Wellness Refocused Education

Wellness Refocused Education: Does stretching make an impact?

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I’m sure many of you have been told that stretching and warming up as well as cooling down are an important part of your workout. Have any of you ever really thought about why or if there are better ways to warm up and stretch?

Would you laugh if you learned that you may want to stretch on a daily basis even if you’re not exercising?

There are a lot of activities that we do that can put stress on our bodies, many we don’t typically think of such as sitting or standing for long periods of time or walking. Crossing your legs or sitting on your wallet can actually be a literal pain in the ass…and lower back.

Just like there are different styles of exercise to achieve different health goals (i.e. strength training, endurance training, etc), there are also a variety of stretches with unique purposes, but first what are we stretching.

Our skeleton is compromised of  206 bones, which makes up about 20% of out mass (Marieb & Hoehn, 2016). Our skeletons are “divided” into two sections: axial and appendicular portions. The axial includes the skull, vertebral column and the thoracic cage. This section of the body has 80 bones. The other 126 bones are found in appendicular portion, which includes the pectoral girdle and the upper limb, the pelvic girdle and the lower limb. This section of the body is what helps us with mobility (Marieb & Hoehn, 2016).

Our bodies have different kinds of muscle tissue, but for this post, we’re talking about skeletal muscle also known as voluntary muscle (Marieb & Hoehn, 2016). Skeletal muscle attaches to bones and during contractions they pull on the bones or skin and create movement. The amount of work a muscle can do is based on stimuli acted on the muscle and the muscle reacts and adapts. Overload helps the muscle increase strength and endurance.

There are three functional classifications for joints:

  1. synarthroses – immovable joints (ex. skull bone – cranial and facial bones)
  2. amphiarthroses – slightly moveable joints (ex. pubic symphysis – pubic bones)
  3. diarthroses – freely moveable joints (ex. shoulder – scapula and humerus)

Within these classifications are structural classifications: fibrous, cartilaginous and synovial. Synovial are considered diarthroses.

The way we move is determined by our range of motion or ROM at our synovial joints (Page, 2012). A synovial joint is where articulating bones are separated by a membrane of fluid. These joints are reinforced with ligaments. There are sixkinds of synovial joints in the human body:

  1. Hinge
  2. Pivot
  3. Plane
  4. Saddle
  5. Ball-and-Socket
  6. Condyalar

“Joints are the weakest part of the skeleton”, but there are ways to stablize them (Marieb & Hoehn, 2016). The shape of the bone plays a small role in stablization whereas ligaments and muscle tone  are the most important for stablizing the joint. Muscle tone in this sense is defined as “low levels of contractile activity in relaxed muscles that keep the muscles healthy and ready to react to stimulation (Marieb & Hoehn, 2016).”

It’s clear that stronger muscles assist our joints, but does stretching prevent injury or even soreness post-workout? Well, there’s research on both sides, but first what kinds of stretches are there to utilize?

There are three kindsof stretches: static, dynamic and pre-contraction.

A static stretch involves holding a muscle in specific position to allow and create tension. This style stretch is repeated and can be done on your own or with a partner.

A dynamic stretch is an active stretch will moves a limb through its full ROM. This style of stretch can also be repeated and done on your own or with a partner.

A pre-contraction stretch involves a contraction of the muscle being stretched such and can be performed with resistance provided by a band, strap or partner.

Both static stretching and dynamic stretching commonly suggested in training, however, studies show that dynamic stretching may have more benefits than static stretches.

A 2009 study examined the effects of dynamic and static stretching on vertical jump and activity of the muscle tissue. Researchers found a signification increase in activity in the muscle tissue after participants engaged in dynamic stretching in comparison to static stretching (Hough, P.A., 2009). “In this investigation electromyographic activity was significantly greater after dynamic stretching compared with static stretching indicating an increase in muscle activation post dynamic stretching.” Dynamic stretching engages the muscle in a movement, versus holding it like static.

This ties back to the amount of work a muscle is capable of is determined by the amount of stimuli placed upon it, repeatedly. It’s hard to say if while the dynamic stretching had more of an impact than static stretching did if it was a combination of positive factors that contributed to the improved jump.

Researchers also found that there was an increase in neuromuscular mechanisms, meaning the contact between the brain and muscle fibers were able to increase communication. Dynamic stretching may better assist in preventing injury because of the potential growth of muscle fibers and the impacts on strength.

A pre-contraction stretch, may be suggested to assist ROM and flexibility. Similarly to dynamic stretching, muscle activation in this kind of stretch may remain the same or increase after the stretch is executed (Page, P., 2012).

The kind of stretch can determine the amount of benefit and overall stretching may play a role in decreasing injury in certain sport disciplines. However, post-workout muscle soreness or “delayed onset muscle soreness (DOMS) can occur after single bouts of high-intensity running and/or unfamiliar activity (Herbert et al., 2011).” This is the body’s reaction to a new activity, which can include doing the same exercise with a different load than previously used such as increasing weight or changing the repetition range or even variations of form. The way the stretching is incorporated into programming can play a role in the amount of benefit.

Literature from a review in 2017 found that acute stretching versus long-term chronic stretching could have different affects on performance, DOMS and chronic injury in endurance runners (Baxter et al., 2017). The review found that much of literature argued that acute stretching during a warm-up may have actually decreased efficiency. Other research examined in the review found that joint stability was a result of muscle strength in general, not acute stretching.

Other research examined in the review argued that engaging in chronic stretching wouldn’t hinder immediate performance and could increase flexibility (Baxter et al., 2017). However, even chronic stretching research came back to discussing the important of muscle strength and stiffness in relation to joint stability.

The same review found that many studies were investigating the benefits of static stretching, not comparing benefits of variations of stretching, which would give different results or incomplete results.

Other research that I found interesting has looked at the exercise interventions – not necessarily just stretching, but incorporating exercises that contribute to prevent. A review on the effectiveness of exercise interventions to prevent sports injuries sought to determine if exercises such as strength training, stretching, proprioception or a combination of these could reduce acute or overuse injury. They examined 25 trials that included 26,610 participant with 3,464 injuries and determined that strength training in general “reduced injuries to less than a third and overuse injuries could be almost halved (Lauresen et al., 2013).”

This I found this interesting because the components of dynamic stretching are similar to components of strength training such as shoulder circles and arm circles, which can be done with or without weight, squats, which can also be done with or without weight. There are some dynamic stretches that are just stretches such as leg swings or neck flexion/extension.

This past spring, when I got back into a structure lifting routine I had less low-back pain, less muscle spasms and tightness and less likeliness of my SI dislocating, which meant less trips to the chiropractor. She explained that exercises like the back squat, even with light weight helped elongate the muscle and stretch it out. I had been seated more often than I ever had been while in school and that was causing an issue for muscle and joints because it meant that it wasn’t being activated as much.

I used a dynamic warm up without my workout and I incorporate components into my lifting, even though I’m doing a prewritten program. My favorite dynamic warm up is of course for legs:

  1. Hip abduction with a medium resistance band (both sides): 10 reps
  2. Hip abduction with a medium resistance band (both sides): 20 reps
  3. Forward hip height knee lifts with a medium resistance bands (both sides): 15 reps
  4. Standing kickbacks with a medium resistance band (both sides): 10 reps
  5. Side hip height knee lifts with a medium resistance bands (both sides) 15 reps
  6. Banded forward hip hinge: 2 sets of 10 reps
  7. Banded barbell squats with just the bar: 10 reps

I do this before I start my workout, but I’ve also incorporated some of these into my routine. I always warm up large lifts like squats, deadlifts, bench press, over head press – mostly, anything with a barbell. I’ve utilized banded clam shells – and those are no joke.

There’s importance in developing strength and flexibility in both joints and muscles, but I think the research shows that it can come from a number of source. It’s not just about one kind of stretch or just resistance training. Together these can lead to less pain and a decreased chance of daily injury.  Regularly activity can also increase circulation by assisting blood to flow into your muscles.

I’m pro-stretching, but I think it needs to be dynamic and it should compliment what you’re doing that day in the gym. My upper body/back day warm up is very different than my lower body warm up.

Do you stretch or do you focus on multiple movements in your programming to assist in muscle and joint development?

<3 Cristina

References:

Claire Baxter, Lars R. Mc Naughton, Andy Sparks, Lynda Norton & David Bentley (2017) Impact of stretching on the performance and injury risk of long-distance runners, Research in Sports Medicine, 25:1, 78-90, DOI: 10.1080/15438627.2016.1258640

Herbert, R., de Noronha, M., & Kamper, S. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane Database of Systemtic Reviews, 1-50.

Lauresen, J. B., Bertelsen, D. M., & Andersen, L. B. (2013). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 871-877.

Marieb, E. N., & Hoehn, K. (2016). The Skeleton. In E. N. Marieb, & K. Hoehn, Human Anatomy and Physiology (pp. 199-250). New York: Pearson Learning Solutions.

Marieb, E. N., & Hoehn, K. (2016). Muscles and Muscle Tissues. In E. N. Marieb, & K. Hoehn, Human Anatomy and Physiology (pp. 278-320). New York: Pearson Learning Solutions.

Page, P. (2012). Current concepts in muscle stretching for exercise and rehabilitation. International Journal of Sports Physical Therapy, 109-119.

Hough, P. A. (2009). Effects of Dynamic and Static Stretching on Vertical Jump Performance and Electromyographic Activity. The Journal of Strength & Conditioning Research, 507-512.

Perrier, E. T. (2011). The Acute Effects of a Warm-Up Including Static or Dynamic Stretching on Countermovement Jump Height, Reaction Time, and Flexibility. The Journal of Strength & Conditioning Research, 1925-19231.