Healthy Times
Your Seasonal Newsletter

Summer/Fall 2008

“To Stretch or Not to Stretch….”

That is a good question. Typically if we have a tight muscle the tendency is to try to stretch it out. Logically, that seems like a good idea. After all, we want the muscle to regain the elasticity of its normal resting state.

Unfortunately, as good as the intention is, the results from stretching are commonly short lived. In some cases stretching can even backfire resulting in an outright torn muscle. Ouch!

If in fact the muscle is tight from just being overworked such as from the first day in the garden or from a long hike, stretching can be all that is needed to ease the muscle. However, if you are not making progress with your stretching, you might want to rethink why the muscle has tightened up. Perhaps the muscle has reached its current state because it is weak.

Every tissue including muscle has a capacity or threshold and once reached will tighten up. This is a guarding mechanism and when the muscle is in this protective state it does not want to be stretched.

Yes, the goal is to get that tight muscle to let go, but when it is due to weakness, an effective and safer approach is to strengthen it first. In doing just this you might find your stiffness disappears and the flexibility improved.

Weak tight muscles can occur anywhere in the body. Fallen foot arches, knocked knees, stooped back, rounded shoulders and forward head carriage are typically due to this.

Now what about being in pain and stretching? As much as stretching is a risky business when just inflexibility is noted, it is extremely high risk for further injury when performed as self treatment for pain. Listen to your body. Never stretch when experiencing pain.

Tight and weak postural muscles allowed to progress can lead to numerous body pains including common forms of back pain and sciatica. In cases like these it is strongly advised not to stretch as this is likely to worsen the condition. When there is weakness typically recovery is sped up by simply not stretching.

I am not advocating inactivity. I am simply advising that stretching be avoided and that as soon as can be achieved without pain to begin strengthening. Sometimes this can be started immediately as even while in pain it is not unusual to find certain body movements and positions that ease the pain. If this is the case almost always strengthening can be safely started. Walking, again as pain dictates, is typically good to do as well.

Depending on the condition these exercises may be quite different from one person to the next and thus must be tailored to the individual. This is one of the key roles of the therapist in really getting on top of the problem, especially in long standing ones. The initial stage of treatment is the most delicate in that the window for exercising pain free and safely may be very narrow. As long as the individual experiences times of no, or near no pain, the likelihood of making progress is good.

Other examples of weak tight muscles that present as pain are many of the repetitive strain injuries that affect runners or triathletes. In fact this is why 50% of runners are not running. These running, cycling and swimming related injuries include common forms of knee, hip, shoulder, shin and foot pain. Yes, as fit as ironman athletes are, they commonly have injuries due to specific weaknesses.

Experiencing results from strengthening is not noticed immediately but usually starts to be appreciated in a couple of weeks. What can be noticed sometimes very quickly is reduced pain. This reduced pain is not the result of improved muscle strength but rather from removing one of the causes - stretching. An example of a high risk stretch is the forward bend done for back pain (i.e. bending forward at the waist while standing or seated).

In addition to recovery from these types of injuries is the realization of being able to more easily carry out daily activities. This might be noticed in taking out the garbage, getting groceries into or out of the car, or by simply just getting out of a chair. For the athlete improved speed, power and strength are typically experienced as a bonus from strengthening these weak links.

The good news is that these injuries are largely avoidable if the weak areas are strengthened.

This general information by no means negates the need of seeking the appropriate health care when experiencing pain (e.g. medical doctor, chiropractor, physiotherapist…). It is very important to diagnose the specific problem so as to help ensure the appropriate care is given.

So where does stretching come in?
When done for performance and the tissue is healthy it seems stretching can enhance the outcome be it speed for sprinting or power for weightlifting.

Oddly in the world of stretching evidence is weak at best. That said, it is hard to imagine that stretching does not plays a significant role when it comes down to sports performance. Take Bruce Lee’s one-inch punch or Donavan Bailey in the 100 m sprint. Its difficult to believe that some of that speed and power has not resulted from the stretching they incorporated into their training.

Another strong link to power is the flexibility of power lifters. Power lifters are 2nd only to gymnasts when it comes to flexibility. And certainly there are poses in yoga that exhibit great feats of strength.

Unless you have a good background in exercise physiology I recommend having a session or two with a knowledgeable professional to help get you started with proper strengthening exercises which have a low risk high benefit ratio. “It is not practice that necessarily makes perfect, but rather perfect practice that makes perfect”.

Listen to your body.

Be safe! There should be no pain while stretching or strengthening.

Quiz

1. When is the best time to lift regarding back safety?
   a) first thing in the morning when you are fully rested.
   b) after being up for at least two hours and feel warmed up from being active like walking.
   c) after lunch when you have been taking a least a 45 minute rest with sitting
   d) it does not matter.


2. Are jaw problems linked with neck problems, and if so how strong is this link?
   a) yes, 70%
   b) there is no connection
   c) yes, 25%
   d) yes, 50%


3. Treatment of pain in the bottom of the foot, a condition called plantar fasciitis, is best treated by?
   a) soft tissue therapy on the bottom of the foot
   b) strengthening exercises for the foot and hip
   c) soft tissue therapy to the leg, thigh and hip
   d) mobilization/adjustments to restricted joints anywhere from the foot to the low back.
   e) all of the above

Health Quiz Answers:
1. b. it takes up to 2 hours after getting out of bed before the discs in the lower back have lost all the fluid that they are going to loose in a day. This leaves the discs less vulnerable to damaging loads such as from improper lifting. It is also important that the muscles are 'warmed up' prior to lifting. A walk or an easy jog are good ways to achieve this.
2. a. research shows that 70% of jaw problems are related to neck problems. From a treatment standpoint this is important as if only the jaw or the neck is treated and both are involved results will be limited.
3. e. it is common especially in long standing foot problems that treatment include not just the foot but the entire lower extremity and lower back. Plantar fasciitis is almost always a result of weak muscles in the hip which increases the load on the foot beyond what it can handle.

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