Stretching is one of those things you either love or hate. Personally, I hate it, I find it boring, awkward, and generally ineffective, also I’m useless at it, usually looking like a cold lump of clay whenever I try. However, I know many people love to stretch, twisting and contorting themselves into some amazing and eye-popping positions with grace and ease. But there are a lot of myths and misconceptions around stretching and I want to discuss these as well as propose a different way to look at stretching… something I call strength stretching!
There has been a lot of debate and disagreement on the positives and negatives of stretching, and I have added to this by giving some of my thoughts a while ago here. However, as time, research, and my understanding progresses, so my thoughts and views change, and although I am still not a huge advocate of stretching I am a huge advocate of movement, so rarely will recommend that someone stops stretching if they enjoy it and its not detrimental.
Stretching is done in a lot of different ways such as the common static hold variety, or the more dynamic and ballistic ways, and then there are the more fancy methods such as contract and relax, or PNF.
However, regardless of what type of stretching you do, they are all believed to help improve flexibility and prepare and warm the body up for sports and other activities and reduce the risk of pulling or tweaking something.
However, a lot of research has shown that stretching doesn’t actually significantly improve performance or reduce the risk of injury for most sports, except for where end of ranges are routinely reached such as in gymnastics or martial arts (ref, ref, ref). For most other sports such as running, field sports, or gym-based activities stretching doesn’t reduce injury or make you perform better, yet this is where you see most people using it.
Waste of time?
Apart from wasting time, I don’t think there are many detrimental effects from stretching before a run or a gym session for most of us, so if you want to stretch go ahead, but don’t be fooled into thinking this sufficient to prepare you for sports or activities. The negative effects of stretching before sport such as reduced power and speed shown in some research realistically will not be noticed by most of us and is only of importance to elite athletes at the top of their game.
For those who do stretch regularly before a sport or activity, there may be positive psychological benefits of a familiar routine and positive expectations. So the only time I recommend someone stops stretching is if they are doing it at the expense of something else that would be more beneficial, or if it was becoming an adverse compulsive behaviour, a bit like those who continuously scratch to try and stop an itch.
I also usually recommend people stop stretching with certain tendinopathies in the early painful stages such as the cross-leg stretch for the glutes in those with glute med tendinopathy, and heel drops for those with insertional Achilles tendons. The reasoning behind this is to reduce the compression forces on the tendon whilst its pathological (ref). However, after listening to Dr Pete Malliaras recently I may rethink this as Pete thinks the forces and the time spent by most when they stretch is too small to cause any detrimental effects, and if those with a tendinopathy feel stretching helps then why should we stop them?
Sisters of science
There are a lot of other misunderstandings around the effects of stretching such as many think stretching changes the length and shape of their muscles, with many females thinking stretching will give them long and lean muscles.
This ‘sister-science’ which is the close relation to the more common ‘bro-science’ is often perpetuated in yoga and pilates classes the world over and is fooling millions of women to waste hours and hours stretching in the vain hope it will make them lean and slender when actually stretching will make very little difference to the appearance of their bodies.
Although stretching isn’t a passive activity and forms part of the continuum of exercise and indeed loading, the forces produced in the soft tissues during stretching are often just too low and too short to create any significant adaptive changes. Many studies do show improvements in subjects range of movement after stretching interventions (ref), but very rarely do they show any change to the structure of the tissues, unless you do it really really hard, for really really long times (ref). Simply put most stretching routines have little effect on the physiological structure of our bodies.
Use the force
Stretching appears to improve a person’s flexibility not by lengthening their muscles but by increasing their tolerance to the stretch sensation by habituating to the protective and painful stretch reflex (ref). If you want to alter a muscles length stretching just won’t do it, instead, you will need to increase the forces applied to the muscle than most stretching can produce.
The easiest way to increase forces into a muscle or any other soft tissue is with an external load, eg resistance training, however many do not associate resistance training with stretching and lengthening muscles. Most, usually the ‘sisters of science’ again think resistance training will create big bulky stiff muscles via hypertrophy… and of course it can, given the right parameters.
But if an external load is applied in a certain way then a muscle can strengthen and lengthen via a process called sarcomerogenesis (ref), which is a fancy way of saying adding sarcomeres. Heavy eccentric forces seem to signal sarcomerogenesis via a complex process that I don’t understand, all I know is if I apply sufficient eccentric forces to a muscle it will adapt via this process, lengthening as well as strengthening… win-win!
So for most things that patients tell me feels stiff or tight I now prescribe strength stretching by giving them a heavy-ish load and ask them to take it slowly into the range or position they feel tight or restricted. How much load I use is dependant on the person and of course their pain levels, but usually, it is heavy enough so that they cant do the concentric phase of the movement.
I usually ask them to do about 5-8 repetitions taking as long as they can for each rep, at least 10 seconds or longer if possible, and to do 3-5 sets dependant on their pain levels and time. They are warned that they will have some soreness after which may last for a few days and they should wait until this soreness reduces before they do it again.
For me I find ‘strength stretching’ a far more effective and efficient way to restore range of movement or reduce stiffness than static stretching. This doesn’t mean I don’t use static stretching at all or tell people to stop stretching, just that if you’re going to stretch, you might as well get stronger whilst you’re doing it.
As always thanks for reading
If you want to learn more about ‘strength stretching’ and lots of other things to help people with shoulder and knee pain then don’t forget me and Erik Meira are hosting our first joint weekend conference in London on the 9th – 10th June at the Crown Hotel, in Cricklewood called ‘Complex Understanding for Simple Solutions’.
We have discounted rates for overnight accommodation and lunch and breakfast is provided on both days. There is currently an early bird rate of £275 available until the 9th of March so ensure you book soon to avoid disappointment.
Full details and online bookings available here