Stretching and Sports Medicine Dr Sahir Pall

Dr Sahir Pall

Consultant Sports Medicine

Stretching and Sports Medicine- Dr Sahir Pall 1

Stretching and Sports Medicine Stretching exercise is one of the most significant ways

we can increase our longevity, improve our health, anddecrease our pain and suffering.

Proper stretching exercise can improve flexibility,increase strength, and even reduce pain.

Proper knowledge of the best exercises to improve yourhealth or decrease your pain is essential to a workoutplan or simply a pain management program.


Stretching A form of physical exercise in which a specific muscle

or tendon is deliberately flexed or stretched in order toimprove the muscle's felt elasticity and achievecomfortable muscle tone.

This results in a feeling of increased muscle control,flexibility, and range of motion.


Flexibility in Stretching Flexibility is the ability to move the muscles and joints

through their full range of motion.

Flexibility is developed by stretching properly.

Increasing flexibility through stretching is one of thebasic tenets of physical fitness and commonly anathlete stretches before and after exercise in order toreduce injury and increase performance.

There are benefits of stretching and these are thereasons why an athlete should improve their flexibilitythrough stretching exercises.


Benefits of Stretching Stretching enhances athletes physical fitness.

Stretching optimizes an athletes learning, practice andperforming many types of skilled movements.

Stretching increases athletes mental and physicalrelaxation.

Stretching promotes athletes development of bodyawareness.


Benefits of Stretching Stretching can reduce an athletes risk of joint sprain or

muscle strain.

Stretching can reduce an athletes risk of backproblems.

Stretching can reduce an athletes muscular soreness.

Stretching reduces the severity of painfulmenstruation in female athlete.

Stretching reduces an athletes muscular tension.


Detriments of Stretching Stretching can be dangerous when performed incorrectly.

There are many techniques for stretching in general.

It depends on which muscle group is being stretched.

Some of the techniques may be ineffective or detrimental.

It may cause tears, hyper mobility, instability, or permanentdamage to the tendons, ligaments, and muscle fiber.

The physiological nature of stretching and theories aboutthe effect of various techniques are therefore subject tomany questions.


Detriments of Stretching Over-stretching or stretching to a point where pain is felt

may be inappropriate and detrimental.

Effects on performance, both short- and long-term, mayinclude predisposition to injury and possible nervedamage.

Some stretching routines will reduce muscle-tendonviscosity and increase muscle compliancy and elasticity.

In sports activities where there are little or no short-stretching cycles.

Stretching routines may be detrimental to athleticperformance and have no effect on reducing injuries.


Detriments of Stretching Static stretching in general reduces strength and

power.

Static stretching also reduce stability in squats.

Static stretching does not help to reduce lower leg injuries .

Static stretching prior to ballistic or heavy activity often decreases performance and may even predispose to injury.


Stretching Types Ballistic Stretching.

Static Stretching.

Passive Stretching.

Active Stretching.

Proprioceptive neuromuscular facilitation.

Contract Relax technique.

Contract Relax Contract technique.


Ballistic Stretching Involves bobbing, bouncing, rebounding and rhythmic

movements.

A controversial technique can cause muscle sorenessand injury.

Disadvantages.

It fails to provide tissues to adapt to stretching.

It initiates stretch reflex and thereby increases musculartension causing difficulty in stretching connectivetissues.

It does not provide adequate time for neurologicaladaptation to take place.


Ballistic Stretching Advantages.

It is an effective method for developing flexibility.

It is in terms of specific training appropriate fordeveloping dynamic flexibility.

It does not provide adequate time for neurologicaladaptation to take place.

It is useful in sports like Ballet and Karate.

It can at times be less boring than other forms ofstretching.


Static Stretching Involves holding a position.

Stretching to the farthest point and holding the stretch.

Splits are the good example of static stretching.

It is the safest way of stretching.

Advantages. It requires less expenditure of energy.

It permits semi permanent change in the length.

It allows adequate time to reset the sensitivity of the stretch reflex.

It can also induce muscular relaxation.


Passive Stretching It involves relaxation making no contribution to the range

of motion. Advantages.

It is effective when the primary muscle responsible for the movement is to weak to respond.

It is effective when attempts are made to inhibit the tight muscles.

It allows stretching beyond active range of motion. The direction, duration and intensity is measurable with

advanced machines in rehabilitative therapy. It promotes synchronization with other athletes.

Major disadvantage is resultant soreness or injury with incorrect application.


Active Stretching It involves using ones own muscles without any

assistance from external force.

Advantages.

It helps in developing flexibility.

It has higher correlation with sports achievement.

Major disadvantage is that it may initiate the stretch reflex and it may be ineffective in case of presence of some dysfunctions and injuries like sprains, inflammations and fractures.


Proprioceptive Neuromuscular Facilitation. It involves in the improvement of the range of motion.

This technique is also referred as muscle energy technique.

It was originally developed as physical therapy procedure for the rehabilitation of the patients.

There are two types.

Contract -Relax technique( Hold-relax)

Contract-Relax- Contract technique(Hold-relax-contract)


Contract -Relax technique( Hold-relax)

It starts with a tight muscle group in lengthened position.

Example.

The tight hamstrings are placed under a gentle stretch.

Then a gradual contract is made isometrically.

It is to build a maximum effort against resistance.

There is no change in the length of the muscle or the movement of the joint.

This is then followed by a brief period of relaxation.

Then at last the tight muscle is slowly lengthened by a passive movement of the extremity through a gained range of motion.


Contract –Relax-Contract technique( Hold-relax-Contract)

It similar to contract- relax technique except after the relaxation phase the muscle group is actively contracted.

Example.

The tight quadriceps are made to actively contract.

It is to build a minimum effort against resistance.

There is no change in the length of the muscle or the movement of the joint.

This is then followed by a brief period of relaxation..


Proprioceptive Neuromuscular Facilitation. Advantages.

Most successful method of developing flexibility.

It enhances active flexibility and helps in establishing a pattern of coordinated motion.

It uses neurophysiologic mechanisms.

Disadvantages. There is a greater risk of injury.

The injuries can range from pulled muscle to certain cardiovascular complications.

This technique requires a well trained and knowledgeable partner.


Muscular Soreness Athletes commonly experience discomfort, soreness,

stiffness or pain.

There are two categories. Immediately after exercise.

Later on after an interval of 24-48 hrs.

Common causes. The torn tissue.

The connective tissue damage.

The metabolic accumulation.

The localized spasm of motor units.


Warming Up An essential part of a good conditioning program. Consists of group of exercise performed immediately

before an activity. It provides an athlete a period of adjustment from rest to

exercise. These exercises are intended to improve performance. It reduces the chance of injury by mobilizing the athlete

mentally and physically. Warm-ups are of

Passive warm-up. General warm-up. Formal or Specific warm-up.


Warming Up Benefits of warm-up.

Increase in body and tissue temperature.

Increase in blood flow through the active muscles.

Increase in heart rate preparing the cardiovascular system for work.

Increase in the rate of energy release from the body.

Increase in exchange of oxygen from hemoglobin.

Increase in rate of nerve impulses facilitating body movements.

Increase in physical work capacity.

Decrease in muscular tension.

Enhancement of ability of connective tissue to elongate.

Enhancement of the athletes psychologically.


Precautions Do not stretch if……

A bone blocks the range of motion..

A recent fracture of the bone.

An acute inflammation or infectious process in or around the joint.

A presence of ligament injury.

An osteoporosis is suspected or known.

A recent sprain or strain.

A presence of certain skin or vascular disease.

A loss of function or decrease in the range of motion.


Stretching and Sports Medicine Dr Sahir Pall

Health & Medicine

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