To Stretch or Not to Stretch

Frequently, patients visit the office expressing common complaints about tightness in their hips, hamstrings, or calves. However, the typical follow-up in our conversation is, "I've been trying to do more stretching, and it just doesn't seem to be working." This blog aims to guide you to think like a Physical Therapist and decide whether stretching is the solution to your problems. 

Scientific Background

Before delving into the decision to stretch, it's crucial to comprehend how our muscles work and how we can position them for optimal function. Our muscles operate through a captivating process (remember, we are thinking like a PT) called "cross-bridge formations." Imagine this formation as a handshake between two microscopic proteins, actin and myosin, residing within our muscle fibers. When your brain signals the muscle to contract, myosin heads reach out to shake hands with actin filaments, forming a "cross-bridge" and pulling them closer, resulting in muscle contraction. Now, armed with this basic understanding of muscle contraction, let's explore a key component known as the "length-tension relationship."

Picture our friends actin and myosin facing each other, going in for a handshake. Visualize an "optimal" distance to stand apart for a normal handshake. If we were to move them further away or closer together, the interaction becomes awkward and inefficient. This is analogous to the length-tension relationship, placing a muscle at its optimal length to provide a full and strong contraction. If a muscle is excessively stretched or shortened, it can still contract but not as efficiently or robustly. 

When Not to Stretch 

This section applies to most (but not all) readers, given the prevalent habit of sitting for extended periods at work. Returning to our discussion on the length-tension relationship, prolonged sitting puts key muscles around the hip and hamstrings in a lengthened position, akin to a low-level stretch. Over time, these muscles adapt to this position, and when it's time to exercise, they aren't optimally positioned to contract. Stretching in this scenario might seem intuitive, but it perpetuates the problem. Instead, focusing on loading those muscles in different positions can strengthen the area and remind the muscle of its optimal position. Another instance where stretching might not be ideal is when diagnosed with an overuse injury of a tendon, such as the Achilles. Instead of static stretching, the emphasis should be on loading and contracting these areas to alleviate pain. 

When to Stretch 

If you find yourself thinking, "But it feels so good to stretch. I feel like my body needs it!!", stretching is indeed beneficial when done correctly and at the right time. Severe lack of range of motion in one limb compared to the other may warrant incorporating more stretching into your routine. Stretching as a way to cool down (instead of warming up) after a run or workout is another effective method to ensure muscles are in their optimal length-tension relationship. 

Conclusion 

Understanding how muscles work and discerning when to stretch versus strengthen is crucial. If in doubt, always consult with your Physical Therapist to determine the right course of action.