Is Stretching the Solution?
Mobility vs Flexibility
Patients ask us about stretching all the time.
Questions about stretching vary, but our most common questions include things like…
“How much should I be stretching?”
“I’m doing XYZ stretch, is this the right stretch for me or should I be doing something else?”
“I’m stretching constantly, why does it seem to not make a difference?”
The simple answer to these questions is… it depends!
Rather than leaving you with that simple answer (and arguably a much easier blog to write) let’s break it down a bit further...
Why do people stretch to begin with?
It seems that whenever we find ourselves feeling “tight” or “stiff” we feel that we need to stretch the problem away in order to feel better.
There isn’t anything inherently wrong with this perspective. Stretching will likely provide you with relief from tightness/stiffness temporarily.
However, it is important to understand where the restriction in your movement is coming from.
What causes tightness?
It’s important to recognize that feeling “tight” can be the result of quite a few things. Here’s a list of examples that covers a wide range of underlying conditions:
Bony blocks (anatomical limitations)
Anatomically short muscles
Capsular stiffness
Neural tension (“tight” nerves)
Soft-tissue adhesions (especially post-injury)
Muscle spasms
Protective tension
As you can see, not everything on this list is something that can or should be helped by stretching.
So the first part of our answer to these patients is that we need to understand why something is tight before we ask whether or not stretching is an appropriate solution to the problem.
Will stretching help?
The second part of this answer has to do with whether or not stretching is the correct intervention to resolve someone’s complaint.
First we need to perform a thorough examination and to determine that the restriction/limitation in range of motion is something that would benefit from becoming “looser” or more mobile.
For example, if we have a patient who has pain while squatting we’ll perform a movement screen to better understand and assess their quality of movement.
A common finding during a squat assessment is restricted dorsiflexion (ability of the ankle to allow the foot to flex upward towards the shin) due to a feeling of tightness in the back of their calf.
Here’s a quick video demonstration that shows how we go about confirming this kind of mobility restriction.
A lack of dorsiflexion causes compensation patterns up the chain (as explained by the Joint-By-Joint Theory), which can result in a more horizontal trunk while squatting and lead to back pain!
So, if we recognize that this movement restriction is contributing to the patient’s pain we can confirm that some sort of “stretching” could be helpful in resolving this complaint.
However, stretching alone likely won’t fix this issue.
The reason that stretching isn’t the direct answer can be explained through the concepts of flexibility and mobility.
What is the difference between flexibility and mobility?
Many use these terms interchangeably, and while they are closely related it’s important to recognize the unique differences between the two.
Putting it simply…
Flexibility is the range of motion that a joint has passively.
Mobility is the range of motion that a joint has actively.
In this context “passive” means that a joint is taken through its full range of motion with outside assistance (think someone stretching your hamstrings for you).
Active means you are able to take the joint through its full range of motion by yourself (think how far you can lift your leg while laying on your back).
The goal of increasing flexibility is to increase the range of motion within a joint by lengthening the tissues surrounding the joint (mostly muscles and tendons). Most commonly we gain flexibility by performing prolonged static stretches.
The goal of increasing mobility is to increase the amount of control we have within the range of motion of a joint. In order to gain mobility we must take the joints through dynamic movement which activate and engage the surrounding musculature (versus a passive lengthening stretch).
Ultimately, we need both adequate flexibility and mobility to develop healthy movement patterns. Flexibility ensures that a joint can move freely but mobility is required in order to USE the range of motion we have.
So we need flexibility AND mobility, but what role does stretching play?
Stretching can be a beneficial tool, but it might not make as long lasting of an impact as we might think.
One research study found that after 5 rounds of an elaborate hamstring stretching protocol the increased range of motion of each participant only lasted for 6 minutes! With an even more extensive stretching protocol the results lasted between 60-90 minutes total.
This isn’t to say that we shouldn’t stretch at all, it can provide short term pain relief.
BUT, the current research has shown that the short term effects of static stretching do not outweigh the benefit of performing dynamic exercises to gain overall flexibility and mobility.
With regards to cases where patients are looking to use stretching as a solution to help them resolve pain it’s important to recognize that it’s not as simple as “stretching away” your aches and pains.
In fact, to improve functional range of motion in a joint we need to gain mobility by activating our muscles in a coordinated manner to move a joint through its entire ROM in a controlled fashion.
This takes practice. Our nervous system has to learn to recognize which muscles need to fire at the proper time and develop the “muscle memory” to efficiently perform the movement.
All this to say… we would be doing you a disservice if all we prescribed to you was a simple static stretch!
If you have any questions please feel free to reach out! If you’re interested in seeking care you can schedule an appointment with one of the Momenta Doctors for an examination and movement screen to figure out the best plan of action for you.
Follow our booking link here to schedule your appointment online now!
