“Is there a stretch for that?” – The who, what, when, where and why of stretching
Stretching is a hot topic in the world of pro athletes and armchair quarterbacks alike. I would be confident to go out on a limb and say there isn’t a soul out there who hasn’t been advised to stretch at some point in their life. On a daily basis in my physiotherapy practice I hear patients saying, “I know I should stretch more”. But should they? Is stretching always the right answer? Is there a better way, time or place to stretch? Can stretching harm you? For every question about stretching there are multiple answers. And every answer leads to more questions. If you turn to the experts or the researchers for the answers, the only consensus on stretching is there is no consensus. So how do we decide who should stretch, what they should stretch, how and why?
Who should stretch? Everyone. Muscles get tight, that’s a fact of life, so we all should stretch and we all do, it’s a natural reflex in some cases, like when you wake up in the morning. General stretching happens with all of our movements. The simple act of getting up from your desk chair and just changing positions is a form of stretching in the most basic sense and that is important for everyone. Keeping your body mobile and limber helps to prevent injury and pain. But who should do therapeutic stretching because something is already painful, that is a more difficult question. The answer is dependent on if there is a tight muscle at fault for the pain.
Knowing what to stretch to try to alleviate pain means understanding what is causing the pain. Muscles are made up of overlapping fibers. A muscle that is at its optimal length will have just the right amount of overlap in its fibers. A muscle contracts by having its fibers slide closer together increasing the overlap. A muscle that is tight has fibers that have too much overlap at rest. When the tight muscle tries to contract, its fibers have little room left to move. Therefore it needs to recruit more fibers than a normal length muscle to get the same force generated. The tight muscle has to work harder and that is why tight muscles can ache and cause pain. This would be an appropriate muscle to stretch. The opposite situation can also arise when a muscle it actually too long and its fibers don’t have enough overlap. In this situation the muscle fibers struggle to grab hold of each other and slide closer together to generate a strong contraction. Again this muscle will have to work harder than an optimal length muscle and so it may ache and be the source of pain. You would not want to stretch this muscle as you would only make the situation worse. Recognizing the difference can be challenging and a physiotherapist is trained to identify these types of muscle imbalances and show you which muscles you need to stretch.
Once a tight muscle has been identified how should you stretch it? (the when and where!) The research is constantly changing from ideas of static vs ballistic stretching to passive vs active holds. Some principles hold true that can be applied to keep stretching safe and effective. Stretching should be done on a warm muscle therefore either after a good warm up, application of heat or at the end of a workout. Stretching should be pain free; a case of less is more. For a muscle to be able to achieve an effective stretch it needs to be able to relax. If you are stretching so hard that it is painful you will not be able to relax and the muscle will not lengthen. Hold the stretch for as long as you need to be able to feel the muscle relax. As a minimum I tell patients 30sec to a minute for a tight muscle.
Last but not least why should we stretch? There are many benefits to stretching. Keeping your muscles at their optimum length will help to keep them strong and avoid muscle imbalances. Without muscle imbalances your body is free to move as it is meant to, meaning less effort and less pain! Having good flexibility and range of motion will allow you to stay active, healthy and enjoy life. Why wouldn’t you want that!
Julie Shearer – Registerd Physiotherapist, Ottawa ON
BScPT, MClSc, FCAMPT