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ACTIVE ISOLATED STRETCHING AND STRENGTHENING Injury Rehabilitation, Part 1 supraspinatus muscle Active Isolated Stretching and Strengthening (AIS) is a uniquely effective exercise system developed by Aaron Mattes. In recent articles ["Active Isolated Stretching" Parts 1 and 2, November/December 2009 and January/February 2010, pages 100 and 88], we gave a general introduction to the stretching component of AIS, explaining the physiological principles underlying the techniques and the various ways in which this modality can benefit our clients. In this two-part article, we're going to discuss the ways in which AIS (including both stretching and strengthening) can play a role in injury rehabilitation—therapy aimed at restoring function that has been supraspinatus tendon lost through physical trauma or other types of soft-tissue damage. A large proportion of our clients require some degree of rehabilitative work, and since we began using AIS, our effectiveness in helping them has increased greatly. In speaking with various AIS practitioners and their clients, we have also collected many other reports of restored neuromuscular functioning. We'll incorporate some of their stories throughout the article as well. Specialists in the field recognize five key components in the rehabilitation process: 1. Addressing the pain. 2. Restoring the full range of motion. 3. Neuromuscular reeducation. 4. Rebuilding strength. 5. Restoring full function. We'll address each of these, one at a time. connect with your colleagues on massageprofessionals.com 89 1. ADDRESSING THE PAIN The first step in rehabilitation is to relieve whatever pain the client feels. This makes intuitive sense—you can't effectively stretch or strengthen an injured structure until it stops hurting. Among other problems, pain usually causes a protective contracture, which ultimately increases the problem rather than solves it. To help resolve the pain, you need to determine what the cause is. We separate three kinds of causes: precipitating event, direct cause, and indirect cause. Suppose a person begins experiencing shoulder pain when lifting a suitcase after returning from vacation. Lifting a suitcase uses a small, fairly weak muscle called the supraspinatus, which sits on top of the shoulder beneath the trapezius muscle (Image 1).