Stretching 101

Flexibility

I hear inflexible clients wishing they were more flexible, and more flexible clients wishing they weren't so much. Everyone is different and it is completely normal to feel like this... The grass looks greener on the other side etc. There is a scale of flexbility, from those who can hardly get passed their knees when trying to touch their toes, to people who are classed as hypermobile, and have a diagnosed hypermobility condition. No matter where you are on that scale, it's normal, but it does not mean there is nothing you can do to improve.

- Inflexbility: Improve flexibility

- Very flexible: Improve strength to help support the increased elastin content in your matrix composition.

Flexibility depends on your genes which code your matrix composition, and can be impacted by posture and biomechanics. Collagen is a prime factor, and increased collagen can reduce flexibility noting there are many collagen variations, where as elastin increases flexibility capacity. There are other factors such as tenascins and lamins for example, and depending on your own composition, depends on where you are on the flexibility scale. Thus, generally the less flexible tend to have increased collagen in their matrices.

What next?

No matter where you are in your stretch, it is important not to compare yourself to other people, and rather focus on your own aims and goals. We all have our own strengths and weaknesses, some can stretch exceptionally well, where as others cannot, so focus on your own body and you will get to where you want to be.

- Inflexibility: Consider things like stretching, hydration (the average water intake per person should be 1.2 liters/day: https://www.itv.com/news/meridian/2018-07-25/how-much-water-should-you-be-drinking-to-ensure-heatwave-hydration/), movement patterns (biomechanics), posture and finding a good balance between rest vs exercise.

- Very flexible: Consider strengthening the joints which are extra flexible, some find that hydrotherapy very helpful due to the reduced gravity and increased resistance (*1). Stretching is not always that helpful without professional advice due to the likelihood that the tendons and ligaments will enable the majority of the stretch, rather than the muscle stretching appropriately, and therefore foam rolling may be more useful. If you find that you hyperextend joints, from fingers to knees and hips, and/or have a history of dislocating joints, I strongly recommend seeking a hypermobility diagnosis from a qualified professional (2*). If you are extra flexible, frequent soft tissue therapy is highly recommended as over stretching can be detrimental to your soft tissue. Please ensure that your therapist is fully aware of your hypermobility, and understands what needs to be adapted to suit your individual needs regarding hypermobility, such as myself.

*1 For those based in Nottingham, the University of Nottingham has recently opened their David Ross center which has hydrotherapy facilities:

https://www.nottingham.ac.uk/sport/davidrosssportsvillage/hydrotherapy-pool.aspx

*2 For those in Nottingham, I recommend Rachel Burr who is a Physiotherapist and a Guest Lecture at the University of Nottingham teaching on hypermobility:

https://theheathcoatstreetclinic.co.uk/meet-the-team/rachel-burr/

- Both inflexible and very flexible: You may find that having Epsom Salt baths are helpful due to the muscles absorbing the magnesium which increases tissue hydration and can help reduce muscle tension. If you have a known or suspected vitamin and/or mineral deficiency, or on medication, please seek advice from your GP before trying Epsom Salt baths. Ebay and Amazon have good deals on medical grade Epsom Salts. The amount of Epsom Salts per bath depends on your weight, height, BMI, and level of physical activity that day.

Why stretch

Stretching is not just for "Yogi's", although many professional teams including Premiership Rugby Teams, use yoga as a part of their training program to improve their team performance! Whether your aim is to lift heavier weights, complete an Ultra Marathon or Ironman, or simply increase flexbility, stretching is an integral part of training as it improves matrix alignment and function, and therefore mobility. However, stretching without considering the objective alignment is inefficient and not overly helpful - it can improve muscle lengthening whilst increasing risk of injury - so HOW you stretch is extremely important. There is much research with varying results, some saying that stretching does improve performance, and others saying it makes no impact - yet there is little research on stretches which promote subjective alignment.

Here is an example of quantitative research on stretching in regards to plantar fasciatis which supports the stretching protocol: Digiovanni et al., (2006) Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis: a prospective clinical trial with two-year follow-up. JBJS, 88(8), pp.1775-1781.

https://journals.lww.com/jbjsjournal/Abstract/2006/08000/Plantar_Fascia_Specific_Stretching_Exercise.13.aspx

How to stretch

Stretching requires initiative and understanding:

1) What are you stretching?

2) Why are stretching it?

You are not only stretching the skeletal muscle, but your soft tissue which includes fascia. Fascia can be found throughout the entire body, encasing everything to ensure tensegrity (how your body holds itself together). So stretching must be done mindfully and subjectively.

- POSTURE: Posture is a BIG integral part to performance and reducing tension. Poor posture can cause reduced power output, hindering performance. Therefore, any stretch, or any soft tissue therapy/conditioning for that matter, has an aim to improve posture. Noting, if you have extra flexible shoulders for example, it is important to stretch in accordance to therapist guidance as mentioned above. It is easy to compensate in stretching, thus, stretching in accordance to your soft tissue alignment which is caused by posture and biomechanics is vital - improve your stretch by considering why you are doing it, and what you want to stretch.

- Legs: From feet, calves/achilles, hamstrings, quads, and hips/pelvis, it is important to consider the relationship between the big toe and hip, and balance through the knee. To believe in plantar fascia and that fascia exists nowhere else is like accepting that there are bones in the feet, but nowhere else! FASCIA EXISTS ALL OVER THE BODY!

* The aim is to improve tissue function, thus alignment, so stretching the hamstrings with a laterally rotated leg (toes pointing outwards) for example is not optimally stretching the tissue.

* To achieve this, the idea is to keep a square pelvis, thus ensuring big toes, knees and hips are aligned, noting this applies to both the leg being stretched, and also the balancing leg. An example of inefficient leg stretching is seen in the image below:

* Note how the torso and hips are square, yet the legs are not. Due to the leg position, the muscles which laterally rotate the legs (based in the pelvis), are shortened, and the gluteus medius and minimus are being lengthened due to fascial adaptions for the movement, which reduces optimum stretch of this area, an area which is paramount for hip stability and pelvic balance. Noting also that this lateral rotation causes tightened SI Joints at the lower back meaning that stretching in this manner as in the image, and not compensating by stretching medially (inwardly rotating), means the stretch is not promoting functional alignment.

- Shoulders: There are 4 muscles of the shoulder which help to maintain the shoulder joint in it's capsule, formerly known as the rotator cuff. If you naturally have rounded shoulders (medially rotated) regarding posture, then these muscles are having to work harder to ensure stability, such as the relationship between subscapularis and infraspinatus.

* There is also the fascial balance between the anterior chain (front) and posterior chain (back) of the arm, noting this includes neural balance which is important for pains such as tennis and golfers elbow, and carpel tunnel syndrome. Due to modern lifestyles be it driving for long periods of time, desk work, sitting on the sofa, and general stress, it is important to stretch the front of the arm to prevent the arm from medially rotating (the palm facing backwards). Noting the importance of preventing the wrist from subluxing (collapsing forward) in any arm stretch to promote true soft tissue balance without strain (this is a common tension in carpel tunnel syndrome).

* The acromioclavicular joint (AC Joint) is a common area for built up tension be it from exercise, stress and/or poor posture, with pectoralis minor inserting from the chest/thorax, and chorobrachialis orginating before inserting on the anterior surface of the humerous - due to this relationship at the AC Joint, they can be prime targets for improving poor posture.

* There are the remaining muscles such as serratus anterior, subclavius, trapezius (inferior, middle, and superior), and scalenes, and fascial connections such as Fascia Transversalis and the Thorocolumbar Fascia. From this perspective, it is evident that understanding what and why in stretching is integral to each stretch. Each muscle has it's own purpose, responsbilities, orgins and insertions, and capacities, and each of those factors are subjective meaning stretch for yourself rather than copying others.

* And finally, considering Tom Myers and James Earles "Anatomy Trains" which helps to increase understanding on improving fascial balance, posture is key when stretching the shoulders as any torso rotation over the pelvis can reduce an optimum stretch along the spiral line, thus inefficiently stretching the shoulder.

- Breathing and stretching: Breathing patterns and rhythm is integral to sport performance, and is a known focus for practices such as yoga and pilates. Why? Because breathing patterns are vital for homeostasis.

* During exertion and/or stress and anxiety, we tend to adopt more thoracic and clavicular breathing patterns which utilizes the assisted breathing muscles. Short term these patterns are beneficial, however, chronically they can cause a plethora of issues due to fascial tension which has the potential to impact the enteric system and overall GI function. The respiratory diaphragm is the primary breather and to utilize appropriately requires abdominal breathing, meaning breathing down into the gut - not the rib cage alone!

* To maximize ANY stretch, focus on abdominal breathing.

My favourite stretch:

The Wall Angel:

Part 1) Stand with your back against a flat smooth wall ensuring there is enough space either side to move your arms. Knees should be slightly bent, and feet facing forward (not laterally rotated/turned outwards) and in-line with the hips to ensure a square pelvis is maintained and weight is distributed throughout the foot. Head, shoulders and bum should be flat to the wall, and arms hanging downwards with palms facing forward, ensuring wrists/forearms are also flat to the wall.

- Note, the closer your feet are to the wall, the more difficult the stretch becomes - this can be used as a measure of improvement.

- The stretch is then attempting to maintain contact and positioning against the wall, thus head, shoulders, bum and wrists flat to the wall, and no change in bend at the knees. To advance this stretch, practice abdominal breathing which can reduce tension in the gut/abdominal muscles.

- Become more aware of your body by feeling what your body is doing to create this stretch, and whether you feel the same stretches on the left and right sides. For example: Is you jaw straight? Does your lower back touch the wall easier on one side? Do your feet/legs want to twist? Does one shoulder blade lie flat against the wall more than the other? Is your head straight or does it want to twist and/or fall to one side as you create this stretch? Can you lie your wrists/forearms flat whilst maintaining contact between your lower back and head with the wall?

Part 2) Maintaining contact and position with the wall, and lower back stretching by flattening to the wall also, move your arms above your bed with palms facing forward, and bending at the elbow as you go - like a snow angel, hence the name!

To advance this movement, practice abdominal breathing during the stretch, exhaling as you move your arms up, and inhaling as you more your arms down. Including this addition has great benefits as it enables a stretch in the lower back and front of the shoulder including clavicles (collar bones) and AC joints. Chiropractor Owain Evans from Backspace London has a good video on 'Youtube' which demonstrates this stretch whilst explaining how it is ok if you find this stretch difficult:

Here is the link for this video found on Owain's 'Youtube' channel: https://www.youtube.com/watch?v=M_ooIhKYs7c

Practices I recommend:

- Soft Tissue Therapy: Good quality soft tissue therapy, especially when from a performance perspective, can greatly compliment and improve your stretch quality, after all, you are stretching soft tissue!

If you are Nottingham based, feel free to get in touch with me at Move Well Nottingham. See the Contact link in the menu.

- Yoga: Whether you have never tried yoga, or have tried it before and didn't find yourself much of a fan, it is important to recognize that there are MANY types of yoga - it's a case of finding the type/s which suit you. Personally, I love Yin Yoga as I enjoy the deep fascial stretch it allows.

If you are Nottingham based, my client and good friend Vicki Green teaches Yoga at Hotpod Yoga, Nottingham and H3 Performance which is less than a 5min walk from Nottingham city centre.

Also, Vicky Henry is an exceptional yoga instructor who conducts yoga classes in Nottingham and is available for private sessions. Vicky's website is: www.ogabunny.com

(p.s you don't have to be named Vicky/Vicki to be an awesome Yoga Instructor, this just happens to be pure coincidence!)

- Pilates: Focuses on strength and stretch within movement patterns, the difficulty being the level of control maintained throughout the various movements. If you have never done Pilates before, please ensure that you book for a beginner as there are varying degrees of difficulty and it is important to do the movements with quality and confidence.

- Feldenkrais: Focuses on specific movement patterns which can deepen your stretches whilst increasing your body awareness and creating improved balance.

If you are Nottingham based, I recommend Adam Ward in Southwell: https://onewithnature.co.uk/movement-intelligence/

Any questions after reading this blog, please feel free to get in contact via the Contact link in the Menu.

Best wishes x