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ACTIVE ISOLATED STRETCHING AND STRENGTHENING Injury Rehabilitation, Part 2 In Part 1 of this article (May/ June 2010, page 88), we talked about the various roles that Active Isolated Stretching and Strengthening (AIS) can play in rehabilitating an injury. We introduced the five steps of the rehabilitation process and gave a detailed explanation of the first three: addressing the pain, restoring the full range of motion, and neuromuscular reeducation. In Part 2, we conclude by discussing steps four and five— rebuilding strength and restoring full function—and various ways in which we can personalize this process so our clients heal as effectively and efficiently as possible. Using AIS to Rebuild Strength Developing and maintaining strong muscles is important for everyone, but particularly crucial for those suffering from atrophy due to neuromuscular disease or trauma. As we've used AIS with clients, we've been surprised at how effective it can be in reversing such declines. For instance, with a client of Ben's who has Parkinson's disease, there appears to be a direct correlation between the strength she builds and the lessening of her tremors and pain. Over the course of a few months, she has reported great improvements in her ability to write, walk without dragging her foot, and sleep through the night. She says that whenever she begins to feel pain in her arm, she does the arm strength protocol and the pain goes away within five minutes. While AIS is a gentle modality and builds strength in small increments, the end results can be quite dramatic. One of the AIS practitioners mentioned in Part 1, Roger McNear, worked with a young man who had suffered a brain trauma in a head-on motorcycle collision. His left arm and both hands lacked mobility and were in a continual contraction, and a year of treatment had failed to restore functioning to his legs; he was told by his doctors that he would probably never walk again. Roger used AIS to help develop strength throughout this client's body. In the first two or three months, he used only manual resistance. Then, as the client grew stronger, Roger had him use resistance bands and weights. Through the course of the treatment, the contractions in the client's hands and arm were resolved to a point where he could grasp and move. Moreover, after three additional months of regular sessions (one to two hours, three times a week), he was able to walk with crutches. After six months, he could walk either with a cane or unaided. 4. REBUILDING STRENGTH While restoring mobility and flexibility is an important step forward, we must be careful not to stop there. Increasing the range of motion without developing strength in that range makes a client more susceptible to injuries and joint dysfunction. Only by actively building strength can balance and resilience be achieved. There are several principles to keep in mind when working to rebuild strength. First, you want to make sure that a person's strength extends beyond the demands of his or her normal activities. Most people are strong enough to meet the basic demands of daily life, but don't have reserves of strength. Therefore, in an unusually challenging situation (such as lifting a particularly heavy object or slipping connect with your colleagues on massageprofessionals.com 91