Author: Dr. Jory Davis
You always hear people say “make sure you stretch! Did you stretch? Stretching is so important!” I’m even guilty to say that I don’t spend enough time stretching. Unfortunately, decreased stretching can lead to injury and imbalance, especially for athletes and people who exercise regularly. Assisted stretching is performed by a trained practitioner and is 1:1 stretching. Assisted stretches utilizes various techniques to increase mobility and flexibility of muscles. It is generally performed by massage therapists, physical therapists, chiropractors, athletic trainers or someone who has received advanced training in stretching. Generally, the practitioner will first perform an assessment to identify areas of decreased range of motion, decreased muscle length or areas of discomfort. Assisted stretching has added value to stretching since the individual can be most passive to maximize muscle relaxation when needed. Assisted stretching can also provide external forces to stretching which can’t be completed individually. The different techniques include proprioceptive neuromuscular facilitation (PNF), static and dynamic stretching techniques.
PNF stretching is a technique that inhibits tonic reflex activity during stretches and increases range of motion. PNF stretching is a combination of neural adaptation and mechanical mechanisms. PNF stretching causes a stimulation of Golgi tendon organs which reduces the muscle tension and allows for increased range while stretching. This technique requires the person to provide static contraction therefore it is not completely passive. Dynamic stretching involves movement occurring during the stretch. Static stretching involves holding a stretch stationary for a period of time. In order to increase the range of motion of a joint, the surrounding tissues have to increase in elasticity. In physical therapy the gold standard for stretching has been 30 second holds by 3 repetitions or one time 1 minute hold duration.
When we stretch, it increases the flexibility of the tissue which then creates increased range of motion. Muscle, tendon and fascia are what become physically stretched. Muscles are lengthened when a stimuli to the receptors cause the muscle to relax and stretch. However, this is only short term unless a routine or stretch protocol is established to result in more permanent elongation. Tendon and fascia will also elongate with a stretching protocol although it is important to note that some stiffness of tendons is required to maintain a normal range of motion and avoid “over stretched” tendons.
If you suffer from acute or chronic pain, stretching may be the perfect remedy for
you. Studies suggest that the acute effect of muscle stretching on pain show a decreased pattern of pain. Decreased pain is contributed to the Gate Control Theory of Pain. Essential, this theory stresses the involvement of the spinal cord in sending signals to the brain within the region of pain perception. Within this theory, the non- painful input of stretching interrupts or closes the nerve “ gates” to the painful input.
Inflexibility can lead to injury especially for those involved in frequent physical fitness. We have all seen those “toe walkers” who suffer from tight calf muscles ( Gastrocnemius/ Soleus muscles) due to repetitive fitness or running. Injuries can result above and below the chain due to the imbalance. Below the chain issues can include plantar fasciitis which is caused by the abnormal patterning of the muscles creating excessive forces on the plantar fascia. Above the chain issues can include hamstring and even low back problems. The calves are just one example of how a tight muscle can impact the various surrounding joints, disrupt the delicate body chain
and even lead to injury. The Bottom line is to stretch regularly! Assisted stretching is a more effective stretching technique. Be proactive and reduce your chance of injury!