Stretching is one of the interventions that a physiotherapist use in restoring their patient’s ability to move in the normal way. Stretching is a general term used to describe any therapeutic maneuver designed to increase the extensibility of soft tissues, thereby improving flexibility by elongating (lengthening) structures that have adaptively shortened and have become immobile over time.
People must be able to perform full range of motion in order to do functional activities. Restricted range of motion is caused by the shortening of soft tissues & muscles. This adversely affects people’s daily activities. Among the factors of the shortening of soft tissues & muscles are prolonged immobilization of a body segment, sedentary lifestyle, tissue deformities, etc. Usually, when muscles are immobilized (not moved) for a long period of time in a shortened position, the muscles’ fiber becomes permanently shortened.
Stretching the shortened muscles & soft tissues can increase their extensibility in order for it to function & perform full range of motion. It is as if you are pulling a hardened rubber band to make it elastic again.
Figure 1:Pulling a rubber band.
Figure 2:Pulling the hamstring muscles
Taking the example of pulling a rubber band, you must pull the rubber band at its ends. The same goes for muscles & soft tissues. You must find the muscles’ point of attachment and pull the muscles by moving the point of attachment away from each other. For example, the point of attachment for the hamstring is the hip bone & tibia bone. To stretch the hamstring, you must flex your leg as far as possible to move the tibia bone & hip bone further from each other.
Usually, you must set a time range to stretch your muscle to get the desired result. The most optimum time range to stretch your muscle is within 20 – 30 seconds. Below this time range, your muscles will not get the optimum result & stretching the muscles above the optimum time range will make it weak. Besides that, you can set the amount of sets for stretching the muscles. The best range of amount of sets for stretching is 3 – 5 sets.
Among the indications that require stretching are :
1. Limited range of motion caused by shortened muscles & soft tissues.
2. Muscle weakness.
3. As part of a total fitness program designed to prevent musculoskeletal injuries (warming up)
4. May be used after vigorous exercises to minimize postexercise muscle soreness. (cooling down)
And the contraindications are :
1. Joint motion restricted by bony block, not shortened soft tissues & muscles.
2. Fracture / Incomplete recovery / Stage of immobilization (recovery process)
3. Infection in stretched muscles’ region.
4. Muscles cause pain when stretched.
5. Loss of pain sensation.
Another precaution that must be considered is that the muscles & soft tissues must be warmed up before stretching to reduce the risk of injury & to obtain optimum results. Among the ways to warm up the muscles is just by doing simple exercises using the muscles involved. For example, to warm up the biceps, flex the arm at
elbow joint while standing with moderate weights in the distal hand & contract the biceps isometrically (muscles not shortened nor lengthened).
Figure 3: Stretching as part of daily physical activities