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Stretching

The “Mystery” of Stretching.

 Stretching has always been part of work out programs for professional as well as amateur athletes, but how one should stretch has been a long ongoing debate that is far from over. I frequently hear from people that they “stretch,” and if I ask how and why, I am often met with a blank stare. I am hoping with this blog to clarify a few things about different purposes and types of stretching.

Pre-workout stretching. Before a workout you want to prepare the body by loosening muscles and tendons in order to increase the range of motion of the joints. In addition, you want to improve circulation throughout the body and initiate release of essential hormones involved in exercising. The best way to accomplish this is to utilize what is typically known as Dynamic-Stretching. This is a moving stretch that works many muscles at the same time, so we are talking “global” versus “local” stretch. Dynamic stretching can be general or sports specific, the latter referring to movements specifically tailored to the upcoming activity, i.e. basket ball, soccer, tennis etc.

Post-workout stretching. After a training session, the muscles have been worked and need to be stretched (or not) so they can return to optimal resting state. That is important because if the muscles that have been working are left to cool off on their own, they tend to stay where they were left off, shortened in some areas and lengthened in others. An example of the latter would be shortened chest muscles and lengthened upper back muscles, which would be typical after activities like bike riding, boxing or a chest workout.

The consequences of not stretching could be:

a) The muscle’s optimal resting length is compromised and thus the amount of force the muscle can generate is reduced.

b) Tight muscles can reduce the range of motion of a given joint and create a sustained stress on the tendons that connect the muscles to the bones. Over time the latter can create tendinitis, tendinosis, and tearing of the tendon.

c) Tight muscle tissue* (lengthened and shortened) can block (impinge) the nerves and blood vessels supplying a given muscle. The latter can compromise blood (oxygen) supply as well as removal of post workout waste products (carbon-dioxide etc.). Impingement of nerves can interfere with nerve signals going to and from the muscle, resulting in “strange” sensations as well as muscle weakness, twitches and cramps.

d) Tight muscles can prevent the joint from having “joint play,” which means a certain degree of movements in the joint. The bones in the joint socket can get jammed and over time this can “chew” up the cartilage resulting in arthritis, bone spurs, cysts, and so forth. The end result of all that is pain and reduced function.

*Both long and short muscle tissue can be perceived as tight, and while a shortened muscle needs to be stretched, a lengthened muscle doesn’t. I know this can be confusing, because how do you know which is what? The easy answer is to utilize dynamic stretching as it targets several muscles and the stretch is moving versus held. If, on the other hand, you use static stretching (see below), it is important to know which muscles need what in order to make the stretching efficient as well as not harmful.

If you feel any burning or pain, it is often rooted in the lengthened myofascial (muscle +fascia) tissue rather than the shortened one. So be aware if a well-meaning trainer stretch your painful area into further pain, or your massage therapist dig deep into the “tight” long tissue, as more bad than good can be happening to the myofascia.

 Types of Stretching;

Static Stretching (SS). This refers to a slow stretch where the end position is held for 15+ seconds. It has been the most popular stretching method for decades. However, it seems like SS has been overrated as far as benefits go, especially if it is used as a pre-workout stretch. Research, over the last decade, has started to show that SS prior to power events such as speed, agility and jumping, actually has a negative effect on performance rather than the wanted effect of priming the body for the upcoming movements. Based on that, we can assume that SS before exerting yourself is not the best preparation for your body, but SS can still be beneficial post workout when it is used for the muscles that are tight as in short.

Dynamic Stretching. As mentioned above, Dynamic Stretching is a moving, global and active stretch. An advanced version of this is referred to as;

3 Dimensional (3D) Dynamic Stretching. This again refers to stretching muscles while moving, but adds the component of moving the muscles in 3 planes of motion. The latter is relevant because we move in 3 planes of motions when we engage in most activities, be it walking, jumping, skating, throwing, kicking, skipping, dancing, swimming, crawling and more. In a 3D stretch the muscles being worked are taken into a lengthening position, close to, but not at, end range, and then you perform little movements in each plane of motion; sagittal, frontal and transverse.

In this type of active 3D stretch we are not only stretching the muscles, but also the fascia surrounding the muscles and the thickened part of the fascia that makes up the tendon. This is important as tendons, which connect muscles and bones, are responsible for storing and releasing energy, more so than the actual muscles, and the condition of the tendon can be the make or brake performance factor. As we age, the tendons tend to stiffen. It is therefore crucial to keep them compliant so that we can benefit from their elasticity, and prevent some of the stiffness and brittleness that comes with aging.

Fascial Stretching (FS). This stretch is quite similar to 3D Dynamic Stretching, but is a relatively new concept with more questions than answers. One version of FS is to put the muscles into a lengthened (eccentric) position, and then stretch further with small bouncing movements, but without the specific 3D component. The hypothesis is that the additional bounce will stretch the tendon and facial bag (the fascia encapsulating the muscle) and enhance the elastic properties of the fascia.

Another version of FS is to stretch along the myofascial lines that extend through the body, and hold it for a long time (from 30 seconds to 2-3 min). We have yet to know if that actually enhances or compromises the elasticity of the fascia. A long held stretch held at end range of motion might over-stretch the fascia to such an extent that it cannot recoil and the tissue then loses some elasticity and strength. In addition, you can also overstretch the ligamentous part of the fascia and thus possibly facilitate hypermobility and instability.

Passive or Assisted Stretching refers to having somebody (usually a trainer) stretch you. This can be fine if the trainer is acutely attuned to your body and to the barrier of the tissue that is being stretched; It should not be painful. I think the most effective form of assisted stretching is when utilizing one of several techniques where the client is actively participating by contracting specific muscles as directed by the educated stretcher.

In conclusion, I don’t think anybody has the recipe for the ultimate right way to stretch. What is proposed here is based on what I know today, and most likely in six months I will have a different take on it as new research asks me to rethink my current ideas.

In summary, the key elements for stretching based on my current knowledge is;

  • Stretching should never hurt beyond a little tug.
  • Pre-workout stretching needs to be dynamic and 3 dimensional and ideally tailored for the upcoming activity.
  • Post -workout can utilize static stretching for muscles that are shortened, but it should not be painful or held longer than 30 seconds.
  • Static stretching should only be applied to muscles that are shortened.
  • Assisted stretching should not be painful, and is most effective if utilizing muscle energy techniques correctly.
  • Stretching is only constructive when used consciously. Stretching a pulled or torn muscle will make it worse.
  • Nobody should claim to be “the” stretching expert as there are more questions than answers and not enough research to prove that one modality is “the right one.”

Stress, Brain and Body

As of 2016 most of you know that mental stress creates tension in the body, but do you really understand what the underlying mechanisms are. It is not just some ambiguous “mind-body thing,” but rather, a concrete physiological process. In other words, when people, be it a professional, a parent or a friend tell you “it is all in your head.” No, it is not.

Fascia (connective tissue) muscles and bones work together as one inseparable unit that is mutually interdependent with our brains (minds). The result of that is that any problem in the body affects the mind and vice versa. All kinds of stress (interpersonal conflicts, panic attacks, deadlines, fears of heights or snakes, etc.) turn on the sympathetic nervous system, which then prepares the body for fight or flight. The adrenaline pump is turned on and blood gets rerouted to skeletal muscles, heart and brain so you can run, fight and think while the adrenaline makes you numb to pain. If, in reality you are not actually fleeing or fighting, but just stressed out in your office or car, you are now stuck with the ready to go muscles and the alertness of the adrenaline, which can have manifold effect. Mentally, you might feel impatient, irritable or angry and you might pick a fight with somebody who doesn’t really deserve it. Physically, it can manifest as an overall feeling of unease, nausea, queasiness, shortness of breath, muscle-ache or a site of an old injury (painful hip or back, osteoarthritis, headache, scar tissue etc.) might flare up and cause pain.

The physical sensations caused by stress can be confusing as they don’t always present as direct cause and effect, meaning you might not feel much in the heat of the moment, but rather afterwards, when the urgency is over and the sympathetic nervous system has calmed down. The beauty of this design is that it lets us fight our battles without the interruption of pain, be it literally as a soldier in war, or the daily battles we all fight, ranging from passing exams to closing deals or dealing with insurance claims. A less active sympathetic nervous system implies that the adrenaline level subsides, and the no longer numb body can feel all sensations including pain.

The emerging physical sensations can be scary and your instinct might be to keep still, as in not moving the body, out of fear that you will make it worse. It is also common to hold your breath as a means to ease the pain. The counter-intuitive solution is to actually create movement, in whatever little pain-free way that you can, as motion is lotion. Similarly, the key is to breathe into the pain and/or tension to help it dissolve. The fascia literally contracts when the sympathetic nervous system is turned on, and with sustained stress it can become brittle and prone to micro-tears, pulls and strains. The movements along with the breath can help dial down the activity of the sympathetic nervous system. In addition, they soften the fascia, like oil on a rusty hinge, and through stimulation of the proprioceptors, movements can reduce the amount of pain signals reaching the brain.

What can you do to deal with stress?

While it is important to seek out professional help, it is also essential to develop tools to take care of yourself. The first step toward that is to cultivate awareness of what is happening with you. A way to obtain that is to simply ask;

“What is it that makes me feel the way I feel right now?”

By asking “what” versus “why” you are more likely to pinpoint the source of your immediate mental and physical experience.

The next question is;

“What do I need to do right now?”

The answers to this will probably be situational and vary from day to day. If your stress can be resolved by communication or other means, there is no better solution. But if resolving the problem is not within immediate reach, the stress might manifest in sync with the coping mechanisms (good or bad) that you have developed in your life. These can range from an urge to eat, drink, walk, run, scream, shop, cry, write, lift something heavy, punch something, hug a tree to have sex. As some of these might be counter productive or out of reach, you then have to ask yourself;

“What is possible to do right now?”

It might not be the best idea to start screaming or having sex in the office (but who knows), and it can be difficult (but not impossible) to hug a tree in New York City. But the one thing you can always do, regardless of where you are, is to acknowledge what you are feeling, as in for instance; “I feel really disrespected right now. ” You then take a deep breath, feel the ground under your feet and exhale. By reconnecting with your physical body through breath and gravity you can start to dissolve the intense energy, and access your rational brain and heart again. As you focus on the breath and the concrete sensation of your body, your sympathetic nervous system starts to calm down, which will help you get a different perspective on the situation. Now, taking a walk around the block might help calm you down further, and the Haagen-Dazs craving you felt a minute ago subsides.

In the long run, it is important that you build into your life “anti-stress” activities that work for you so that you can counteract the stress that life throws at you. This can help bring balance to your life, both within your body and in relation to your environment, and thus you are one step closer to staying healthy.