Sally John is a Registred Physiotherapist in the province of Ontario , Canada. She has been qualified since 1981 at the Royal London Hospital UK and registered with the College of Physiotherapists in Ontario since 1988. Sally John has worked in manual therapy since 1987 and worked with Sports Physiotherapy Canada since 1989. Currently, she works with kids and adults participating in Ontario level downhill and cross- country skiing. She sets dryland programs, programs to prevent injury and therapy post injury.

Why does one stretch?

o To improve flexibility
o To prevent injury

The problem that has been discussed many times over is - How do we stretch? When do we stretch? How long do we stretch and how often?

How do we stretch
When we stretch, muscles are lengthened and:

• nerve tissue - sensation has been reported to become less with stretching (ref; Borkland; Stretching of the Rectus femoris muscle 82), Shacklock says that after 2 seconds damage to nerves can occur, if there is an inflamed nerve and is held against its resistance.
• blood vessels get narrower or can twist on themselves. (ref; Ogata, Ngaito 86 – Blood flow of peripheral nerve effects of dissection, stretching and compression . Shacklock 95)
• fascia (muscle sheath and tissue that covers and holds together muscle and its surrounding blood & nerve tissue) gets tighter over the muscle and can restrict the circulation to it (ref;R Shultz, R Feitis,, The endless Web).
• Muscle resists being stretched, but due to its receptors will adapt, however, can put strain on the attachment area if stretched quickly; hence injury can occur.

For all these reasons, it is sensible to assume that holding the stretch for more than 2 seconds could cause damage if the stretch is not well managed. It is therefore important to know that if you have pain when stretching, the stretch is not being performed correctly.

The safest way to stretch is:.
In a comfortable, stretched position; contract –relax. One muscles are being stretched and the opposite muscles not being stretched. Repeat contract/relax at a pump rate. 1-2 secs on and off over a 60 second interval. During that period, you will notice that the tone will reduce in the muscle and you will be able to stretch a little more. Always be careful not to increase discomfort.

This method ensures that the muscle fibers are independently moving from the fascia, the nerves are able to still function and send information to the CNS, the blood vessels remain open by the pumping mechanism and muscles are receiving the correct body fluids in order to repair.

Hamstring stretch

There are two ways of stretching hamstrings. In these positions you contract-relax hamstrings, the muscle at the back of the leg and quadriceps, the muscle opposite this.

When
If the muscle or joint has been recently stressed, then we know that the tissue is in the inflammatory stage of healing and after 1 hour fibrocytes (scar tissue) are laid down. Therefore, as soon as you are able, it is important to gently stretch into the restricted range as much as pain will allow and hold the stretch in that position with isometric contractions (contractions of the muscles above and below the injured part). You should do this until as near to your normal length of muscle has been regained.

Length of stretch
Taylor & Brooks cite that there is no difference between holding a stretch for 15 seconds up to 2 minutes.
Brent , Myrer, Schulthies, Fellingham, Meason, say if you are older than 65 years, you should hold the stretch for 60 seconds.

How Often
There appears to be no real guide-line, but at least 3 times /day is minimum, especially upon rising. Start warming the muscles to be stretched with general contract - relax exercises, or use the stationary bike with no resistance. Then follow the stretch protocol. However, if you have had a recent injury, continue with the hourly movement.

Muscles to stretch for soccer

Remember to contract - relax in the stretched position. The Vibrosphere® can assist with this stretch, as it can cause contract-relax many more times than one can conscientiously do! Rule of thumb is that recent injury should wait to be stretched for up to 2 days and then gentle vibration one to two sets at 25Hz with no increase in pain. The pain should reduce when this vibration is happening. If you have chronic tightening, start with 30Hz or 35HZ for two to three sets depending on tolerance.

• Hamstrings as above on the Vibrosphere® reaching to your toes.
• Quads: One leg stance with other knee bent (heel to buttock) – hip as straight as you can get. For better balance - use another person or bench. Contract - relax and try to gain more stretch. This also can be done with the use of the Vibrosphere®.
• Calf – back leg straight on the Vibrosphere® and toes facing forwards – now lean forwards into stretch and repeat stretch procedure.
• IT Band – Cross legs and reach to toes and repeat stretch procedure. This position can also be done on the Vibrophere®.
• Adductors: Stand astride as far apart as possible. One knee bent a little on the Vibrosphere® and one straight. Put the weight on the bent knee, while stretching straight leg.

For trunk stretches you can do deep breathing.

• Trunk side flexors – Feet a little apart and reach arm above head on one side and reach down the other side
• Trunk rotators – twist upper body

If you have any questions send an e-mail to sallyjphysio@rogers.com

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