Stretching 

Over time, an accumulation of physical stress can begin to take a toll on our muscles and joints. Overuse of muscles can cause them to become chronically tight and sore; and compression and torque forces on the joints can lead to joint dysfunction and pain.  In turn, joint pain can lead to further tightening of the muscles via protective muscle splinting and the pain-spasm-pain cycle.  Tight muscles can then further limit joint motion, leading to fascial adhesions.  This cycle, once begun, can be difficult to stop.

The key is to be proactive and practice self-care so that we prevent problems from occurring in the first place. One aspect of self-care is to have good posture and body mechanics while working. However, even the best body mechanics do not eliminate physical stress to the body; they simply minimize it.  It is also wise to take regular breaks to give your body time to rest and heal. However, as important as these things are, perhaps no aspect of self-care is more important than regular stretching.

Stretching is very simple.  The essence of stretching is that it lengthens soft tissues.  Taut soft tissues limit motion, whether they are tight muscles or accumulated fascial adhesions.  Stretching can help to reverse this process.  Even better, stretching on a regular basis can prevent soft tissues from becoming taut in the first place.

There are many benefits to be gained from a regular stretching routine:

• Increased flexibility and range of motion
• Improved circulation and nerve function
• Pain relief
• Stress relief
• Relaxation
• Improved posture
• Injury prevention
• Preventing Delayed Onset Muscle Soreness (DOMS)- pain and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise – usually 24 to 72 hours after the exercise.
• Improved sports performance

When and How to Stretch

There are a number of choices when it comes to stretching.  Perhaps the first question is: When should we stretch?  Interestingly, the answer to this question largely depends on what type of stretching is done.  Stretching can be broadly divided into two main types: classic static and dynamic stretching.

Static stretching, as its name implies, involves a stretching position that is statically held for a prolonged period of time, usually between 30 and 60 seconds (although some advocates recommend holding the stretch for several minutes). 

Dynamic stretching, on the other hand, is a more movement-oriented style of stretching in which the position of the stretch is held for only a very short period of time, usually between one and three seconds.  A greater number of repetitions, usually between five and ten, are performed.  Also known as mobilization stretching, dynamic stretching is actually as much a warm-up activity for the body as a stretch.

Returning to our question of when to stretch, conventional wisdom now states that classic static stretching should be done only after the tissues of the body are first warmed up by physical movement.  We should statically stretch after engaging in some physical activity, such as exercise.  Alternately, we could statically stretch after warming the body via the use of heat, perhaps a shower, bath or even a heating pad.

Static stretching is best performed after physical activity, and dynamic stretching is best done as a combination warm-up mobilization and stretch before activity.  The movement aspect of dynamic stretching better increases local blood circulation and moves synovial fluid, aiding in better nutrition to the joint surfaces.  Also, the soft tissues on the other side of the joint are lengthened and therefore stretched.

How Hard Should We Stretch?

Too gentle and nothing is accomplished; too strong and the muscle will respond with a muscle spindle stretch reflex that causes a spasm.  Muscle spindle stretch reflexes are triggered by a stretch that is either too strong or too fast.  Therefore, the force of a stretch needs to be just right, and it needs to be done slowly.  It is also very important to breathe while stretching and not hold your breath.
When stretching a muscle, bring the muscle to the point of tension where it just starts to resist the stretch; then the muscle should be slowly stretched, just slightly longer than the point where tissue tension was reached.

How Much Time Should We Spend Stretching?

How much time we spend stretching is largely determined by our schedule and how much of our body we want to stretch.  Engaging in a stretching program for the entire body is optimal.  If time is tight, however, there are certain key regions of the body that tend to be physically stressed more than the others.  These regions are the shoulders, forearms, back and neck muscles of the spine, and the hip flexors, hamstrings and calves.

The figures below demonstrate a stretch for each of these key regions.  They should be performed equally on both sides.  If we assume that a stretch of a muscle/muscle group typically takes between 30 and 60 seconds, then the following routine should require approximately 10–15 minutes.  Of course, if one of these specific regions is tighter than the rest, then it may be desirable to stretch that region more often than the other regions.  If a stretch is performed correctly—not done too forcefully, too fast, and does not cause pain—then it can be repeated during the day as often as needed.

Upper extremity:  Poor posture often results in a rounded shoulder posture.  For this reason, it is especially important to address the musculature of this region.  Figures 1-5 demonstrate stretches for the upper extremity.

Spine: Because we are so often posturally inclined forward, the back muscles of our trunk and neck are especially used/overused to maintain this imbalanced posture.  Therefore it is important to stretch these muscle groups.  If we lean to the side when working, the lateral (side) trunk musculature should also be stretched. Figures 6–8 demonstrate stretches for the trunk and neck.

Lower extremity:  Much of the force that we create during everyday activities can and should be generated from the lower extremities. It is especially important to stretch the gluteal, hip flexor, hamstring, and gastrocnemius/ soleus (calves) groups.  Figures 9–12 demonstrate stretches for these groups of the lower extremity.

12 Stretches for Better Self-Care
Illustrations © Mosby/The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns and Stretching

The following stretches target the commonly affected areas- upper body, spine and lower body.Figures 1-5 demonstrate stretches for the upper extremity; figures 6–8 for the trunk and neck; figures 9–12 for these groups of the lower extremity.


Figure 1
demonstrates a stretch of the (chest and frontal shoulder) pectoral and anterior deltoid regions. Place the forearm against a door frame and lean into the doorway. Note: The arm is shown abducted to ninety degrees (i.e., horizontal); it could be abducted more or less to better stretch lower or upper fibers of the region respectively.

Figure 2 demonstrates a stretch of the posterior (back of the) shoulder and shoulder girdle region. The arm is moved or brought forward and across the chest. Changing the height of the arm can alter which fibers are optimally stretched.

Figure 3 demonstrates a stretch of the muscles of the (shoulder) glenohumeral joint. A towel is used to facilitate this stretch. Pulling upward with the left hand stretches the right shoulder region; pulling downward with the right hand stretches the left shoulder region.

Figure 4 demonstrates stretches of the muscles of the wrist and fingers. A, flexors; B, extensors. Note: Extreme caution should be used when performing wrist joint stretches because of the increased compression force that is placed into the carpal tunnel. If these stretches cause any pain or discomfort in the wrist, they should be discontinued. The muscles of the forearm and hand that are involved in these stretches are easily accessible and can be self-massaged instead.

Figure 5 demonstrates a stretch of the flexors and adductors of the thumb.

Figure 6 demonstrates two stretches for the extensor muscles of the posterior neck. Both stretches involve flexing and laterally flexing the neck and head. In A, ipsilateral(same-sided) rotation is added; in B, contralateral (opposite-sided) rotation is added.

Figure 7 demonstrates a stretch for the extensor muscles of the posterior trunk. Both knees are drawn into the chest. To increase the stretch for the extensor muscles on one side, shifting the thighs toward the opposite side can be added to the stretch.

Figure 8 demonstrates a stretch for the lateral trunk.

Figure 9 demonstrates a stretch for the gluteal region. The thigh is drawn up and across the body. Varying the exact angle of the thigh can optimally stretch different fibers of the gluteal region.

Figure 10 demonstrates a stretch for the hip flexor group. Note: When performing this stretch, it is important to keep the trunk vertical.

Figure 11 demonstrates a stretch for the hamstring group. With the knee joint fully extended (straightened), rock forward with the pelvis (the spine does not need to bend).

Figure 12 demonstrates a stretch for the plantarflexors (calves) of the posterior leg. A, for the gastrocnemius, the knee joint must be extended. B, for the soleus, the knee joint should be flexed. For both muscles, the heel must remain flat on the floor.

 

When stretching a muscle, bring the muscle to the point of tension where it just starts to resist the stretch. Then the muscle should be slowly stretched, just slightly longer than the point where tissue tension was reached.

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