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It ‘just needs a stretch’…

By Dr Fauntine Lariba (Osteopath)

Stretching** a rigid or sore part of the body is quite an instinctive action. We can find ourselves stretching as a conscious behaviour or as a subconscious habit. However stretching is not always appropriate and can be counterproductive or even harmful at times. Below are four instances when stretching is not advised. Each scenario is also accompanied with a safe and conservative alternative. 

(**: There are various types of stretching techniques and for this article stretching is defined as a passive static stretch e.g. Tilting/side bending your head to the right hand side and holding to stretch along the left hand side of the neck. 

Stretching efficacy and efficiency is a highly debated topic that this article will not explore.)

1. Stretching an injured muscle within 0-72hrs of the injury

Muscle injury involves a degree of tearing of muscle fibres. Within the first few days the body is furiously trying to repair the damaged site. During this time the injured site is vulnerable, inflamed and does not need any further stress. 

Directly stretching an acutely injured muscle will delay the natural healing process by tearing more muscle fibres leading to further inflammation. Depending on the severity of the injury, the injured site may now require an even longer relative rest period. 

ALTERNATIVE:

Assuming that this injury doesn’t require surgical intervention and/or prolonged immobilisation, moving the injured muscle through a gentle pain free range will help with the healing process. It is very important that these movements are 100% pain free, no discomfort should be experienced. Acute injury management should be overseen by an Osteopath for optimal recovery.

2) Stretching a muscle near an injured structure within 0-72hrs of the injury 

Muscles can become tight as a protective strategy to support nearby injured tissue. For example, imagine that you tore a ligament in your knee. Your hamstrings (muscles on the back of the thighs) will probably tighten up to protect and stabilize the knee joint, and avoid further damage. If we were to stretch out hamstrings too soon the knee will no longer have that protection and limited range that the hamstrings were providing. Initially, whilst the knee ligaments are weakened and inflamed, we may need the hamstring tension for knee stability.  

ALTERNATIVE:

Please seek the advice of an Osteopath if you suspect you’ve injured any ligaments, bones, joints, tendons or other supportive structures. Your body will move and compensate in a variety of ways depending on the injury and your individual characteristics and a practitioner can provide a tailored management strategy.

3) Stretching an area that is hyper flexible (hypermobile) 

For a person who is hypermobile in (e.g.) their hamstrings are too loose, further stretching of this muscle group would be counterproductive. The hamstrings are already at or beyond an optimal length and the muscle’s resting tone (the degree of tension) is already low. These concepts can be best described using the analogy of a rope, a rope’s length is the muscle length and how much tension there is in the rope represents the muscle tone. So a rope can be pulled tight (high tone) or it can hang loosely (low tone). 

When the muscle has a low degree of tone (hypotonia), stretching this muscle would further reduce it’s tone. Someone with hypermobility usually requires more tone within their muscles rather than less in order to optimize the length/tension relationship necessary to stabilizing healthy joints. 

ALTERNATIVE: 

Strength training can be a good way to build muscle tone as this resistance training requires the muscles fibres to contract and resist gravity. In turn it “switches them on” and makes them more efficient and effective at supporting the joints they cross. 

4) Stretching a muscle which is tight and weak

Muscles can become tight in response to weakness as the fibres do not have the strength to complete a given task. This causes the muscles to respond by tightening to generate the force required to stabilise and protect the body. 

Thinking about our rope analogy, imagine 2 ropes, one thin rope with the capacity to hold 51kilos and a thick rope that could hold 200kilos. Imagine each rope is supporting a 50kg weight. The thin rope will be under a proportionally larger amount of stress in contrast to the thick rope which will only be supporting a quarter of its capacity.

If someone has tight hamstrings it may be because their hamstrings are weak and doing everything they can to support the weight of the body. The tone (tension) in this person’s hamstring muscles is high (hypertonic) because the muscle is constantly having to work close to its capacity just to sustain normal activity. The intense contractions become somewhat habitual, like an over caffeinated barista who can’t wind down even after their busy shift is over.

Stretching in this case is like our barista winding down from all of their coffee with a bottle of wine, it will relax them temporarily, but it is not addressing the cause of the stiffness in the first place.

ALTERNATIVE:

Strength training through a full range of motion would be helpful for building capacity. We could make our ‘rope’ thicker, building stronger hamstrings, or lighten the load on the hamstrings by coaxing the glutes into contributing. The latter is like hiring some more staff so that our barista does not feel so overworked that they need 7 long blacks to get through their shift. Either way our hamstring/rope/barista is less stressed.

Please note that strength training doesn’t inherently mean extreme heavy lifting and it should be scaled according to your level and goals. For some people strength training can simply be walking up stairs 2 at a time. As long as you are contracting muscles against progressively harder resistance, you will drive an increase in muscle strength. 

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October 8, 2020

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