http-equiv='refresh'/> Global Therapies: Stretching Part 2

Friday, 5 August 2011

Stretching Part 2

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One of the key things to know when stretching is WHAT you are stretching. Not necessarily specifically which muscles (though that can be helpful), but more to do with the structures.
So, what exactly is causing the body to be "tight" and what exactly are you stretching when you stretch?

Muscle Tissue
When muscle is broken down by exercise, it is built back up again during rest. The "stuff" that actually does this is Collagen. Collagen is laid down in muscle tissues in a fairly haphazard pattern, its sticky, and it causes adhesions. However, it does align to lines of stress, and when you stretch the tissues, the collagen aligns to the stretch, causing the muscles to be healed in a more efficient pattern. If the tissues are not stretched, the collagen can cause cross fibres not only across fibres within the muscle making it less efficient as a unit, but across different muscles, making them both less efficient and more easily tired. Yes, Your muscles can stick together if you don't stretch.

Collagen is laid down in muscle tissue wherever there has been stress - it is there to support the muscle - however, as more collagen is laid down, it upsets the balance of water and elastin in the muscle making it more rigid than flexible. Exercise is the most obvious one, but also sitting around doing nothing causes stiffness as well. As you sit looking at this computer, your muscles are being used, and stressed, when they stop working (when you sleep, or whenever), collagen will be laid down in the muscles around your neck, upper trapezius, SCM and scalenes. This is helping the muscles distribute the strain of what you do on a day to day basis. This collagen is basically scar tissue in your muscles.
The extra tissue slows you down, and collagen will quickly lose its elasticity. Stretching will help maintain the elasticity and flexibility which you would otherwise lose through either over or under training.

Trigger points
The exact nature of a trigger point is an area of exquisite tenderness in a muscle. The pain will often radiate or refer to another part of the body. Trigger points are areas of ischaemic tissue, and are a major cause of myofascial pain and/or dysfunction.
They develop through muscle fatigue (again, this can be from exercise, or, from sitting in front of a computer for 12 hours a day). As the muscle is contracted, individual muscle fibres begin to fatigue to beyond the limit they can function. When they shut down, they contract to the minimum length they can. At this point, the fibre is "splinted" by fibres around it which take up the strain of the fatigued fibre. Over time, these become overly fatigued, and shutdown, causing more fibres to splint them, and so on and so forth.
When you have an area of chronically contracted muscle fibre, nutrients cannot get in, and waste products cannot get out. The muscle (or specific spot in the muscle tissue) is in a state of fatigue and will cause painful restrictions in movement, and will also shut down athletic strength and ability.

Joint Capsule
The joint capsule often shares nerves with the muscles around it, and can affect the range of movement by being too tight. The muscles may become hypertonic (too tight). Sometimes if a muscle becomes injured, the ligaments and tendons around the joint may tighten up to protect the structure, as the muscle heals, collagen (scar tissue) builds up, and then the joint is restricted by more than one thing.
Joint "blocks" feel abrupt. Like a tightening of the joint. It stops you from moving into a correct range of movement. A tight joint capsule will rob you of speed and power.

So why am I so inflexible?!
Well, any number of reasons really.
Overtraining or undertraining
As mentioned above, if you train too much, or not enough, there are excessive forces placed upon the muscles. If you then don't take the opportunity to stretch and make good the new collagen laid down in your tissues, that collagen loses its flexibility and thus, you lose flexibility.
Muscles and fascia can shorten to accommodate accumulated stress in everyday life. Look around you at people staring at computer screens, their shoulders around their ears. This is a sign of excessively short levator scapula, SCM and scalenes. Its not a short term thing, the muscles and fascia have adapted to their work posture to be as efficient as possible, ie. use as little energy as possible. That means laying down more collagen to hold muscles in a shortened position. It might be efficient for the muscles, but it isn't pain free.

Trigger points manifest themselves in muscle and fascia. This is a sign that the web of fascia is becoming unbalanced. The accumulation of stresses and forces can be seen across the body as it changes posture according to what you do with it, and what is done to it by the outside world.
For example, when an injury occurs, the body automatically tries to protect the area from injury. It will do this by creating a compensation pattern. Maybe you hurt the right knee. The body will start limping, placing more emphasis on the left leg in order to spare the musculature on the right in order for it to heal. As time passes, the injury heals, but the body continues to work in the compensation pattern. You continue to limp despite the fact the pain has gone away. Even years after, a discernible movement pattern can be seen despite the fact you have forgotten that you ever hurt the knee.
These altered patterns are often a response in which the path of least resistance is taken instead of the path of greatest efficiency. This will cause the body to do more work, increasing stress and strain.

Myofascia and this causes daily aches and pains. Compensations are made and sacrifices are made in terms of speed and power, medication is sometimes relied upon to get you through training, you become slower and you are never as good as you once were. Its all blamed on getting old. But what is getting old if not the accumulation of scar tissue in places where you didn't have it when you were young? What if that tissue was flexible and pliable again?

The final point is about stress - mental, and emotional. Physical stress affects fascia and muscle. This stress and strain can feedback to the emotional side, and when you are in pain, this can be increased in a very negative way. Pain increases bad moods, depression and feelings of hopelessness. In some cases, it may be that medication is taken to make these things go away.
However, medication masks the symptoms, it does not heal them. In many cases, the liver actually has to work harder as it tries to de-toxify the blood from the medications that are being thrown into the body.
I'd just like to clarify that I'm not saying all medication is bad, but just make sure that it's healing rather than masking. If it is masking symptoms, maybe the issue is deeper and, in some cases, may well be caused by pain in myofascia.

So its not just muscle.
Now, if you think about muscle, and about fascia, and the joint capsule, if you stretch in only one direction, you are introducing stretch along one area of the tissue, and pretty much in one plane of movement. Just as a thought, might it be a good idea to introduce that stretch to more than one area of the tissues that you are trying to stretch? Might those muscles be used for more than one plane of movement? As you stretch, it is a good idea to move the body around to get the stretch into different parts of each muscle. You may find that some areas are tighter and less flexible than others. These are probably going to be places that you need to work on, areas with less mobility, range and more tissue congestion.

Its probably a good point here to note when NOT to stretch.
  • If you have joint instability, stretching is not a good thing to be doing. Personally I'd look at doing some kind of rehab work with weights to gain muscle and re-introduce stability into the joint, but that's just me. 
  • Infection or inflammation around the structures you are going to stretch
  • Acute injury. If you have been injured in the past 48hours, please don't stretch. You are likely to make it worse. 
  • Excessive pain or other negative reaction to stretching. We aren't looking for pain. Mild discomfort is the worst that you should be feeling. 
  • Not wanting to stretch. If you don't want to, you don't have to. Its your body. Decide what you want to do with it.  
So when IS a good time to stretch?
Forgive me for being a little facetious when I say "anytime".
It's true to a point, but not the most useful of answers.
Stretching before exercise is fine - but only in terms of warming up - helping blood to circulate, enabling nutrients to get to the right places etc. Generally a bit of arm waving/slight cardio before a stretch is a good idea - to get blood pumping around the system, and then light stretches - nothing deep or "developmental". You are about to exercise, you want muscles, tendons and fascia to be ready to work optimally, not trying to work out why they are longer than they have been in weeks...

After exercise is also good. The tissues you have been using are "injured" - they have been used, lots of metabolic waste product is lying around, blood is potentially pooling in muscles, so a little warm down, followed by stretching to get things in line, and repairing well is a good thing.
Also - at this stage, and in the proceeding hours, collagen is being laid down in the muscles. Collagen lies along lines of stress, so in the hours after exercise, even the day after, when you are relaxing, stretching and foam rollering will help the collagen form correctly, not haphazardly, and fewer adhesions and trigger points will form.

The best time for stretching is when you aren't exercising. Not as a warm up or a warm down - just generally when you are relaxed. It should also be noted that you shouldn't necessarily rely on stretching to work knots out of your muscles, its more of a prevention rather than a cure - for that you will probably want to use a foam roller or a massage therapist. Once the knots are gone, stretching can be used to maintain the quality of the tissue.

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