Hesperian Health Guides

Guidelines for Doing Stretching and Range-of-Motion Exercises

1. When doing these exercises, consider the position of the whole child, not just the joint you are moving. For example:
The knee will often straighten more (and you will be stretching different muscles) when the hip is straight than when the hip is bent.
a boy lying down while adult is exercising his leg
Adult extending leg of distressed child, child speaks.
This is because some muscles go from the hipbone to below the knee.
A child bending over touching his feet
To prove this, try to touch your toes with your knees straight. You will feel the muscles stretch, and the cords tighten here.
In a similar way, movement in the ankle is affected by the position of the knee, and movement of the fingers by the position of the wrist.

2. If the joints are stiff or painful, or cords and muscles are tight, often it helps to apply heat to the joint and muscles before beginning to move or stretch them. Heat reduces pain and relaxes tight muscles. Heat can be applied with hot water soaks, a warm bath, or hot wax. For methods, see How to Care for Painful Joints.
For a stiff, painful joint apply heat for 10 or 15 minutes before doing the exercises.
an arm with a stiff hand
a hand wrapped in towel held over steaming water
hand being exericed by somoene else

3. Move the joint SLOWLY through its complete range of motion. If the range is not complete, try to stretch it slowly and gently just a little more each time. Do not use force, and stop stretching when it starts to hurt.
Hold the limb in a stretched position while you count to 25. Then slowly stretch the joint a little more and hold it again for a while. Continue this way until you have stretched it as far as you can without forcing it or causing much pain.
A boy lying down while his arm is being held
Adult massaging arm of child and speaking.
22, 23, 24, 25
DVC Ch42 Page 372-9.png
The more often you repeat this, the faster the limb will get straighter.
4. Have the child herself do as much of the exercise as she can. Help her only with what she cannot do herself. For example:
Instead of doing the child’s range-of-motion exercise for her, have her do the exercise using her own muscles as much as she can. Then have her help with the other hand (or you help her if necessary).
An adult helping a child who is lifting her hand
A child lifting her hand up wihtout assistance
Child using left arm to lift her right hand up

Whenever possible, exercises that help to maintain or increase joint motion should also help to maintain or increase strength. In other words, range-of-motion, stretching, and strengthening exercises can often be done together.

This page was updated:27 May 2020