CHAPTER 4 · FROM MY PT NOTES
It feels tight. Should I stretch it?
Maybe—but “tight” is a description, not an explanation. I’d first ask which movement is limited, what the person needs that movement for, and what happens when they try it.
1. What is limiting the movement?
Compare active and passive motion when appropriate. A difference can guide further assessment of force, pain, coordination or other contributors; it does not identify one diagnosis by itself. A restricted passive range also does not automatically mean a short muscle.
ROM describes movement at a joint. Flexibility concerns the ability of tissues to allow motion. Functional mobility includes using and controlling movement to complete an activity. A larger number on the goniometer is only useful if that motion is needed.
2. PROM, AAROM or AROM?
Take shoulder elevation: table slides may provide assistance or support for a permitted range they cannot yet manage alone. Active reaching can follow when appropriate, then reaching toward the actual shelf. Assistance changes with the purpose—not because everyone must pass through the same stages.
After surgery, follow the specific tissue restrictions. Passive motion is not automatically permitted just because it uses less muscle effort.
3. Stretch what needs stretching
A calf stretch may fit a measured ankle-motion restriction relevant to stepping. Recheck the ankle and the step afterward. Don’t keep stretching just because the person reports a pulling sensation.
Static stretching holds a position; dynamic stretching moves repeatedly through a range. Choose method and dose for the task, tissue status and response. More pressure is not automatically better.
If a joint already has excessive motion, work on control and capacity where indicated instead of chasing more range. A hypermobility score alone does not tell you what to treat. New neurological symptoms, a suspected bony block or an unhealed injury call for assessment—not a stronger stretch.
Before you move on
There is plenty of passive shoulder motion but active reaching is limited. Stretch harder?
Not automatically. Assess why the person cannot use the available range. Strength, pain and control may matter; precautions and task demands still guide the choice.
Ankle ROM improves, but stair descent does not. Finished?
No. Recheck the task and other contributors. A changed ROM measure does not establish that it was the cause or that the goal has been met.
Practice this chapter · 2 questions
Sources & learning scope
Based on these uploaded class references: 7 Stretching; 3 Functioning and Disability. Original explanations and examples; class slides and licensed assessment forms are not reproduced. Current reference links: NHS: joint hypermobility · AAOS: shoulder conditioning. This is a concise student overview, not a complete treatment protocol. Apply skills within supervision, assessment findings and current precautions. Reviewed October 29, 2026.
