper body by moving into thoracic extension. Doctor assists by gently passively pushing patient’s thoracic spine into extension until a mild comfortable stretch is achieved.
Doctor asks patient to inhale and hold breath. Doctor instructs patient to push against hands with a contraction force of seventy-five percent to one hundred percent of the thoracic spine’s maximum. Hold isometric contraction for ten seconds.
Immediately after isometric contraction, lightly increase stretch while patient exhales.
Repeat three to five reps.

Proprioceptive Neuromuscular Facilitation (PNF) is one of the most widely used stretching techniques and most common type of pre-contraction stretch.
Very popular among clinicians and researchers.
Considered to be more effective than static stretching in increasing ROM due to neurophysiological mechanisms mediated by Golgi Tendon Organ and Muscle Spindle.
Considered one of the most effective stretching techniques used to improve ROM particularly in respect to short-term changes in ROM.

Combination of isometric contraction and passive lengthening of target muscle or group of muscles.
PNF involves contraction of muscle being stretched or its antagonist before stretching.
Generally performed by having patient contract muscle being used during the technique at 75-100% of maximal contraction, holding for 10 seconds and then relaxing.
Resistance can be provided by a partner or with an elastic band or strap.

Stimulation of nervous and muscular system with the aim of achieving the highest possible functional level.
Utilized to improve muscle elasticity.
Known to be more effective than other stretching techniques4 in that it increases both passive and active flexibility and improves short term range of motion.
Positive effect on active and passive range of motions.
Range of Motion (ROM) increases are seen bilaterally, supporting a possible neurologic phenomenon.

When performed consistently and post exercise, PNF increases athletic performance and range of motion.

In addition to the characteristics of PNF stretching, the general features of static stretching are also involved in PNF stretching.

Post-Isometric Relaxation (PIR):
Refers to reduced muscle tonus experienced in a brief period following its isometric contraction.
Submaximal contraction of twenty percent is just as effective as PNF thus supporting the effectiveness of PIR stretching.
Considered to be an effective method of increasing hamstring flexibility.

***Disclaimer: Viewing this video does not take the place of receiving proper training in medical profession or proper stretching technique. Viewing this video does not take the place of seeing a medical professional, working with a nutritional professional, working with a fitness professional and receiving proper training in the medical profession. Please visit a medical professional for evaluation, diagnosis and treatment. Please work with a nutritional profession to develop individualized nutrition strategies. Please work with a fitness professional to learn proper exercise technique and to develop a proper training program. Never perform an exercise that elicits or intensifies symptoms. If an exercise elicits or intensifies symptoms, stop immediately and use a viable substitute. Always perform all exercises through a symptom free range of motion. Begin your training at your current health, fitness and strength levels. Increase intensity in small gradual calculated increments. Please use nutritional strategies that are designed to work for your individual needs.

Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV
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