by Mark A. Jenkins, M.D.
Stretching is useful for both injury prevention and injury treatment. For
the purposes of this discussion I will concentrate on prevention. If done
properly, stretching increases flexibility and this directly translates
into reduced risk of injury. The reason is that a muscle/tendon group with
a greater range of motion passively, will be less likely to experience
tears when used actively. Stretching is also thought to improve recovery
and may enhance athletic performance. The latter has not been fully agreed
upon in the medical literature, but improved bio-mechanical efficiency has
been suggested as an explanation. Additionally, increased flexibility of
the neck, shoulders and upper back may improve respiratory function.
How to Stretch
There are three methods of stretching: static, ballistic, and
proprioceptive neuromuscular facilitation (PNF). Static is the method
recommended for the majority of athletes since it is the least likely to
cause injury. Ballistic (bouncing) and PNF stretching are probably best
reserved for a select few who are experienced with their use. To get the
most benefit from your static stretching routine while minimizing injury,
stretching should be done after warm-up exercises. The increased blood flow
to the muscles aids in the flexibility gains from stretching and is an
important component for injury prevention. Static stretching is done by
slowly moving a joint towards it's end-range of motion. A gentle "pulling"
sensation should be felt in the desired muscle. This position is then held
for 15 - 20 seconds. Do not stretch to the point of pain and do not bounce
since this may cause injury to the muscle. Within a session, each
subsequent stretch of a particular muscle group seems to give progressively
more flexibility. A set of 3 to 5 stretches is probably sufficient to get
the maximum out of the routine. Alternate between agonist and antagonist
muscle groups (e.g.. quadriceps and hamstrings), and alternate sides. It is
also a good idea to start with the neck and progress down to the feet. This
enables you to take advantage of gains in flexibility from the previously
stretched muscle groups. Stretching should also be done after the workout.
The post-workout stretch is thought to aid in recovery. Cold packs can be
applied to sore areas in those of you who are recovering from injuries.
Why am I so tight?
There is considerable variation in baseline flexibility between
individuals. There may also be variation within a given individual (e.g..
flexible shoulders but inflexible hips, or flexible right hamstring, but
tight, inflexible left hamstring). Genetics, injuries, and abnormal
biomechanics all play a role in these differences. One shouldn't try to
make big gains in flexibility in a short period of time. Stretching should
be done gradually over a long period of time and then maintained to prevent
slipping back towards inflexibility. Some people will enthusiastically
embark on a stretching program, but then quit two weeks later because they
haven't seen any benefit. Be patient and consistent. It takes time.
It is very important to relax during the stretching routine. It should not
be a rushed event. Don't think about your job and don't look at others
working out. The "I've got to hurry up and do this so I can go" attitude is
the wrong way to approach stretching. This is a time to slow your breathing
and to free your mind. Some athletes employ mental imagery while stretching
-- in a relaxed state, the athlete visualizes proper form in preparation
for training or competition.
If you have any back, neck, bone or joint problems consult your doctor
before beginning a stretching program. No stretching routine should be
painful. Pain indicates either incorrect technique or a medical problem. If
in doubt, ask a qualified health professional. I have a few examples of
some good stretches on my web page. Have fun and stay loose.