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humerus, blocking any further extension beyond anatomic position. Therefore, given that the elbow joint has limited extension, there is a limit to how much an elbow flexor muscle (like the brachialis) can be lengthened and stretched. IT IS CHALLENGING TO STRETCH CERTAIN MUSCLES It is fair to say that it is difficult or challenging to effectively stretch some muscles, but to make the absolute statement that a muscle cannot be stretched is excessive hyperbole that is simply not true. The negative ideology that certain muscles cannot be stretched begins with what is essentially a valid concept, but then carries it too far conceptually. This can be damaging to our field because it leads therapists to believe that certain muscles can never be stretched, thereby convincing these therapists to not even attempt to assess or stretch them. Perhaps instead of leading with the misleading statement that there are muscles that cannot be stretched, it would be more accurate to say there are certain muscles in the human body that are challenging to stretch. WHAT DEFINES STRETCHING A MUSCLE? Before looking at specific muscles that are often touted as not being able to be stretched, let's define what it means to stretch a muscle. The definition of stretching a muscle can vary, but a reasonable definition might be to lengthen a muscle beyond its resting length. A further addendum to the definition of stretching might be that the client can feel the sensation of the lengthening/ stretching of the muscle. If we begin with these parameters as our definition, then stretching a muscle requires lengthening it beyond its resting length to its tissue tension barrier, and then a bit farther, to challenge it to stretch and have this stretch be felt by the client. Therefore, the ability to stretch a muscle is dependent on the range of motion (ROM) of the joint that is crossed (or joints that are crossed) to allow one attachment of the muscle to move farther away from the other attachment. And the distance that the two attachments are separated must be sufficient to go beyond the tissue tension barrier of the muscle. Returning to our example of the brachialis, it has little or no ability to lengthen and stretch, if we assume the resting length of the client's brachialis allows the client's elbow joint to be in full extension of anatomic position. For most people, this is the case. But what about those clients who have lost full elbow joint extension? Perhaps this is due to excessive weight training for elbow joint flexor musculature. Or maybe it is due to the immobilization of a casted elbow joint in a position of flexion during rehabilitation after surgery or broken bone of the upper extremity. Prolonged elbow joint flexion can result in adaptive Stretching the elbow joint into extension. shortening of the elbow flexors, including the brachialis. For these clients, because the brachialis is adaptively shortened and tight, it can be stretched (Image 2). MUSCLES THAT ARE CHALLENGING TO STRETCH The brachialis might be the most extreme example of a muscle that is difficult to stretch. But there are many others that are cited by proponents of the "muscles that cannot be stretched" (MTCBS) ideology. Let's examine and discuss a few of these. Tibialis Anterior Proponents of MTCBS state that the tibialis anterior cannot be stretched because there is a limit to the ROM of plantarflexion of the foot at the ankle joint. Yes, there is a limit, but from anatomic position, the foot can plantarflex 50 degrees—an appreciable amount. Also, the tibialis anterior is an inverter of the foot at the subtalar joint, so 2 N e w ! A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 61