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Stretching Demystified

4/27/2016

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Flexibility is an important aspect of fitness, along with muscular strength and endurance, and aerobic capacity.   However, it is not uncommon to find athletes who are unable to bend over and touch their toes!  This is most likely due to sitting most hours of the day and attempting to reverse the changes by ten minutes of stretching at the gym.

In the past decade, there has been much discrepancy in recommendations about stretching: how long, what kind, which muscles?  Does it depend on your sport of choice? Before or after a workout?

There have been countless studies published, even in the past year, with varying results. However, they all agree on one thing: Do not perform static stretches prior to exercising
.

WHY NOT?

Static stretching alters the (microscopic) length of the muscle which can alter, and likely decrease
, its firing potential.  Stretching may also activate tendon structures that inhibit muscle action.  Both of these proposed mechanisms will decrease power output.

“Then how should I warm up?”

Warm-ups are essential to performance and injury prevention.  They are useful for increasing the core temperature to decrease stiffness of muscles and alerting the neurologic system to the events about to take place.  This should be achieved with specific, dynamic exercises rather than static stretches or laying on the foam roller.

Runners—Studies found that a dynamic warm-up increased performance of endurance runners, meaning they ran longer without exhaustion1.  This warm-up consisted of movements such as high knees, butt kicks, leg swings and hopping.  Total time: 4 minutes
.

Notice, I said nothing about running.  Those athletes warming up with running had comparable results to those not warming up at all. Check out Dr. Danny’s post specifically addressing running warm-ups.

Weightlifters—Other studies found that just ONE set of static stretches decreased 1RM performance by 5.4%2.  That would decrease your 400 lb back squat by 21.6 lb!

When performing sets for reps, static or ballistic stretching decreased amount of reps by 17-20%3
. That’s 2 less reps in your 10 rep set.  The most effective was a specific warm-up of 20 reps around 30% 1RM, then appropriately building to working weight.

For Olympic Lifts, additional dynamic warm-ups may be warranted, specifically for the overhead movements. One of my favorite drills is thoracic rotation, performed in between light warm-up sets:
CrossFitters—You fall somewhere in between; Choose your warm-up type based on the workout of the day.  The same theme holds true: specific, dynamic warm-ups!

Sport-Specific Athletes—Dynamic, sport specific warm-ups are the most effective to prepare for practice or competition.  This includes running, cutting, jumping, ball handling, throwing or whatever your sport demands.  Begin at a slower pace and then work up to competition speed movements.

Your workout is over, you ran your fastest 5K, PRed your back squat or scored the winning goal... NOW you stretch. 
​
To address the earlier question: When, how long, what kind, which muscles?
To receive any benefit, hold static stretches for at least 30 seconds but 2 minutes may show better results. Static stretches can work but they take a few weeks for sustainable differences.  
PNF (proprioceptive neuromuscular facilitation) stretches have been shown to be superior to static stretching.  These can be done with a buddy or by yourself using bands or straps.  A common form of PNF to increase range of motion is contract-relax.  You have likely seen it before:
  • Bring muscle to limit or restriction
  • Increase tension in muscle by contracting maximally but counteracting movement with the strap
  • Relax muscle and gain a few more degrees of motion
So on the hamstrings, it looks like this:

​This would also be the appropriate time to work with the foam roller or PVC pipe on the muscles that are sore or may be lacking flexibility.

Of course, the cartoon at the top is wrong.  Touching your toes IS everything.  Every athlete should have the flexibility to bend over and touch their toes whether or not they are warmed up.  Inefficient muscle length can lead to compensation by other muscles.  This causes joint pain, tendonitis, faulty movement patterns, poor form and then decreased performance or injury. Stretching is also great to incorporate into rest days. A light warm-up, then your favorite stretches or maybe your least favorite if you have some restrictions.

Self-management is 100% possible when it comes to flexibility and recovery!  Take the time to take care of your body and it will perform better. Remember, at Athletes’ Potential you can supplement your stretching and take recovery to the next level with full-body cryotherapy and NormaTec compression boots. Call us anytime to schedule an appointment!


Thanks for reading,

     Dr. Jackie, PT, DPT, CSCS



References
  1. Yamaguchi, T, Takizawa, K, and Shibata, K. Acute effect of dynamic stretching on endurance running performance in well-trained male runners. J Strength Cond Res 29(11): 3045–3052, 2015.
  2. Winchester JB, Nelson AG, Kokkonen J. A single 30-s stretch is sufficient to inhibit maximal voluntary strength. Res Q Exerc Sport, 2009; 80: 257-261.
  3. Barroso R, Tricoli V, Dos Santos Gil S, Ugrinowitsch C, Roschel H. Maximal strength, number of repetitions, and total volume are differently affected by static-, ballistic-, and proprioceptive neuromuscular facilitation stretching. J Strength Cond Res, 2012; 26: 2432-2437.
  4. https://v1.voltathletics.com/node/879
  5. https://www.cooperinstitute.org/2014/03/self-pnf-stretching-better-than-static-stretching/ 
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How to Outsmart a Desk Job

4/20/2016

1 Comment

 
“Sitting is the new smoking!” I’m sure that you have heard this line recently, and research shows us how this may be true:

  • ​Frequent sitting is linked to cardiovascular disease, cancer and mortality. This still applies to individuals engaging in regular moderate to vigorous physical activity, but to a lesser degree.1,2
  • There is evidence of declining lipid profiles and increased plasma glucose levels after one extended sedentary bout.3,4
  • A study found that office workers averaged 10.6 hours of sitting and just over 9600 steps per day.  The kicker is that on the weekends, the averages were nearly identical!1

What conclusions can we draw from this?  Sit less, move more.  You may be thinking, “sure but I work out 5-6 times each week!”  Let’s do the math: Five 2-hour workouts every week is 10 hours of physical activity in a 168 hours week.  That means less than 6% of your week is exercise.  Is the other 94% spent sitting and sleeping?

Driving to work, sitting at the desk, driving home, sitting down for dinner, sitting down to catch up on your favorite TV show, etc.  Do you see where this is going?  
​

More apparent effects of sitting are mobility issues that stem from maintaining hip and knee flexion, rounded shoulders and lazy abdominals throughout most of the day. For many, sitting in unavoidable so it is important to adjust how you are sitting.
Is your work space set up for comfort and ideal positioning?

Sit down in your desk chair and place your hands on the keyboard. Are you sitting up straight?  Your torso should be stacked on top of your sit bones (pelvis). The seat and back rest angle can influence this considerably.  If your seat slopes backward, this position will be tough to maintain.  Keeping it horizontal or even slightly tipped forward will put you in a better position.

Notice how your head and neck are positioned: is your chin jutted out in front of your chest?  If so, this is usually due to one of two things: poor posture (even though I told you to sit up straight!) or the computer screen being positioned too high.  Ideally, the screen should be in the upper 1/3 of your field of vision while looking straight ahead.

Next, take note of your arm position: Are your shoulders relaxed and elbows in a comfortable position?  Ideally, your elbows should be bent and slightly in front of your hips. You want to avoid being too far from you keyboard and reaching forward. Also, using the arm rests can decrease the load on your back.   Finally, your wrists should remain in neutral, avoiding extension.  Overly extended wrists are often seen when a keyboard is on a tilt but the wrists are rested at the base of the keys. 

​If you use the phone often, consider purchasing a headset.  Continuing to hold the phone between your ear and shoulder will lead to neck and shoulder issues quickly. 
Picture
Standing desks are ideal for health and ergonomics.  Understandably, it is not feasible for every work space to have this based on cost and space but why not ask?  The worst your boss could say is no!

​It is important to continue moving throughout the day.  Some suggestions to help combat sitting:

Wiggle.
  If you are working on a task that requires extended sitting periods, I encourage you to fidget. Start by leaning against the back rest with your feet planted on the ground below your knees.  In a few minutes, change position by sitting on the edge of the chair and engaging your core to maintain the upright position. Drop your feet behind you so that your knees are pointing forward and the balls of your feet are on the ground.  This position can provide a nice stretch to your tight calf muscles.

Walk.  Take a short break every fifteen to twenty minutes to walk a lap in the hallway.  Set a timer! Take conference calls on your mobile and walk while they talk.

Leisure Time.  Be cognizant when choosing weekend or free time activities.  Dinner, movies, painting classes are all fun but they are all prolonged periods of sitting!  Try taking a stroll, going bowling, etc.

Mobilize as you work.  Keep a lacrosse ball under your desk and roll out the arch of your foot as you work.  You can even find a tight spot in the hamstrings and pin the ball between your leg and the chair.  Keep the pressure until you feel that spot relax.  At regular intervals roll your shoulders back in circles, lace your fingers together and reach your arms to the ceiling.
Rest in other ways.  If you are able to stand at work, or during leisure time, it is perfectly acceptable to lean.  Similarly, propping one foot (think Captain Morgan pose) can decrease the load on your lumbar spine in standing posture. If you decide to sit when you get home, try different lounging positions. Cross-legged sitting stretches various hip muscles and allows you to maintain the lumbar curve better than most positions.  Also, while playing with the kids or working at home, try lying on your stomach and propping on your elbows.  This provides a nice stretch to the hip flexors that have been shortened all day while sitting.


​Thanks for reading,

     Dr. Jackie, PT, DPT, CSCS
References 

Smith L et al. Weekday and weekend patterns of objectively measured sitting, standing and stepping in a sample of office-based workers: the active buildings study. BMC Public Health (2015) 15:9.

Healy GN, Dunstan DW, Salmon J, et al. Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care 2008;31:661–6.

Healy GN, Dunstan DW, Salmon J, et al. Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose. Diabetes Care 2007;30:1384–9.

Bey L, Hamilton MT. Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity. J Physiol. 2003;551(Pt 2): 673–82.

Elements of Ergonomic Programs, A primer based on workspace evaluations of musculoskeletal disorders.  Cohen AL, Gjessing CC, Fine LJ, Bernard BP, McGlothlin JD. US Department of Health and Human Services, Public Health Service, CDC and Prevention, NIOSH, March 1997, 16-33,91,92,99.

​https://em-poweredwellness.com/2015/01/16/how-to-set-up-your-desk-ergonomically/

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