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Varieties of Stretching

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The limitations in flexibility which people exhibit are of interest to a large group of professions from medicine to physiotherapy, osteopathy and chiropractic. Yoga and other eastern traditions have employed stretching techniques called asanas for thousands of years although this was not their primary purpose. The eastern martial arts, such as karate, judo and taekwondo, also emphasise flexibility in the performance of these comprehensive martial ways of living. Flexibility is not precisely defined but in anatomical terms it mostly refers to the ability of joints to go through a particular range of motion.

Static versus Ballistic Stretching

Many aspects of stretching are controversial and one aspect is the discussion about the relative merits of ballistic and static stretching. There may be some benefit in performing ballistic stretches in terms of maintaining interest as static regimes can be a bit....static, ballistic stretching can be rhythmical and add dynamism to a performance. Most sporting and hobby activities are dynamic in nature and ballistic training permits the practice of manoeuvres specific to the activity. Static stretches may not relate very closely to the active nature of some sports.

Ballistic stretching does have severe possible negative characteristics which can limit their usefulness. Rapid elongation of a muscle and the accompanying connective tissues means the tissues do not have the time they need to adapt by more permanent lengthening as using longer periods of low force stretching has been shown to be more effective. Muscles which are stretched quickly can react by reflexly contracting to prevent injury, limiting elongation. If the movement develops much momentum this can cause forces which overwhelm the tissues' tolerances.

Static Stretching

Static stretching occurs when a stretch position is held for a defined period of time at least once, but it could be more times. The stretch should be performed in a controlled manner, without any movement or speed of movement. Static stretching has been researched and shown to be effective in changing the ranges of movement of joints. Static stretches are easier and more convenient to perform, require less energy and may result in less muscle soreness, but many of these things have not been proven.

Whilst effective, static stretching is often used alone without thinking about any requirements for ballistic performance in an activity or sport. There have been many supposed benefits and these include:

Warming up is promoted by stretching. This seems unlikely as there is no temperature change in the muscular tissues with stretching.

Stretching helps cooling down. Cooling down consists of allowing the blood flow to be moved away from the recently exercised muscles. This cannot occur with passive stretching of muscles and might even impede this.

Stretching relieves delayed onset muscle soreness (DOMS). No good evidence has been brought forward to support this contention.

Performance in athletics and sport is improved by stretching. Dynamic flexibility is more closely allied to athletic ability and static stretching has little evidence to support this idea.

Prevention of injury is enhanced by stretching. Injury may be more likely with lack of flexibility but stretching to increase this has not been shown to limit injury. The likelihood of injury may even be increased by static stretching before exercising.

In physiotherapy movements of the patient are classified in slightly different ways and this can also be applied to stretching. If a person moves their joint through a range of movement the movement is said to be active, in other words performed by the person themselves. If the physiotherapist moves a person's limb for them entirely the movement is said to be passive, performed by somebody else. Stretching can be looked upon in the same way.

Physiological stretching can be active where the patient lifts their arm up with one set of muscles, stretching the joint and the opposing set of muscles. If the joint will not go through the full range expected it is possible it is stiffness, weakness or pain which is limiting the joint. By checking the passive physiological range a physiotherapist can determine which one of these problems is troubling the joint. If the movement is full when the joint is stretched passively and there is not much pain then weakness must be the presenting problem.

Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for physiotherapists in Sheffield visit his website.

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