Stretching has become so fashionable with yoga, yoga wear products and social feeds keeping us fit ‘n healthy. But stretching goes far beyond trends. It keeps muscle tissue pliable and nutrient / oxygen rich, helps to release tension from holding patterns as well as prevent adhesions in our connective tissue which can lead to injury. It can increase our body awareness and requires, generally, that we slow down. Occasionally, it may induce us to slow our breathing, which in its own right also has many physiological benefits. For some, stretching is a chore, it feels hard to do because initially, it feels physically unpleasant, even painful. For others, stretching seems more natural, feels easy, requiring little attention and little effort. For these people, however, stretching is not the best prescription or recommended in an exercise program. The reason stretching is problematic has to do with joint laxity. The same folks who are flexible often lack the awareness of going beyond a natural range of motion, often gifted with incredible range.
Stretching is found to reduce injury and enhance sports performance. The American Council of Sports Medicine in general recommends static stretching after a warm up to increase range of motion (ROM) in the synovial joints. Increasing ROM is key to avoiding muscle imbalance. A research in the International Journal of Sports Physical Therapy (2012) defines stretching ‘…[as] generally focus[ing] on increasing the length of a musculotendinous unit, in essence increasing the distance between a muscle’s origin and insertion’. As you guessed, stretching the muscle at its origin/insertion is work! And since increasing ROM is key to avoiding muscle imbalance, it is also necessary in order to address biomechanical inefficiency. For example, did you know that tight hamstrings can lead to a posteriorly tilted pelvis? I will be discussing this at length in a future post but this quite common muscle pattern can contribute to a “tucked bum” position and eventually cause a combination of back strain and weak abdominals. Restoring alignment by stretching a muscle is a key feature in Pilates and other treatment modalities. However, stretching is not for everybody. Stretching is just one piece of the tensegrity puzzle. Let’s look at why.
For some individuals, stretching just happens more naturally. Looking closely at these “flexible types” in particular, stretching is not the issue, joint laxicity is. Extension, from the latin term ‘extendere’ means “to pull apart”. Extension of a joint generally means straightening it. The term hyper mobility or hyper-extension is given to describe an extreme or larger than normal range whereby the limb/s move away from the same joint axis.
For a growing number of people over stretching or stretching incorrectly can contribute to, if not create, major problems-often a result of insufficient stabilization. Those with hyperextension issues who generally seem to have an easier time stretching, will find it difficult to “feel” exercises or don’t feel sore even after workouts that leave most of us hobbling for days. Pain symptoms related to hypermobility typically include: pain in the hips, knees, elbows, fingers, wrists or neck. Hypermobility is a predisposed, legitimate weakness of the connective tissue around the joint. In the worst case it increases one’s risk of joint strains, and sprains. In the worst cases, dislocation. It is often, but not always, indicated by a poor or misaligned posture; either a flat back (a tucked bum), rounded shoulders, knock knees (classic pigeon toe) and often a head shear (forward head posture).
Hypermobility is influenced by one or all of the following:
- Bone structure: the shape and depth of the joint sockets,
- Muscle structure: muscle tone or strength
- Proprioception: sensing how far you are stretching
- Family History: hyper mobility is often inherited.
For people with hypermobility changing the shape or depth of the joint sockets will not be an option. However, there are ways to limit the laxicity that occurs around the joint:
Exercises that promote alignment and proximal, centred movement that requires stabilization at those sites are key. As a result, the muscle structure is influenced to work more effectively at maintaining and supporting the bones. Proprioception is a little trickier so it is super important that an awareness exists when reaching greater than maximum or greater than normal ranges when stretching in order to get the most benefit of the stretch without feeding into the loop of going beyond a range which is not stable. Think of it as a working stretch. The issue simply is that often we aren’t aware of “bad form”. If you’re hypermobile you don’t know that knees/elbows are locking or that your leg is not extended, etc., unless you know when to stop and learn to recognize which muscles should be working to support the joint/s in the socket/s. The awareness piece and body re-education is crucial to treating hypermobility issues.
It is important to know if you are overstretching or have hyper mobility in some or all of your ranges of motion. I teach clients who have hypermobility in the knees but have very tight hips. Again, some lock their elbows when bearing weight upon their shoulders such as in a plank or when using arm resistance. Others tuck their pelvis (a posterior tilt), lock elbows, knees and over extend their ankles at once or a combination-even in simple standing! If left unchecked these misaligned joints will eventually create issues, injury can result and/or the hypermobility will hinder physical strength/fitness gains.
There is a huge benefit from strengthening the ligaments and muscles around the joint. This cannot be achieved through stretching or with movements that do not emphasize stability and control. The awareness can be amplified with resistance either through the use of equipment or sticking to closed chain exercises. A good program can address hypermobility and improve muscle/joint function overall so that strength and flexibility is achieved.