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To Stretch or Not to Stretch

Who doesn't have tight hamstring muscles? Why are some people constantly injured and others seem to tolerate just about anything?  Many patients ask, “should I be stretching more”, and our answer is often surprising.  We are not big on static stretching.  There is a big difference between a tight, short muscle and a tight, over stretched, overworked, weak muscle.  Too often patients come in having been given a set of stretches from other practitioners that have not helped, and in some cases make the problem worse.  It is critical to properly assess the actual load a muscle is under.  

Everyone has a “knot” at the top of their shoulder.  When this spot gets tight and sore the common reaction is to drop the chin to the chest and to pull the arm across the chest. Most patients have a head forward posture, and suffer from rounded shoulders; this “knot” at the top of the shoulder forms to help deal with stress.  The muscles get tired trying to hold the weight of the head.  As a result of this ongoing mechanical stress the muscles at the top of the shoulder stick together, forming a focal adhesion.  To stretch this area does two things: it further reduces the muscles ability to support the weight of the head and will cause the “knot” or focal adhesion to get even thicker from more stimulation.  Instead, tension should be taken off of this area.  Standing up straight, pulling the shoulders back and even doing some stretches for the muscles in the front of the shoulder will produce much better results.

This is also the case with the hamstring muscles. Often they are weak and overstretched, not tight and short.  Most people are quadricep dominant, meaning they misuse their quad muscles in activities and have an excessive anterior pelvic tilt. If you add the fact that most people also have some form of anterior rotation to one of the hips, then it is easy to see why the Hamstrings would be so tight.  Simply stretching the hamstring will allow for further pelvic tilt and rotation and allow the quads to clamp down even more. Instead, foam rolling the quads and doing some posterior chain strengthening exercises like glute bridges or kettle bell swings will help to take load off of the hamstrings.

In general we recommend using a dynamic warm-up before activity.  This is done by moving the body through multiple planes of movement.  An example would be doing an easy lunge matrix; forward, side and reverse lunges to loosen up the hips.  Instead of a static stretch use a foam roller to locate restricted areas.  Once you find them, use the roller to pin this tissue in place and do active range of motion to release the adhesive area.  When static stretching too much load is placed on the attachment site of the muscle.  The thickened area where the “knot” has formed is much stronger than the tendon.  Rather than lengthening the muscle, you are weakening the tendon.  

At Structural Elements® we do a thorough postural analysis.   We identify any structural imbalances that need correction and try to free up restricted tissue. We then prescribe Strengthening and Lengthening exercises to help keep the body in proper alignment. If we do recommend stretching, it is seldom where people feel pain or even know is tight. Not only might the stretching you are doing be a waste of time, but could very well be making your problems worse. Warm up slowly! Mimic the activity you are looking to do at full strength and speed. Be sure to move in multiple planes, not just in linear directions. And always STAND UP STRAIGHT!

Douglas Bertram, L.Ac., MTCM, Owner 

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