Many medical and allied health professionals are concerned with the assessment and promotion of flexibility, including osteopathy, chiropractic and physiotherapy. Asanas, specialised techniques which include stretching, have been performed for thousands of years in yoga and other eastern belief systems. Taekwondo, judo and karate all work on advanced flexibility to enable the performance of their martial techniques. There is no precise definition of flexibility but the anatomical ability of the body's joints to pass through their ranges of motion is often quoted.
Ballistic versus Static Stretching
Many aspects of stretching are controversial and one aspect is the discussion about the relative merits of ballistic and static stretching. There may be some benefit in performing ballistic stretches in terms of maintaining interest as static regimes can be a bit....static, ballistic stretching can be rhythmical and add dynamism to a performance. Most sporting and hobby activities are dynamic in nature and ballistic training permits the practice of manoeuvres specific to the activity. Static stretches may not relate very closely to the active nature of some sports.
The general use of ballistic stretches is limited by their disadvantages which include the muscles and other tissues not having sufficient time to elongate if the stretch is very fast. Effective stretch is more usefully performed by longer periods of stretch with lesser force. Reflex contraction of muscles can occur also if stretching is quick, limiting the effect in order to prevent potential damage. With ballistic movements it is easy to generate momentum in limb or trunk movements which could take some of the tissues beyond their normal tolerances, leading to injury.
Static Stretching
Static stretching occurs when a stretch position is held for a defined period of time at least once, but it could be more times. The stretch should be performed in a controlled manner, without any movement or speed of movement. Static stretching has been researched and shown to be effective in changing the ranges of movement of joints. Static stretches are easier and more convenient to perform, require less energy and may result in less muscle soreness, but many of these things have not been proven.
Joint ranges of motion are altered by stretching but there are usually some ballistic parts of most activities and sports. The benefits of stretching have been variously reported as:
Stretching helps to warm up. There is no evidence for this and stretching does not increase muscle temperatures.
Stretching helps cooling down. Cooling down consists of allowing the blood flow to be moved away from the recently exercised muscles. This cannot occur with passive stretching of muscles and might even impede this.
Stretching relieves delayed onset muscle soreness (DOMS). No good evidence has been brought forward to support this contention.
Athletic performance is enhanced by stretching. Evidence does not support this idea either and dynamic flexibility may approach performance more closely.
Stretching reduces the likelihood of injury. A restriction in the ability to be flexible can make injury more likely but increasing flexibility has not been associated with injury reduction. Evidence has come forward linking stretching to an increased likelihood of injury in exercise.
Physiotherapists use a different way of defining and recording stretching and movements. In active movement the person moves their joint themselves using the muscles of the limb. In passive movement the same joint ranges may be performed but this time the physiotherapist might do the movement for them. Stretching may be passive or active or be a combination of the two.
Physiological stretching can be active where the patient lifts their arm up with one set of muscles, stretching the joint and the opposing set of muscles. If the joint will not go through the full range expected it is possible it is stiffness, weakness or pain which is limiting the joint. By checking the passive physiological range a physiotherapist can determine which one of these problems is troubling the joint. If the movement is full when the joint is stretched passively and there is not much pain then weakness must be the presenting problem. - 14130
Ballistic versus Static Stretching
Many aspects of stretching are controversial and one aspect is the discussion about the relative merits of ballistic and static stretching. There may be some benefit in performing ballistic stretches in terms of maintaining interest as static regimes can be a bit....static, ballistic stretching can be rhythmical and add dynamism to a performance. Most sporting and hobby activities are dynamic in nature and ballistic training permits the practice of manoeuvres specific to the activity. Static stretches may not relate very closely to the active nature of some sports.
The general use of ballistic stretches is limited by their disadvantages which include the muscles and other tissues not having sufficient time to elongate if the stretch is very fast. Effective stretch is more usefully performed by longer periods of stretch with lesser force. Reflex contraction of muscles can occur also if stretching is quick, limiting the effect in order to prevent potential damage. With ballistic movements it is easy to generate momentum in limb or trunk movements which could take some of the tissues beyond their normal tolerances, leading to injury.
Static Stretching
Static stretching occurs when a stretch position is held for a defined period of time at least once, but it could be more times. The stretch should be performed in a controlled manner, without any movement or speed of movement. Static stretching has been researched and shown to be effective in changing the ranges of movement of joints. Static stretches are easier and more convenient to perform, require less energy and may result in less muscle soreness, but many of these things have not been proven.
Joint ranges of motion are altered by stretching but there are usually some ballistic parts of most activities and sports. The benefits of stretching have been variously reported as:
Stretching helps to warm up. There is no evidence for this and stretching does not increase muscle temperatures.
Stretching helps cooling down. Cooling down consists of allowing the blood flow to be moved away from the recently exercised muscles. This cannot occur with passive stretching of muscles and might even impede this.
Stretching relieves delayed onset muscle soreness (DOMS). No good evidence has been brought forward to support this contention.
Athletic performance is enhanced by stretching. Evidence does not support this idea either and dynamic flexibility may approach performance more closely.
Stretching reduces the likelihood of injury. A restriction in the ability to be flexible can make injury more likely but increasing flexibility has not been associated with injury reduction. Evidence has come forward linking stretching to an increased likelihood of injury in exercise.
Physiotherapists use a different way of defining and recording stretching and movements. In active movement the person moves their joint themselves using the muscles of the limb. In passive movement the same joint ranges may be performed but this time the physiotherapist might do the movement for them. Stretching may be passive or active or be a combination of the two.
Physiological stretching can be active where the patient lifts their arm up with one set of muscles, stretching the joint and the opposing set of muscles. If the joint will not go through the full range expected it is possible it is stiffness, weakness or pain which is limiting the joint. By checking the passive physiological range a physiotherapist can determine which one of these problems is troubling the joint. If the movement is full when the joint is stretched passively and there is not much pain then weakness must be the presenting problem. - 14130
About the Author:
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapists, physiotherapy, physiotherapists in London, back pain, orthopaedic conditions, neck pain and injury management. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.
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