MICROSTRETCHING TO IMPROVE FLEXIBILITY Moverrent is hat is dosest to the Soul “Aristotle £00 NOREEN 12 AA AALS In recent years, intense training, competition and record-breaking performances have exposed the athletes’ body to strains and stresses often exceeding its inherent adaptive capacity. ‘The athlete’s primary concem is the execution of movement - a dynamic equilibrium between structure and function. A blind unconscious activity executed in an orderly, coordinated manner, directive towards becoming inherent and instinctual. In training, when skill acquisition and competition exceed the adaptive parameters of the body the result is trauma, The extent is directly or indirectly related to the response of repair. ‘The magnitude of the response is complex. If there is a chronic breakdown in the response this becomes a pathological disorder develops. The extent of change of the musculoskeletal system is similar wo a cascading effect, itis a plastic response associated with structural rearrangement. As time progresses, and the potential energy of the trauma is maximized, the athlete undergoes a morphofunctional change, The epigenesis of trauma is at the micro-level, but the repetition of a small disturbance compounded over many months and years cteates a physical disorder, a chronic injury. ‘The later is often disproportionate to the former cause (micro-injury-traunta) as this progression adheres to the principle of “geometric progression”, With an athlete, it's not only the nature of their motion that we must interpret in terms of force, but also an explanation of the interaction and/or balance of forces, “The distribution of force during an injury is determined by the extent and duration of the injury. Once an athlete has developed a chronic injury, itis highly likely they also have an extensive muscle imbalance. ‘The symmetrical application of force has been altered. This is known as a compensational shift. The body is an open system engaging in free exchange with the environment and its structure is not permanent. It is continuously broken down by wear and tear of action and built up by the process of repair. ‘This auto-anabolic/ catabolic process is part of its “mode operandi”. ‘The body is the reference point of movement; therefore an innate knowledge of anatomy is paramount to fully understand its functions and ensure proper structural and functional development of the body, according to the athlete’s rate of growth. Any movement or skill that deters the proper development of the musculoskeletal system should be avoided, Negative patterns of development reinforce negative dynamics affecting an athlete's carver, especially with the onset of age. It is the responsibility of the coach during the formative years to guide the novice athlete. ‘The concept of stretching applied only as a means of a warm up or warm down is archaic. Physical abilities can be discovered and further enhanced with proper flexibility training. In fact, flexibility determines movement. A flexible system is an open system, awakening inherent and instinctual movements requiring less thouglst with the enhancement of greatermicroStretching to Improve Flexibility reaction time. The athlete becomes an automatic, highly responsive system through flexibility, often developing a greater sensory awareness of their surroundings, Flexibility assists in the refinement of the senses. It is through the senses that all facts of physical activity are awakened thereby developing an understanding of the unity of form. Sense and sense perception are information gathering and processing systems developed via the maturation of the motor system. Both the motor and sensory systems existed since birth, and influence each others maturation. The interplay between the two helps develop and foster a spatial-remporal awareness. As the athlete matures their ability to discriminate between physical and mental stimuli is not only enhanced but also purified. ‘An adjunet to this purification is the development of movement pattems aided and reinforced by the senses resulting in movement becoming “second nature”. ‘This may be both beneficial, as well as detrimental, Once a movement pattem becomes part of the subconscious it is hard to shift or alter its nature as discussed eaalier with regards to the principle of “geometric progression”. With the onset of an injury, a shift happens in the symmetrical usage pattem of muscle groups. This compensational shift occurs at the subconscious level in order to protect the injury. This shift is automatic and a response of the sympathetic nervous system. ‘The first sign of protection is a decrease in the range of motion (ROM) about a joint or joins. If the coach and athlete do not ty to reestablish this dectease in ROM, the body begins to form a habitual pattern. TF the pattern becomes entrenched in the athlete's repertoire of movement it will always be a factor in skill acquisition. We then should question whether or not the athlete has truly reached their maximum potential? Tt should be noted that these habits may yield to a little pressure, but they quickly reassert themselves. Its through prolonged effort that we can permanently change such habits. If the training or therapy is intense and pain is elicited, it only reinforces this subconscious protective loop. If we do not address the effects of an injury, we make an anatomical-biomechanical imprint, exposing the body to a litany of further problems, Athletes, coaches, trainers and therapists need methods to help in recovery and regeneration of injury, but more importantly to help in enhancing performance. Many findings at the Serapis Stretch Therapy® Clinic have led to the development of the technique known as microStretcbing® . The work in the Clinic has allowed us to research and investigate new pathogenic intexpretaions of injury, develop original techniques, review and interpret patient's comments, and change certain pathological concepts and treatments with regards to stretching. The result is a more comprehensive understanding of the potential of microStretching® not only for recovery and regeneration, but more importantly for performance enhancement. (206 RTA ebony 6 Tf NSA NRE ‘The anatomical structures of kinesis are muscles, tendons, ligaments and bone (Diagram 1). Muscle by nature is an elastic tissue, while tendons and ligaments are inelastic. Every skeletal muscle cell connects directly to the tendons on which it acts at origin and insertion ends of the cell attached to bone. “Tendons are much stronger than the muscle that acts upon them.microStretching to Improve Flexibility ‘The tensile strength of muscle tissue is approximately 77 to 80 pounds per square inch, while tendons are between 8600 to 18000 pounds per square inch. This enables a large muscle to act through a small tendon, The discrepancy in tensile strength, suggests that a Diagram 1: Sdematic gram of msde, tender ard bare Muscle microtear will occur primarily in the muscle before the tendon, In fact, the tear occurs several millimeters prior to the myo-tendon junction. Another site of injury is the osteo- tendon junction where it is not uncommon for bone to be avulsed before any damage will ‘occur to the tendon (Diagram 2). ‘This is the kinetic model on which the technique of microStretching? is based. Diagram 2: Diagn myo tendon ae csteo tenon juris i Bone Myo-tendon Tendon junctiog py Usteo-tendon junctionmicroStretching to Improve Flexibility When stretch is performed and a sense of buming or extreme pulling occurs in the muscle, that is a strain, A form of stretching exemplifying strain is the isometric contraction phase of a proprioceptive neuromuscular facilitation (PNE) stretch, A strain results in microtears of the muscle just prior to the myo-tendon junction, Microtears ate microinjuries. The body responds to these tears with the release of collagen in the area, specifically collagen III, later transforming imo collagen I. As time progresses, the mass of collagen used to repair the tear will form scar tissue. As scar tissue ages, it contracts, further tightening the surrounding tissues. ‘These microtears are unlike the postlifting and pre-growth repair process during hypertrophy: They are located in an area of transition between elastic (muscle) and inelastic (tendons) tissue, Unlike the middle of the muscle belly this area has poor circulation, which is further diminished with the development of scar tissue ‘Therefore, the repair process is slower. ‘As microtears increase in number and size, they progress into an acute injury. ‘This results in compensational shifts of muscle or muscle groups. ‘These shifts are an attempt to compensate for the lack of proper function of a weak muscle or muscle group. This is the beginning of muscle imbalance, and it occurs, in order to minimize pain, protect the injury and retain maximum function. During the acute phase, attempts to re-pattem these natural shifts prevent the injury from progressing to the chronic phase, The constant avoidance of pain results in the akeration of motor pattems, manifested by a physical dectease in the range of motion about a joint. If the pre-injury ROM is not established, this will result in an altered motor pattem with a related sub-optimal functional behavior. According to the kinetic model described in section 2.00, it is possible to improve the elasticity of the normally inelastic connective tissue without deformation or tearing. The flexibility of all the links that comprise the locomotor system should be trained to the ‘maxinmam range allowed by the joint structure. The shape and contact of the joint surfaces a5 well as the elasticity and strength of the ligaments, enndons and muscle determine the type of movement. Over development of the connective tissues, with regards to elasticity, may result in an irreversible deformation of joints, ligaments and tendons directly and adversely affecting motor abilities, When flexibility training is done properly and the integrity of the connective tissue and muscle is maintained, one can develop a ‘flexibility reserve”. This reserve enhances performance, allowing movement to be executed without excessive tension, Tt also decreases the resistance of the extended muscles and serves as a safeguard against injury. ‘The development of flexibility through static stretching and microStretching® , may exceed other forms of flexibility (passive-active, ballistic, active assisted and MicroStretching® helps develop the flexibility reserve, decreases the influence of hypertrophy and other muscular changes during the development of strength, and decreases muscle tension thereby increasing circulation and neural conductivity. Decreased musclemicroStretcbing to Improve Flexibility tension also assists in decreasing muscle tone and aids the removal of metabolic wastes (ie. lactic acid). Like all forms of training, microStretching® adheres to the principles of frequency, intensity and duration. 3.10 Frequency ‘As suggested by Tudor Bompa, renowned sports trainer and father of Periodization, in order for an athlete to improve his/her flexibility they need to stretch at least twice per day. In agreement with Bompa, each muscle group needs to be stretched at least three times per session. Repetition is important. Learning movements and improvement of skills, both in infancy and adulthood, are dependent upon repetition, Repeated stimulation of the central nervous system integrates the new physical pattern, turning it into an automatic response. With the ongoing development of flexibility, perceptual skills are also enhanced. Increased elasticity in the tendons, and muscles increases the sensitivity of the joint receptors to processing more information. ‘This enables athletes to sense the significance of a physical stimulus and in tum affect a suitable motor response. 3.20 Intensity MicroStretching® is always executed -———————_—______________ at a low intensity level (approximately | Disgeam3: Musde spirale and Gali terion organ 30 - 40 percent of a perceived exertion). Ar this level there is an increase in the pliancy of the connective tissue specifically the tendons and ligaments. Similar to microinjuries the influence of microStretching® is manifested at the cellular level. Unlike a strain, it results in minimal activation of the specialized receptor tissues of the muscle and tendon (the muscle spindle fibres and the Golgi tendon organ) (Diagram 3). The muscle spindle senses muscle lengthening while the Golgi tendon organ senses tension MicroStretching® helps damaged tissue to recover and regenerate, and aids in the breakdown of scar tissue. As scar tissue ages, there is a tendency for compression to occur in the area. This developed compression predisposes the injured area to a greater level of strain with the performance of an aggressive stretch. This in tum will activate themicroStretching to Improve Flexibility specialized receptor tissues. However, microStretching® may bypass these receptor tissues, further enhancing the process of recovery and regeneration. Its critical while stretching to avoid strain or pain, which would result in the activation and /or constant maintenance of the subconscious protective loop. ‘This loop is established as a response to an injury. Its activation results in the development and reinforcement of muscle imbalances, and a further decrease in the ROM about a joint With low imensity stretching (micro Stretching® ), an athlete is able to recover from injury, decrease the muscle tone affected by connective tissue (ie. fascia), regenerate connective tissue (ie. tendons, ligaments and muscle), and re-establish and re-patem the musculoskeletal system. 3.30 Duration ‘The optimum length of time to hold a stretch is approximately 60 seconds. On average it takes about 30 seconds for a stretch to progress from the middle of the muscle belly to the tendons. A token 10 - 15 second stretch may be beneficial to the muscle, but it has minimal influence on the connective tissues ligaments, tendons and fascia that are largely responsible for range of motion and flexibility. At the Serapis Stretch Therapy Clinic® in Vancouver, BC, Canada, we have found that if a stretch was held longer than 90 seconds individuals often complain of feeling tighter. The Golgi tendon organ is probably the cause of this tightness. Prolonged, low intensity stretching of a muscle causes the muscle to lengthen slightly beyond its normal resting length. This is sufficient to trigger a slight increase in tension. Since this increase stimulates the Golgi tendon organ to react, thereby triggering the muscle to contract. As this increase in tightness may result in microtears, a stretch should not be held longer than 60 seconds. {TAVOG. SVB HS SHREYA EES In order to reap the benefits of stretching, both for performance enhancement and recovery regeneration and injury prevention, one needs to stretch every day. Stretching should not remain in the domain of the warm up and warm down exercises. Even though one needs to perform some light warm up stretches as well as more extensive cool down stretches, by performing microStretching® daily, an individual will realize the residual effects of stretching. In fact, proper stretching has a lasting effect of approximately 24 to 72 hours. Bearing this in mind, one should stretch at least 8 hours pre-workout as well as 2 hours post- workout,microStretching to Improve Flexibility Tee ee All athletes will benefit from microStretching® . Whether competing as an individual or on a team, an athlete with a balanced muscular system will perform bette The concept of a 30 to 49 percent intensity level may be forcign to athletes who identify with the “no pain, no gain® philosophy. Stretching at the recommended intensity will help to develop power and allow the athlete to remain injury free ‘The quality of movement, whether judged or not, is affected by flexibility. When an athlete has command of stored flexibility, he/she will be able to perform exercises, and/or events strongly, quickly and expressively. ‘The human body occupies one of three positions in sports; standing, siting, or lying. All three positions involve the coordination of many muscles or muscle groups. A properly designed flexibility routine enhances the interaction of the muscles, ‘The suggested routine is based on two principles. The first principle is the ‘microStretching® principle of frequency, intensity, and duration (Table 1). ‘Table 1: The guidelines for the training principles of microStretching® TRAINING — ‘APPLICATION OF THE TRAINING PRINCIPLE PRINCIPLE 7 * Once ortwice per day FREQUENCY + Three times per muscle group per session INTENSITY + 30-40% of maximum stretch (100% = pain) |__ + Each stretch should be held for approximately DURATION, | 60 seconds ‘The second principle concems stability, balance and control (SBC®), To observe this principle, position the body in a manner that isolates a muscle group, thereby allowing the rest of the body to relax. One accomplishes this using a wall, chair or any other base of support, Observing both principles facilitates microStretching® . "The stretches selected follow a specific kinetic order. The recommended stretches are to be performed in this sequence. Morphologically, there is no value in doing a lower-body stretch followed by an upperbody stretch. ‘The orderly progression is important for each strevch flows into the other but more importantly t makes an imprint on the neural system.microStretching to Improve Flexibility ‘Seretelh Digan} Soles] (all serch vith book an WA IE S/N oe Key Points for Diagram I | Key Points for Diagram II + Sit comfortably ina chair + Ensure that your hips and + Keep hips and shoulders square, shoulders are square to a wall or with legs shoulder width apart other immoveable object | * Place ball of foot on the edge of * Position legs shoulder width apart | a book, or similar object, with * Lower yourself into the stretch, your heel touching the ground ‘keeping both heels on the ground + Position lower leg in a manner and both knees bent which produces a warm, gentle + Place more pressure on the wall 10 stretch lighten the load on your calf. You + Hold stretch for 60 seconds can also stretch over a table or © Repeat on other foot for a total of countertop to help support your three times per foot weight + Hold stretch for 60 seconds ‘+ Repeat on other foot for a total of three times per foot |microStretching to Improve Flexibility ‘Snitch Dia 2s Giatbal Strutoks agai 2F 7 (UA LMNT I Ne WALL FLooR The key points to remember are to lie on your back and place a pillow under your head. Keep your hips and shoulders square to the wall and then cross your left leg over your right knee. Ensure that the left ankle is past the right knee and that your hips and pelvis are flat on the ground. Remember to hold each stretch for 60 seconds and then switch legs. Stretch each leg three times, alternately. ‘Seetdcl Dinghitt3i Pidmistring Streceh gas wall]. PMU AY This stretch is designed to stretch the hamstring muscles (Biceps Femoris, Semi- Membranosus and Semi-Tendinosus). Lying flat on your back place a pillow undemeath your head. Keep the hips and shoulders square to the wall. Place leg against wall adjacent to a door jam with the opposite leg lying on the floor, and passing through the door opening. ‘The knee of the leg being stretched should be slightly bent, cwith the stretch being felt in the belly of the hamstring, and not behind the knee. Hold each stretch for 60 seconds and then switch legs. Stretch each leg three times, alternately.microStretching to Improve Flexibility ‘Sitetch Dinka 4) Sted atin sid aan RHE a He IN AL) ‘When doing this stretch you need to keep your low back and mid back flush against the wall, Bring your legs towards your body with the soles of your feet together. Do not force your knees down to the ground, and let gravity create the stretch, Hold each stretch for 60 seconds and then rest for a minute. Repeat the stretch for a total of three times Q WALL FLOOR ‘Siete Digit i Lana aie cep id 1 a street 102 1/10) NIE Lying flat on your back place a pillow undemeath your head to ensure the flattening out of the lumbar region. The hips and shoulders need to be square to the floor with the legs being shoulder width apart. Bring one of your knees up towards your stomach placing the foot on the opposite leg just above the knee. Ideally try to take your stretching leg and form a 90-degree angle to your body. ‘Try to keep your pelvis and hips flat on the ground. Using your opposite hand gently pull your bent knee over the opposite straight leg. Do not force the stretch. Hold the stretch for 60 seconds and then switch legs. Stretch each leg three times, alternately. 10microStretching to Improve Flexibility SHTERCh ars 6 MEROP Sept PLONE ERLE PE Begin this stretch with hips and shoulders facing forwards and legs shoulder width apart. Place one leg forward maintaining square hips. Sit gently into the stretch with the forward lag bent at 90 degrees. If necessary use a chair beside you to maintain balance and a pillow under you knee for comfort. Keep the back fairly straight. Hold the stretch for 60 seconds and then switch legs. Stretch. cach leg three times, altemately. ‘Streteh Diag Glatel andl Liner Back Stretty |ho1/8)01iS00 100001 wT pd Lie down in the fetal position with the thighs at a 90-degree angle to the upper body. Ensure that the Knees are in line with each other and that the hips and knees are positioned at 90 degrees to each other. Place the opposite hand on the opposite knee and the let the shoulder gently roll back towards the floor. Hold the stretch for 60 seconds and then switch legs. Stretch each leg three times, alternately. When changing sides straighten out your legs and then rotate to the opposite side and resume the foetal position as described above, utmicroStretching to Improve Flexibility ‘Stretch Diadeathi 8: Shotulded{and Upper Bick Stedtehi()/01/- 1) ne Sitting in a chaie with hips and shoulders facing forward and legs shoulder width apart. Keep the shoulder of the arm being stretched down and gemtly pull the am across the body. Make sure the upper body does not pivot from above the pelvis but remains fixed. Do not let yourself Jean away from the stretch and make sure your neck and head are in the neutral position (Le. they are in the middle of the shoulders). Hold the stretch for 60 seconds slowly release, Stretch each arm three times. Standing with square hips and shoulders facing > forward make sure that the legs are shoulder width apart. Lightly hold the edge of a wall with your hand and your arm being extended to your side. It is not necessary for the arm to be in the position as depicted in the diagram. However, it is necessary that the shoulder of the side being stretched is kept gently down and not forced, The outstretched arm is in a position ensuring that the shoulder of the side being stretched is not raised up. In this position you gently begin to rotate your body away form the wall until you feel a gentle pull. Hold the stretch for 60 seconds. Suetch each arms three times. 2microStretching to Improve Flexibility No muscle or muscle group works in isolation, Each contributes to the others function. This also applies to stretching. ‘The sequence of stretches presented is an example of the progression from the lower to the upper body. Each stretch complements the other. The key is to remember to position the body in a manner that allows the isolation of a muscle group with the total relaxation of the rest of the body. If stretching does not follow the SBC® principle we are setting up a scenario of a stretch strength situation, If the mandate is to increase ROM about a joint this will not fully be accomplished if an athlete partakes in stretching that sinwkaneously incorporates strengthening. This follows the law of “diminished return”. The belief is that if you can increase ROM to pre-injury levels or pre- adolescent growth phase, you will be able to generate greater power for the joints to move through a greater range of motion. This in tum will increase performance and prevent injury. Aa Oe | In conclusion, the concept of microStretching® presented in this chapter with the principle of SBC® , will enable coaches to develop an effective flexibility program, By using 30 to 40 percent perceived exertion, the athlete will perform a proper stretch and not a strain, This will decrease the development of microinjuries and scar tissue, The duration of a stretch for 60 seconds helps to re-pattem the connective tissue system, decreasing the influence of habitual patems and ukimately allowing the proper development of muscle groups that were injured. The repetition of the stretches reinforces the imprint on the neuromuscular system, by following the principle of “geometric progression”. With an open, flexible system the athlete will develop greater body awareness, a greater fluid movement patter, thereby generating more power through a symmetzical use of muscle groups that are not affected by a habitual compensatory muscle shift. With a balanced system the athlete will reach their true maximum potential, About the Author: Nikos Apostolopoulos is the fuer of Stretch Therapy® and microStretching®. He is te rector of the Serapis Stretch Therapy Clinic®, bused in Vaneacer, BC, Cana, the only divi in be ‘ld pioneering in te dewepmee of theapawic stetdring Stretch Therapy® and microStretching ® ave reaery magneton tenes based on feral dial anaterry. Mary profsional, dite and amntenr lees and indiducs sien fran arias rascdoskdetaldscrcers ave trata atthe Clinic Nikos graduated from the Faadey of Physica! and Heath Eduction at the University of Tero, with an emphasis in Spars Medicine. He has cxer 20 years experince in. Gress and Funetional Anatary, He is menker of the American Assecation of Anaeniss (AAA), Areriam Assocation of Clinical A natarasts (AACA), Americin Callee of Sports Maticne (ACSM), ar the Intemational A sscation forthe Study of Pain(1ASP) BmicroStretching to Improve Flexibility REFERERS EPL ETE aE 1. 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