by Peter Terilli, DPT, PT
“Can’t you just stretch it out, bro?”
This question was posed to me by a patient a few weeks previously. With recurrent muscle strains, my fella was hopeful that by simply stretching his pain would subside and his functionality would improve.
Well, stretching is only a part of the equation. Yes, your tissue needs pliability and flexibility to prevent overloaded tensile forces that lead to injury. He’s absolutely right with his comment; but, the imparting of flexibility to a tissue via an external source, for example, a physical therapist, is only part of the equation.
I break it down this way: You need mobility in order to allow your joints to passively go through all range of motion (ROM) available to it. However, you need volitional muscle actions in those final end range positions to promote stability in that position. Otherwise, your joints are about as protected as a screen door in a windstorm, meaning they’ll go wherever force directs it, leading to overload and injury.
Or, your body will try extra hard via organelles called your muscle spindles to keep the tissue from stretching. Your nervous system does whatever it can to feel safe and stable in a position. If your body is lacking stability in an area, you better believe it’s going to grab it from elsewhere.
Let’s talk about a common male flexibility problem. Hamstring tightness. The answer has to be stretch it, stretch it, stretch it, right? Not quite so. As a PT we have to ask the question, “Well, why is the hamstring tight?” If you follow Gray Cook, you’d be familiar with the pattern of stable joint, mobile joint. This means that in an alternating fashion, each joint is either meant to be stable, or mobile.
Take your hips, for example. They are meant to be a mobile entity, enabling grand motions as we propel ourselves through space. Above it we have the lumbar spine and below it we have the knee. Well, if my lumbar spine has lost its ability to be stable, then guess what? My hips are going to have to stiffen up to promote safety and stability through my body. Guess what structures often contribute to hip stiffness and tightness. You guessed it, hamstrings.
So, what is a body to do? Well first and foremost, tissue quality needs to be improved. Soft tissue work to make structures that are tight more supple or weak structures more stable is paramount. Next, we need to address our nervous systems over active response to the stretch. We can do this through repeated exposure to positions in order to down regulate activity of the nervous system and enable greater ROM. Breathing is imperative in this process; if you cannot comfortably breathe in a position, your body perceives the motion as an emergency! Finally, once mobility has been granted, it is important to participate in motions that demand that ROM to enable your brain to lock in that new pattern.
To determine where you fall along the spectrum a thorough assessment needs to be done to determine if there are any insufficiencies. PTs and other credentialed professionals can help you determine where your speed bumps may be prior to your participation in activity. If mobility and motor control seem to be your issue, give our Kinstretch course a shot. Kinstretch, created by Dr. Andreo Spina (check him out on Instagram – @drandreaospina), is about the development of usable ROM that translates into improved mobility, tissue quality, injury prevention and motor control.
Hope to see you there, we can all get more mobile together!
…And maybe I’ll finally decrease my hamstring tightness.