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APRIL, 2024
Human movement is dependent on the amount of range of motion (ROM) available in synovial
joints. In general, ROM may be limited by two anatomical entities: joints and muscles. Joint
restraints include joint geometry and congruency as well as the capsuloligamentous structures
that surround the joint. Muscle provides both passive and active tension: passive muscle tension
is dependent on structural properties of the muscle and surrounding fascia, while dynamic
muscle contraction provides active tension. Structurally (Figure 1), muscle has viscoelastic
properties that provide passive tension. Active tension results from the neuro-reflexive properties
of muscle, specifically peripheral motor neuron innervation (alpha motor neuron) and reflexive
There are many factors and reasons for reduced joint ROM only one of which is muscular
tightness. Muscle “tightness” results from an increase in tension from active or passive
mechanisms. Passively, muscles can become shortened through postural adaptation or scarring;
actively, muscles can become shorter due to spasm or contraction. Regardless of the cause,
tightness limits range of motion and may create a muscle imbalance hence the need for stretching
techniques.
Stretching is a form of physical exercise in which a specific muscle or tendon (or muscle group)
is deliberately expanded and flexed in order to improve the muscle's felt elasticity and achieve
comfortable muscle tone (Weerapong et al, 2004). It is a physical exercise that requires putting
a body part in a certain position that'll serve in the lengthening and elongation of the muscle
or muscle group and thus enhance its flexibility and elasticity. The result is a feeling of
used therapeutically to alleviate cramps and to improve function in daily activities by increasing
Stretching can be dangerous when performed incorrectly, there are many techniques for
stretching in general, but depending on which muscle group is being stretched, some techniques
permanent damage to the tendons, ligaments, and muscle fiber (Tsatsouline, Pavel, 2001).
Stretching is effective for the treatment of orthopedic conditions or injury and is a common
intervention performed during rehabilitation which is prescribed to increase muscle length and
range of motion (ROM), or to align collagen fibers during muscle healing. Stretching of muscle
applies tension to other structures such as the joint capsule and fascia, which are made up of
different tissue than muscle with different biomechanical properties. Stretching is often included
in physical therapy interventions for management of shoulder, back and knee pain etc, clinicians
must choose the appropriate intervention or technique to improve muscle tension based on the
cause of the tightness. Therefore, stretching generally focuses on increasing the length of a
musculotendinous unit, in essence increasing the distance between a muscle's origin and
insertion. In terms of stretching, muscle tension is usually inversely related to length: decreased
muscular tension is related to increased muscle length, while increased muscular tension is
1. Static Stretching
2. Dynamic Stretching
Hypermobility
Mechanism of stretching
The stretching of a muscle fiber begins with the sarcomere, the basic unit of contraction in
the muscle fiber. As the sarcomere contracts, the area of overlap between the thick and thin
myofilaments increases. As it stretches, this area of overlap decreases, allowing the muscle
fiber to elongate. Once the muscle fiber is at its maximum resting length (all the sarcomeres
are fully stretched), additional stretching places force on the surrounding connective tissue.
As the tension increases, the collagen fibers in the connective tissue align themselves along
the same line of force as the tension. During stretching, the muscle fiber is pulled out to its
full length sarcomere by sarcomere, and then the connective tissue takes up the remaining
slack. When this occurs, it helps to realign any disorganized fibers in the direction of the
tension. This realignment is what helps in the rehabilitation of scarred tissue. The initial
changes that are produced by stretch training involve mechanical adaptations that are
followed by neural adaptations, which contrasts with the sequence observed during strength
training. When a muscle is stretched, some of its fibers lengthen, but other fibers may
remain at rest. The more fibers that are stretched, the greater the length developed by the
stretched muscle.
Stretch reflex
When muscle stretched, so is the muscle spindle. The muscle spindle records the change in
length (and how fast) and sends signals to the spine which convey this information. This
triggers the stretch reflex which attempts to resist the change in muscle length by causing
the stretched muscle to contract. The more sudden the change in muscle length, the stronger
the muscle contractions will be. This basic function of the muscle spindle helps to maintain
muscle tone and to protect the body from injury. One of the reasons for holding a stretch for
a prolonged period of time is that when a muscle is held in a stretched position, the muscle
spindle habituates and reduce its signaling. Gradually, the stretch receptors can now be
Static stretching (SS) is a slow-paced controlled physical activity which involves putting
the body part in a comfortable position that elongates the muscle without causing pain with
low force for a prolonged duration of time. Static stretching is a type of stretching exercises
in which muscle is held in the same elongated position without movement. Static stretching
has a relaxation and elongation effect on muscle which increases range of motion (ROM),
decreases musculotendinous stiffness and also reduce risk of acute muscle strain injuries. It
is a slow, controlled movement with emphasis on postural awareness and body alignment.
SS is widely used in athletic, fitness, and clinical settings. It consists of a controlled continuous
movement to the end range of motion (ROM) of a single joint or multiple joints where the
muscle(s) remains in a lengthened position for a specific period of time. Static stretching can be
conducted by either contracting the agonist muscles (i.e., active static) or by using external
forces such as gravity, the help of a partner, or stretching aids such as elastic bands (i.e., passive
from an external force which can be a partner, an accessory or the force of gravity.
sports events as a warm up, in order to improve muscle performance and minimize risk of
injury. Reviews have found that stretching immediately prior to exercise does not prevent
injury and can lead to detrimental effect on muscle performance, therefore performing static
stretching before the main exercise session or main sport events can lead to decrease in
performance in these subsequent events (Kay et al, 2012). However, studies suggest that
there is strong evidence suggesting static stretches of below 60 seconds cause only trivial
negative effects on subsequent strength and power performances (Chaabene et al, 2019). To
understand how static stretching can lead to decline muscle performance we have to
understand the acute effect of static stretching and the effect of regular stretching.
Decreases the visco-elastic behavior of muscle and tendon only on the short term
Decreases motor neuron excitability through inhibitory effect from the Golgi Tendon
Decreases the activity of muscle spindles, which results in decreasing the activity of
stretch reflex.
neuron pool.
Collectively all these acute changes in the muscle lead to decrease in force
Regular static stretching exercise improves force and performance in activities. Its
that if stretching a muscle group for 30 to 60 sec/day over months results in hypertrophy
(Chaabene et al, 2019). Panidi et al, (2021) examined the effects of a 12-week, five times per
area and fascicle length of the stretched leg as well as larger one-leg counter-movement jump
performance compared with the control leg. Andrade et al, (2020) investigated the effects of
12 weeks of SS training on triceps surae architecture in university students. While they did not
report any differences in gastrocnemius muscle thickness, they found changes in gastrocnemius
medialis fascicle length in the triceps surae stretching group, with no such result observed in the
control group.
you
Bend the left leg and place the sole of the left foot
Calf Stretch
Stand tall with one leg in front of the other, hands flat
Ease the back leg further away from the wall, keeping it
Keep the hips facing the wall and the rear leg and spine
in a straight line
widths apart
Bend the right leg so that the right thigh is parallel with
You will feel the stretch along the front of the left thigh
Adductor Stretch
widths apart
Ease both of the feet up towards the body and place the
The stretch will be felt along the inside of the thighs and
groin
your chest off the floor, keeping your hips firmly pressed
Bend the right knee and place the right foot on the
Using the left arm against the right knee to help ease
further round
The stretch will be felt along the length of the spine and
Quadriceps Stretch
on right hand
Biceps Stretch
slightly bent
forward
possible
Side Bends
slightly bent
Hold the arms out to the side parallel with the ground and the
The duration of the hold of the stretch is irrelevant to notice improvement but rather how
many times the stretch is repeated in a week. It’s important to note that each muscle should
be stretched only once and should be held for five minutes which is broken into five one-
minute exercises or ten exercises of thirty seconds. The more we stretch in a week, the
better the outcomes where according to certain studies stretching for more than three weeks
served in decreasing stiffness and increasing the range of motion. For individuals whose
main objective is general fitness, it's recommended that static stretching should be done at
least twice a week and stretch held for a minimum of 15 seconds followed by dynamic
stretching.
REFERNCES
Andrade RJ, (2020). Chronic effects of muscle and nerve-directed stretching on tissue
mechanics. Journal of Applied Physiology; 129(5):1011–1023.
Behm DG, Blazevich AJ, Kay AD (2016). Acute efects of muscle stretching on physical
performance, range of motion, and injury incidence in healthy active individuals: a systematic
review. Applied Physiololgy Nutrition Metab; 41(1):1–11
Contraindications to stretching. (n.d.). Stretching Exercises Guide. Your ultimate guide to
stretches. https://www.stretching-exercises-guide.com/contraindications-to-stretching.html
Panidi I, Bogdanis GC, Terzis G (2021). Muscle architectural and functional adaptations
following 12-weeks of stretching in adolescent female athletes. Front Physiology; 12.
Tsatsouline, Pavel (2001). Relax into stretch: instant flexibility through mastering muscle
tension. Dragon Door Publications. ISBN 978-0-938045-28-1.
Weerapong P, Hume PA, Kolt GS (2004). "Stretching: Mechanisms and Benefits for Sports
Performance and Injury Prevention". Physical Therapy Reviews. 9 (4): 189–206.
Zaffagnini S, Raggi F, Silvério J, Espregueira-Mendes J, di Sarsina TR, Grassi A (2016).
"Chapter 4: General Prevention Principles of Injuries". In Mayr HO, Zaffagnini S. Prevention of
injuries and overuse in sports: directory for physicians, physiotherapists, sport scientists and
coaches. Springer. ISBN 978-3-662-47706-9.