Stretching comes naturally to all of us. You might notice that if you have been sitting in a particular position for a long time, you stretch unconsciously. It feels good! In addition to that good feeling, a consistent stretching program will produce large gains in flexibility and joint movement.

What is Stretching?

The act of stretching is to extend or lengthen your body or limbs. Stretching helps you develop and maintain a healthy level of flexibility, which refers to the range of movement at any particular joint. Stretching is also referred to as flexibility training. Examples of stretches include: calf stretch, hamstring stretch, triceps stretch, and certain yoga poses and Pilates exercises. The Fitness Resource Center includes stretching routines, videos and stretching demonstrations.

Flexibility training is broadly accepted as a way to increase joint mobility. The goal of stretching is to optimize joint mobility while maintaining joint stability. Although research has shown that different stretching methods will improve joint flexibility, it should be noted that inappropriate stretching can cause injury. Recently, researchers have promoted the concept of a “functional range of motion.” This refers to developing just enough flexibility for a specific activity (or sport) without compromising joint stability.

Everyone should stretch, regardless of age, gender, or flexibility level. Stretching should be a part of your daily routine, whether you exercise or not. There are simple stretches you can do while watching TV, using the computer, or getting ready for bed.

What are the Benefits of Stretching?

Without regular stretching, your muscles will tighten and the range of motion in your joints will decrease as you age. This can put a damper on active lifestyles and even hinder day-to-day activities. Tasks that used to be simple, such as zipping up a dress or reaching for a can off of the top shelf, can become extremely difficult. A regular stretching program can help you to maintain your range of motion and make daily living activities easier.

Stretching does not demand a huge time commitment, but it can give you huge results! Here are some of the benefits you can expect from a regular stretching program:

• Reduced muscle tension
• Increased range of movement in the joints
• Enhanced muscular coordination
• Increased circulation to various parts of the body
• Increased energy levels (resulting from increased circulation)
• Delayed onset of muscle fatigue
• Enhanced performance in daily life, sports, or other physical activity
• Improved posture
• Mental relaxation
• Added variety, enjoyment, and satisfaction to your exercise program

Stretching is important for people of all ages! One of the greatest benefits of stretching is that you’re able to increase your range of motion, which means your limbs and joints can move further without discomfort or injury. Post-exercise stretching can also aid in workout recovery, decrease muscle soreness, and ensure that your muscles and tendons are in good working order. The more conditioned your muscles and tendons are, the better they can handle the rigors of sport and exercise, and the less likely that they’ll become injured.

What Influences Your Level of Flexibility?

There are four main factors that affect your flexibility level and ability to stretch:

Age. Younger people are naturally more flexible than older people. Why? Muscle connective tissues have a natural tendency to shorten and lose elasticity as you age, resulting in muscle tightness and stiffness.

Gender. Females on average tend to be more flexible than males.

Exercise history. Active people tend to be more flexible than inactive people.

Temperature. When your muscles are warm (whether from exercising or from a warmer environment), they will be more flexible than when they are cold. Why? Increase in muscle temperature decrease muscular resistance, which boosts your range of motion.

How Much Stretching Should You Do?

When considering the guidelines for aerobic exercise, keep the FITT principles in mind (Frequency, (Intensity, Time and Type).

Frequency: Number of stretching sessions per week

The more frequently you stretch, the more quickly you will gain flexibility. It is recommended to stretch all of the major muscle groups daily—or at the very least, each time you exercise (a minimum of 3-4 times per week).

Intensity: How deeply to stretch

Each stretch should be done in a slow and controlled manner, without bouncing or forcing, which can cause your muscles to tighten, increasing your risk of injury. Stretch in a slow, steady motion to the point of “mild discomfort.” If you are stretching to the point of pain, you have stretched too far.

Time: How long you should stretch

Ideally, most experts recommend that people stretch for 10-15 minutes per day. Hold each stretch for 15-30 seconds, repeating one or two more times, depending on how you feel.

Type: Activities that count as stretching

There are several different types of stretching. The methods described below will help you safely improve your level of flexibility. The two most common and accepted techniques for improving flexibility are static and PNF stretching.

Static stretching is a low-force stretch where the muscle is held at the greatest possible length for up to 30 seconds. This is probably the most common type of stretch, mainly because it benefits from being both effective and safe. SparkPeople’s Stretching Demos are all examples of static stretches.

PNF is short for Proprioceptive Neuromuscular Facilitation. This involves maximally contracting a muscle (usually with a partner or trainer who is trained in this technique) and then immediately doing a static stretch for the muscle. This type of stretching may be performed without a partner, although it is usually more effective with a partner’s assistance. In all cases, it is important to note that the stretched muscle should be rested (and relaxed) for at least 20 seconds before performing another PNF technique. There are two types of PNF stretches, Contract-relax (an isometric contraction of the muscle, followed by relaxing, then stretching to the point of limitation) and Contract-relax-agonist-contract (an isometric contraction of the muscle, followed by relaxing, stretching to the point of limitation, then contracting the agonist/opposing muscle, followed by a stretch to the point of limitation).

Passive stretching increases the range of motion by using an external force (like a partner, a wall or the floor). These stretches can be very useful in the development of stretching but care must be taken to ensure the stretch is not forced; it should remain within the realms of comfort at all times.

Active stretching involves assuming a position (or stretch) and then holding it there with no assistance other than using the strength of your “helper” muscles. When you lie on your back with one leg extended up in the air, for example, and continue to hold it there without any assistance you are doing an active stretch. Active stretching increases active flexibility and strengthens the “helper” muscles too. Active stretches are usually quite difficult to hold and maintain for more than 10 seconds and rarely need to be held any longer than 15 seconds. These types of stretches are frequently used in yoga.

Dynamic stretching involves controlled, gentle leg and arm swings that take you to the limits of your range of motion. There are no bounces or “jerky” movements. An example of dynamic stretching would be slow, controlled leg swings, arm swings, or torso twists. Dynamic stretching improves dynamic flexibility and is quite useful as part of a warm-up for an active or aerobic workout (such as a dance or martial-arts class).

“Arthritis” is a term used to describe inflammation of the joints. Osteoarthritis (OA) is the most common form of arthritis and usually is caused by the deterioration of a joint. Typically, the weight-bearing joints are affected, with the knee and the hip being the most common.

An estimated 29 million people in North America have some form of OA.  Until age 50, men and women are equally affected by OA; after age 50, women are affected more than men. Over their lifetimes, 21% of overweight and 31% of obese adults are diagnosed with arthritis.

OA affects daily activity and is the most common cause of disability in the US adult population. Although OA does not always require surgery, such as a joint replacement, it has been estimated that the use of total joint replacement in the US will increase 174% for hips and 673% for knees by the year 2030.

Physiotherapists help patients understand OA and its complications, provide treatments to lessen pain and improve movement, and offer education about obesity and healthy lifestyle choices. You can contact a physiotherapy directly for an evaluation.

Research has shown that light to moderate activities such as walking, biking, and swimming can provide more benefits than harm to your joints, and promote weight loss. One study showed that just an 11-pound weight loss reduced the risk of OA in the women studied.

What is Osteoarthritis?

Your bones are connected at joints such as the hip and knee. A rubbery substance called cartilage coats the bones at these joints and helps reduce friction when you move. A protective oily substance called synovial fluid is also contained within the joint, helping to ease movement. When these protective coverings break down, the bones begin to rub together during movement. This can cause pain, and the process itself can lead to more damage in the remaining cartilage and the bones themselves.

The cause of OA is unknown. Current research points to aging as the main cause. Factors that may increase your risk for OA include:

• Age. Growing older increases your risk for developing OA because degeneration and aging of the cartilage and synovial fluid increases over time.
• Genetics. Research indicates that some people’s bodies have difficulty forming cartilage. Individuals can pass this problem on to their children.
• Past injury. Individuals with prior injury to a specific joint, especially a weight-bearing joint (such as the hip or knee), are at increased risk for developing OA.
• Occupation. Jobs that require repetitive squatting, bending, and twisting (eg, construction, landscaping, childcare) are risk factors for OA. People who perform jobs that require prolonged kneeling (eg, miners, flooring specialists) also are at high risk.
• Sports. Athletes who repeatedly use a specific joint in extreme ways (eg, pitchers, football linemen, ballet dancers, runners) and those who engage in high-impact joint loading done in a repetitive manner (eg, running, jumping, landing on hard surfaces) may increase their risk for developing OA later in life.
• Obesity. Being overweight causes increased stress to the weight-bearing joints (such as knees), increasing the risk for development of OA.

How Does It Feel?

Typically, OA causes pain and stiffness in the affected joint. Common symptoms include:

Stiffness in the joint, especially in the morning, which eases in less than 30 minutes
Stiffness in the joint after sitting or lying down for long periods
Pain during activity that is relieved by rest
Cracking, creaking, crunching, or other types of joint noise
Pain when you press on the joint
Increased bone growth around the joint that you may be able to feel
Caution: Swelling and warmth around the joint is not usually seen with OA and may indicate a different condition or signs of inflammation. Please consult a doctor if you have swelling, redness, and warmth in or around a joint.

How Is It Diagnosed?

Osteoarthritis is typically diagnosed by your doctor using an X-ray, but there are signs that may lead your physical therapist to suspect you have OA. Joint stiffness; difficulty moving; joint cracking, creaking, or crunching; and pain that is relieved with rest are typical symptoms. physiotherapists often use the American Academy of Rheumatology criteria for diagnosing knee OA, which lists the presence of pain, plus at least 3 of the following 5 criteria:

• Age >50 years
• Stiffness <30 minutes
• Crepitus (a grinding/crunching sound emitted from the joint with movement)
• Bone tenderness
• Bony enlargement

How Can a Physiotherapy Help?

physiotherapy treatment has proven to be an effective treatment for OA, and may help you avoid surgery and use of prescription painkillers. Although the symptoms and progression of OA are different for each person, starting an individualized exercise program and addressing risk factors can help relieve your symptoms and slow the condition’s advance.

Your physiotherapist may:

• Perform a thorough examination to determine your symptoms.
• Observe what activities are difficult for you.
• Design an individualized exercise program to address your specific needs and improve your movement.
• Use manual (hands-on) physical therapy to improve movement of the affected joint.
• Offer suggestions for adjusting your work area to lessen the strain on your joints.
• Teach you aerobic and strengthening exercises to improve your movement and overall health.
• Design and teach you a home-exercise program to improve your strength and movement.
• Teach you an exercise program for safe weight loss, if you need to lose weight to ease pressure on your joints.
• Recommend simple lifestyle changes that will help keep the weight off.
• In cases of severe OA that are not helped by physiotherapy alone, surgery, such as a knee or hip replacement, may be necessary. Your physiotherapy will refer you to an orthopedic surgeon to discuss the possibility of surgery.

Heel pain is very common and often painful.  There are many heel conditions that arise from the wear and tear and stress on your heel bone. One of the conditions being heel spurs. A heel spur (or osteophyte) is a small bony growth or collection of bony growths on the back or underside of the heel. Fortunately, most of the time they are painless, and cause minimal discomfort and generally have no symptoms.

Heel spurs are often associated with plantar fasciitis, although similar, they are two completely different diagnoses. About 70% of patients with plantar fasciitis have a heel spur that can be seen with an X-ray. Usually, plantar fasciitis is followed by a heel spur.

Calcium deposits building on the underside of the heel bone is how a heel spur is formed.  This process take a long time to form. The cause of heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are typically prevalent among athletes whose activities include large amounts of running and jumping.

The recommended treatment of heel spurs  is to rest from any physical activity, apply ice to heel area, and stretch the calf muscle and foot.  Stretches and exercise will help relax the tissues that surround the bone.  Going to a physiotherapist will help you take care of all heel spurs.  You may also take anti-inflammatory medication to help control the pain, and if pain worsen, an injection of cortisone. It is also important to be sure to wear well- fitting shoes.

Spectrum can treat your heel spurs, contact us today to learn more.

What are Shin Splints?

Shin Splints is the common name for generalized lower leg muscle pain that occurs below the knee, usually along the bottom 1/3 of the tibia. They can be either on the inside or outside of the leg. Though they’re most often associated with running, the pain and annoyance of Shin Splints can affect basketball players, tennis players, dancers, or anyone who spends long hours on their feet. In fact, anyone who changes their routine too quickly, adds too much, or doesn’t warm up properly can develop them.

What causes Shin Splints

The muscles on the front portion of our lower legs tend to be weak. And repetitive stress from running constantly aggravates them. If you’ve begun increasing your mileage, gone from a flat route to a hilly one, aren’t stretching enough, or are wearing shoes that don’t provide enough support, you can end up in pain.

Weaker muscles on the front legs, combined with the chronically tight calves so many runners have, creates an imbalance. This imbalance causes extra strain where the anterior shin muscles attach to the shin bone. The strain on the muscles is too much and they become inflamed. That inflammation is what we call Shin Splints.

How to avoid getting Shin Splints

1. Keep your running shoes in good condition. Your foot mechanics may predispose you to Shin Splints, so be fitted by a professional and replace your shoes every 300 – 400 miles.
2. Try not to run every day on hard surfaces like concrete or asphalt. Running on the grass reduces the impact and force transferred through your legs. This is particularly important early in your training.
3. If you notice pain in your shins while you run, massage the area with ice for five to 10 minutes after every run. This will help calm the inflammation.
4. Stretch often and stretch properly, particularly your calf muscles. Maintaining flexibility and staying loose there will help you avoid Shin Splints. The runner’s calf stretch at the wall is a great one you can do anywhere, anytime.

Treat shin splints sooner, not later

If you continue running (or whatever activity is causing them), you’re just creating more strain on your tibia. That can lead to more serious conditions, like stress fractures.

Shin Splints are not something you should ignore or one of those times when you “run through the pain.” In fact, experts suggest you stop running completely. Try a different workout like swimming or biking until the pain goes away.

How Results Physiotherapy treats Shin Splints

One of the things Physiotherapists are trained to do, especially those like us who specialize in manual or “hands on” therapy, is recognize muscle weakness that can lead to pain. So if the pain isn’t going away, it’s a good idea to contact us.

We start by analyzing every aspect of your running gait, look for joint or soft tissue restrictions around your foot and ankle, and examine the biomechanics of your foot. This can tell us what predisposes you to Shin Splints.

Then we work with you to create an individualized plan for treatment and recovery. Our goal is to get you back where you want to be – on the roads.  Contact Spectrum today to learn how to help treat your shin splints.