Stretching – The Big Picture and Updated Guidelines

I saved the most controversial part of fitness for last in this series. 

When I ask patients if they stretch the #1 answer is (sheepishly said) “Well… I know I should, but I just don’t”.

The research on this topic does not help motivate us one way or the other.  The who, what, where, when and whys of stretching are not clear from the research available.   Here is some key points about stretching research:

• Stretching is difficult to measure because it is based upon how it feels for you. We might tell someone to stretch to the point of pulling but not pain.  Pain tolerance differs for everyone. So some folks in the studies may be stretching to pain and not aware of it, thus causing a very different muscle reaction and varied research. 
• Many stretching studies look at “performance” – meaning athletic.  The studies on the benefits of stretching for general health and fitness are much more conclusive – stretching is an important part of a good physical activity program because of the improvements in joint range of motion, balance and reduced risk of falls.  The tricky part is that when a news story talks about stretching they may not highlight this very important difference.  Improving athletic performance and improving quality of life are two very different goals. 
• Stretching to the point of discomfort in studies reduces “performance”.  Stretching below the point of discomfort has better results in terms of rang of motion, reducing soreness and improving range of motion.  Bottom line: The intensity of the stretch makes a big difference.
• The subjects in the studies are not always representing your age group.  Many are done with college students, many lump different ages together.  We really need more studies that distinguishes ages, body types activity level, etc.
• How long a stretch was held in the study seems to make a big difference.   Stretching held for less than 30 seconds does not seem to decrease strength.    STretching longer decreases strength but only for about 10 minutes after the stretch.  (thus why it is not recommended before exercise)  A longer stretch after exercise, held for about 30-60 seconds can reduce muscle soreness. 
• A missed benefit of stretching in research is the increased blood flow to an area – bring fresh nutrients and removing waste products that accumulate with prolonged stillness.  This is a health benefit that can’t be measured by looking at “performance” 

Lets take a step away from the “performance” (athletic or exercise) for a moment.   Our daily activities and stress certainly presents a challenge for our muscles and joints. Prolonged sitting creates tightness in the hamstrings (back of the thigh), and hip flexors (front of the hip) Sitting or standing with the shoulders rounded and in a “slumped” position (ie: on the couch or at a desk)  the chest muscles and back muscle become tight from being used more than other muscles.   Add a dose of mental stress (like driving in the snow) to that and the shoulders creep up toward the ears tensing the shoulder muscles and the jaw clenches.  Any kind of positive heel shoe (an even sneakers have a slightly elevated heel) cause calf tightness.  The hand, wrist and finger muscles contract into certain positions with texting, typing, using a computer mouse, etc. 

Do we need stretching to undo the strains on the body from everyday life – absolutely! 

Most people agree, it feels good, helps them relax, stand up straighter, move easier. 

My untested yet professional opinion of why stretching is just not a priority – It does not burn a ton of calories.  When time is limited and the goal is weight loss, the top calorie burners win.

Lets take a step back even further.  All the life effects I spoke of above – take the joints out of  healthy and proper alignment.  Also, the muscle fibers end up being like a crumpled up grocery bag – a bit “disorganized and tight”.  That means that muscle is not going to allow the joint to go through its full range of motion thus decreasing their strength.  Take that body for a walk, run, spin class, zumba class or strength training session.  That machine is just not going to “perform” as well.  Yes, you can do those movements but the body will need to find another way, less efficient way to get the movement done at the expense of other joints.

For example:  The chest and front of the shoulder muscles are tight from a few hours in front of a computer.  You decide to go for a walk (good for you!) but those tight front muscles cause a slight rounding of the back.  To lift your head you now need to bend your neck causing strain on the joints there.  You go to the gym and start lifting weights.  Lifting your arms overhead with tight shoulder muscles causes the ribs to flare forward  thus increasing tension and strain on the middle and lower back.   You did the exercise but down the road your spine will  probably tell you it was over worked. 

Rewind and stretch those chest and shoulder muscle to get the range of motion back.  Now you can stand up straight when you walk and use your shoulders to their full ability when you do an overhead press lifting weights.   Now THAT is improved performance and true healthy movement. 

So in the end I would bet you WOULD burn more calories if you stretch.  Not from stretching itself, but from feeling better with a body that can move easily in the most efficient, natural way.  Reduced  tension in the body and stress in the mind means you are more likely to make a choice to move.  Less risk of injury means less time taken off from regular exercise to heal. 

In the past I have recommended not to stretch before exercise, to just warm up with light movement.  However I am changing that recommendation based upon further research and learning in this area. 

Stretching Guidelines*:

• How to stretch
  • A static stretch is when you move into a position of slight pulling and hold that position for the stretch.  A dynamic stretch is when you move a joint through its full range of motion such as moving the arm in a circle for the shoulder joint. 
  • Stretching form and technique is as detailed as strength training.  It is so important to have good guidance with this. 
  • Make sure you feel it in the muscle you are trying to stretch. 
  • Mindset is so important when stretching. One of the biggest risks of injury with stretching is doing it in a mindless and competitive way.  Staying very aware of how the muscle feels during the whole stretch lets you get the most out of it.  If you are distracted when stretching, you are less likely to gain the benefits. stretching is a GREAT way to practice mindful meditation.  It gives you something to focus on (the sensation in the muscle) and breath and relax.   At the same time you are helping your muscles and joints and body alignment you are help;ing your mind learn to focus and relax.  How is that for a “selling point” for stretching.  
• How Often:
  • Stretch every day several times a day. 
  • Stretch before bed – it will help muscles relax so your mind can relax too.
  • Before exercise a light intensity and short 10 second stretch.  Try some gentle static and dynamic stretches  to see what works best for you with different activities.
  • Immediately after any physical activity while your body is still warm  (Ie; Stretch at the gym instead of waiting until you get home)  Warm muscles and connective tissue are more pliable “(like a warm piece of plastic) so this is a GREAT time to work on some stretching that has a more lasting effect of improving flexibility and range of motion. 
• How long:
  • when the body is “cold” like first thing in the morning, before exercise, or after sitting for a while – do a shorter stretch for less than 30 seconds combined with some movements just taking a joint through its range of motion.
  • When you have been moving such as after exercise, snow shoveling, yard work, cleaning, (really any physical activity) hold a stretch for 60 seconds or more.  You should feel the muscle letting go and let this guide you as to how long to hold the stretch. 
• How intense:
  • This is a KEY to good stretching.  Hold a stretch to the point you feel a slight pull in the muscle you are trying to stretch.  When the muscle senses pain or a sudden stretch it protects itself from tearing by tighten more.  So pushing a muscle to get it to stretch has the opposite effect that you want from stretching. 
• What to stretch:
  • Everything! 
  • Stretch t he major muscles used after exercise but don’t forget about the smaller joints too – like your hands and fingers. 

* As with all the advice on this blog – these stretching guidelines are general and many not apply to everyone.  If you are not sure, please feel free to contact me. 

I get a lot of questions about yoga and will blog on this more soon.  There are so many different forms of yoga and levels of training for instructors that I cannot say yes or no if taking a yoga class would be a good way to stretch.   However, I would recommend a proper and regular stretching routine first before trying a class so you are aware of your own tight areas before going to a class.

Bottom Line:   please do not miss out on the many, many benefits of regular stretching because it is not a great calorie burner or because of the incomplete research available.   Please feel free to post questions on this topic. 

Keep Moving, Be Well (and stay warm!)

Janet