STRETCHING AND FLEXIBILITY

This Form of Exercise Prevents Injury, Reduces Chronic Pain, and Improves Mobility

FOCUS ON FITNESS

The key components of fitness are cardiovascular condition­ing, muscular strength, and flexibility. Unfortunately, flexibility often is neglected in favor of more cardio or greater strength. Clients skip stretching because they believe flexibility isn’t a good workout or that it’s an inherent trait—someone either is naturally flexible or they’re
tight. But this isn’t true.

Benefits of a Flexible Body

Clients can improve flexibility by training, subsequently pre­venting injuries while doing aerobic and strength workouts. Maintaining flexibility throughout life helps aging adults func­tion better and prevent falls. Flexibility is important for ath­letes and advanced exercisers who may be at higher risk of exercise-related injuries. Becoming more flexible can improve performance and help relieve and prevent chronic pain associ­ated with poor posture and a sedentary lifestyle. In fact, flexibil­ity training is a primary component during physical therapy to rehabilitate musculoskeletal injuries.

Flexibility not only includes muscles but also joints. It’s defined as the ability to move joints effectively through their full range of motion, and it’s related to the elasticity, or suppleness, of muscle tissue. Because muscles are attached to joints by lig­aments and tendons, flexible muscles also affect their proper functioning and can decrease the risk of injuries to ligaments, tendons, and joints.

Stretching exercises must be performed regularly to main­tain and improve flexibility. Muscles become tight when they shorten from postural habits or injury, spasms, or contraction. Most of us have a muscular imbalance due to one side of the body being dominant during activity. This imbalance frequently manifests as muscle tightness or inflexibility.

Stretching Exercises

The following stretching techniques may be used to improve flexibility:

• Static stretching: This is the most common in which a muscle is moved into a position that creates tension and a stretching sensation and is then held.

• Dynamic stretching: This involves moving a limb repetitively, with control, through its full range of motion. It’s typically used as part of a warm-up before workouts and athletic activities.

• Precontraction or proprioceptive neu­romuscular facilitation stretching: Using this technique, the muscle is contracted, held, and then relaxed. This type of stretch­ing generally involves a therapist’s or part­ner’s assistance or the use of a strap or resistance band.

Note that ballistic stretching, a stretching technique that involves rapid bouncing movements at the end range of motion of a joint or muscle, is considered risky and is no longer recommended.

Guidelines from fitness organizations recommend per­forming stretching exercises at least three times per week after warming up the body. Static stretches targeting the major muscle and joint/tendon groups should be held in a position where mild discomfort is felt for 15 to 30 seconds. Eventually, the stretch can be held for as long as 60 seconds. Each stretch should be repeated two to four times. These recommenda­tions are for healthy clients. Those with movement limitations and beginning exercisers may need modifications; athletes and advanced exercisers may need options for sport-specific flex­ibility improvements.

The advice “stretch before every workout” is considered outdated. Numerous studies have found that stretching before a workout doesn’t prevent injury during the workout or neces­sarily warm up the muscles to be worked. Light activity mim­icking the more intense movements during the workout (eg, walking before running) has been shown to be more effective.

Clients can perform dynamic stretching movements before a workout in combination with activity that warms up the mus­cles, such as standing alternating knee lifts, half squats, arm circles, and torso twists. The optimal time to stretch to achieve gains in flexibility is after the body is warmed up, such as at the end of a cardiovascular workout. Individuals can integrate stretching in between strength exercises for each muscle group as well as at the end of the work­out. Clients also can perform stretching exercises by themselves simply to relieve aches or tightness throughout the work­day as a break from sitting or standing in one position too long or at the end of a long day to promote relaxation.

Built-In Flexibility Exercises

Your clients may ask about what types of stretching exercises they should do and what exercises count as flexibility training. Due to the increasing popular­ity of mind-body workouts, your clients already may be satisfying the flexibil­ity component of fitness training. Both Pilates and yoga contribute to improved flexibility and have the added benefit of improving muscular strength in the same exercise session. Many styles of mar­tial arts involve movements that improve flexibility as do the slower-paced tai chi and qigong. However, even if clients do martial arts, Pilates, and/or yoga mul­tiple times per week, they should still stretch after or during other types of workouts, such as cardiovascular condi­tioning and strength training.

Components of Flexibility Training

In general, flexibility training should include all major muscle groups in the upper and lower body. Depending on your clients’ overall fitness level and daily activities, flexibility exercises can focus on specific anatomic areas to pro­vide more benefit. For example, clients who do computer work or sit at a desk all day should pay special attention to stretching their neck, shoulders, back, and hamstring muscles because the neck and back muscles tighten up due to the common postural misalignment that occurs when typing and sitting for long periods of time (ie, hunching).

Clients with jobs involving the pro­longed use of forearms and hands in one position (eg, typing, sewing) or strength movements (eg, hammering, assembly work) may benefit from frequent daily stretches for the forearms, shoulders, neck, hands, and wrists.

Tight hamstring muscles contribute to lower back pain, a common complaint for many clients. So stretching the back muscles as well as these large muscles in the backs of the thighs will help allevi­ate back pain.

Athletic clients should consider adding sport-specific flexibility exercises to their stretching regimen. For instance, golf­ers should focus on flexibility of the hips and shoulders to improve golf swing. Runners and cyclists can emphasize hip, thigh, and calf flexibility to prevent muscle pulls in the lower body.

Resources for Clients

Clients can view images and videos of basic stretching exercises by visiting the Mayo Clinic’s website (www.mayoclinic.com). Click on “Health Informa­tion,” “Healthy Lifestyle,” “Fitness,” then “Multimedia.”

A recent trend in flexibility training is to use foam rollers for myofascial release, especially for clients with musculoskel­etal pain or injury. A cylindrical foam roller is used in conjunction with a per­son’s body weight to perform self-mas­sage, which breaks down soft tissue adhesions, stretches muscles and ten­dons, and increases blood circulation to muscle tissue. Foam rollers also can be used as a prop for yoga poses and Pilates movements that improve flexibility. 

                                                                                                                             By Jennifer Van Pelt, MA