Flexibility and stretching- how to stretch, when to stretch

I advise everyone to perform any stretching under supervision. A lot of muscular and joint damage can occur if the technique is not correct. I have list here some guidelines and contraindication but these are not enough to avoid injury.

Durring jogging the muscles tend to shorten so stretching is necessary to bring the muscles back to their normal length after the session. It also brings other benefits such as:

1. increased range of motion (ROM)2. reduced muscle tension and increased physical and mental relaxation3. reduced risk of joint sprains or muscle strains4. reduced risk of back problems5. decreased muscular soreness (DOMS) associated with other exercise

activities6. decreased muscle viscosity, causing contractions to be easier and smoother7. improved co-ordination by allowing for greater ease of movement8. improvement and development of body awareness9. improved capability for circulation and air exchange10. improvements in posture

Factors affecting flexibility

Age

Young people are normally more flexible than older people (Wilmore et al, 1978). Babies and infants are very flexible and start to lose this natural flexibility as soon as they start to walk (when the joints become weight-bearing and need more stability).

As we get older, muscle contractility remains, whilst elasticity is lost, resulting in tighter, stiffer muscles. There is also a reduction in activity levels as we age, which will cause a decrease in flexibility.

Gender

Studies have shown females to be more flexible than males in most joints and to remain so throughout adult life (Getchell, 1979). The reasons for this are uncertain, but may be attributed to the structural or anatomical differences or different activities and training experiences of boys and girls early in life.

During pregnancy and in the post-natal period, women produce excess amounts of a hormone called relaxin to assist the birth process. The effects of relaxin are not

restricted to solely the pelvic area, but act throughout the body, allowing greater flexibility than normal. Small levels of relaxin are constantly present, and will fluctuate slightly throughout a normal menstrual cycle.

Temperature

An increase in temperature due to either direct heat or the weather can increase the range of motion and elasticity of muscle and tendons.

A decrease in temperature can result in a decrease in flexibility of as much as 20%.

Exercise and resistance training

Active people tend to be more flexible than those with a sedentary lifestyle (Getchell, 1979). This is especially the case if the activity involves stretching exercises. Although a comprehensive resistance training programme may increase ROM, resistance training exercises with a limited ROM and higher loads may actually decrease ROM.

Heredity

Flexibility can be an inherited characteristic, as well as an acquired one. Some people are born with a naturally excessive ROM. This can create a greater potential for injury (e.g. joint dislocation) and it may be necessary to concentrate on strengthening the muscles acting over the joint in order to increase stability.

Fashion

Female clients who constantly wear high heels may find that the muscles of the lower limb (gastrocnemius, soleus, peroneals) adaptively shorten over a period of time.

Methods of stretching

Method of stretching Type of stretching Example

Active stretching StaticDynamicBallistic

Standing chest stretchLeg swingsToe touches

Passive stretching StaticPNF

Wall chest stretchSupine partner hamstring stretch

Active - using antagonist muscles; no assistance from external force or object

It involves actively contracting one muscle or muscle group in order to stretch its opposing muscle group.

For example, pectorals actively contract to stretch posterior deltoids.

Tibialis anterior actively contracts to stretch gastrocnemius.

This type of stretching is very important for athletes, because it is an essential aspect of dynamic flexibility and thus has a greater correlation with sports performance than passive stretching.

Passive - assistance from partner, anoter part of the body or wall

A lying hamstring stretch where the hands are held behind the thigh or on the calf.This method is used by physiotherapists to increase joint range and muscle length.

A partner can assist by gently pressing parts of the subject’s body through full range. Great care and communication is required between partners using this method and so it is not recommended for beginners.

Applying the external force incorrectly, excessively or too quickly may cause the stretch reflex to initiate, perhaps causing injury. However, it can provide a greater range of movement than active.

Types of stretch

Ballistic

This form of stretching involves quick, repetitive bouncing or bobbing actions. It is undertaken in order to increase the stretch beyond the muscle’s normal range using momentum and body weight.

It is generally considered unacceptable for the average exerciser, due to the intramuscular damage that may occur as a result of the stretch reflex. These stretching exercises can produce muscle soreness and even losses in resilience and elasticity.

They are used as a radical method of stretching adhesions and stubborn fibrous tissue in physiotherapy and rehabilitation.

Dynamic

This is similar to ballistic stretching, however, the limb movements do not end with bouncing or jerky movements, but instead, are performed under control. These stretches should mimic the movements of the following sport or activity and act as a kind of rehearsal.

perform 10-15 repetitions of each stretch under control, gradually increasing the ROM

Static maintenance

Static maintenance stretching is where the muscle is taken to the end of its normal range and held without bouncing. These are short stretches, held for 10-15 seconds (Moffat, 1988), and are used to maintain the normal length of the muscle.

Following repeated contractions during exercise, the muscle becomes shorter and thicker and a maintenance stretch is used to return the muscle to its normal length. Guidelines:

take the stretch to the point of bind, maintaining good alignment and posture hold for 10-15 seconds repeat the stretch if desired

Static developmental

These stretches are used in flexibility training to develop the length of the fibres themselves, thereby increasing range of movement at a joint. It should follow this pattern

take the stretch to the 'point of bind', maintaining good alignment and posture hold for 10 or more seconds, until the tension within the muscle has reduced relax and passively increase the ROM of the stretch until tension is felt again again hold for 10 or more seconds, until the tension within the muscle has

reduced again increase the ROM of the stretch until tension is felt again hold until the tension reduces, then slowly return the limb to its normal position repeat the stretch if desired

When to stretch

Although always advocated after a warm up, stretching can be performed at any time of the day, appropriate to each person. You can stretch at home, watching TV, or at the office, in order to balance out periods of immobility in positions of poor posture.

Stretching should form an integral part of the warm up and cool down. Static stretching in the warm up has not been shown to decrease the incidence of injury, but may be selectively included in a ‘corrective’ form.

An example of corrective static stretching would be to relax pectorals when training the upper back for a more effective range of movement during retraction.

Dynamic stretching can be more easily prescribed as part of the warm up, using exercises that will mimic the general movement of the following session.

Corrective static and dynamic stretches should be performed after some kind of pulse raising/temperature rising warm up (Alter, 1998).

In the post-training, cool down part of the session, some kind of static stretching is advised. This may be static maintenance, static developmental, or a form of muscle energy technique stretch.

Warm up Cool down

Static stretching Static stretchingDynamic stretching DevelopmentalBallistic stretching Muscle energy techniques (METs)

Technical advice for flexibility training

ensure correct position, posture and alignment prior to and during the stretch take the stretch to a point of mild discomfort and do not strain or passively

force a joint beyond its normal range of movement ensure correct breathing patterns are maintained and try to breathe calmly

and rhythmically exhalation during increases in ROM will aid whole body relaxation closing the eyes, where applicable, may aid relaxation, focus and awareness do not force a stretch whilst holding the breath wait until the stretch reflex has subsided, and the muscle has ‘relaxed’ before

attempting to going further into the stretch unilateral stretches should be performed on both sides, where required emphasise stretching the weight-bearing muscles and in particular, the multi-

joint muscles stretch towards the end of each workout as a minimal requirement, to prevent

any unwanted adaptive shortening. The muscles should be very warm and receptive to

extension, thus promoting recovery and relaxation stretching in either a sitting or reclining position may aid relaxation for

corrective and post-exercise stretching concentrate and communicate when working with a partner come out of a stretch as carefully as going into it

When undertaking a stretching programme: wear loose, comfortable and appropriate clothing remove all jewellery and discard any chewing gum choose a clean, quiet place with a non-slip surface, preferably a firm mat

Precautions for flexibility training

decrease the stretch intensity or stop if the client experiences any local or radiating pain, or any loss of sensation

any mild soreness following stretching should last no longer than 24 hours. If the soreness is prolonged, then the stretching was too aggressive

use extreme caution when stretching any hypermobile joint, and question if developmental stretching is necessary

avoid excessive or aggressive stretching of recently immobilized tissues (casting). These tissues can become dehydrated and lose tensile strength

stretch with caution if there is known or suspected osteoporosis

For most individuals, stretching will provide many of the benefits previously mentioned. However, there are certain individuals or groups for whom flexibility training may be likely to cause injury, or where the possible concerns outweigh the potential benefits.

Contraindications for flexibility training

any developmental, excessive, uncontrolled or ballistic stretching should be avoided during pregnancy, due to the softening effects of relaxin

if the movement is limited by a bony block avoid stretching a fracture site for approximately 8-12 weeks post-fracture any sharp pain occurring during a stretch any uncontrolled muscle cramping occurring during a stretch any infected joint or nearby tissue any acute inflammation, except for the majority of arthritic people a local haematoma (bruise), resulting from an overstretch injury certain vascular or skin diseases

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