Sometimes it just feels so good to stretch!!!!!
As a sports medicine practice with DPT's and DO's, we get asked a lot of questions about stretching. Usually, people come to us for advice on different ways to stretch before or after a workout. Most of the time its because people feel tightness or pain and feel as though stretching would be the right way to approach their perceived tightness/pain.
We also get dozens of questions from people asking for beneficial stretches for a "pulled muscle" or a "slight muscle strain."
The purpose of this article is to discuss some of the "do's and don'ts" of stretching and hopefully provide some clarity on the concept of stretching.
We think its important to address a couple of things:
There are still a lot of advancements to be made when it comes to researching stretching. Multiple theories have been proposed to explain stretching. These are highlighted in this article by Weppler 2010. https://pubmed.ncbi.nlm.nih.gov/20075147/
"The sensory theory" is probably the best explanation of stretching we have to date, based on the studies that have been conducted. The Weppler study mentioned above explained this theory well. Another randomized controlled study published in the Journal of Clinical Biomechanics highlighted this same concept as well. https://pubmed.ncbi.nlm.nih.gov/24856792/
So let's explain the sensory theory real quick before we dive into the Do's and Dont's of stretching.
Sensory Theory = The sensory theory states that the changes in the range of motion that we experience during stretching are due to changes in sensation and perception when we stretch.
So let's give a quick representation of what this means.
→ My body perceives my hamstrings are tight → I stretch my hamstrings
→ My body now feels as though I can get to this new range of motion and feel less "tightness"
Hopefully, that makes sense. The key point is that it has yet to be demonstrated in the research with absolute certainty that we are increasing the length of our muscles, making them longer, or "stretching them out." It might be that it is just a sensation modification. Also, the effects of stretching are short-lived! These are highlighted in the article mentioned above.
Now that we have addressed some of the research and described the sensory theory it's important to discuss that there are different types of stretching... Static vs Dynamic
Static stretching = when you take a muscle to its maximum extensibility and hold it that position for a period of time.
→ Based on the research we recommend at least 60 seconds for a few repetitions and move on!
Dynamic stretching = when you incorporate movement to the stretch by taking the muscle to its length capacity and then coming out of that position for a number of repetitions.
→ Same thing, 30 60 seconds and incorporate movements you will likely perform during your next activity.
Here are two examples of static vs dynamic stretch
Lastly, let's highlight some key factors:
1. Duration is important
2. Timing is important
3. Type of stretching is important Static vs Dynamic)
These three key factors will be discussed when answering some of the common questions we get from patients below!
Incorporate dynamic stretches and movement patterns that mimic the movements you are about to perform during the workout. Dynamic stretches are great because they warm up the muscle and primes our nervous system before exercise. Too often we see people spending a lot of time static stretching before exercise. We usually recommend to statically stretch after exercising as part of a cool down to decrease the perceived "stiffness" we feel after working out. Another great option is doing your stretching not after, but hours after your workout. (ex. run/workout in morning and stretch at night).
TYPE of STRETCH MATTERS - Static vs Dynamic
It is important to note that static stretching is often indicated for a patient. Especially when we start to look at previous injuries, surgeries, and orthopedic conditions that may lead to decreased mobility over time. But remember, no need to aggressively hold a static stretch with the intent of elongating tissue. Rather, just try to gently stretch with the purpose of reducing muscle tone and perceived stiffness.
30-60 seconds for 3-5 repetitions
The reality is... you might not want to be stretching a pulled muscle. Let's think about it... if there is damage to muscle fibers because you "pulled it", then why would we want to stretch your muscle even more with hopes of making it feel better? The reality is you might end up making it worse.
This is exactly why we recommend you consult a rehab specialist with extensive knowledge and education on tissue healing. This is one of the BIGGEST differences in between a Physical Therapist and a personal trainer, chiropractor or massage therapist. Our job is to take you through a systematic progression of interventions/exercises that are going to facilitate healing within the muscle, while also protecting the tissue from further injury.
The ultimate goal is homeostasis, we want to help create the best environment for the tissue to heal itself. Other alternatives for muscle tears in combination with physical rehabilitation can accelerate this process such as prolotherapy, PRP and stem cell therapy. (more on this on a later blog post) Other interventions like manipulation and massage are especially important in the overall plan to recovery.
This is a tough one. Because pain is a hard concept to explain sometimes to patients. The reality is that pain can be due to mechanical damage or no damage at all. If you feel pain, it doesn't necessarily mean you are injured. My advice would be to visit a rehab specialist that can properly examine you and determine the course of action. This exactly why we have strategy calls for our clients to determine the best course of action for each person.
We hope this article has served its purpose in answering some of the common questions we get from patients!
We have linked a couple of articles if you are interested in geeking out about stretching.
Finally, we at Alliance Regen & Rehab would like to take this moment to thank Dennis Colón, DPT, Owner of Performance Based Rehab for being the lead writer of this blog. During his time as an intern at our clinic, Dennis was able to write this blog and be a huge help in helping Alliance Regen and Rehab grow to what it is today. Go and give him a follow on Facebook and Instagram and also check out his website above for more blogs and content!
To Stretch or Not to Stretch: The Role of Stretching in Injury Prevention and Performance https://pubmed.ncbi.nlm.nih.gov/20030776/
Negative Effect of Static Stretching Restored When Combined With a Sport Specific Warm-Up Component https://pubmed.ncbi.nlm.nih.gov/18768355/
Effect of Warm-Ups Involving Static or Dynamic Stretching on Agility, Sprinting, and Jumping Performance in Trained Individuals https://pubmed.ncbi.nlm.nih.gov/19855310/
Ask us about our Alliance Rx Method Co-Evaluation