Stretching Or Strengthening | What’s Best?
When it comes to Physiotherapy and treating painful conditions then there is only 1 clear winner between stretching and strengthening. Lets look at the evidence.
Does Stretching Work?
Different types of stretching exist but historically when stretching or warm ups are mentioned we immediately visualise standing against a wall stretching out a calf muscle or pulling your heel to your bum while trying not to fall over. Classically known as ‘static stretching’.
Static stretching usually involves holding positions for around 30 secs aiming to elongate the length of a muscle to become more flexible. However, research has shown even regular stretching will not create a sustained lengthening of the muscle fibres. Muscles attach to fixed points on bones, so by nature alone it’s impossible to actually increase it’s length. Research has also proven that the initial effect of static stretching can actually reduce muscle strength and performance if done alone. So just like a rubber band, if stretched too much muscles can loose their elasticity. Not ideal.
So if muscles don’t get longer when stretched how do you increase flexibility?
What Really Happens To Muscles When Stretching?
Your muscles are full of tiny stretch receptors that fire off like little sirens whenever you begin to move. By sending signals to your brain they ensure that your muscles are not overly stretched and damaged if moved too far or too quickly. Essentially, it is your nervous system acting like a master conductor, reflexively determining how far your body can stretch. Otherwise known as stretch tolerance.
‘Your body adapts to whatever regular stresses you expose it to on a daily basis.’
Modern society means most people spend all day sitting. Consequently, your body will stiffen and your nervous system will likely be on higher alert to movements because they don’t happen so often. Ultimately, your stretch tolerance is reduced meaning when you try to move or stretch it feels stiffer and more painful. The key is movement.
People who want more forgiving hamstrings need to get up, move, squat, walk, run, or play sports. Generally change position more often and give your body the variety it needs to counteract the perils of sitting. Check out our advice on ‘the perfect posture’.
Dynamic stretching is the other main form of stretching. Essentially stretching muscles while moving has more favourable evidence for increasing flexibility and improving performance. It usually involves some kind of movement or drill that mimics the task or sport about to be performed. Just like the movements in our 7 Series Running Warm Up video.
Muscles in motion don’t experience as much of an inhibitory response to stretching. On the contrary, they get an excitatory message. Increasing your heart rate, prepping your body for activity, and filling muscles with warm, oxygen-rich blood, are all very favourable responses. Hence, research favours dynamic stretching over static stretching.
So Why Strength?
Mobility is the first step in being able to move well, pain free. Hence the initial stage of any Physiotherapy treatment and rehab will involve manual therapy and exercises aimed at doing just that. Read about our Levels of Rehab at The Physios here.
However, in order to provide a lasting change, reduce the risk of pain or injury reoccurring then the next stage of rehab must involve strengthening. Whether it be common conditions such as lower back pain, or more sports specific injuries like running.
In 2014 a research review of 26600 subjects and 3464 injuries concluded that strength training-alone was able to reduce the likelihood of acute sporting injuries by 33% and overuse sporting injuries by 50%, whereas stretching-alone was not found to be effective.
One of the most common complaints we treat in our clinic is chronic low back pain (CLBP), and there is strong evidence that suggests that resistance training is very effective in reducing pain, improving function and quality of life in these patients.
Running-related injuries are the most common sports injuries we see on a daily basis in our clinic. Most people believe that warming up and stretching are most important to reduce injury. However, current research favours strengthening over stretching when aiming to do so.
So, when you next type in ‘best stretches’ to a Google search for your pain or condition, think again!View more articles from Jon Grayson