Friday, March 11, 2011

To Stretch or Not to Stretch, Part I

So I'm in the gym where I work out and see a sign to this effect:

"Please Ask A Personal Trainer About Assisted Stretching."

And I'm thinking, sort of wryly, "Yeah, there's a full-employment act for personal trainers -- not only do you need to hire them to show you the stretch, you need to keep them on, in perpetuity, to help you with the stretch."

Okay, that sounds a bit snarky. It's not that I dislike personal trainers. My sister-in-law is one, and she's one of the nicest people I know. But during my recovery from chronic knee pain, I had the opportunity to investigate the benefits of stretching. And what I discovered left me distinctly underwhelmed.

PREPARE FOR A GLORIOUS JOURNEY ...

I'm going to spend a few weeks blogging about exactly why I turned into a stretching skeptic.

This is a moment I've sort of dreaded, just because stretching is such a big topic and there are so many stretching advocates out there (and they can all touch their toes, and they're so damn proud of it :)). I'll probably end up annoying the hell out of someone. Stretching has become a quasi-religion in the world of physical fitness. Stretch before exercise! Stretch after! If you have knee pain: stretch, stretch, stretch!

But what are the arguments for all this stretching? What is the actual evidence about its benefits? Does stretching really make sense if you have knee pain? In other words, what are you trying to fix, and how does stretching help you fix it? Who was the first human anyway who said, "Hmm, I'm going to run across that field, so maybe I better stretch my quads first?" And if stretching turns out not to be that useful (as I believe), why has it become so solidly entrenched in our physical fitness culture?

I plan to cover most of those questions (I'm not sure about the "first human" one :)) in a series of posts. Hopefully, anyone who perseveres with me to the end will be inclined to accept that, at the least, the benefits of stretching have been (as I say in Saving My Knees) greatly oversold.

STRETCHING CAN HURT YOU

Even if you think I'm nuts, and you're loathe to give up your four or five favorite stretches, be careful. While cruising the KneeGuru bulletin boards one day, I came across an object lesson for stretching fanatics.

"Phrank" (his nom de message boards) started a thread "Can Certain Stretches Damage the Knee?" His story, in brief (I've edited his post down for length and readability):
First let me explain my history with my right knee. In 1992 it was dislocated, sept 2008 i had a lateral release and debridement ... it was also supposed to fix my knee instability ... In Jan 2010, I needed another surgery to correct my knee instability ... I would also like to include that I also suffer from I.T. Band syndrome ... In May of 2010 I began to jog, i was doing great, i slowly got up to jogging 3 miles non stop ... no pain, just i.t. band stiffness/soreness alone with muscle soreness. About two weeks ago I was doing a new stretch that a co-worker told me about that would help stretch my tendons and IT Band ... the last time I did it ... it felt fine when I was stretching it, I felt releif, nothing popped, nothing gave way ... so i sat back done to continue my work, got back up 10 mins later to get something, As i stood up I felt so much knee pain. It was really intense ... Now two weeks later my knee makes popping sounds when i get in and out of bed or sitting down and getting up from a chair.
Was the stretching necessarily to blame? Obviously, it's impossible to be sure, especially since we have only Phrank's account to parse. But he did include a diagram of the stretch he was performing. When I saw it, I just shook my head. Check this out:



In a reply I made to his post, I suggested that another name for this might be the "Just Asking for Trouble Stretch." Because look hard at this image, and think about what Mr. Knee Pain Sufferer is doing. He's putting torque-like pressure on an unstable knee joint in an unnatural position.

Let's break down that bold type:

1. putting torque-like pressure: For this stretch to work, you need to push down on that knee, and since the leg being stretched is bent and folded over the other leg, the knee is subject to a bit of twisting pressure. Ugh. My knees have healed, and I just started to try this stretch, and quickly abandoned it out of fear.

2. unstable knee joint: Now imagine your knees are unstable. That makes this a double bad idea.

3. unnatural position: Now for the kicker: You're not even helping your knees adapt to some motion you'll be undergoing later. Look at this weird position! What physical activity does this replicate? When do you, in some sporting or life activity, swing your bent leg up over your other leg, and push down on it? What about, like, never? There's value to putting some pressure on your knee joint, say by climbing up stairs, if you want to train your joint to better climb stairs. But here you're putting pressure on your knees for no other reason than you think you need to stretch some muscles/tissues and can't find a better way to do so.

Stretching can be dangerous! Even seemingly benign stretches can lead to small tears in the muscles or tendons being stretched, especially for people who are weak (from short-term or chronic injury or whatever)/out of shape/healing from injuries. So even if, after reading all I have to say today and in upcoming posts, you continue to stretch, please be careful.

NEXT TIME

What's wrong with your knees? And how does stretching help fix that?

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