Rehab 101

I haven’t had a patient yet that doesn’t know it is important to stretch. But not many know why, and it seems even fewer know how to stretch correctly. First, lets cover the why. Most soft tissue injuries I see in the clinic involve either hyper or hypomobility, meaning there is either excessive or restricted motion in a joint. This can be from something inside the joint like unusually lax ligaments (hypermobility) or something like scar tissue restricting the joint (hypomobility). The greater population though, especially men, have limited flexibility/mobility due to muscle restriction. And when you have limited mobility, it puts a greater strain on the muscle and surrounding muscles, which in turn eventually leads to injury through tendonitis or sprains and strains.

Before we get into the nuts and bolts of stretching, a quick example. Limited range of motion at your ankle, due to tightened lower leg muscles, means you have to compensate at your knee and hip to walk as normal as possible. This compensation puts extra, and unusual, stress on these joints and surrounding muscles. This is how you can end up with low back pain from a recurring ankle problem, by constantly favoring and putting strain on muscles that aren’t used to it.

There is much argument on stretching, how effective it is and when to do it. So check the links at the bottom for further reading if you’re so inclined. But basically, stretching can be broken down into dynamic or static. First, lets cover the better known, but poorly practiced, static stretching. Static stretching is what it sounds like, holding a stretch without movement. The typical runners stretch or hamstring stretch is usually the first to come to most people’s minds when they think of stretching. The key to a quality static stretch is to hold it for at least 30 seconds, as research shows that less than that doesn’t really have a lasting effect, and more than that doesn’t seem to help you any more. It is very important to not force a stretch and to not bounce. You can take the stretch a bit further if you feel the muscle relax, but again, don’t force it. For example, if you find yourself holding your breath, you’re trying too hard.

Dynamic stretching involves moving the muscle and joint through its full range of motion in a controlled manner. Examples of this are running with high knees or leg swings like you’re kicking a ball. This helps to bring blood flow to the area and prepare the muscle for activity. This is especially important in high intensity and high impact activities, but is a good practice for any sport. Many people do this without realizing it. For example, many people will swing their arm in a circle a few times before trying to throw something, or golfers will take a few “practice swings” at half speed, in essence performing a dynamic stretch.

While there is research going both ways, it seems the current consensus is to perform dynamic stretching before your activity and static stretching after your workout for the most benefit. Stretching is still very important where there is restricted motion, but just remember that you can overdo it or underdo it, so make sure you’re doing it right!

An article on dynamic and static stretching referencing several research articles - [url=http://www.elitesoccerconditioning.com/Stretching-Flexibility/DynamicStretchingvsStaticStretching.htm]Dynamic Stretching Vs. Static Stretching[/url]

A research article comparing dynamic and static stretching - [url=http://thesportjournal.org/article/effect-dynamic-versus-static-stretching-warm-hamstring-flexibility]Effect of dynamic versus static stretching in the warm-up on hamstring flexibility | The Sport Journal[/url]