This Form of Exercise Prevents
Injury, Reduces Chronic Pain, and Improves Mobility
FOCUS ON FITNESS
The key components of fitness are
cardiovascular conditioning, muscular strength, and flexibility. Unfortunately,
flexibility often is neglected in favor of more cardio or greater strength. Clients
skip stretching because they believe flexibility isn’t a good workout or that
it’s an inherent trait—someone either is naturally flexible or they’re
tight. But this isn’t true.
tight. But this isn’t true.
Benefits of a Flexible Body
Clients can improve flexibility by
training, subsequently preventing injuries while doing aerobic and strength
workouts. Maintaining flexibility throughout life helps aging adults function
better and prevent falls. Flexibility is important for athletes and advanced
exercisers who may be at higher risk of exercise-related injuries. Becoming more
flexible can improve performance and help relieve and prevent chronic pain
associated with poor posture and a sedentary lifestyle. In fact, flexibility
training is a primary component during physical therapy to rehabilitate
musculoskeletal injuries.
Flexibility not only includes muscles but
also joints. It’s defined as the ability to move joints effectively through
their full range of motion, and it’s related to the elasticity, or suppleness,
of muscle tissue. Because muscles are attached to joints by ligaments and
tendons, flexible muscles also affect their proper functioning and can decrease
the risk of injuries to ligaments, tendons, and joints.
Stretching exercises must be performed
regularly to maintain and improve flexibility. Muscles become tight when they
shorten from postural habits or injury, spasms, or contraction. Most of us have
a muscular imbalance due to one side of the body being dominant during
activity. This imbalance frequently manifests as muscle tightness or
inflexibility.
Stretching Exercises
The following stretching techniques may be
used to improve flexibility:
• Static stretching: This is the most common in which a muscle is moved
into a position that creates tension and a stretching sensation and is then
held.
• Dynamic stretching: This involves moving a limb repetitively, with
control, through its full range of motion. It’s typically used as part of a
warm-up before workouts and athletic activities.
• Precontraction or proprioceptive neuromuscular facilitation stretching: Using this
technique, the muscle is contracted, held, and then relaxed. This type of
stretching generally involves a therapist’s or partner’s assistance or the
use of a strap or resistance band.
Note that ballistic stretching, a
stretching technique that involves rapid bouncing movements at the end range of
motion of a joint or muscle, is considered risky and is no longer recommended.
Guidelines from fitness organizations
recommend performing stretching exercises at least three times per week after
warming up the body. Static stretches targeting the major muscle and
joint/tendon groups should be held in a position where mild discomfort is felt
for 15 to 30 seconds. Eventually, the stretch can be held for as long as 60
seconds. Each stretch should be repeated two to four times. These recommendations
are for healthy clients. Those with movement limitations and beginning
exercisers may need modifications; athletes and advanced exercisers may need options
for sport-specific flexibility improvements.
The advice “stretch before every workout”
is considered outdated. Numerous studies have found that stretching before a
workout doesn’t prevent injury during the workout or necessarily warm up the
muscles to be worked. Light activity mimicking the more intense movements
during the workout (eg, walking before running) has been shown to be more
effective.
Clients can perform dynamic stretching
movements before a workout in combination with activity that warms up the muscles,
such as standing alternating knee lifts, half squats, arm circles, and torso
twists. The optimal time to stretch to achieve gains in flexibility is after
the body is warmed up, such as at the end of a cardiovascular workout. Individuals
can integrate stretching in between strength exercises for each muscle group as
well as at the end of the workout. Clients also can perform stretching
exercises by themselves simply to relieve aches or tightness throughout the
workday as a break from sitting or standing in one position too long or at the
end of a long day to promote relaxation.
Built-In Flexibility Exercises
Your clients may ask about what types of
stretching exercises they should do and what exercises count as flexibility
training. Due to the increasing popularity of mind-body workouts, your clients
already may be satisfying the flexibility component of fitness training. Both
Pilates and yoga contribute to improved flexibility and have the added benefit
of improving muscular strength in the same exercise session. Many styles of martial
arts involve movements that improve flexibility as do the slower-paced tai chi
and qigong. However, even if clients do martial arts, Pilates, and/or yoga multiple
times per week, they should still stretch after or during other types of
workouts, such as cardiovascular conditioning and strength training.
Components of Flexibility Training
In general, flexibility training should
include all major muscle groups in the upper and lower body. Depending on your
clients’ overall fitness level and daily activities, flexibility exercises can
focus on specific anatomic areas to provide more benefit. For example, clients
who do computer work or sit at a desk all day should pay special attention to
stretching their neck, shoulders, back, and hamstring muscles because the neck
and back muscles tighten up due to the common postural misalignment that occurs
when typing and sitting for long periods of time (ie, hunching).
Clients with jobs involving the prolonged
use of forearms and hands in one position (eg, typing, sewing) or strength movements
(eg, hammering, assembly work) may benefit from frequent daily stretches for
the forearms, shoulders, neck, hands, and wrists.
Tight hamstring muscles contribute to
lower back pain, a common complaint for many clients. So stretching the back
muscles as well as these large muscles in the backs of the thighs will help
alleviate back pain.
Athletic clients should consider adding
sport-specific flexibility exercises to their stretching regimen. For instance,
golfers should focus on flexibility of the hips and shoulders to improve golf
swing. Runners and cyclists can emphasize hip, thigh, and calf flexibility to
prevent muscle pulls in the lower body.
Resources for Clients
Clients can view images and videos of
basic stretching exercises by visiting the Mayo Clinic’s website
(www.mayoclinic.com). Click on “Health Information,” “Healthy Lifestyle,”
“Fitness,” then “Multimedia.”
A recent trend in flexibility training is
to use foam rollers for myofascial release, especially for clients with
musculoskeletal pain or injury. A cylindrical foam roller is used in
conjunction with a person’s body weight to perform self-massage, which breaks
down soft tissue adhesions, stretches muscles and tendons, and increases blood
circulation to muscle tissue. Foam rollers also can be used as a prop for yoga
poses and Pilates movements that improve flexibility.
By Jennifer Van Pelt, MA
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