Ask anyone why they stretch and you will usually get a pretty consistent answer. We want to “loosen up”, improve movement in some part of the body, recover faster/reduce pain, and avoid sore muscles.
However, you may find it surprising that your trusty stretching routine you’ve been doing for years could be limiting your progress in the gym, field, or court. Should we be surprised that a generic list of stretches probably won’t do much for these specific goals?
It is often misunderstood in fitness and health that in stretching, one size does NOT fit all. Just like those exercises your trainer gave you to improve your game, your stretching program should meet your needs to help you reach your goals.
So if you’re feeling stiff or sore and it’s not getting better, take a minute to identify your goals for stretching. Here are some of the major reasons I see in the clinic and on the field, and a look at some of the strategies to make them work for you.
- Stretching for pain relief and recovery
- Stretching for increased flexibility and range of motion
- Stretching for injury prevention and performance
Stretching for pain relief and recovery:
People who are recovering from a muscle tear, have had surgery, or a chronic condition such as stroke or Parkinson’s are often prescribed stretching to improve mobility and aid in recovery. They experience muscle tightness and pain that is caused by overactive nerves holding the muscles in a tightened, protected, state. Since the muscles are constantly under tension, these people have a much higher risk of muscle injury and inflammation during activities and exercise.
The goal of stretching for pain relief and recovery is to get the muscles to quiet down. This involves gentle stretches that are low effort and free of pain. A study by Kubo et al. (2001) showed that consistent gentle stretching caused something called “stress relaxation” of the muscle. Stress relaxation occurs when sensory receptors in the muscle, called golgi tendon organs (GTOs), react to increases in muscle tension. As a response to protect against potentially damaging stresses, they send a message to the brain to lower the activity of the muscle, causing a relaxation and decreasing muscle tension. In other words, after stretching the muscle allowed the joint to move more freely through its full range. The authors suggested that this may be a possible mechanism for a reduced risk of injury with stretching exercises.
Stretch techniques for pain relief and recovery
In order to maximize the results of stretches for pain and recovery, start conservatively but work up to performing your stretches multiple times, as long as you avoid pain. Always remember that the first priority is to not cause any more pain and swelling (inflammation) in the tissues. As a muscle lengthens from a stretch, its tension will rise. The key to stretching for pain relief is to ease the nervous system before muscle tension rises high enough to cause any pain. That’s why it is very important to slowly progress the number of times you stretch to make sure you don’t get a negative reaction.
You can put this into practice yourself by holding your stretch for 20 seconds so that it you feel a gentle pulling in the muscle, but that does not cause discomfort. After 3 consecutive days of doing this, you should be confident you can do more without irritating the muscles. At that time, you can try performing the stretch a second time with at least a minute between stretches for the same muscle. Continue this strategy until you are able to perform the stretch three times pain free on a daily basis.
Stretching for flexibility and improved range of motion:
Prolonged postures and repetitive movements can cause our muscles to adapt at the cost of our mobility. In these cases, the muscles are still normal and healthy, and may not even be sore or painful. Yet some will have shortened to accommodate the body’s “new normal”. Improving range of motion is possible by using prolonged stretching that is just “before” the onset of pain, and held for a longer duration than for pain relief.
Laboratory studies on stretching have shown that stretching can promote changes at the microscopic level and make your muscles actually longer. Sarcomeres are the muscle fibre’s building blocks that are lined up end-to-end to give it its length. Sarcomeregenesis is a term used to describe an increase in the length of the muscle fibre (Martins et al., 2013). When applied enough times for long-enough duration, a stretch actually stimulates the body to build more sarcomeres. The more sarcomeres, the longer the muscle fiber, the looser the muscle, and the more flexible you will be.
In order to successfully increase range of motion, the focus must move toward the muscle itself, meaning that tissues need to be able to handle more tension for a longer duration without becoming painful. Still, the most important rule is to avoid painful stretching habits at all costs.
Stretching to the point of pain makes the muscle fight back against the stretch as it contracts to stop the excessive movement. In turn, golgi tendon organs won’t help lower muscular tension, and sarcomeregenesis becomes physiologically impossible. In fact, five of seven studies evaluated in a recent meta-analysis (Apostopoulos et al., 2011) showed that stretching to discomfort and pain produced no improvement in range of motion regardless of the population studied.
Stretch techniques for flexibility and improved range of motion
If you have a muscle that is limiting your mobility but otherwise normal and pain free, you can try the following approach. Find a comfortable body position that does not involve supporting your bodyweight over the part you are stretching, so that you can relax and use a minimum of effort to hold the stretch position. Perform your stretch and hold it for approximately 1 minute, repeating it 3 times with at least a minute rest between each repetition.
Stretching for injury prevention & performance:
Despite popular belief for some, stretching doesn’t show any overall effect to reduce overuse injuries. However, there may be a benefit in reducing acute muscle injuries in running, sports that involve sprinting, or other repetitive dynamic muscle contractions.
Surprisingly, the current research indicates that stretching before exercise may help prevent muscle injuries in sports with a sprint running component but not in endurance-based running activities, where overuse injuries are more common. They key is to incorporate at least a 10-minute warmup that includes movements in your sport, just at a lighter intensity.
Stretch techniques for injury prevention & performance
Active people who participate in sports and exercise regularly generally don’t have limited movement and do not experience muscle pain as described earlier. They can stretch more intensely before experiencing pain, and hold a stretch for a longer-duration may have a greater potential to decrease injury risk. A meta-analysis by Behm et al (2016) observed that several studies on this topic have indicated a 54% risk reduction in acute muscle injuries associated with pre-activity stretching followed by a specific warmup.
Setting Your Stretching Goals
So if the problem is that you stretch and stretch, but never get better, then something in your program is not supporting this long-term adaptation of your muscle fibers. Start by checking your body position, the intensity you are using to stretch, and the both the frequency and duration of the stretches. For athletic events, make sure you are fully warmed-up by doing dynamic movements that mimic the sport itself, but are at a controlled speed.
Other important factors that can contribute to tightness and pain include imbalances in your muscles. Imbalances can get in the way of the normal physical response to appropriate stretching, and should be assessed by a trained musculoskeletal therapist.
If you would like more information or would like to find out how you can improve your range of motion, reduce muscular pain, or improve performance, please feel free to contact John Gray at jgray@orthophysio.com, or call us at The Orthopaedic Therapy Clinic at 416-925-4687.
