“One of the biggest reasons people cannot mobilize themselves is that they try to accomplish great things.  Most worthwhile achievements are the result of many little things done in a single direction.” - Nido Quebin 

We use at least 430 muscles to move our bodies.¹ People take the time to exercise yet don’t allow the time to stretch.  But guess what happens?  When you exercise, your  muscle contracts.  Over time, it could gradually shorten, which also could affect the performance of the other muscle groups.  This imbalance, could eventually lead to a change in how you move and result in injury.  If you have symptoms of stiffness or tightness, cramps, achiness, fatigue, or feeling tired, stretching may help. This article will provide you with the benefits of stretching, guidelines for stretching, and how to stretch with some pictures to use for stretching your lower extremities. 

Benefits of Stretching:
“Normal” flexibility varies among each individual. Younger people and females tend to be more flexible than others.²  But everyone can stretch to better prepare the body for an activity and also facilitate recovery from that activity.  Flexibility is generally defined as the range of motion around a joint. The goal of stretching is to improve your flexibility to enable you to perform an activity without compromising joint stability.  Improved flexibility has many benefits:³

·        Increased range of motion of your joints- requires less energy and provides a safer and more efficient movement.

·        Injury prevention- although there is insufficient evidence to prove, by improving your range of motion, the soft tissue’s resistance to stretch is decreased. Soft tissue damage may not occur as this elastic limit of the tissue is not exceeded.

·        Decreased muscle soreness- stretching after exercise can prevent or reduce delayed muscle soreness and enhance recovery. ( This may be attributed to the increased muscle temperature, circulation, enhanced blood supply and nutrients available to the muscle and joint during the stretching activity)

·        Increased blood supply, nutrients and joint synovial fluid- regular stretching and proper warm-up increases the deep muscle and tissue temperature which decreases the synovial fluid thickness. This enables nutrients to be transported more easily to the joint articular and hyaline cartilage, possibly decreasing degenerative joint changes and allowing increased joint range of motion.

·        Better posture- by improving your flexibility, better postural alignment and muscular balance can occur. Studies show that by improving pelvic mobility and strength, decreased low back pain is noted.

·        Stress reduction- stretching encourages muscular and mental relaxation. These positive adaptations should lead to healthy, supple muscles that are more resistant to fatigue and injury.

Guidelines for Stretching:
I.) When to Stretch?

    -Stretching is not a warm-up. The goal of your warm-up is to gradually increase the metabolic demands required for running. By doing a progressive warm-up, muscle temperature and blood circulation will increase. More blood flow (and nutrients and oxygen which fuel exercise) to the working muscles helps prevent metabolic by-products such as lactic acid. Improved core temperature allows for increased elasticity of the soft tissue structures improving flexibility and range of motion. Nerve impulses also travel faster at higher temperatures preparing the muscles for increased speed of contraction.

·        Warm-up:  should be gradual and of sufficient intensity to increase muscle and core temperature without causing fatigue or reducing energy stores. Usually 3-5 minutes is appropriate. Older, beginner, overweight, pregnant, or cardiac individuals may need 10-15 minutes.⁴ 

·        If you will be running at a leisurely or steady state pace, stretching may not be needed if a proper warm-up is done. Stretching is encouraged; however, hold stretches to only 10 seconds before or during this warm-up phase.⁵

·        For competition or more vigorous training, you may want to do a 10-15 minute warm-up, stretch, do an additional warm-up and then begin that specific activity.

·        Cool-down:  After an appropriate active cool-down of lowered intensity level, stretching is most beneficial. Try and stretch within 5-10 minutes after your activity. Increased body temperature increases the elasticity of the soft tissue structures allowing more stretch and flexibility.

 II.) When NOT to stretch? ^6,7

-If a sharp pain or discomfort is felt in either the muscle or joint
-When a muscle or joint is infected or inflamed
-Within 24-72 hours of a muscular or tendonous trauma
-Following a muscle strain or ligament sprain
-After a recent fracture
-If osteoporosis is present
-If a hard or bony block limits joint range of motion
-Use caution when you have a hyper mobile joint

III.) Types of Stretching?^2,3,7

    -A review of the literature revealed there is no one best way to stretch. Flexibility is joint specific, meaning if you are flexible in one joint, you may not be in another. A variety of structures (joint, skin, tendons and ligaments, muscle, etc…) affect flexibility. Some can be changed, while others can not. Muscle and its fascial components are changeable and respond to the following 5 types of stretches:

1) Static- generally the safest, being controlled, low-force, long duration, low risk.  Stretches are held at end range for 30-60 seconds. May use active or passive movement combinations.

2) Dynamic or Ballistic- both are classified as active stretches using bouncing or abrupt type  movements. They are high force, high risk activities. Dynamic stretches can be sport specific to running using fast, long strides ( with a posterior pelvic tilt). Dynamically, this stretches the hip flexors.

3) Active- voluntary, requiring strength of the muscle opposing the muscle to be  stretched. It is low force and low risk. An example is lying on your back using your quadriceps to extend the knee, stretching the hamstrings.

4) Passive- when movements are applied by another source, such as a partner. They potentially have higher force and higher risk.

5) PNF (proprioceptive neuromuscular facilitation)- usually are performed by a partner and requires some expertise. Involves both active and passive movements (concentric and isometric). It is high force and high risk.

Common techniques are:
a) Hold-Relax: perform a passive pre-stretch of the muscle to end range.  The athlete is instructed to ‘hold’ resisting the movement (isometric contraction) and then a passive stretch is then performed.

b) Hold-Relax with Agonist Contraction: same technique as hold-relax, however, during the final phase, a concentric contraction of the agonist (opposing muscle) is used along with a passive stretch to further increase range of motion. 

How to Stretch:

Your stretching program is a planned and regular routine that promotes permanent elongation of the soft tissue without causing or contributing to an injury. Improving flexibility is a slow and gradual program. It may take several weeks of stretching before significant gains in flexibility are noted. Consider the following recommendations when performing your stretches:^6,7

* In review, after a proper warm-up of at least 3-5 minutes, perform a static stretch for 10 seconds to each muscle group.

* During your cool-down, stretches should be applied for at least 30-60 seconds.

* Perform 2 sets of a stretch per muscle group during the cool-down.

* Stretch from distal to proximal muscle groups (gastrocnemius up to hip complex)

1) Move slowly through your range of motion to the point of tightness.

2) Perform the type of stretch.

3) As you stretch, the tension should gradually decrease. Take the muscle just beyond

    the point of tightness at that time.          

4) Stretch for the recommended time frame.

5) The stretch should apply tension on the soft tissues but not create pain.

6) Slowly release the stretch.

7) Repeat on the other extremity.

Pictures:  Two pictures are provided for stretching each of the major muscle groups of the lower extremity. Below each stretch is an explanation of how to stretch that muscle in a ‘start’ and ‘finish’ position.  In conclusion, muscle stretching should become a relaxing and enjoyable time to better prepare you both mentally and physically for your running program. Although this article only showed lower extremity stretches, consider stretching all of the major muscle groups for balance and symmetry 1-2 times a week. Yoga classes are one example of a group class program. Try the various types of stretches to see which you respond best to. Also, once you become comfortable with stretching, stretch your muscles in variations of each position of stretch. Our muscles have different fiber directions and orientations, and may respond better to these subtle changes. Contact a Sports Physical Therapist if you have any specific needs or problems. Maintain your flexibility gains by performing a regular and routine stretching program.

The author: Dave Reese PT

Is a Physical Therapist and certified strength training specialist at Performance Therapies, P.C., 2590 Holiday Rd., Ste. 10, Coralville, Iowa 52241. Correspondence can be sent to this address or by calling 319-625-3030.

Lower Extremity Stretches

Gastrocnemius: Place hands against wall, feet pointing forward, leg straight. Bend front knee keeping the heel of the back leg on the ground.

 Soleus: Place hands against wall, feet pointing forward, leg straight. Bend back knee
keeping the heel of the back leg on the ground.

 Quadriceps: Place foot on object with the other foot ahead of your knee. Tighten abdominals holding a posterior pelvic tilt. Drop the knee down keeping it close to other leg.

 Hamstring: Place foot on object. Do an anterior pelvic tilt (arch your low back). Leading with your chest, lean forward.

Gluteals: Place foot on object. Lean forwards on that leg, moving through your opposite hip.

 Hip Flexors: Place foot on object. Internally rotate other leg (heel turned out). Tighten abdominals. Lean forward through rotated leg. Sidebend (reach arm overhead to opposite side) away.

 Adductors: Stand with feet apart. Step one leg out to side. Bend that knee, keeping your other leg straight.

 Piriformis: Lying on your back with knees bent, cross your leg onto the other knee. Extend opposite hand out to stabilze. Use other hand on knee to rotate hip. Don’t let hip come off
the ground.

  Gluteal Complex: On hands and knees, extend one leg back. Pivot and rotate the other leg
under you. With an anterior tilt slide extended leg further back. Keep hips level.