Article by Steve Lockhart www.learnmyotherapy.com
For as long as I can remember people have been told to stretch as a warm up or warm down to prevent injuries and for just as long physiotherapists have been using stretching, along with exercises, as the basis for their treatment of painful conditions. Everyone has jumped on the band wagon from doctors to personal trainers and most therapists and whenever someone complains of feeling tight or sore there are invariable asked ‘have you been doing enough stretching’ or ‘I know a good stretch that will help you’.
But in saying that there are also varying opinions on the type of stretching that are good to do and which are bad or harmful and in fact whether any stretching does any good at all. Research conducted by Army physiotherapist Rod Pope and his colleagues on 2600 Army recruits showed that stretching provides no benefit in preventing injuries and his is not the only study that has reached this conclusion.
Now I’ll grant you that stretching a tight area will provide some temporary relief but what is it actually doing to our body when used regularly over a long period of time?
Before I discuss that question I would like to take you back to where it all started with the exercise craze of the late 70’s and early 80’s. Back in those times people didn’t go to gyms or do fitness classes like aerobics or pump and the topic of stretching was rarely raised because people hardly ever needed it. The only gyms that existed were for the serious sportspeople or trainers where you could use hand weights or punch a heavy bag in a dingy back room somewhere, run by an ex fighter or trainer. It wasn’t the place the average person would go and most exercise was confined to organised sports such as tennis, basketball or touch football. Injuries that people sustained were seen to by your GP and treated with rest and anti inflammatory drugs and physiotherapists were mainly used for helping people rehabilitate after surgery or treating the elderly in nursing homes.
When the exercise craze finally did take off and gymnasiums as we now know them started to spring up everywhere, people started getting serious injuries that doctors were not equipped to deal with either with expertise, or experience and so Physiotherapists inherited the job because they were the only option available and stretching became the new buzzword.
If you ask most people, they will tell you they imagine that muscles are like lengths of elastic that when pulled from both ends, stretch evenly just as elastic does and are not aware that a muscle works more like a telescope where the filaments slide over one another requiring ample lubrication and a healthy function to be able to properly lengthen through its range of movement. Healthy function refers to the condition of the muscle generally, whereby the tissue needs to be supple and strong and responsive to the nerve stimulation orchestrated by our brain.
The reality of course is that perhaps 10% of people would fit into this category while the other 90% are dominated by muscle tissue that is damaged, stressed, congested, unhealthy or overworked. The result for this group is an inability for the muscles to respond to stretching exercises without putting most of the pressure on the origin and insertion points and connective tissue around the joints. So what does that do? And more importantly what proof is there that indeed this is in fact what happens?
If you develop a pain in the body where does it usually manifest? In the joint. Most pains that people experience are things like knee pain, back pain, shoulder pain, elbow, wrist or ankle pain etc. And most of these pains when checked show that there is actually no damage to the structure of the joint, according to medical diagnosis they mainly come under the heading of inflammation or tendonitis and are treated with rest, anti inflammatory’s or cortisone injections. In fact most medical specialists will tell you they are not sure why a pain is felt in a joint that shows no signs of injury when scanned. If it hangs around for too long, some people are told the pain is all in their head or other are operated on anyway with arthroscopy’s so the specialist can ‘have a look’ because they can’t figure out what the problem is, but regardless of which category you might fit into everyone is told to do more stretching.
It may be found that the joint is tracking incorrectly or there is an irritated nerve, ligament or tendon and where some of these injuries respond to a bit of ice and ‘stretching’ most hang around and require constant ‘stretching’, strapping or strengthening before they eventually settle. The reason they eventually settle is the body compensates for the injured muscle(s).
In fact what is really happening is a problem with the muscle supporting that joint is either causing an imbalance or irritation that settles or recovers in direct relation to the improvement of that muscle problem. Many times that muscle doesn’t recover very well and despite all the stretching, the pain or irritation becomes chronic until the body slowly compensates and settles the problem away by itself.
Eventually as we get older and have an accumulation of these problems the body has no where else to compensate and the chronic pain stays with us, causing a curtailing of the activity that irritates the joint, tendon, ligament or nerve. On the other hand, if the problem muscle is able to be identified and its length and function restored, the pain can disappear overnight as mysteriously as it came.
Stretching doesn’t achieve this goal evidenced by the fact that chronic pain, of all types, is an epidemic amongst the masses of people who exercise and stretch and stretch and stretch as advised by their doctor, physiotherapist, other therapist or trainer, with no result.
If you do some research into stretching you will see it gets quite complicated, there is dynamic, ballistic, active, passive, static, isometric and PNF stretching or proprioceptive neuromuscular facilitation which is really a technique combining passive and isometric stretching. Even the process of what happens in the muscle when we stretch is quite scientific, enough to tell you that in a perfect world maybe but certainly not in this world or stress, junk food and toxins where muscles do not behave in the manner that they are suppose to, at least for the 90% majority anyway.
The complicated anatomy we have that facilitates a stretch let alone the precise control and movements required that most people would have no idea about, should be enough to put doubt in anyone’s mind that the effect of a stretch would come anywhere close to what is expected.
Which brings us back to our original question of what happens to the body when we do all this stretching over a long period of time, the answer is many things:
Firstly as the connective tissue at the joint is the weakest point along the line we end up stretching the ligament, the small fibrous tissues that plays an important role in the support of the joint against dislocation and excessive, incorrect movement. Over time this constant stretching of a ligament causes it to stretch and become loose and weakened, making the joint hyper mobile and changing the important relationship that ligament has with muscles that also support that joint.
As we know from the science books a stretched loose ligament stays that way and doesn’t return to its original length even after a long time has passed, especially if it is continually being stretched.
As a result the person doing the stretching feels looser and they are, in the joint, but that only makes them more susceptible to injury’s like dislocation or more serious joint or ligament damage. A hyper mobile joint might work well in ballet or for martial arts kicks but it is not a good thing for a person involved in sports such as basketball, soccer, football, netball, or any activity involving body contact or where they are changing direction quickly.
If the ligaments are not providing the support for a joint that they should be, it is left to the muscles to pick up the slack and that causes them to become overworked and react by becoming tighter.
When the muscles become tighter a person feels like they need to stretch even more and the situation is exacerbated until you have the loose hyper mobile joints and muscles that are contracted in the belly and won’t let go. An experienced bodyworker will feel this condition quite easily when working on a person who has stretched consistently over a long period of time.
The body has the ability to know when a joint is weak or unstable and contacting the muscles is the way it protects itself and strengthens against the joint being dislocated. Over time the constant state of contraction affects the circulation and the muscles correct function and co-ordination with the nerves, which in turn causes the muscle to become weaker and the chances of dislocation, ligament, tendon or joint damage even greater.
So as you can see if you think about it logically there is a valid reason why stretching is not as good for you as perhaps you have been led to believe and in fact long term stretching is very bad for the ligaments, muscles and joints in particular. How do I know this, well as a Myotherapist doing a lot of deep tissue massage work over a 17 year period, working on all types of body’s, I have been able to compare the constantly stretched body with the rest and the difference is very obvious, loose sloppy joints and contracted belly of the muscles that does not respond to the usual techniques I successfully use to release the muscle contractions.
The chronic stretcher’s don’t have any fewer injuries than the non stretcher’s in fact I’d say they have more, especially niggling injuries. When I get them to stop stretching, (which is like getting someone off a drug), the ‘niggles’ disappear and the injuries become less frequent, providing their body hasn’t already changed too much.
Warm up and warm down very well before activity, using ROM exercises.
Eat a balanced healthy diet including supplements so your muscles and tissues are strong and will be supported for the activity you want to undertake.
Get full body deep tissue massage as regular maintenance for your muscles and when you feel the need to stretch, do so sparingly and seek out a treatment that can restore length and function to your muscles. Get your body put body back in balance without involving stretching or strengthening exercises because strengthening tight, imbalanced muscles with poor circulation causes them to tighten further, worsening and locking in any imbalances, but that is another story which has been expanded on in The Bad Back Book, available FREE from www.backpain.com.au
Article by Steve Lockhart www.learnmyotherapy.com