Friday, 14 November 2014 11:48

To Stretch or Not to Stretch?

By By Matthew Goodemote, MPT | Families Today

Today I would like to offer everyone reading this an opportunity to take a step back and examine your way of thinking. This is what I did a few weeks ago and it has helped me grow as a physical therapist. Hopefully it will open up some new possibilities for you too.

For me, resistance to change has been an obstacle I have had to deal with throughout my life. I am specifically talking about how a habit has become so ingrained because you have done something a certain way for a long time or have believed something is absolutely true for so long that the thought of changing it or doing something different brings anxiety and tension you can feel throughout your body.

My example today seems like a small thing, and in and of itself it really is relatively insignificance, but the effects of the experience reverberated throughout my entire life and lead to me questioning other firmly held beliefs. Funny how something so small can have such big effects.

Recently I wrote an article about the difference between mobility and flexibility. I wrote this article because I believe most people who think they are “stretching” are really just moving the tissue, which I define as "mobility" not "flexibility." I wrote this article with the intent of offering a different view on a common belief and hoping people would begin to ask themselves if they are really doing what we thought they were when exercising.

Well, a few weeks ago a headline caught my attention. The headline said something about how stretching wasn't actually beneficial. Intrigued, I decided to investigate further. As I did I learned that several studies published have contradicted the belief that "stretching" was as beneficial as we have thought.

I remember reading something 10-15 years ago about how stretching "before" activity is not beneficial and this has only just recently become part of the mainstream, and yet there are still a lot of people being taught to "stretch" before working out or practicing a sport.

So after a few days of digesting what I was reading I began to ask myself what exactly does stretching do...and why do we think it is helpful?

This is what we seem to currently know about stretching:

·         Stretching, regardless of form, does not reduce muscle soreness.

·         Static stretching, whether before or after exercise, does not prevent and, in excess, may even cause performance injuries.

·         Static stretching of a muscle before exercise decreases its subsequent performance.

·         Static stretching does not increase strength or muscle gains from resistance training.

What matters most to me is doing what helps my patients. So if that means I have to rethink what I am doing and really pause to consider why I would do something in particular, then I am going to do it.

Or, it is going to happen because I honestly don't feel like I am "trying" to do it. It is more like it is being done whether or not I want to do it because that's just how my brain works.

I like to offer my patients how I see things and to help educate them about what I have learned so they too can learn about themselves. In the end, I am merely a guide and my job is to help people find their way back to themselves so they can figure out what to do, why to do it and when to do it.

For this article I will resist offering my opinion about when "stretching" should be done and instead leave the question hanging for you to ask yourself. Are you sure that stretching is what you think it is? Do you really understand "why" you are doing it? Have you been taught it is good for you without being told why? If you have been told why does it really make sense?

Because in truth there are things that we thought were brilliant 10 years ago that we now realize were backwards and in some cases detrimental.

When I did my McKenzie training I learned to question everything...including the McKenzie Method. Early in my career I did things that I learned because that is what I learned. But as Confucius said: "Tell me and I'll forget. Show me and I'll remember. Involve me and I'll understand."

I involved myself so I would not just "know it" but I would really understand it. There is a difference in knowing when and why to do something and just doing it because you were taught to do it or you read about it. It requires consideration and contemplation.

I often say to my patients, "Ask me anything you want and challenge what I say because if I can't explain why I am doing something, you shouldn't have to do it."

One day, a long time ago, I realized that my job wasn't to be right all the time. My job was to help my patients. So I routinely ask myself "Why am I doing what I am doing?" If my answer is "just because" then shame on me. If my reason is because "that's what learned," then shame on me.

Early in my career I stopped "stretching" people because I noticed how holding a painful stretch was no more effective than simply moving someone. I first noticed this with my patient's that had knee replacements, so I stopped "stretching" my knee replacements.

I never understood why holding a painful stretch was helpful...still don't...and there is no physiological reason why either (at least none that I know about).

So now—some 17 years later—I am wondering if stretching is as important in other areas too!

Take a look for a minute at how you react to the possibility that stretching is not helpful. See if you have been so convinced that you need to stretch that you are unwilling to consider that it is not what is actually helping you.

Let me just share one example that may help convey the process more clearly.

I have had countless patients tell me they have tight hamstrings and have been told to stretch them. Unfortunately, most people have learned to stretch by bending forward when standing or with their leg straightened and in some cases on their back. In most cases the person was taught to stretch the muscle with a movement that is in a straight direction...meaning the knee and toe are lined up directly in line with one another and often with the hip. Some are even told it is not safe to do it otherwise. Unfortunately this would be an ineffective way to stretch the hamstring.

The hamstring does not attach down the middle by the knee. The hamstring attaches on the inside and outside of the knee and in order to stretch the muscles properly the muscle should be stretched the traditional way and by turning the toe in and turning the toe out.

In addition, the hamstring inserts into the buttock region and to get a thorough stretch the hamstring should be stretched at both ends, not just behind the knee region. And to do this the hip should be flexed...and to maximize the effectiveness the muscles should be rotated and stretched laterally, thereby hitting different angles and directions while the hip is flexed.

Also, to truly effect "flexibility," the muscles need to be taken to their end range. Most people stop at a gentle pull feeling and hold it there, despite the fact that going deeper into the motion is how to get an effective stretch. Most people do not hold long enough nor stretch deep enough, so are you really "stretching" the muscle or are you simply mobilizing it?

It may not sound all that important until you are like my patient that injured his hamstring in high school. Now he is in his 50s and still dealing with a hamstring issue that he has been "stretching" for decades. He has gone to multiple therapists and specialists and all have told him to stretch and he has...faithfully. But no one told him how to stretch at multiple angles and no one told him that the muscle should be stretched on both ends simultaneously. So for him it clearly is important. Now he understands, and now (just today) he told me he can already tell a difference in just a few weeks of taking a different approach.

My patient was willing to "understand" the process by questioning his beliefs. Hopefully this article will help others to consider a different view may be the very thing that helps you feel good again!

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