| 10.
Stretching: When, Why, How
"Stretching for warm-up is dynamic.
Stretches for cool-down are static and held for 20-30 seconds.
Stretches for muscle lengthening can be held longer (60 -90 seconds
and more) but should not be performed before sport participation."
The term "stretching" is used to generally mean anything
that takes a muscle to its end range.
People generally assume that the flexibility and extensibility
of a muscle, or lack thereof, is associated with muscular injury.
In fact, most muscle and tendon pulls do not occur at the end
or range of motion, but within the normal range of motion while
the muscle is lengthening under tension.
While working in Germany, we used MRI (magnetic resonance imaging)
to assess players' injuries. With few exceptions we found that
lower body muscular injuries correlated with MRI findings of low
back pathologies. The well known Dr. Muller Wohlfahrt uses muscle
and joint injections (non-medicinal) directed to the injured muscle
and also to the muscles and joints of the low back. His theory,
simplistically stated, was that irritation to the spinal nerves
caused a tightening and a weakening of the muscles supplied by
that nerve. The analogy used was that the affected muscles were
like 100 Watt light bulbs receiving only 80 Watts of power. When
the bulb is asked to produce the full 100 Watts it is unable to
do so and injury results.
Working with Dr. Wohlfahrt led me to study with Dr. Chan Gunn,
the creator of the IMS (Intramuscular Stimulation) model. Dr.
Gunn's model uses nerve and muscle research to explain the processes
behind chronic pain. His theories though, also apply to the athlete
because the athlete needs the nervous system even more so than
the average individual in order to recruit muscle and to recruit
it quickly. Over the past few years I have found excellent results
using IMS as an adjunct in the treatment of athletic injuries.
If we apply this line of thinking to the role of stretching then
one conclusion that might be reached is that the state of the
nervous system is more important than the relative flexibility
of the muscle (not that flexibility is unimportant, only that
nervous system preparation is more important). Observations of
soccer players doing pre-game static stretches only to pull a
muscle during competition did little to bolster my confidence
in stretching as a warm-up technique. On the other hand I also
observed many players perform their own dynamic type stretches
and continue without injury.
I use the terms static and dynamic stretches quite a bit so I
think it is worthwhile to define these different types of stretches:
Static Stretching: A static stretch is one where
sustained pressure is applied to a muscle or group of muscles
in a lengthened positioned. One example of this is the hamstring
stretch.
These positions are held for varying lengths of time with the
typical advice being 20-30 seconds because research has told us
that static stretches held for 20 seconds will improve muscle
flexibility and muscle resistance through a range of motion.
Dynamic Stretching: Repeated movements are made
either through the range of motion or at the end range of motion.
If the player were to swing his leg up and down to stretch his
hamstring then this would be an example of dynamic stretching.
The term ballistic stretching is where a bouncing movement is
applied at the end range which stimulates a stretch reflex.
PNF Stretches: PNF stands for proprioceptive
neuromuscular stimulation. Essentially these stretches involve
taking the muscle to the end of its range and then contracting
the muscle without movement at the joint. After the contraction
is held for a period of usually 10 seconds, the muscle is taken
to its new range of motion.
I think that at the end of the day we really use stretches as
a tool to achieve one of the following goals:
- As part of a warm-up and injury prevention routine
- To enhance performance by stimulating the nervous system
- As a part of the rehabilitation process of an injured muscle
or joint
- To reduce muscle stiffness
- To make increases in muscle length
- To relax the nervous system
Warm-Up
A warm muscle will have greater extensibility than a cold muscle.
The warm-up phase requires stimulation of the nervous system to
recruit muscle quickly and to allow the muscle to act with force
and power. Warm-up activities should increase muscle and joint
temperatures, increase nerve firing rates, recruit movement patterns
required for soccer, and optimize the body's readiness for action.
A relaxed nervous system will not accomplish this task, therefore
the use of static stretching during warm-up is of questionable
value.
We should use instead a series of movements that progress from
simple to complex and will involve sport specific movements seen
in the game. A dynamic warm-up such as this will not only increase
heart rate and warm the muscle tissues but it will also prime
the nervous system to recruit muscles that will be required for
sprinting, jumping, tackling and so on.
We use the term dynamic stretches quite often now - the term
is different than the ballistic stretches used in days gone by.
Dynamic stretches are controlled movements that take a joint through
an entire range of motion. I will give some examples of dynamic
stretches that can be used as a part of a soccer warm-up. I will
not include other warm-up drills as these will be under the supervision
of the team coach.
Example of a Soccer Warm-Up
- Start with 10 minutes or so of easy jogging. The jogging should
include forward and backward movements and also sideways motions
(Carioccas).
- Walk on the toes for 20 m. straight, 20 m. in toe-out (external
rotation) and 20 m. in-toed (internal rotation).
- Walk on the heels for 20 m. straight ahead, 20 m. turned
out and 20 m. turned in.
- Lunge walks for 20 m.
- Skipping with high knees for 20 m.
- Kick your hands. Place hands behind the back and then, while
jogging, kick each heel to tap the hand behind the seat.
- Swing one hip around to the front, skip or shuffle step and
then repeat with the other hip going across the front as well.
Go for at least 10 in each direction with a nice full yet controlled
range of motion.
- As above but swing the hips from the inside to the outside
instead. Shuffle step to get in position for the next hip swivel.
These routines should be coordinated and when they are done
in unison as a whole team it helps develop tempo and rhythm
to the warm-up.
- While jogging forward, reach down and touch the grass with
the left hand. Keep the body upright as you do so then repeat
with the right hand. You can also touch down with both hands
to alternate. Get in at least 10 touches on each side.
- While standing, swing the leg up and down with a bent knee
to warm-up the hip flexors; swing the leg in the same way with
a straight leg to warm-up the hamstrings; swing the leg inside
and out to warm-up the adductor or inner thigh muscles. Point
the toe to the grass and make large circles in each direction
to warm-up the ankles. These movements may be performed at increasing
speed but control is the important thing - they are not bouncing
or uncontrolled movements - the nervous system is controlling
the muscle movement through each degree of the particular range
of motion. 10-20 of each movement pattern with a slow increase
in speed.
- Shadow drills with or without the ball. Now players are starting
to move faster. One player dribbles the ball in various directions
while the partner attempts to contain or defend the dribbler.
Switch off every 40 m or so.
- Move into progressively sport specific movements and drills.
Cool-Down
After a hard game or intense training, the muscles will be fatigued
and may even have levels of damage to the tissue. As a part of
cooling down, or what is now often called "warm-down",
continued movement of the body and gentle static stretches are
used. Since there may be microscopic muscle damage, the player
should not stretch aggressively and the holds should be in the
range of 20-30 seconds. All the major muscle groups of the legs
should be addressed as well as the muscles of the torso.
Stretching for Range of Motion
I see many soccer players each week and some of them seem to be
tight at every joint. I often refer to these players as "hard
wired" as I believe that the muscles of these players are
the result of the state of the nervous system. These players often
have fantastic speed and reaction time but they are also at risk
of injuries related to inflexibility and therefore require a separate
stretching regime to maintain muscle balance and range of motion.
There are two primary types of stretching to gain range of motion
at a joint
- Prolonged Static Stretches
- PNF Stretches
Muscles contain collagen and therefore if it is to achieve a
greater length then the load on it must be held into the "plastic
zone" which is at least 20-30 seconds. PNF stretches are
also effective as they will hold a muscle under tension for a
period greater than 20 seconds.
If the stretches for range of motion are done at night I like
to prescribe prolonged static stretches of 60-90 seconds. these
stretches are held at a gentle intensity (for example if 10/10
was an unbearably painful stretch and 0/10 was no stretch whatsoever
then the ideal stretch intensity would fall under a 2 or 3/10).
Holding a gentle stretch like this will improve muscle extensibility
and will calm and relax the nervous system. Anecdotally many people
sleep better after performing a series of stretches like this.
Note that your posture must be in good form through all stretches
but especially with the prolonged ones. Sometimes I have the player
resting on the floor so that they do not have to worry about posture
as much and rather just relax into the stretch. |
