STRETCHING

Stretching is used to maintain and/or improve unrestricted pain-free flexibility,

resulting in increased ROM. It is defined as a sliding elongation of the overlapping
protein fibers (actin & myosin proteins) of the myofilaments past each other. This
results in a lengthening of the myofilaments past their current resting length.
(THEX, fig 4.3, p 71) See attached fig.

• The sarcomere length increases due to the elongation of the

myofilaments. The myofilaments elongate because the actin and
myosin protein fibers slide past each other. Neither the actin, nor the
myosin protein fibers change length.

Some definitions:

FLEXIBILITY: the ROM of a particular joint, and its surrounding muscles; may
be increased by stretching.
• Also refers to the ability of a muscle to relax and yield to a stretch.
• Flexibility is specific to each joint.

STRENGTH: the ability for a muscle to produce tension and a resulting force, in
one maximal effort.

Force = Mass X Acceleration

*Before a muscle can be strengthened, its’ antagonist, the tight muscle opposite
the agonist, must be extensible.

AGONIST: is the muscle opposite the tight muscle.

ANTAGONIST: is always the muscle that is stretched

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Soft tissue properties affecting elongation:
ELASTICITY: is the property of soft tissues to temporarily resume their original
length after a passive stretch, Thex p. 75
PLASTICITY: occurs when soft tissue assumes a new increased length after the
stretch force is removed.
Both contractile and non-contractile tissues have plastic and elastic qualities

OVERSTRETCH: results in hypermobility and is necessary in some sports, but

detrimental when supporting structures can’t adequately stabilize the joints.
An overstretched muscle will often display stretch weakness.
CONTRACTURE: passive shortening of muscle and other tissue across a joint,
resulting in decreased ROM

Neurophysiologic Properties of Connective Tissue, (Thex p. 72): See attached fig.

a. MUSCLE SPINDLE: stretch receptor; sensory ‘bags and chains’ respond to

velocity, duration of stretch, and length changes; stimulated by stretch
and contraction of intrafusal fibers via gamma efferent neural pathway.

*** The monosynaptic stretch reflex utilizes the muscle spindle where a quick
stretch increases muscular tension, but if a slow stretch is used, the GTO will fire
and decrease muscular tension.

b. GTO (golgi tendon organ): located near the musculotendinous junction;

Sensitive to muscle tension; Possesses autogenic inhibition – when
excessive tension may damage a muscle, the GTO fires and inhibits the
alpha motorneuron activity, decreasing muscle tension

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Types of stretching:

STATIC: refers to passive stretching where a stretch is held in a specific location

for a certain time.

DYNAMIC: uses speed of movement, momentum and active muscular effort to

bring about a stretch. Unlike static stretching the end position is not held. (By
definition, not a true stretch, but are good mobilization exercises and will help
maintain healthy sarcomeres at the ends of the muscles)
• Similar to ballistic stretching except that it avoids bouncing motions
and tends to incorporate more sport-specific movements.
• Arms circles, exaggerating a kicking action and walking lunges
(without weights) are examples of dynamic stretches. A walking lunge
dynamically stretches the hip flexors by emphasizing hip extension
and can reduce muscle tightness around the hip joint necessary for
competition.

Dynamic stretching is useful before competition and has been shown to reduce
muscle tightness. Muscle tightness is one factor associated with an increase
occurrence of musculotendinous tears. More recent scientific studies seem to
suggest that dynamic stretches before activity are preferably to static stretches.
(www.sport-fitness-advisor.com)

PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF) – assisted/partner

stretching
1. Hold-Relax (HR), or Contract-Relax (CR)
2. Agonist Contraction (AC)
3. Hold-Relax w/ Agonist Contraction

*PNF will be covered more in Sports Tx class; also, more techniques to

increase mobility of soft tissue are listed in THEX, pp 68-69.

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Factors that limit stretching:
1. Body type
2. Gender
3. Age
4. Bone and joint structure
5. Medical history

Conditions that may produce adaptive soft tissue shortening:

1. Prolonged immobilization
2. Restricted mobility
3. Connective tissue or neuromuscular diseases
4. Tissue pathology due to trauma
5. Congenital and acquired bony deformities

Purpose of stretching:
• Increase/maintain complete ROM of the joint
• Relieve muscle soreness
• Help improve body’s capacity for activity – stretched mm require less
energy for completion of movements
• Assists in decreasing unnecessary neuromuscular tension, promoting
general body relaxation and reducing emotional stress
• Relieve muscle-joint stiffness associated with the aging process
• Increased musculotendinous extensibility
• Elongate fascia
• Help prevent joint sprains, muscle strains or tears including
preventing re-injury to previous joint and muscle trauma
• Increase muscle and fascia length in pre-activity warm-up
• Part of warm-down process to increase blood flow to the fatigued area,
eliminate toxic waste products from cells, reduce soreness, mm
relaxation and additional flexibility improvement.
• Help provide greater potentials of physical and athletic skills
• Reduction of tightness that may contribute to pain, spasm, or
cramping
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 • Provides an important adjunct toward recovery during the process of
rehabilitation

Precautions to stretching:
• ROM’s vary, therefore use bilateral comparison to establish normal
ROM, do not force past the normal ROM
• Stabilize newly united fracture (#) sites
• Use caution with osteoporosis and like patients (steroid users)
• Long-term immobilization should be stretched slowly and cautiously
• Balance flexibility with strength
• Joint pain and mm soreness lasting longer than 24 hrs indicates too
much force (secondary mm soreness) (Bikram’s yoga example)
• Avoid stretching edematous areas
• Don’t overstretch weak mm
(For more, see THEX p 91)

Contraindications, in box 4.2, THEX, p 68. See attached fig.

Indications are listed in box 4.1, THEX, p 68. See attached fig.

Goals of stretching:
• Regain normal ROM
• Prevent irreversible contractures
• Increase flexibility prior to vigorous strengthening exercise* (dynamic
vs static)
• Decrease and prevent musculotendinous injuries

Principles of stretching:

Slow and relaxed; never no-pain, no-gain

Just want to feel gentle tension in belly of muscle
Breathe
Hold for a minimum of 30 seconds, but ideally until tension disappears
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REFERENCES:

Therapeutic Exercise, 5 ed., Kisner & Colby – CHAPTER 4

th

Principles of Manual Sports Medicine, Steven J. Karageanes

The Stark Reality of Stretching, Dr. Steven D. Stark

Areas that most commonly need to be stretched:

• Neck – ant/mid/post
• Chest
• Lower back
• Shoulders/Rot cuff
• Hipflexors/Quads
• Glutes/Hamstrings
• Gastroc/Soleus

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