Why stretching is rehab rather then exercise

The subject of flexibility has come up recently and the question raised was, what are the most effective techniques to increase flexibility. The most obvious answer would be stretching and there are many good books available that teach the basic techniques. You may also take a yoga class or join a flexibility/stretching session at the local gym. However the question that I ask myself, is there a lack of flexibility and why the limitation. Injury can be a factor, as the healing process may lead to adhesions and contractures.

Adhesions occur when collagen fibres are laid down in cross links during healing. A lack of movement or even immobilization prevent proper arrangement of these fibers and leads to reduced range of motion. Similarly contractures develop when the normally elastic (stretchy) connective tissues are replaced by inelastic (nonstretchy) fibers (scar tissue). These structures include muscle, tendon and the soft tissue of the joint capsules. Contractures prevent the structures from fully lengthening and therefore also result in reduced range of motion. Stretching routines or yoga are not going to be effective for these conditions. A more aggressive approach has to be taken, often requiring the skilled hands of a registered massage therapist to reduce adhesions and contractures through a number of aggressive manual techniques. Depending on severity, it can easily take several months to restore normal range of motion.

A further factor leading to reduced flexibility is poor posture, often due to lifestyle habits. Take someone sitting in front of a computer all day for example. They will often exhibit a forward head posture (hyperkyphosis), which shows itself as an exaggerated rounding of the upper spine and slouching or forward rolled shoulders. This happens due to tight (hypertonic) chest muscles (pectorals), from a repeated arm forward posture, using a keyboard and mouse. The individual will frequently complain of pain and discomfort in the upper back, which is caused by chronically over-stretched and weakened muscles between the shoulder blades (rhomboids and trapezius), due to the tight pectorals. The obvious remedy is to stretch the tight pectoral muscles as to relax the overstretched rhomboids and trapezius. In practise however that is often difficult, as stretching a hypertonic muscle may lead to cramping (spasming). The more effective way, is to strengthen the rhomboids and trapezius muscles by performing a resistance exercise such as towel rows. This technique is called reciprocal inhibition (RI), which forces a muscle to relax by contracting the muscle(s) that opposes its action. And that leads me to my point …… stretching is a rehab exercise. Once general full range of motion movement exercises are performed on a regular basis there should be no reason for inflexibility.  Some are naturally more flexible than others and in general, being able to perform the splits in whatever direction is functionally just not necessary. In a follow up article I will talk a bit more about effective stretching techniques and full range of motion exercises, so stay tuned …


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