To stretch or not to stretch….. that is the question (February 26th, 2018)
It might surprise you that I often tell my patients to STOP stretching. ‘Why?’ I hear you ask… Well let me clarify and explain my thoughts on this topic.
Range of movement of the joints in your body is essential for normal movement, and if movement is restricted, it can lead to muscle imbalance and subsequent pains or injury. Stretching can be a very beneficial self-management tool to ease tightness of muscles. However, ‘muscle tightness’ is only one reason which may be causing your movement restriction, and in fact your muscles could be tight for a very good reason.
The body has excellent coping strategies to deal with injuries and pain. In certain circumstances muscles may well tighten to protect another part of the body, and so you should ask yourself ‘is it definitely beneficial to loosen this muscle or is it tightened for a reason?’. An example of this is if you have a painful and stiff neck – this may be caused because muscles around your neck go into protective spasm, causing tightness, but this may be your body’s way of telling you there is not sufficient strength and stability of your stability muscles in your neck to protect the joints. This is a positive tightness and if you take the tightness away, suddenly the joints in your neck become unstable and with nothing to support them, will lead to persistent neck pain. Yes, stretching can be useful in this scenario, but first you have to concentrate on strengthening the weak muscles.
Stretching can be appropriate in the following circumstances:
To increase a joint’s range of movement (if the reason that joint is stiff is due to muscle tightness!)
In preparation for sport
As recovery post sport
Studies have shown the benefits of stretching programs in order to increase joint range of movement but interestingly it has been questioned whether stretching actually increases the length of the muscle rather than just create an increased tolerance to the stretch (i.e. the participant’s ability to withstand a greater stretching force).
So, the next question to ask yourself is which type of stretch should you do? The main types are static or dynamic. When you participate in a sporting activity, such as running or jumping, static stretching as a warm up prior to commencing the activity is not recommended because it has been shown to reduce both immediate muscle strength and running and jumping performance. In contrast, dynamic stretching has not been found to lead to this stretch induced strength loss. However, if you carry out a sport which requires flexibility (i.e. dance / gymnastics) then static stretching may be more preferable for you as a preparation. In short, I would recommend carrying out the appropriate stretching exercises dependent on the activity, however, it is worth noting that no research has shown that muscle stretching leads to a direct reduction of injury risk.
My recommendations for general stretching based on experience and current research are:
Active warm up followed by static stretching should be included in your weekly exercise regime 2 – 3 days / week
Hold static stretches for 15-30 secs and repeat 2 – 4 times (American College of Sports Medicine)
Choose the correct type of stretch prior to partaking in sport or exercise (i.e. static stretching is not always the most appropriate)
For rehabilitation purposes, stretching may OR may not be appropriate. The decision should be made on an individualised basis. It is therefore optimal to see a health professional for advice. There are some injuries where stretching can actually be compressing injured structures and will therefore aggravate your injury even more.
In conclusion, to return to my original statement of sometimes telling patients to STOP stretching. This is basically because activating / strengthening muscles is sometimes the first step in resolving the problem. Essentially it should be an individualised approach and in my opinion, the health and fitness ethos of ‘it hurts, so stretch it’, should be eliminated.