Panel Discussion: Why Stretch?
There have been debates in the fitness community over why, what, when and how to stretch. Let's take a look at some of the fundamental reasons for this modality, and then consider various techniques.
Moderated by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS
This Panel Discussion was originally posted on my facebook page - https://www.facebook.com/brent.brookbush - on March, 14th 2010
Shawn Fears
This should be a good discussion. I think there are 3 main reasons for stretching; prehab, rehab, and maintenance. When to stretch is mode and reason specific. The how to stretch I think is the most important aspect of this topic. Is it necessary to stretch? For most people the answer is yes, to varying degrees. This is a very general topic Brent, maybe we could narrow it down and tackle different aspects of stretching one at a time.
How about starting with a list of modalities? Static, dynamic, active, active assisted, passive, passive facilitated, antagonistic contract relax, and agonist contract relax…did I miss any? See More
Brent Brookbush
Hey Shawn, this is a very broad topic indeed. Taking this into consideration lets discuss the various modalities. Generally, we can categorize stretching into static, active, dynamic and PNF. We could also consider static release techniques as part of our stretching continuum. One point that I have made in previous courses: These different stretching techniques elicit different effects on the human movement system, that is your body does not adapt to each technique in the same manner. One mistake that has been made by some professionals is an attempt to replace one technique with another. For example, research has been fairly inconclusive on the efficacy of active isolated stretching. This is not to say that active isolated stretching is less effective, but it is not the most effective technique for every goal. If we are trying to create relatively permanent length change in a muscle that has adaptively shortened than we would be better served by using static release techniques and static or PNF stretching to return the muscle and connective tissue to optimal length. We can then progress to active techniques to further decrease muscle spindle over-activity (via reciprocal inhibition), increase strength of antagonists at our new end range, and improve neurodynamic extensibility.
Kelli Patch March 14 at 11:16am:
Great topic Brent, what is your opinion on Bikram Yoga for stretching part of weekly workout added with a couple days of cardio?
Brent Brookbush March 14 at 12:38pm:
I would say that twice per week is optimal for seeing continued results in any program. So if you can… add another day of yoga. Second, no need for the heat. Research has shown no increase in gains made from warming up, or adding heat to stretching.
Mikal Payne March 15 at 7:48am:
This is good to know. One Myth Down. 999 left to go.
Shawn Fears March 14 at 1:58pm
Ok so let’s dive into passive static stretching. I agree that this is the best modality, but most people do it completely wrong. This is the most common form of stretching and the most misunderstood as well. When we hear instructions for static stretching a common phrase for instruction is "stretch to the point of discomfort". Here is where we run into the mentality of no pain no gain.
A stretch is meant to relax the muscle not activate it. When most people stretch to the point of discomfort it is too far, and the muscle is unable to relax. For this reason I think beginners need to be facilitated in their passive stretching and coached in their breathing till they understand what stretching is. Having somebody move a person through the stretch and show them the point of tension, then have them breath deeper into the stretch will give them a better feedback as to how to stretch and what it feels like when a muscle releases.
How many times per week is another point of contention that I would like to get further into as well.
I have read that 3 times per week, with 3 sets of 30 seconds per stretch has elicited on average a 20% increase in range of motion in 6 weeks. I have also read that it takes about an hour for a muscle to return to its pre-stretched length and have had physical therapists prescribe to me to stretch every hour on the hour for best results. There seems to be quite a bit of difference in the studies out there and also between professionals in the field.
If I had the time I would stretch every hour as this has been the most productive for me in specific corrections, but if I only have to stretch 3 time per week to get a 20% increase then there is a higher return for the time put in it would seem. Also in the study with 20% increase in 6 weeks it was a stretch only study and didn't include any type of resistance training so its external validity can be questioned as far as resistance training clients are concerned.
Mikal Payne March 15 at 7:48am
Every hour on the hour? Rehab.? Seems a bit much to me? Looks like another case of taking a good thing and making it boring. I think I am off point but my 2 cents.
Well, I do try to include corrective stretching in my cool-down, I am confused about stretching as a warm-up. You read “Yes, it's OK”, and then another study that says, “No, never stretch cold.” I tend save it to the end of a class or the end of my hour/hour and 1/2 or whatever with client, I also tend to air on the side of caution. I will add corrective stretch exercise to a work-out (rotator cuff, lower back pain) to help the client, I have also continued with corrective exercises when a Physical Therapist has recommended me to a client and has given them an exercise program to follow. See More
Brent Brookbush March 15 at 3:54pm
A couple of points:
One, somewhere I have a study that shows no benefit gained from stretching more than 2 times per day. Second, if stretching is limited to short/hypertonic musculature there is evidence to support an increase in performance when done pre-activity - this includes static stretching. Third, If you are stretching something other short/hypertonic musculature you are likely wasting your time. Research has shown very little increase in range of motion gained in muscles that already exhibit normal or beyond normal extensibility are stretched.
Brent Brookbush March 15 at 4:32pm
Response to an e-mail - resources on flexibility: Fowles, Alter & Moore are some researchers to try and look up. Text books by Alter, Chaitow, Barnes, Neuman, Saladin, Sahrman, and Clark are also great references on the topic. My suggestion is to start with some of the textbooks mentioned and then slowly add the research listed in those bibliographies to your reading. One book at a time.
Mikal Payne March 15 at 4:45pm: Are they recent?
Brent Brookbush March 15 at 4:47pm:
The texts and research I mentioned are very current. Second editions of Alter and Neumann’s text were just published in the last 2 years. Travell and Simmons is another great resource and was updated in the last 10 years for sure.
Shawn Fears March 15 at 4:51pm:
As for the twice per day statement Brent, my case was extreme as I was unable to walk for 6 months and yes I continued to make tremendous leaps in function with stretching every hour on the hour for 6 weeks this was a combination of static,… active Isolated, and Contract/relax. The whole routine was for my hips and low back and took about 15 min. We then progressed to strength training the gain in range of motion. Overall I was in rehab for 3 months. Studies have shown that the inhibition time on a muscle to return to its original length is around 60 min, this coincides with maximal strength inhibition after stretching.
Shawn Fears I took the CEC two years ago, to look at the dates I would have to be home. They also point out how hard it is to do a reproducible study on flexibility because of the many factors that go into flexibility.
Mikal Payne March 15 at 5:00pm:
That sounds very extreme even in a rehab situation.
Shawn Fears
I had 5 degrees hip flexion in a straight leg raise lying supine…after 6 weeks I had 90 degrees. I couldn't even lift my leg without sciatic pain when I started…no pain at all when I was done. What you consider stretching and what I consider stretching sound like two different things.
Stretching to me is the relaxing of the sarcomere to create length. I had to learn to relax injured and in pain in order to actually do what most people consider "stretching" I learned to NEVER force a stretch in any kind of way but to let the muscles relax naturally. This was a big breakthrough in what I considered stretching and why I posted what I did earlier about the misconception about static stretching that most people have. If you are in a stretch and you never feel the muscle release at least twice you are forcing the stretch instead of letting it happen this activates the muscle spindles and creates activation instead of inhibition. I don’t' time my stretches either, I base each set upon two releases of the muscle and do that for 3 sets.
I don't like the use of the word stretch in flexibility training because just the word alone makes me think of forcibly elongating something. It should be muscle relaxation training for flexibility instead.
Shawn Fears March 16 at 12:49pm:
Hey Brent, Do you think the body adapt to a specific of stretching techniques and then plateaus? Is there a need to progress and change stretching modalities to continue seeing change or are modalities specific to types of exercise?