To stretch or not to stretch, that is the question. Stretching has become a hot topic in the rehab world as of late. If you would like to take a peek into the research, these scholarly studies on stretching are a great place to start. For those of you who took the time to check out the studies you should have noticed one glaring consistency….inconsistency. When one digs deeper into the studies it becomes clear as to why stretching is such a controversial subject, variety and individuality.
Lets start with variety, ready, go! Static stretch, passive stretch, active stretch, PNF stretch, dynamic stretch, contract/relax stretch….the list goes on and on. Now lets talk about individuality, take a deep breath and go! Hypermobility, hypomobility, viscero-motor inhibition, type 1 fibers, type 2 fibers, vertebral subluxations, injury history, inflammation levels, daily activities, athletic history, free time, these are but a few of the factors that need to be addressed before deciding if stretching is beneficial or detrimental.
This topic strikes a nerve with me each time I release an athlete from my care into the hands of their high school and college athletic trainers that consider stretching an after thought. Most recently I worked with three soccer soccer players transitioning from high school into the world of division one college athletics. During their respective high school careers these ladies thrived, all state, all conference, state titles, and most importantly NO Injuries! During our time together we focused on dynamic multi-planar stretching paired with isometric and dynamic resistance training based on individual limitations. We treat the body like a finely tuned guitar, tighten the loose strings while stretching the tight ones. Once these ladies left for the University they were taught not to stretch and forced to do heavy powerlifting (this protocol has also leaked its way into the high school ranks). The results: a dislocated shoulder (in the weight room), a torn ACL (non contact injury), and a broken foot (non contact injury). So what happened to theses young budding athletes? The truth was stretched and their ligaments followed suit.
When I say the truth was stretched I mean that the studies showing stretching as detrimental were held in the highest regard while the studies showing stretching as beneficial were left in the shadows. This information bias completely eliminated the concept of individuality and threw many unprepared athletes into the fire of hypomobility and repetitive motion injury. While it may currently be unrealistic to perform individualized assessments and programs for all athletes on the current budget of most athletic trainers (high school and college alike), a few fundamental tests could swing the pendulum back into balance.
Muscle testing can be learned relatively quickly and should be a part of all trainers repertoire. Why, because if you test a muscle and it responds as “weak” the last thing you want to do is stretch it. In this particular case the “tightness” is due to a lack of joint stability. Manual activation and isometric contractions work best in this precarious situation. If you find a lack of range of motion and the muscle tests strong you are most likely looking at a muscle that needs some stretching to help reset the muscle spindles. I prefer contract-relax stretching followed by dynamic stretching in the limited range of motion. The bottom line is this: every body you deal with is a different as the fingerprints on it. As trainers we must learn to look past the sewing circle gossip of the latest trends, we must look past the opinions of our mentors and dig into the studies supporting both sides of an argument. Once we have done this we can apply our clinical experience and make an informed decision….to stretch or not to stretch!
BS Exercise Science, CHEK 2, MTA