By: Kim Kranz, PT, DScPT, SCS
As PTs, we often preach the basic rule of stretching: If you want to improve length in a muscle, you have to consistently perform static stretching, doing 3 sets of each stretch and holding each stretch for at least 30 seconds. Not a bad place to start; but, maybe we have something to learn from the other disciplines that promote flexibility: Yoga and Pilates. After studying Anatomy Trains by Thomas Myers, it’s become clear that yoga practitioners really do have a leg up on us. Anatomy Trains shows us that the fascial lines (connective tissue that is interwoven throughout our bodies) are more connected than we once thought and that to truly improve fascial mobility, and thereby muscle length, it’s important to stretch through the whole fascial line. If we take the hamstrings, for example, we could stretch like this and target only the hamstring muscle:
Or we could stretch like this and stretch the whole superficial back line of fascia:
If you doubt the role of fascia in “hamstring flexibility”, here’s a simple test. Stand up and bend forward as far as you can. Make a mental note of how far you can bend forward and then stand up. Now, take a tennis ball (or other firm ball) and roll the ball on the bottom of your foot for one minute on each side. Remove the ball and bend forward again. Did you go farther? Most likely, yes. You released the fascia in part of the superficial back line (in this case, the fascia on the bottom of your foot) and as a result, you had better mobility throughout the fascial line, including the hamstrings.
Another thing that Yoga and Pilates have on us is the use of breath with stretching. When you get stressed or frustrated and you take a few deep breaths, you feel a little more relaxed, right? Well, the body uses deep breathing as a way to help your muscles relax, too. By coordinating our breathing with our stretching, we can make stretching more effective. Pilates is well-known for using rhythmic, controlled and low-intensity movements to gain flexibility. In their book Stretch to Win, Ann and Chris Frederick (Chris Frederick is a Physical Therapist) postulate that a stretch should be undulating or wave-like, timing the stretch to your breath. Inhale and then exhale as you move into the stretch, release the stretch as you inhale again. Anyone who has ever taken a Pilates class will be familiar with those instructions.
The third thing to keep in mind is that the “no pain, no gain” mentality should never be used with stretching. Our body has multiple protective mechanisms in place to try to keep us from hurting ourselves and the stretch reflex is one of those. This reflex causes a muscle to tighten up or shorten in response to either a quick stretch or a prolonged, high-intensity stretch. So, if your leg is “shaking” while you’re trying to stretch, that’s a sign that your stretch reflex is kicking in and you need to back off a little until that stops.
Lastly, we need to remember that most muscles work in many planes and across joints. So, when you’re stretching, don’t just stretch in one plane of movement. Thorough stretching of the hamstrings, for example, requires you to extend your knee and flex your hip (sagittal plane), rotate your leg in and out (transverse plane) and vary the position of the leg side to side (frontal plane) to stretch all of the fibers. A good example is shown in this video: https://www.youtube.com/watch?v=oDpuNRznih8
If you have any pain with any activity, including stretching, consult your physician or a physical therapist for a personalized assessment and guidance in the best way to rehabilitate the injury.
CHKD’s Sports Medicine program is a comprehensive sports medicine program with services provided solely for athletes under the age of 21. Call 757-668-PLAY (7529) or visit our website at www.chkd.org/sportsmed.