UPPER EAST SIDE — Most of us know that tense, tight muscles make us uncomfortable and put us at risk of injury.
But what is the best way to improve flexibility and how much is enough? Should everyone be stretching or are some people already too flexible? Is stretching really as important as strength training?
I recently posed these and other common questions to three local experts. The consensus seems to come down to one word: balance.
Optimum health and performance depends on a trio of factors: monitoring whole body strength and flexibility; regulating the length and tension in each muscle; and balancing the sets of muscles that work together to move and stabilize our joints.
"It's very important to maintain good muscle length-tension relationships for proper function and posture. But not everyone needs to stretch every muscle," says Kevin Towers, DPT, who has a private practice on the Upper East Side.
The right amount of stretching depends on the individual, Towers said.
"For the person who does need it, a daily routine is best," he said. "Stretch only what needs to be stretched."
And that perfect stretch may take less time than most people imagine.
"Thirty seconds is enough to allow the muscle spindles and fibers to relax to actually gain the stretch," Towers said. "Anything less is not sufficient. Anything greater is not necessary."
Range of Motion and Strength Training
Joe Tatta, PT, OCS, CHS and owner of Premier Physical Therapy, recommends a routine that focuses on range of motion — particularly for baby boomers.
"Especially as people start to age — and we have this baby boomer population getting older — a minimum of twice a week, people should be doing something that addresses the range of motion of their joints," Tatta says.
"When looking at any stretch though, you have to ask, how does that carry over into something that's functional?"
Rowland uses the example of a hockey goalie who must do a split to block a goal. Getting down into the split is only half the job. The goalie must then also have the strength to come out of the split quickly.
"True flexibility has strength and control throughout the whole range of motion and dynamic stability," Rowland says.
Not just for NHL athletes
But good balance between strength and flexibility isn't just for Henrik Lundqvist wannabes. It's crucial for good posture and optimal health in everyone.
For example, the upper back muscles of someone who habitually slouches become over-strong in a lengthened position, as they constantly strain to keep that person from falling forward. The sloucher's chest muscles on the other hand, become short and weak from their perpetually caved-in position.
"You need to relieve the tension before re-educating and strengthening the muscle," Towers said. "Once you gain what I call 'new real estate,' by stretching the muscle, you can build strength there and re-educate it."
In other words, stretching the chest in this example is just as important as contracting the upper back in order to correct the poor posture.
Another common postural problem develops when the muscles in the lower back become short and tight as abdominal muscles become weak and long, no longer able to properly do their job of holding in the core. This leads to a protruding belly and pain or discomfort in the lumbar spine. In this case, it is just as important to strengthen the core as it is to stretch the muscles that are compressing the low back.
Passive Stretching, PNF or Resistance Stretching?
So what's the best way to achieve ideal length and strength in muscles and the full range of motion in joints that comes with that balance?
There are many stretch techniques available, but not all are appropriate for everyone. Passive stretching is the most commonly known and is usually safe to practice without the direct guidance of a professional. In passive stretching, you simply move your body into a stretch position, such as putting your leg up on a chair, for instance, in order to stretch your hamstring.
Another popular stretch technique used by trainers and physical therapists is PNF — Proprioceptive Neuromuscular Facilitation. PNF uses innate neurological reflexes to trick your body into relaxing the muscle you intend to stretch, allowing the muscle to stretch further than it otherwise would.
The muscles of our body are organized in pairs, known as agonists and antagonists. As one contracts, the other stretches. It's an ingenious system designed to balance and control our movements. When you contract your quadriceps, the front of the thigh, for example, your brain automatically sends a message to the hamstring, the muscle in the back of the thigh, to relax. A variety of PNF techniques employ this principle, known as reciprocal inhibition, to temporarily increase range of motion.
PNF is best done under the guidance of a trained professional though since it can lead to injury when performed improperly.
Active Isolation and Ki-Hara
Active Isolation (AI) is one form of PNF, in which the client moves their joint into and out of its end range of motion several times under their own power, followed by an assist from the trainer or therapist, who then augments the stretch as the client relaxes.
Ki-Hara is a form of resistance stretching that Rowland says develops strength and flexibility in a uniquely balanced way. The trainer cues the client to contract the muscle being stretched against resistance provided by the trainer, who simultaneously moves you into a stretch position.
When the client can no longer maintain a contraction, the stretch is over. "Resistance stretching is the only way to release tension along the entire muscle and not just at the end ranges of motion," Rowland says.
Regardless of which technique you use, diaphragmatic breathing can enhance the effect by helping you to relax. In fact, instead of timing the stretch for 30 seconds, try taking five to 10 deep, slow breaths in each stretch position instead. You'll end up being in the position for the right length of time, and you'll know you got the maximum benefit from your breathing.
The value of heat
There is less agreement about the benefits of stretching in a super-heated room, such as sauna or practicing hot yoga. Heat may increase blood flow to the muscles through vasodilation, or the relaxation of muscle cells within blood vessel walls. But whether that is a safe and effective way to enhance a stretch is unclear.
Tatta believes a good old-fashioned warm-up can achieve a similar result. "I prefer to warm my body up from the inside out before stretching," he said. A light warm-up, like light jogging or calisthenics, "brings blood flow up, and gets heat to vital organs and large muscles" in a way that's proven to be safe and effective.
Towers, on the other hand, says hot yoga can be helpful to some people. "For someone who needs to stretch, and likes yoga, I think it's totally fine, as long as they drink a lot of water."
Rowland says that while "all types of yoga and Pilates have their applications, it's really all about muscle elasticity." Unless a muscle can contract through its full range of motion, it is "functionally bankrupt."