Usually, the first thing people ask when you talk to them about pain is usually “have you tried stretching it”. For some, the answer is yes, and they’ve been stretching the same issue for months or even years. What’s worse, if you look up stretches for headaches, shoulder pain, sciatica, bursitis, knee pain, or plantar fasciitis and you’ll get a ton of suggestions and quite a few of them contradict each other. Plus, there’s tons of types of stretching from yoga positions to using a stretch out strap to stretching while seated/lying down/standing up… it is often difficult to figure out what is the right stretch for you, how much to do it, and how far you should actually push into the stretch. On top of that, some pain issues only need one or 2 specific stretches and not the 8-10 that are sometimes recommended. Other pain issues are actually your nervous system or alarm system inhibiting(think limiting how much “gas” a muscle can get) a muscle and stretching actually makes the pain worse. Sometimes it is a tendon issue and stretching makes things worse. And…just to complicate things a bit more, where you are feeling the tightness may actually be a symptom of a problem elsewhere like the always tight hamstrings being a symptom(not a cause) of back troubles.
So, how can you figure out what you actually need to get to the root of what’s causing the pain?
First, let’s cover some myths about stretching
Myth #1: Stretching has to hurt. There is a lot of needless suffering when it comes to stretching. While some elite athletes and certain sports require hyperflexibility to get to doing things like a flying split, most of us mere mortals don’t require that type of flexibility. Why? Because when we’re stretching, we are actually trying to get our muscles to relax so that they can let our joints get to their maximum safe mobility. For example, the ever-present tight hamstrings. While I don’t need to be able to put my nose to my shin, I do need and it is safe for my leg to come up to about 120 degrees(straight up and down is 90 degrees), that’s actually a full range of motion and most activities don’t require us to go beyond that. Now, if I’m hammering away at getting my leg further than that, it will struggle to actually relax and allow you to go there. Sure, if I’m hammering away at a muscle, it may actually relax and feel looser but often you can improve flexibility for less than a 2-3/10 on the pain scale.
Myth #2: I’m actually making my muscles longer with stretching. This is a common myth and misconception. Why? Because first, our muscles and the fascia surrounding them are incredibly strong. In fact, it takes about 2000 pounds of force to deform(or actually stretch) fascia by 1%. Our mechanism of action with stretching is actually a nervous system mechanism. Our nervous system can either tell a muscle to get tighter or looser. Short of you being laid up in a wheelchair, cast, or bed, your muscles and their tendons aren’t actually shorter(a condition called a contracture). They have more tone i.e. the nervous system is telling them to hold themselves tighter for whatever reason(see myth #4). So we’re really getting the nervous system to relax which then lets your muscle relax. The looseness or reduced stiffness you feel is the nervous system letting that muscle move better.
Myth #3: I’m breaking up scar tissue with my stretch. This goes along the line with myth #2 which is that we’re actually making muscles and tendons longer with the stretch. Consider this, if I was actually breaking up scar tissue or making the muscle longer(i.e. Pulling the muscle fibers apart) that would mean that many of the lifts that we do in the gym, running, jumping, or sports would do the same thing. If that was true, our bodies would literally fall apart with a little tension(because we’re not actually using a whole lot of force when stretching). In addition, it takes a surgeon a lot of effort with a scalpel to actually break up scar tissue and that’s without the muscle fighting back. So, we’re not actually breaking up scar tissue, our stretches are still focused on getting the nervous system to relax.
Myth #4: Pain is coming from where I’m feeling it. This is truly a difficult one because it goes against what our bodies feel. While some stretches treat the source of pain, others can irritate it(like if you’re dealing with a nerve issue like the sciatic, radial, or ulnar nerve) or a tendinopathy(like a tennis elbow, hamstring tendon, or achilles tendon issue). On top of that, the joints around above or below the muscle could be the problem and the nervous system has told the muscle to be tighter in order to protect the joint. Often I’ll find that somebody’s stiff ankle is to blame for their plantar fasciitis or their hip is responsible for leg tightness. More often than not, your spine is often the reason the nervous system tells muscles to tighten up to protect. And when we move the spine in the right way, the muscles loosen without ever having stretched them. So then the big question is how to figure out the right answer to whether or not stretching is the fix or if its something else.
How to know whether to stretch a muscle(or not)
First, if we are just looking to have less stiffness in general, then stretching is definitely part of the answer along with use of tools like a foam roller, lacrosse ball, or floss band. Using those tools will help you narrow down on what part of the muscle is the problem and let your stretching be more effective. In addition, we need to slow down and change the style of breathing that we’re doing while stretching. Ideally we’re doing a belly breath focusing on a 2:1 ratio of exhale to inhale or if I inhale and that breath makes the belly expand, my goal is to breathe in for about 3-4 seconds with a 6-8 second slow exhalation while sinking into the stretch. Each stretch should be 4-5 breath cycles and should be generally more functional patterns or yoga patterns.
Now, if pain is involved, then we really need to drill down to causes(note, this isn’t medical advice). But generally if pain changes with a change of position or from sitting too long, looking at a phone or screen, or builds over time then often our pain is coming from somewhere else other than or in addition to where we’re feeling it. Meaning that if I’m getting back or hip pain and I feel tight hamstrings when I move around, it is less likely that my hamstrings are the problem and that my back is more of the culprit. Also, if I’m feeling stiffness when my muscle isn’t at maximum stretch like maybe the same hamstring or calf muscle when I’m doing a squat or lunge, then the more likely culprit is joint mobility loss. Lastly, if I’m feeling muscle stiffness after an actual injury like a pulled muscle or strain, then mobility work with a massage gun, foam roller, or lacrosse ball to the injured area or other thickenings in the muscle(if you poke around and feel an area that is denser than the surrounding muscle) might be the better option before stretching.
As always, thank you for reading this post. Confused about where to start? Book a call from the comfort of your home or office and on your schedule with one of our Back Pain and Sciatica Specialists. You can schedule your call here. Need help now? Come by and talk with one of our Doctors of Physical Therapy at no charge. We offer FREE consultations, which give you the opportunity to come in and meet us and see for yourself how we can help you.
Here are just a few of the things you will learn in one of our free consultation:
What is the underlying cause of your pain? (hopefully nothing too serious!)
Roughly, how long will it take to fix the problem?
What to do to help – which doesn’t include painkillers, resting or surgery etc.
What other, natural, drug free methods are there to speed up recovery alongside treatment?
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About the Author
Dr. Brandon is the owner and a Physio at Body Mechanix Physiotherapy and Fitness. Four of his favorite people call him daddy while he's been married to his other favorite person for 21 years. He enjoys teaching martial arts and is a Mestrando in Capoeira while in the mornings, he can be found working out with the guys in F3 around town. He's the author of 4 pain relief guides for sciatica, low back, shoulder, and knees and the lead contributor to the Active Tallahassee Blog.
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