Ok, I am the first to admit that I either 1) never stretched, or 2) when I did stretch I ended up hurting myself. I even tried few yoga classes, but who wants to go to a class where you are just humiliated by 20 year old ladies to your left and 70 year old grandmas on your right. Not even to mention the disapproving glare of the instructor. So I kept going along like a robot, barely able to touch my toes. Need to put sucks on? Better sit down. And as a distance runner I got every injury there is to get: plantar faccitis, IT band and runners knee to just name a few. Finally last year after I suffered an IT band injury just a week before my first marathon race, and 16 weeks of hard training all wasted, I had had enough. I embarked on a journey of self healing and finding out whether I am genetically doomed as a runner (spoiler alert, there is no such thing) or I am just missing something in my training. So I went to see a sports medicine doctor who also happens to be an accomplished marathoner. After 2 minutes of moving my legs around, she basically told me my hips are glued in place, I am as tight and immobile as a chair. Although I always knew I am no ballerina, but I didn't know that I am not even a human, I am a chair.
So I spent the next month pouring over all medical literature and talking to various local experts in the field (mostly physical therapist, accomplished runners without injuries and blogs). What I discovered is that a lot of of runner's injuries are due to poor mobility and flexibility. Yours truly a perfect example. So, you may ask how is any of this relevant to you?
Well, it turns out what inflicts runners also inflicts most of us 21st century creatures. In fact I never really realized how many of my own patients, that is YOU, suffer in some shape or another from the same inflexibility issues. Golfers coming in with back or shoulder pain, gardeners coming in with low back pain, some of you older folks with back, knee and hip pain and my desk job workers with shoulder and back pain. Talking to some of the very physical therapist I have referred some of you to, most but obviously not all, of these aches and pains are from tight upper back muscles and tight hips. So, how do you fix this?
By APPROPRIATE stretching.
Lets talk about what is stretching and how does it work:
First of all lets make something clear. When we say stretching, we do not actually imply that you physically stretch your muscles every time you stretch. If that was true your muscles will eventually get longer than the bones they are attached to and tear apart.
Lets do some brief and basic anatomy.
Part 1) Neuromuscular connection: Muscles are attached to bones. When you want to move a body part your brain tells the corresponding muscle(s) to contract, hence moving that body part. Muscles also work in pairs. Lets look at your femur (the bone connecting your hip to your knee) The main muscles in the front of your femur are your quads, the main muscles on the back of your femur are the hamstring. So, when you want to flex your hip, the quads contract, pulling the femur close to your body, bending the hip. But the opposing muscle, the hamstring, also has to lengthen, or relax, to allow the femur to move away. Otherwise this will become a tug-of-war between the hamstring and the quad, Just like this, most bones in our limbs are attached to antagonizing muscle groups. When one contracts to pull the bone, the opposite muscle has to relax to allow the bone to move away. This coordination is done through a complex neuromuscular connection between the brain, spinal cord and the muscle fibers. The brain tells one muscle to contract and the other to relax. In addition, at any given time the brain exerts a small tone on all muscles, so when your limb is stationary, both opposing muscles have a small tension, essentially keeping the bone in place. Now, when you want to do the opposite, for example extend the hip, then your brain tells the quads to chill and relax and the hamstrings to contract.
In old times when we did a lot of manual work, we naturally stretched our muscles by applying heavy loads such as lifting rocks to find food or logs to build a shelter. Now a days we spend most of our time sitting. At best we exercise for a short time and then continue being either sitting or minimally active. So over time these muscles tighten up, meaning they have more contractile tone at rest. Now, remember, when a muscle contracts it shortens. So, tight muscles are shortened. This shortened, contractile state is what really causes us to be immobile and not have full range of motion of our joints. In turn, this exerts undue pressure on the bones, muscles, joints tendons and ligaments that are attached to the muscles, leading to chronic pain.
Stretching allows us to restore the natural tone and length to the muscles. Now, as we already discussed, the tone of our muscle is a complex connection between the brain, spinal cord and the muscle fibers. So, stretching is a lot more than just a mechanical pull on the muscle. In fact there is little change in the actual length of the muscle, instead stretching changes or resets the neuromuscular tone; reducing the resting tension or contractile state of the muscle, so it is less contracted and more elongated (stretched). This is one part of stretching.
Part 2: How do our muscles know their length? How does the brain know that? This is done through a small apparatus called the Spindle Muscle Group. The Spindle group is a small tensile unit in each of the muscle fibers. It is like a tight spring. Therefore it is very sensitive to the length of the muscle. Its main job is to prevent our muscles from over stretching and getting injured. Remember, when a muscle stretches it is actually not doing work, muscles work by contracting. Stretching only occurs if an outside force is manually stretching it or the opposing muscles are contracting. If the muscle is stretched beyond its comfort zone, which is set by the tension in the Spindle group, the a strong signal is sent from the Spindle apparatus to the spinal cord, the Spinal cord in return sends a potent signal back to the same muscle group to contract and oppose the stretching, hence preventing an injury.
This is a muscle-spinal cord-muscle loop that is meant to prevent the muscle from over stretching. It is quick, it is powerful and it does not even involve the brain.
Fun fact: we have a lot of muscle-spinal cord reflexes, in fact some of our muscle memory is done through this, biking and swimming are two examples, this is why you don't forget how to swim or bike once you learn it as a little kid. Once the muscle spinal muscle reflex is created, it remains there forever.
So, how does stretching come into play in all of this. Well, we already talked about how in our modern life we rarely use our muscles and do not naturally stretch them because we rarely do any heavy physical work. So, overtime the Muscle Spindle gets shorter and more tense, and when the time comes to stretch the muscle, guess who is not happy? The Spindle. You want to bend down and tie your shoes? Well, your hamstring and calf muscles need to stretch, but since you rarely stretch these muscles, the Spindle is too tight and. immediately activates the "muscle-spinal cord - muscle" reflex. You have no chance of reaching your shoes without either sitting down or bending those knees and taking the tension of your back leg muscles.
This is why if you have ever tried stretching you may actually feel like your muscles are contracting and getting a little work. But here is the trick. Research has shown that in order to stretch the muscle long enough to reset the Spindle to the new length, you have to hold the stretch for at least 30-60 seconds. By holding the stretch for this long you desensitize the Spindle-spinal cord reflex at the shorter length. Our body has. a magical way of adopting and making new set points based on repetitive stimuli. So, you can now stretch that muscle to new lengths without triggering an opposing force.
Part 3: Actually, stretching the muscle: Ok, now that you know all about the neuromuscular connections and the muscle spindle apparatus, lets talk about the last part of stretching. Do we actually stretch our muscles? Sort of. Our muscles are attached to our bones via ligaments and to other muscles via tendons. These are very strong connective tissues that can withstand a lot of force. There is no evidence that we can actually stretch our ligaments and tendons. They are just too strong. Our muscles also do not really stretch, they have a set length that is based on the number of muscle fibers in each muscle group. But stretching has been shown to increase the water content in the muscles, allowing more space, and hence increasing the length. Stretching has also been shown to increase the number of contractile units, called Sarcomeres, in each muscle fiber, hence adding to the length of the muscle. So, although stretching does not actually elongate a muscle by stretching it, but it may stretch it by adding structural components and as a result increasing the length. But this is very minimal and has a limit. Think of it, if stretching actually stretched your muscles then the yoga masters would have had muscles growing out of their body. Our muscles are attached to our bones, which do not grow past puberty, so the actual "stretching" of the muscle is limited. Most of the benefits of stretching come from the neuromuscular changes we discussed in part 1 and 2.
SO, how do to stretch:
Now that I have hopefully convinced you to stretch, here is a short guide on how to start. Disclaimer: I am no expert in stretching, this is really the Dummies version. If you really thought you will be a ballerina by reading this blog, I have bad news for you. You are not. Get real help if that is your life long passion. But by doing just a stretching a day you can significantly improve your mobility and reduce your risk of injury.
Some rules before you start:
In order to get the benefits of stretching you have to hold each muscle group for at least 30 seconds, at least 5-6 days days a week. Sorry.
Never stretch past the point of pain, in fact if you feel pain back off on your stretch until the point at which you feel the stretch, but not pain. There is no "more pain more gain" in stretching, in fact there is "more more pain more strain" in stretching.
Only stretch once a day, doing more is not really beneficial.
Never stretch a unprimed muscle. By priming I mean a gentle and short warm up to get blood flowing to the muscle. Which means, NEVER stretch before you exercise. Always stretch in the middle or after you exercise. If you hate exercising and never do it, then just do a 5 minute warm up like walking, jumping jacks.
If you are new, start with a yoga class or a home video. I do not have the time nor desire to go to yoga class ( I really do not like the whole talking and feeling the earth stuff, I just want to get my stretch and be done), there are lots of great online videos that you can do on your own. Here are my favorite ones.
This is the best. Adriene has become an online yoga celebrity and for good reason. She is a great instructor, easy to understand and has videos for all levels. I am including two of her videos here, first one long and complete second one short but less comprehensive. And for my runner's friends, the third one is a great 30 minute and a life saver. You can go to her site and pick whatever suits you.
This is another good video. This is good for those who have no time and want the shortest and most effective class. I do this sometimes when I am really short in time, The whole thing lasts about 3 minutes.
You can do sport specific stretching or whole body. I am a runner, so I do runner specific stretching 7 days a week and whole body 3-4 days a week.
If you are short in time, you can break it up. Do 10 minute time blocks, maybe 10 minutes in the morning and 10 minutes at night. Ust make sure you are targeting different joints and muscles each time. TV time is a great time to stretch while you watch.
If your joint hurst when you stretch, stop and see your doctor. Stretching should not hurt, you should feel the stretch, but not pain. If it hurts, stop. Something is not right.
And to finish this long blog, a word about yoga. Yoga is great. There is plenty research that shows the benefits of yoga. But stretching and Yoga are not necessarily the same thing. Although all yogas do focus on stretch and range of motion, but some yogas also do a lot of strength training. So, if you are only planning to stretch, then be sure you don't end of up in a class where you have to hold lots of squads, lunges and planks. Trust me, if it is your easy day, last thing you want to do is end up in a class with a nut job instructor that screams and yells at you to man up and hold that squat for a minute when you just ran, your muscles are already sore and you thought you are just in for a gentle stretch.
On a personal note, I started daily stretching 6 months ago when I started to train for my marathon. I was so tired of getting injured that I was willing to try anything. It has changed my body in ways I did not know is possible. And I have not gotten a single injury or even aches or pains after my long or hard runs. I do it at home. I used the videos I shared with you, but after having done it for sometime now I can essentially do them on my own. Give it a try. just 15 minutes a day. Specially you seasoned (40 and above) and grayed (60 and above) will thank me. Trust me.
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