Stretching is a form of physical exercise in which a specific muscle is stretched by moving it away from the body to improve the muscle’s felt elasticity and regain comfortable muscle tone. It results in improvement of muscle control, flexibility and range of motion and usually reduction in pain.

In short, static stretching does not reduce soreness or risk of injury before and after exercises!
The general routine with most people when they decide to do any form of exercise is a quick 2 minute warm up which includes a static stretch of the hamstrings and sometimes the calves and off they go. A muscle when stretched in its not warmed-up stage can lead to reduction in its performance, strength and endurance. Also, stretching can be dangerous when performed incorrectly. Research and its systematic review indicate that, on average, “Individuals will show a reduction in less than 2mm on a 100mm scale during 72 hours after exercise. The combined risk reduction of injury is only 5% which shows that in general stretching may not meaningfully reduce the risk of injuries”. (ref: Herbert RD, Gabriel M. Effects of stretching before and after exercise on muscle soreness and risk of injury: systematic review. BMJ. 2002;325:468).

Then why do we stretch? Well, there is some research out there to support stretching but it is based on the TYPE of stretch performed. There are many different techniques for stretching in general, but depending on which muscle group is being stretched, some techniques can be dangerous and cause permanent damage. Incorrect technique can cause damage to the ligaments, tendons and even joints leading to increased pain and even stiffness from the muscle going into protective spasm. Hence, it is helpful to be aware of the types and do’s and dont’s of stretching.

STATIC STRETCHING:

As the name suggests, static stretching involves holding a muscle at the stretched position for 20 -30 seconds.

• Best done after your workouts.
• Stretch the muscle up to a point you feel a slight discomfort but bearable stretch, hold this for a maximum of 30 sec and breathe through the stretch until you feel the muscle slowly letting go.
• Research has shown to decrease strength and power if done immediately before weight training

ACTIVE STRETCHING:

Dynamic stretching is similar to active stretching with the main difference being, you do NOT HOLD the stretch. You are always moving or performing a dynamic or functional movement.

• Dynamic stretching is not the best for improving flexibility. It mainly helps in improving function
• Research has supported that this type of stretching increases acute muscle power much more than the other types
• It is good way to warm up for your sport and has shown to improve performance

DYNAMIC STRETCHING:

Dynamic stretching is similar to active stretching with the main difference being, you do NOT HOLD the stretch. You are always moving or performing a dynamic or functional movement.

• Dynamic stretching is not the best for improving flexibility. It mainly helps in improving function
• Research has supported that this type of stretching increases acute muscle power much more than the other types
• It is good way to warm up for your sport and has shown to improve performance

FUNCTIONAL STRETCHING:

Functional Stretching is the most updated type according to research. Most of the strength coaches and trainers use functional stretching to improve flexibility in their clients/athletes.

• The theory of specificity says that strength, coordination, speed, & balance are highly specific to that movement. Functional stretching is based on the same theory. If you want to transfer the newly achieved range of movement into your functions/tasks, the stretching should be specific to that function.
• eg: For ground based movements or tasks, like lifting, you perform the task a few times as a stretch.

SUMMARY AND TIPS FOR STRETCHING:

• Do not stretch 1st thing in the morning when you get out of bed. Move around and do your morning chores for 30 mins and then stretch if you need to.
• Pain whilst stretching should be a “stretch” pain and not “pain” pain.
• Do not hold your breath while stretching.
• Stretching is good before and/or after your physio exercises if tightness is restricting you from switching muscles on or actually performing the exercises.
• Use static stretching after your activity/end of the day, if the muscle is really tight. Better to avoid static stretching before your workouts (gym/walk/sport). Instead perform Dynamic or Functional stretching, for example before starting any physical activities at work/school/sport.
• Your physiotherapist can help you with what type of stretches are best for you at your next appointment.

The tape you are referring to is known as Kinesiology Tape (or Kinesio Tape) and has become very popular amongst athletes and practitioners. It was developed by a chiropractor, Dr Kenso Kase, in the 1970s but became an overnight sensation in 2008 during the Beijing Olympics when the tape was donated to 58 countries for use during the games. Since then it has been used widely to prevent and relieve sporting injuries and a variety of other conditions.

The theory behind kinesiotape is that it:

• stimulates sensory pathways in the nervous system, increasing feedback to the brain
• lifts the skin and reduces pressure on pain receptors
• increases blood circulation to the taped area which may increase range of motion
• reduces fear of movement, which is associated with increased pain levels, thus increasing range of motion
• facilitates small immediate increases in muscle strength by pulling on the tissue of the muscle which may increase muscle contraction
• gives proprioceptive information to the brain if a joint is being stretched beyond normal limits
• may increase muscle activity

As Kinesio tape has only become popular in the last 5 years the research on its use and effectiveness is limited, mainly due to poor study designs. There has been some research (meta anaylsis by Williams et al. 2012) on the benefits of using kinesiotape in the following conditions:

• decreased pain in acute whiplash disorders (Gonzalez-Iglesias et al. 2009)
• improved range of motion in patients with a rotator cuff impingement (Thelen et al. 2008)
• improved biomechanics in baseball players with rotator cuff impingement (Hsu et al. 2009)
• in healthy individuals (with no injuries!) it has been shown to increase trunk flexion, extension and side flexion (Yoshida et al. 2007)
• increase in strength of lower trapezius muscle (an important shoulder stabilizer) and decreased activation of upper trapezius muscle (a muscle overactive in shoulder conditions) (Hsu et al. 2009)
• increased hand grip strength when tape is applied to wrist flexors (Lee et al. 2010)
• increased quadriceps peak torque (strength) (Vithoulka et al. 2010)
• increased VMO activation in patients with patellofemoral pain (Slupik et al. 2007)

Use of Kinesio Tape at Take Control

At Take Control Active Rehab we use kinesiotape for many conditions and particularly like using it around the neck, shoulder, lower back and hips. In saying that, we use it as an adjunct to our treatment to try and maintain the benefits gained from manual therapy. It is never used purely by itself to treat a condition.

We find that the tape is a lot more hypoallergenic compared to other types of tape that we have in the practice. Ask your physio if you would like more information on Kinesio Tape.

Did you ever want to increase your performance on the sport field without having to spend hours at the gym or track? Or have you been working furiously on increasing your strength and balance without seeing any corresponding improvement in function? One of the reasons for this could be as simple as posture!

A good neutral posture is organised in such a way that all our bones are nicely set up to counterbalance each other, requiring minimal muscle activation to maintain, and also ensuring your weight is precisely balanced over your feet. Changes to this postural system lead to increased activation of those muscles trying to hold you up, and therefore taking energy away from the muscles you want to increase your performance, as well as shifting your weight away from its most balanced position (centre of gravity). This in turn leads to compensatory movements of the body to right itself.

When the body uses energy to maintain extra use of postural muscles and/or correct compensatory movements due to poor control, this energy is not used by those muscles that help improve your speed, strength or agility and therefore result in a loss in performance. A good example of this is a runner who cannot control their hip position. As they land their hip will collapse and shift slightly to the side. To compensate for this they will sway their trunk to the same side in order to stay balanced. This compensatory movement uses energy that would otherwise be involved in making them run faster or longer. Correcting this could be something as simple as ‘standing tall while running’, or as complex as trying to control or strengthen specific muscle groups in order to hold your body weight.

Not only can good posture during sport improve your performance, it can also decrease your risk of injury. Poor posture during activity, particularly repetitive activity, can overload muscles that are used excessively to hold you in this poor position which can lead to strains and tears in the short term. In the long term, muscle overload from one direction, and muscle inactivity from another will lead to shearing forces in your joints which can create more significant joint or ligament damage which is much harder to fix. An example of this could be a fast bowler playing cricket who severely arches their back and twists during bowling. Over time this will overload the vertebra in the lower back by repeatedly compacting the rear portion of it and is one of the major causes or stress fractures in cricketers. By changing their posture when they bowl you can significantly decrease the risk of an injury occurring as well as improving their speed and accuracy!

Objective (measureable) data makes it easier and more reliable to detect any abnormalities with posture and movement patterns, which can enable people to change their technique in order to prevent injury and/or maximize performance. This is often done with high speed video cameras that can be used to examine your running technique frame by frame. However now many elite sporting bodies are beginning to use the latest in computerized feedback systems where electrodes are placed along the spine and data is recorded for a certain period of time (i.e. whilst participating in sport) to give highly accurate measurements of peoples postural control. This allows people to gain a much clearer idea about what they need to change, as well as providing an excellent feedback system to measure if these changes have been successful or not.

I’m sure at some point in your life you have been told to sit up straight or stop slouching, but why is it really important in the first place, and how straight should I sit, or stand, or walk for that matter? As well as this, we all know someone who seems to slouch too much, or has a big arch in their back when they walk but do not complain of any pain. Why is it that posture should be important for me but not them?

Sitting up straight is probably not an accurate term as our spine is not designed straight. It is made up of three separate curves, one each for our lower back, upper back and neck which if you look at it from side on, forms a rough ‘S’ shape. If these curves are maintained in a neutral position, the weight is distributed evenly though the various structures of the spine (bones, joints, discs and ligaments). If this neutral balance is upset, weight distribution will become uneven, and so one area will have to transmit more load, and therefore undergo more stress than another.

When this weight distribution is uneven the weight of part of your spine does not balance comfortably on the rest of it in response to gravity. To hold this area in place you need to increase activity of the surrounding musculature which can result in fatigue and tightness of these muscles. A good example of this would be getting tight shoulder muscles when your head has been poked forward to look at a computer too long.

So does this mean if I sit up straight, all my pain will go away? In some cases yes! However remember that pain will often depend on many factors, of which posture is only one, and therefore other issues may need to be addressed to resolve your symptoms. Remember too that there is no perfect posture for everyone. It will depend on the type of injury you have, age, sex, and activities that aggravate your symptoms.

An interesting article about why play is so important! Our Kids Bounce Back programme is a play-based programme working on improving fine and gross motor in school children. The play based atmosphere allows for each child to have fun whilst they are learning new skills.

http://www.newscientist.com/article/mg21929330.800-play-your-way-to-evolutionary-fitness.html