Stretching Basics
Compiled by Linda Craigg, NMT, LMT*

WHAT STRETCHING IS
…the body’s link between your sedentary life & active life.

1. Keeps muscles supple, prepares you for movement, increases flexibility and facilitates a healthy transition from inactivity to exercise.
2. Injury prevention – especially for active sports such as running, which can create tightness & inflexibility. Reduce affects of joint compression caused by high impact sports and removes toxins (including lactic acid) from body.
3. Tool to increase body awareness – determine tight areas (right hamstring, left hip, etc.); target areas that need more focus.
4. Develop stretch routine to restore balance to your body; should be customized to individual muscular structure, flexibility & tension. NOT one size fits all!
5. Goal = reduce muscular tension + promote ease of movement. Stretching promotes extension in the body to offset the flexion prevalent in modern life.

KEY TO SUCCESS = REGULARITY, PATIENCE & RELAXATION

1. Competition between others or yourself (your flexibility varies daily)
2. Stressful or rushed
3. Ballistic/bouncing
4. Time to hold your breath or hyperventilate (breathe naturally)

WHEN TO STRETCH... ANYTIME!! In the morning when you wake up; at work to release nervous tension; after extended sitting or standing; when you feel stiff; before & after exercise; during travel; at odd times during the day (leisure time); before bed

• Stretch slowly and evenly – No Bouncing!
• Gently pull muscle to end zone; hold 15 second; repeat 3 times on each side; stretch bilaterally (work right and left sides)
• Overstretching is worse than no stretching; contracts and tears muscles, resulting in injury and/or decreased flexibility
• Know your limits; stretching is not a competition or contest; individual needs are different and require specific stretches
• Breathe during stretch to help body take in oxygen and allow muscles to release
• Stretch before and after activity (Warm ups/Cool downs)
• Be consistent – try to stretch every day
• Feel younger, enhance awareness and have fun!

Not only are there numerous ways to stretch an individual muscle, but there are several techniques to stretch as well. Finding a successful stretching program is like finding a successful diet – and what works for your running partner may not work for you. For stretching the hip flexors, one runner may prefer a standing stretch, another may prefer a seated stretch and yet a third may get the most benefit from a recumbent stretch. Always warm up before stretching. Some of the primary types of stretches are:

STATIC – slow movements; gentle pulling; hold 10 - 15 seconds; repeat 3 – 5 times per side, alternate left & right
BALLISTIC - Old school (bouncing); worse than not stretching at all
PNF (Proprioceptive Neuromuscular Facilitation) – specific and involving contraction (resistance) alternating with lengthening stretch; usually done with trainer or therapist
PARTNERS STRETCHING - uses leverage to attain a deeper stretch; fun variation
THAI MASSAGE – traditional bodywork in Thailand, integrating yoga techniques, deep leverage stretching and acupressure.

• Hydration – plenty of WATER supplemented by sports drinks (for electrolytes)Stretch books/charts/guides; Check out internet sites with illustrated stretches for general lifestyle and running

• Cross-training – especially swimming, pilates, yoga (all low impact)

• Theraband, yoga strap or wide belt

• TheraCane, tennis balls and/or massage tools

• Hydrotherapy – ice packs (acute pain) & moist heat (chronic pain) Topicals such as Biofreeze (cold therapy gel for specific muscles) + Epsom salts (soak feet or add to bath)

• Therapy as needed, including physical therapy, chiropractic/applied kinesiology, sports/therapeutic massage & personal trainers (trained in sports & exercise physiology)
• Inversion tables for traction/extension of spine

*Reference: Stretching, 20^th Anniversary *Revised Edition by Bob Anderson, Illustrated by Jean Anderson, Copyright 2000, Shelter Publications, 223 p. (also available as DVD)

Common Conditions & Repetitive/Overuse Injuries For Runners
By Linda Craig, LMT, NMT *

1. Pes Planus (Fallen arch/flat feet): leads to over-pronation, and if not corrected can cause shin splints and stress fractures. Treatment options include orthotics and/or arch supports such as Super Feet; strengthening tissue with exercises and massage techniques. An easy exercise to strengthen the arch is to “scrunch” & pick up a wash cloth with toes.

2. Pes Cavus (High Arch): increases tensile stress & shortens the plantar fascia and may cause plantar fascitis and/or bone spurs. Treatment may include loosen plantar muscles to lengthen tissues on the bottom of foot via foot massage roller, tennis ball or massage; ice & stretch calf muscles and plantar (bottom) surface of foot.

3. Morton’s Foot (shortened great toe relative to 2nd toe); 20% of population has this condition; effects foot mechanics and push-off of stride and may cause plantar fascitis or shin splints. Treatment protocols include orthotics, massage and wider toe box in running shoes.

4. Plantar Fascitis; overuse condition causing pain and inflammation, especially at the heel attachment of the fascia. Left untreated and continued overuse may develop in to a bone spur at the attachment. Treatment includes rest, cryotherapy (ice), stretching of the Achilles tendon and foot; deep friction massage to break up adhesions and stripping of calf and foot flexors.

5. Achilles Tendinitis; intense shock absorption combined with poor blood supply at the base of the Achilles make this tendon vulnerable to overuse injury; may cause distal pain in the tendon, tight, inflexible calf muscles, and swelling of tendon. Treatment includes rest, cryotherapy combined with stretching & massage, especially to calf muscles (lengthens and releases the tendon).

6. Tibial Stress Syndrome (Shin Splints); overuse condition; Lateral/outer shin splints occur due to running long distances downhill or on sidewalks with uneven camber or running track. Causes of Medial/inner shin splints include flat feet, inadequate footwear, overpronation, running on poor surfaces or poor body mechanics of foot or leg. Treatment includes modification of activities, change of shoes, and rest. Friction massage along with active & passive stretch will benefit

7. Muscle cramping/spasm; common in calves but can occur in quads, hamstrings. Causes include inadequate stretching, poor muscle metabolism, salt deprivation, potassium imbalance and commonly dehydration at the tissue level. Treatment includes hydration (water, electrolytes), stretching – especially PNF, and contraction of antagonistic muscle to disrupt the pain-spasm-pain cycle causing the cramp. [i.e. if quads in front leg spasm, contract the hamstrings to release the quads]. Dehydration is a primary cause of muscle cramps & spasms - DRINK MORE WATER!

Knee injuries – Meniscus & ligament (ACL, PCL, MCL, LCL) sprains & tears; depending on severity require braces, P.T. or orthopedic surgery. Massage techniques along with P.T. used more in rehab (post-surgical) to avoid scar tissue and increase flexibility, and enhance mobility of surrounding muscles

Hamstrings & Quadriceps pull/tear; as with knee, depending on severity may require medical treatment; massage techniques can be used to loosen and release the muscle belly, but deep tissue pressure should not be applied to the muscle attachments

Adductor/groin pull; pain and tightness in front inner pelvis down the inner thigh; massage & stretch adductor group, stretches to release and lengthen inner thigh muscles

IT Band Syndrome; IT band stabilizes the knee and allows it to track properly. Often IT Band Syndrome affects the knee on one side; left untreated muscular imbalances occur on the opposite side (including tight leg muscles & hip flexors, shortened psoas); felt in lateral knee but involves thigh & hip due to increased tensile stress. Treatment is to stretch IT band to reduce tension; ice and massage especially to gluteal region and hip muscles; also release upper leg muscles (hip flexors & hamstrings)

Sacroiliac (SI) Joint Dysfunction; posterior junction of the sacrum and pelvic bones create a wedge; compressive forces common in runners can stretch or weaken the ligament structures which support the SI joint. Depending on cause, treatment may include chiropractic adjustment and massage of soft tissue in hip & low back

Piriformis Syndrome; nerve compression syndrome in which the sciatic nerve is impinged by the primary lateral rotator of the hip (piriformis muscle). Pain begins in glutes, then migrates into the hamstrings, and eventually down the back-leg. Massage of gluteal region and deep hip muscles aids in healing.

Shortened Psoas; tightening of the largest and strongest hip flexor; mimics low back pain; common in runners and dancers. Massage, stretches and exercises to extend and strengthen the core (such as pilates) help treat this condition.

Pelvic Tilt; caused by structural/postural deviations and/or poor body mechanics; Anterior tilt (may be caused by shortening/tightness in the psoas muscle); Posterior tilt (may be due to weak lumbar and abdominal muscles and tight hamstrings; and Lateral tilt (muscular imbalances in pelvis/hip).  All respond well to massage and stretching techniques.

*Based on 13 years experience working as a massage therapist on a wide variety of recreational & professional athletes. Compiled based on personal knowledge and information in Functional Assessment in Massage Therapy by Whitney Lowe (forward by Benny Vaughn). Whitney is a graduate of Atlanta School of Massage and now heads up the Orthopedic Massage Education & Research Institute (OMERI) in Bend, Oregon.