What is a passive exercise?

Passive exercise is a type of physical activity that helps improve flexibility and range of motion but requires little effort from the muscles. Unlike active exercise that builds strength, passive exercise relies on an external force to move the body. While it doesn't provide all the same benefits as more vigorous exercise, passive exercise plays an important role in rehabilitation, injury prevention, and maintaining range of motion.

How Passive Exercise Works

The key distinction between active and passive exercise is that passive exercise does not require the muscles to exert their full effort. Instead, an outside force moves the body to provide motion. This allows the joints and connective tissues to move through their full range of motion without overexerting the muscles or stressing the joints. The primary benefit of passive exercise is increased flexibility.

Some examples of passive exercise include:

• Stretching or yoga where you hold poses. The weight of gravity acts as the external force to lengthen the muscles and connective tissues.
• Range of motion exercises where a therapist moves the joint through its full range of motion.
• Using exercise equipment like a continuous passive motion (CPM) machine that slowly moves the joints without effort from the patient.
• Massage. The massage therapist provides the external force to move and manipulate the muscles and joints.

In all these cases, the muscles stay relaxed rather than contracting to move the body as they would in active exercise. The joints and connective tissues benefit from the motion without developing fatigue or strain.

Benefits of Passive Exercise

The benefits of passive exercise primarily involve increased flexibility and range of motion. This provides both physical and mental benefits.

Physical Benefits

• Increased joint mobility and range of motion
• Reduced muscle tension and stiffness
• Prevention of frozen joints or joint contractures
• Improved circulation and reduced swelling
• Faster recovery after injury or surgery
• Maintained flexibility and mobility for the elderly and disabled

Mental and Emotional Benefits

• Reduced pain and discomfort
• Improved mental relaxation
• Reduced stress and anxiety
• Increased feeling of wellbeing

For patients recovering from surgery, illness, or injury, passive exercise helps restore mobility and prevent additional loss of range of motion while avoiding further injury or trauma. It provides a gentle way to start moving again without taxing the weakened or damaged tissues.

Passive stretching also gives an immediate feeling of relaxation, both physically and mentally. Releasing muscle tightness provides both physical and mental relief.

Types of Passive Exercise

There are several categories of passive exercise:

Assisted Stretching

Stretching exercises where a partner, therapist, or assisted device provides the external force to move the joint through its range of motion. The individual relaxes the muscles and allows the stretch. Types of assisted stretching include:

• Partner stretches like the hurdler stretch. One partner holds the leg and gently pushes into the stretch.
• Assisted devices like rope pulleys or stretch bands that provide resistance and gently pull the joint into a stretched position.
• Therapist stretches where the provider manually moves the joints through the range of motion.

Flexibility Training

Exercises designed to improve range of motion without building strength. Flexibility training includes:

• Static stretches where the muscle is held at its maximally stretched length for a period of time using the weight of the limb or gravity. This includes stretches like the seated hamstring stretch.
• Dynamic stretches that take the joint through its full range of motion repeatedly using momentum but without holding the stretch. Examples are leg swings and arm circles.
• Proprioceptive neuromuscular facilitation (PNF) stretches that involve alternating contraction and relaxation of the muscles to allow greater range of motion.

Foam Rolling

Using body weight against a textured foam roller to apply pressure to the connective tissues and muscles. The gentle pressure relaxes muscle tightness and reduces soreness without active effort from the muscles.

Massage

Having a massage therapist manually manipulate the soft tissues provides passive motion to both the muscles and joints. The pressure applied works out muscle knots and loosens restrictions. Massage improves circulation and provides pain relief.

Water Therapy

The buoyancy and warmth of water allows for gentle range of motion exercises. Water provides the optimal environment for passive exercise as the water resistance enables motion while supporting the body to avoid strain. Passive water exercises may include walking, underwater cycling, or swimming strokes that emphasize technique over exertion.

Continuous Passive Motion

Devices like continuous passive motion machines gently move the joint through its range of motion without muscle activity. These are often used after surgery to restore mobility and prevent scar tissue formation while avoiding muscle strain during early healing.

Passive Exercise in Rehabilitation

One of the most common uses for passive exercise is during the rehabilitation process after an injury or surgery. Starting gentle passive range of motion soon after an injury or surgery helps:

• Restore normal mobility after a period of immobilization
• Prevent scar tissue formation and adhesion formation
• Maintain flexibility and prevent frozen joints from developing
• Reduce swelling and stimulate circulation
• Improve proprioception
• Decrease pain and muscle guarding

After an injury that required a period of immobilization, the tissues become stiff and contracted. Passive motion helps realign the fibers to restore normal range of motion and flexibility. It also allows nutrients to flow into the area and prevent fluid accumulation.

After surgery, there is inflammation and typically a period of immobilization during initial healing. Gentle passive motion prevents the formation of adhesive scar tissue while moving healing nutrients into the surgical site. It helps maintain a functional range of motion during the immobilization period.

For both injuries and post-surgical cases, passive range of motion lays the foundation for progressing into active rehabilitation exercise.

Maximizing the Benefits of Passive Exercise

To get the most out of passive exercise:

• Relax muscles and breathe during the stretches and movements. Don't tense up or try to assist the motion.
• Move slowly and gently until you feel mild tension. Avoid sharp pain or pushing the joint beyond its normal range of motion.
• Warm up the muscles first with gentle movements or heat. Cold, tightened muscles don't stretch as well.
• Focus on proper technique and moving through the full range of motion. Don't worry about repetitions.
• Communicate with your therapist or partner about your comfort level. Only stretch to the point of feeling tightness, not pain.
• Balance with active exercise once mobility has improved. Passive exercise alone does not restore full strength.
• Be consistent. Stretching and passive movements must be repeated regularly to maintain and improve flexibility over time.

Passive exercise offers an excellent way to improve flexibility and range of motion while allowing damaged or weakened tissues to rest. When paired with active exercise, it promotes full rehabilitation.

Risks and Precautions with Passive Exercise

While gentler than active exercise, passive exercise still requires caution, especially in certain situations:

• Recent injuries or post-surgical cases. Avoid passive exercise until approved by your doctor and start very slowly.
• Severe osteoporosis. Fragile bones may be at risk for fracture with excessive pressure from massage or stretching.
• Joint instability. Passive stretching of overly mobile joints may increase instability.
• Active inflammation. Don't stretch inflamed joints as it may further aggravate.
• Unhealed fractures. Stressing healing bones with too much range of motion can disrupt the repair process.
• Pregnancy. Use caution with stretches that compress the abdomen.
• Communicable skin conditions. Direct skin-to-skin contact spreads infections. Avoid massage or partner stretches.

Proper communication with your therapist or healthcare provider is key prior to starting a passive exercise program after an injury or surgery. Always start gently and slowly increase intensity over time while avoiding pain. Stop any exercise that causes pain or discomfort.

Combining Passive and Active Exercise

For full rehabilitation, a combined approach of passive and active exercise works best. Here’s how they complement each other:

• Passive exercise restores range of motion and flexibility. Active exercise builds strength.
• Passive exercise provides gentle joint motion for early healing stages. Active exercise stimulates tissues and improves circulation.
• Passive exercise precedes activity to increase movement. Active exercise follows to reinforce those gains through strength.
• Passive exercise first loosens the muscles. Active exercise then activates the muscles through exertion.
• Passive exercise relaxes the body. Active exercise energizes and stimulates.

Alternating between the two allows for gentle, progressive loading on the tissues to aid healing without overstressing the area.

Sample Passive Exercise Routine

A complete passive exercise routine should move all the major muscle groups and joints through their available range of motion.

A full body program might include:

• Neck: gentle range of motion in all directions and light stretching of neck muscles.
• Shoulders: arm circles forward and backward, shoulder rolls, and gentle shoulder stretches such as across the chest or behind the back.
• Arms: wrist rotations, elbow range of motion, and gentle triceps and biceps stretches.
• Back: spine twists, knee to chest exercise, and spine flexion.
• Hips: leg swings front to back and side to side, knee rolls, and hip flexor stretches.
• Legs: ankle circles, knee bends if able, calf and hamstring stretches, and supported leg raises.

Each exercise would involve repeating slow, controlled motions 10-15 times through the available range of motion while relaxing the muscles. Move until feeling mild tension then ease back slightly.

Spending just 10-15 minutes a day performing these gentle range of motion and stretching exercises provides tremendous benefits for flexibility, pain relief, and improved function. It's an easy addition to any rehabilitation routine.

Frequently Asked Questions

What are the main differences between passive and active exercise?

Passive exercise uses an external force to move the body while the muscles stay relaxed. Active exercise requires the muscles to contract and exert effort to move the joints.

What conditions might benefit from passive exercise?

Passive exercise aids recovery after surgeries, injuries, illnesses, or periods of immobility. It also helps people with disabilities, limited mobility, or conditions affecting muscle function.

When is passive exercise appropriate after an injury?

Gentle passive exercise can typically begin immediately after an acute injury to maintain range of motion. However, always consult your doctor first after a significant injury.

Can you build muscle with passive exercise?

No, passive exercise will not build muscle. It improves flexibility but provides no muscle strengthening stimulus since the muscles remain relaxed.

Is passive stretching before activity helpful?

Yes, light passive stretching before activity helps prepare the muscles and enhances range of motion. It should not be intense enough to cause fatigue.

What precautions are needed with passive exercise?

Avoid over stretching joints or irritating inflamed areas. Communicate pain levels and only move to mild tension. Have unstable joints supported. Avoid passive exercise over unhealed fractures or fresh surgical sites until approved.

Conclusion

In conclusion, passive exercise provides valuable benefits, especially for rehabilitation and improving flexibility. While it should not replace active exercise entirely, passive motion restores range of motion and joint mobility without taxing weakened or healing tissues. It encourages circulation, relieves stiffness, and hastens recovery. Including passive stretches and movements enhances overall health and physical abilities. Passive exercise qualifies as an important component of a balanced, therapeutic exercise routine.