Why Stretching Sucks!
To Stretch or Not to Stretch?
By Chad S Brenzikofer & Donna Phelan
Quite simply, when asked by athletes if they should be stretching, my answer is NO. The primary reason is because you are doing it wrong, way wrong! The vast majority of athletes, and healthcare professionals that prescribe stretching, are often putting other structures at risk. When it comes to stretching, there are a lot of assumptions that have been embraced and prescribed without much evidence of benefit. For example, many have argued that stretching reduces the likelihood of injury, however, scientific literature fails to support this notion. Stretching has been touted as a very simple way for the athlete and nonathlete to “self-treat” nearly any and all orthopaedic problems.
Problem #1 With Stretching: The term itself refers to a need to make something longer.
The above statement is likely one of the biggest assumptions that sadly has become widely accepted as true. Not only is this assumption false, it’s a very dangerous one to make. Muscles are extensible, meaning they have a keen ability to elongate then return to their normal resting position. Stretching does not change the resting length, it simply trains the nervous system to allow more elongation to occur. A second key component to stretching is the sensation of stretch. The sensation of stretch is the nervous system’s protective mechanism to control elongation and protect the tissues. This sensation is critical to understand and must be handled with care.
Problem #2 With Stretching: “tight =’s short”
I am constantly hearing and reading people talk about how tight must equate to short, overworked muscles. Although this may very well be possible, the assumption is made without simple muscle testing to support the statement. A sensation of tightness doesn’t confirm short. In many cases, that perception of tightness is coming from muscles that are too “stretched” out and are working hard at the outer range of motion. In this scenario, the preferred treatment is often the same as if it were short, stretch! These muscles routinely pass length tests and stretching them will compound the problem.
Problem #3 With Stretching: It assumes joint mobility and neural mobility are normal.
Joint mobility should also be assessed when an athlete presents with muscle tightness. For example, are the hip flexors too tight or is a hypo-mobile joint restricting hip extension? Conversely, is the hip joint hyper-mobile and the hip flexors have increased tension in an effort to produce joint stability? Differential diagnosis is key to finding a solution and in either case, stretching is NOT the answer. This idea of differential diagnosis must then be taken one step further. In the example of restricted hip extension, once the hip joint has been ruled out, we still aren’t done! This only confirms the problem to be muscular, but fails to tell us which muscles are tight and limiting extension range. Is it the one-joint hip flexor Iliacus, or the two-joint Rectus Femoris, or to complicate things even further is it the TFL or ITband?
The nervous system, due to its amazing complexity, is likely most overlooked when talking about stretching. We need to respect the fact that manipulating the nervous system alone can yield massive improvement in muscle elongation abilities. In the presence of pain and pathology, extra care most certainly is warranted. However, even in a non-injury state, the nervous system must be evaluated effectively in order to understand its limitations and nature of response.
Problem #4 With Stretching: The dreaded Iliotibial band (ITB).
Let’s get right to the point… Energy storing fascias, like the ITB are NOT stretch sensitive, unless they are inflamed. This means that the silly ITB stretch you are doing where you feel a good stretch by your hip, is your hip being stretched not your ITB. The body has several energy storing fascias throughout the body but the ITB and Plantar Fascia are by far the most well-known. The Plantar fascia (PF), for example is “stretched” every step you take as the arch of the foot absorbs your body weight. This elongation of the PF, stores energy and when the foot is unloaded during gait, that energy is released recoiling the arch in preparation for shock absorption. Unless you have Plantar Fasciitis (inflammation of the PF), you are unaware of the PF stretching every step you take. The ITB works very similarly during gait to assist in leg swing during gait. These are well designed systems to reduce the energy demand of human activity.
Problem #5 With Stretching: It can hurt! And not where you think.
The concept of give and restriction is an easy to understand principle that allows us to better understand how stretching can lead to problems in neighboring structures. For example, a quad muscle that is too tight (restriction) can cause increased extension movement (give) in the lumbar spine eventually leading to pain in that structure. Conversely, a tight hamstring muscle (restriction) can cause increased flexion movement (give) in the lumbar spine or hip joint eventually causing flexion related back pain or possibly hip impingement.
Stretching can be a very powerful modality and should be treated with caution. It is very difficult to perform correctly and safely. The human machine has great adaptability, a good stretching program will yield rapid results. Stretching without progress is like interval training without improvement…disappointing, de-motivating, and pointless.