Stretching the Truth - Physio Penrith
Stretching the Truth - Why Stretching & Foam Rolling Doesn't Work
Research on stretching has shown, despite popular belief, that this form of exercise has almost no benefit
Stretching has forever been one of those great interventions that physiotherapists, personal trainers and medical professionals have prescribed for endless therapeutic benefits - reduce pain, improve flexibility, reduce stiffness, prevent injury and the list goes on. But, alas, there is no clear evidence that any method of stretching is a clear winner for any important therapeutic goal.
One of the primary goals is that it used because you feel tight and you need to increase flexibility, but even flexibility does not have any clear value to anyone, not even most elite athletes, let alone the average individual trying to reduce low back pain. Most stretching is simply a waste of time - unless you just enjoy it. This would be the only reason we would endorse stretching.
This study certainly appeals to our bias of what a waste of time stretching is. The authors investigated the relationship between running economy (running faster while expending less energy) and lower body flexibility. They used the old sit and reach test to measure flexibility of the lower body.
The results suggest that the least flexible runners are also the most economical! So stretching and attempting to become more flexible negatively affects running performance.
Some research supported stretching truths:
At Sydney Muscle & Joint Clinic our avoidance of using stretching is based on these key scientific features:
Load builds capacity: most of rehab is (or should be) just “load management” — applying progressive load to increase the resilience of the injured or damaged tissue in each phase of recovery. Stretching obviously doesn’t have much to contribute to load management.
Stretching improves your tolerance: any gains thought to be due to stretching is probably due to an increase in tolerance of stretch, and that’s all. It’s one of many clues suggesting that stretch tolerance is the secret sauce in flexibility. You provide a noxious, uncomfortable sensation during a stretch and your brain perceives this threat. When it realises it is of no consequence, our brains send out an inhibitory neuron to dull the sensation and we perceive this as a therapeutic benefit. In other words, muscle (probably) doesn’t change, especially in response to an average stretching regimen … but our willingness to elongate it probably does. This is clearly supported by some research.
Anatomy has its limits: deeper hip sockets, longer parts of the vertebra, tighter connective tissue, are all examples of anatomical variants that will impact stretching and make certain muscle groups mechanically impossible to stretch.
PNF stretching: which involves the contract-relax (CR) method, was investigated in a 2011 study with results showing with or without a contraction, the result was the same: a slight increase.
Stretching for back pain: a common treatment is stretching hamstrings to treat back pain, but it is not effective, because there’s no correlation between back pain and how the hamstrings are behaving in the first place.
Stretching for tendon pain: tendons change only in response to long term “just right” loading (or exercise) and actually get super annoyed with compressive load most often seen in stretching.
It feels good: the only and best reason for stretching.
Stretching to warm up: you can't warm muscles up by stretching, it's like trying to cook a steak by pulling on it. Overwhelming evidence in this study showed that stretch durations of 30-45 seconds imparted no significant effect
Stretching for back pain is old world, not supported by research and can actually irritate your low back.
Most back pain presentations have what we call "flexion intolerance", this means your pain is irritated by prolonged sitting, driving and repeated bending. Bending of lumbar flexion will irritate you back pain, so why would you do a hamstring stretch that places your irritable back in a bent position? It's madness and should be done or prescribed by a physiotherapist.
Find out the directional preference of your low back during painful episodes and focus on these movements.
stretching provides NO benefit and should not be utilised unless you do it to feel good.
"...current findings indicate a link between increased tolerance to stretch, pain inhibition and shows us that stretching doesn't work by lengthening muscles, but by inhibiting the uncomfortable sensation of stretching - tricking us that the stretch has been of benefit"