Have you ever hurt your low back and been told to lay on your back on the floor and bring your legs in to your chest, or bring one knee across towards your opposite shoulder? I bet, if you did this exercise, your back would feel better for a minute, but it doesn't seem to last.
This has been a common response to low back pain, for many health care professionals over many, many years.
In my experience, and as evidence shows, this response to pain can actually be hurting us. When pain occurs, our body is trying to tell us that something is wrong. If our pain is muscular, it could make sense that stretching out that muscle would help it feel better. But the opposite is actually true. Neurologically, if we have a muscle that our brain thinks is injured, stretching can actually make the neurological response stronger. Making the contraction worse, or the pain worse.
Consider this example: if you stretch out a rubber band for a few seconds, about twice as long as its natural length. What happens when you release the tension on the rubber band? What shape does it go back to? Does is remain stretched out, or go back to normal? It goes back to normal, right? Well this is basically how our body's muscles react to stretching as well. They usually take a few minutes but they are right back to their original length pretty quickly. This means the pain is usually back.
Stretching can Actually Hurt
Stretching as a warm up for exercise has been shown to reduce performance.
The metabolic activity involved in muscle contraction does literally warm up your muscles - Pain Science
To warm up, it is more beneficial to move your muscles in an easy way, before you begin your full exercise, for example walking before you run.
Many people believe that stretching can help prevent or heal DOMS (delayed onset muscle soreness; the soreness you feel after doing a new exercise). Unfortunately, the evidence strongly suggests that stretching does not prevent DOMS, and there is no evidence to suggest that there is a cure or prevention for DOMS.
Stretching has little/no effect on preventing injuries.
In 2005, the Clinical Journal of Sports Medicine published a review of the scientific evidence to date, and found that the (admittedly limited) evidence “showed stretching had no effect in reducing injuries.” - Hart
Injury rates for all kinds of injuries were the same with or without stretching, in a study of 2700 runners, half of which stretched before running and half did not. It’s almost as though stretching made no difference at all.
Stretching to recover from an injury. Millions of athletes, trainers, coaches, and healthcare professionals still consider it to be a staple of rehab. The belief is that if stretching can prevent injury, then it should also be able to help us recover from injury as well.
Stretching could be considered a form of light exercise that could be used for some stimulation in the early stages of rehab, but that is where is should end.
Many people believe that the reason they get iliotibial(IT) band syndrome, one of the two common kinds of runner’s knee is because the IT band is “too tight.” Unfortunately, that almost certainly isn’t the problem. The IT band is a thick band of fascia, and is much too tough a structure to stretch, and trying a foam roller is a painful way to learn this. what is more likely happening is the glute is not strong enough, often from sitting too much, and a simple glute strength exercise like the one shown below can activate glutes making the IT band no longer tight.
I have personally struggled with plantar fasciitis for many years, and done everything to help, frozen water bottles, calf stretches, massage therapy, a very painful scraping along the bottom of my foot, etc. and nothing worked until a classmate of mine took a myofascial release course while we were in massage school. 1 treatment for her to practice and I was cured for about 3 years. Now, I can't promise it works that well every time, but I am so grateful that she taught me this method and I have seen it work on many of my own patients, with varying degrees of success.
Strength exercises have a much better long-term effect on the body than stretching. I have be recommending strength exercises for my patients for over 5 years and when they do them as prescribed, they have reported less pain, and better movement leading to their need to seek massage therapy less often. Ultimately, this is my goal. To see my patients until they are well enough to not need me anymore.
Patients who feel better, who are 'fixed', tell many more people than those who need to come back and see their massage therapist often. I want them to come back they want to, and not because they need to.
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