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PASSIVE EXTENSION OP THE MUSCLES.
The passive extension is carried to the natural limit of the
muscle, and is a passing, not a continued one. The stretching
causes compression of the blood-vessels, while the nerves and the
muscles are directly stimulated. After the completion of the
movement, there will be an afflux of blood, and, following upon
this, brisker nutritive changes. It has long been known that, if
a muscle is stretched within certain limits, and not for too long
a time, it becomes more sensitive to other mechanical stimulation,
and contracts with greater force. In using Ling’s exercises, it is
therefore generally the custom to precede an active movement
with passive extension, and to keep up the extension during the
movement. In applying it, it is often found that apparently
powerless muscles are capable of reacting against slight resistance,
sometimes at once, sometimes after only a short treatment.
This passive extension stands on the borderland between
passive and active movements, and at the commencement of
treatment in many cases it is substituted for the latter, until
strength begins to return in the affected muscles.
The expression " to keep up the extension during the move-
ment " may seem a little extraordinary at first sight, and
therefore I will try to explain it.
Suppose we have the movements of adduction and abduction
of the upper arm, the patient resisting during the former, the
manipulator during the latter. The shoulder-joint is the centre
round which the movement takes place ; the upper arm is the
radius, with the elbow as the terminal point. (The forearm
is supposed to be kept bent towards the upper one.) The
manipulator, standing behind the patient, grasps his elbow,
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