A common test used in elementary schools to measure flexibility for the back and hamstrings is the sit and reach test. Although testing positions have been modified, the original testing position for the sit and reach is on the floor with legs straight and feet inside the metal testing box. The participant would slide the metal tab on top of the box as far forward as he or she could. Most of the time this was a quick push forward in an attempt to out stretch your classmates. This test can be used for all age groups, but as your age increases your sit and reach score tends to decrease.
Flexibility is defined as the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain-free range of motion. (Kisner, C, Colby L, 2012). The hamstrings originate on the pelvis and attach below the knee joint to allow the knee to flex and the hip to extend. These muscles are a common site for muscle ‘tightness’ due to the hours spent sitting in a desk chair or on the couch at the end of the day. Proper stretching and flexibility within the hamstrings may help reduce back, hip and knee pain for some individuals. However, over stretching and improper quick stretching can lead to a strained hamstrings or a hypermobile joint.
Flexibility is an important component to our overall health as we age. Common everyday tasks such as reaching down to tie your shoe or turning your head to look both ways before crossing an intersection become much harder as the years pass. Associated with flexibility, stretching is often an overlooked exercise that is put on the back burner.
Rubber bands and muscles have similar properties in the way they can be stretched. If a rubber band is quickly pulled apart, the band will recoil just as quickly back to the bands resting state. If the rubber band is slowly stretched and held for a longer duration of time, the band will lengthen to a new size. The same is true with muscle fibers. In older individuals stretch durations of 15, 30, and 60 seconds applied to the hamstrings for four repetitions have all been shown to produce significant gains in range of motion with the greatest and longest-lasting improvements occurring with the use of repeated 60-seconds stretch cycles (Kisner, C, Colby L, 2012). The evidence shows that longer duration stretches produce greater range of motions and more flexibility. Two repetitions of daily 30-second static stretch of the hamstrings yield significant gains in hamstring flexibility similar to those seen with six repetitions of 10-second static stretches daily (Kisner, C, Colby L, 2012). The duration of a stretch is a major component of muscle lengthening but time spent with improper alignment or technique will not produce the desired outcome.
Proper alignment and stabilization are essential elements of effective stretching. Utilizing a health care professional to help instruct proper alignment and positioning will aid in achieving the greatest amount of motion with the least amount of injury. Alignment of the muscles and joints to be stretched as well as the alignment of the trunk and adjacent joints must all be considered (Kisner, C, Colby L, 2012). When performing a seated hamstring stretch for example, proper alignment of the trunk during the stretch can prevent injury and help achieve optimal results. Because of the origin of the hamstrings a rounded thoracic spine will produce less stretch of the hamstrings and more stretch of the spine. While hinging at the waist and maintaining full knee extension will put the hamstrings on stretch to achieve the desired outcome. Along with proper technique, stabilization of the joints is equally important.
Hypermobile joints, or joints that have too much motion, can lead to instability within the joint which often causes pain and may predispose a person to a musculoskeletal injury. Overstretching can become detrimental and create joint instability when the surrounding tissues become lax and cannot hold the joint in a functional position. When hypermobile joints are present, strengthening programs can be implemented to help stabilize the lax joint.
Hypo mobility refers to decreased mobility or restricted motion. Due to common sedentary lifestyles and desk jobs, the hamstrings are a common site for hypo mobility. Having decreased range of motion in the hamstrings produces excess strain on the back which can lead to improper body mechanics. This chain reaction can lead to poor movements during functional daily tasks. The improper balance in muscles can also result in a back injury, which originated at the hamstrings.
Stretching is often seen as a warm up prior to exercise without increasing body temperature. It is well documented in human and animal studies that as the body temperature increases, the easier a muscle can stretch. (Kisner, C, Colby L, 2012). Proper warm up to increase core temperature prior to stretching can not only help lengthen muscles but can also prevent injury. A few examples of warm up exercises are a brief walk, using a stationary bike or walking up and down stairs prior to starting stretching. Warm up’s should be performed for 5-10 minutes until the body temperature rises, just before a sweat starts.
Consider seeking out a health care professional to help implement a stretching program that is catered to your specific needs. Although stretching seems like a basic concept there are many precautions and contraindications for stretching that you may not know about. Always have a proper warm up before stretching and never vigorously quick stretch a muscle. Strive for balanced flexibility throughout the body to help eliminate radiating pain and reduce injury.
Kisner, C, Colby, L. 2012. Therapeutic Exercise: Foundations and Technique. Philadelphia, PA. F.A. Davis Company
Questions and or comments regarding this week’s health column please contact, Lawrence Ingvalson, PTA at Marcus Daly Rehabilitation Center and Services, a service of Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton, MT 59840. Working together to build a healthier community!