The Politics of Stretching

Vitamin C is good for colds. Fat is the cause of the world's obesity epidemic. Milk is vital for growing children. 

What do the above statements have in common? They are all statements that at one time were believed by a majority. They probably still are. Yet they have been researched extensively and evidence is, at best, mixed. 

Misconceptions relating to stretching and exercise are one my biggest bugbears. Much like Windows or Mac many people - athletes, coaches, physiotherapists - have an almost religious belief in the benefits of stretching, sometimes to the point that they struggle to take-in  alternative explanations. As someone who wants to get people back running again this can be somewhat frustrating.

"I've been stretching for weeks but it still hurts and I'm not getting any better"

"I stretch all the time but I still get injured"

"Did my calf go because I didn't stretch before running?"

"Did my calf go because I didn't stretch after running?"

This blog is an attempt to explain my thinking with respect to stretching in athletes.

Reach for the sky 

If you're a climber it's pretty obvious stretching is a key component to improving your performance. Greater mobility directly improves your ability to place a foot on a high hold. But, this is of no consequence if you don't then have the strength to push up!

What if you're a runner or a cyclist?

Take a look at the picture of physio Dave Sprot below. He is running at 2.30 min/km pace. Can you get into this  position? The answer for most of you is yes. You don't need to stretch to achieve that range of mobility. But can you race at 2.30 min/km pace? That pace would equate to a 12.30min parkrun!

A very small percentage of us are strong, powerful and aerobically fit enough to run like that except for very short distances (Dave is racing a 800m). Most of us run with a greatly decreased range. Stretching isn't going to change that.

Alicia Hudleson - top American ultra runner on her way to completing the Bob Graham

Andy Preston - top Bamford dentist "striding" out to finish Sheffield half in 85mins 

What can stretching do and what can't it do?

Stretching does not make the muscle stronger. This has been studied extensively and the scientific evidence is fairly clear. In most cases stretching will not directly prevent an overload injury nor will it help it to get it better. 

Stretching can alter the distribution of loads through the body. This can be beneficial, detrimental or irrelevant, depending on how your body is working. Muscle tightness that causes other muscles to take more load than they normally would is a potential source of injury so should be addressed. 

The vast majority of runners and cyclists are sufficiently mobile and don't need to increase their mobility. Some are hypermobile and in runners this can increase the risk of joint injuries although in most cases if someone has been running regularly for a long period their muscles are strong enough to prevent this.

Case Studies:

Here are two contrasting case-studies to illustrate this point:

Case #1

A female athlete ran a marathon whilst ill. She was strong enough and fit enough to manage the load of a marathon, but in her fatigued state she overworked the muscles around her hips which tightened causing reduced range of movement. This led to an overload on the tissue at the knee. The cause of the injury was greater load on the iliotibial band. However the injury continued and didn't resolve until the hip muscles were loosened and stretched back to their normal length - alongside her normal strength work and careful load management as she built up her running again.

Case#2

A male athlete presented with the same injury. He had been stretching his glutes and hips on the side of his injury, the left, such that he now had greater range of movement on that side than the other. Nonetheless the injury persisted. His cause had been overloading due to a much longer than normal run. Despite the stretching his left glute was still much weaker than the right. He had restored mobility but not restored strength. The injury was resolved through strength work and careful load management as he built up his running again. 

Conclusion:

Feel free to stretch if you feel it helps you. But it is not a panacea. If you neglect strength work and load management you will very probably get injured.