Stretching, Tom Goom

From youtube video

Title: "Should runners stretch?"

Transcript: "hi it's tom here from running physio today i wanted to talk to you about stretching now still working with lots of runners a lot of them really focus on stretch stretch stretch as part of their routine and a lot of therapists actually still focus on stretching a lot as part of their treatments and and we know that actually sometimes this can make things worse uh in the lateral hip pain for example we know that when people stretch a lot it tends to just aggravate symptoms and it's one of several common mistakes we see in management of lateral hip pain and we talk about this a bit more in our webinar series that i've linked to in the details in the title here for you so i wanted this video to talk a bit more about stretching does it help performance in runners does it help muscle soreness from doms does it reduce injury risk so we're going to explore that over the course of this video and then towards the end talk to you about how you can use stretches a bit more effectively in clinic in a slightly more targeted way now this is all part of a discussion point from running repairs online where we try and talk about these key topics and get people discussing them so i'd really love to hear your views what do you think do you find stretching effective in clinic do you think it gets a bit of a bad press do you think actually it's overused i'd really like to hear what you think in the replies in the comments let me know what your views are on it so let's start with some of the findin gs then in the literature the first one is that actually if we're talking about runners and endurance athletes elite athletes tend to be less flexible and a lot of runners want to be like the elite athletes they want to be able to mimic their running and their performance but actually not many of them want to be less flexible even though it tends to be what we see in that elite group and actually inflexibility particularly around the hip and the calf the ankle joint is associated with improved r unning economy so you're likely to be a bit more efficient actually if you are a little bit less flexible so that leads to a phrase i quite like to use with athletes tight is all right it's actually good it might lead to improved performance and the analogy i often use is thinking of a spring we want the legs to behave a bit like a spring and i know this is a bit of a simplification but we want it to behave like a stiff bouncy spring that bounces us along and takes advantage of that elastic ener gy that runners use what we don't want is a really flexible floppy spring we don't want a spring that looks like this which is actually my little boys which i've stolen from him that's not going to bounce you along very efficiently we need some tightness we need some stiffness from our springs so tight is all right so that begs the question then well do we really want to spend time stretching stretching stretching if we need this tightness for economy and for performance and actually when you lo ok at some of the research on things like pre-run stretching it's been found to be detrimental for economy and performance and we think because it's because what it does is when we do a prolonged stretch particularly a static stretch over about 30 seconds is it reduces the stiffness and it reduces the muscle's ability to produce force quickly which is not really what we want when we're about to go for a run so pre-run stretching particularly static stretching is something that we're moving away from so on the whole here what we're seeing is there's no evidence that either acute or chronic stretching improves economy or performance in our runners now by a acute there we mean essentially pre-run stretching and by chronic we mean using stretches in their own standalone session done repeatedly over a period of time so even in runners diligently doing daily stretches away from their running practice it doesn't seem to have major benefits in terms of economy or performance but it is time con suming so could they be spending that time working on something that's going to get them somewhat better results so it doesn't seem that from a performance point of view stretching has lots of benefits for our runners next up well what about dom's delayed onset muscle soreness now wisdom has often been that if you get some doms stretching is going to really help and it can help prevent doms however research from baxter at all this great review of the role of stretching and runners says that doms cannot actually be influenced by stretching and that stretching doesn't seem to make much difference to it it is something we know that is likely to go away with time and that as an athlete gets used to whatever sport that they're doing whether it's running more or doing more eccentric based strength work the doms gets less and less it's one of those things where actually if we leave it alone it tends to do quite well so i don't we need to do an awful lot in terms of stretching to address thing s like doms so so far stretching is getting in a bit of a bad rep here it doesn't seem to help economy of performance it's not very effective for doms what about prevention of injury the kind of golden goose that we want can we stop runners getting injured well most studies show that static stretching has no impact on risk of running injury it doesn't seem to reduce your running injury risk to do lots of static stretching and if you think about it we most running injuries we think link to excess ive load placed upon the tissues and static stretching isn't going to change that it's not going to magically transform you so your body can manage 50 miles when it could only do 20 miles before so it's not surprising perhaps that it doesn't seem to have a major effect on injury risk either now i think one of the problems we have with uh with stretching is that it's been applied like a kind of general one-size-fits-all approach for so many years we've all been told to stretch stretch stretch bef ore exercise runners are still told to stretch regardless of their needs and the thing we actually need to try and make it a bit more specific to the individual and one way we can do this is using this idea of a stiffness scale now this again is a bit of a simplification but if you imagine down one end of this scale you've got too much flexibility think of perhaps someone with hypermobility they don't actually have enough stiffness perhaps and what we tend to see then is increased joint excursio n so more range of movement utilized during running and this is associated with decreased efficiency because it's not really stiff enough you spend a long period of time in contact with the ground with this running technique and it can increase load and if you look at the image below here we've got a runner that's that's quite uh in quite flexible and going into quite deep knee flexion positions which has been found to increase the stress on the patellar femoral joint so there may be a downside in terms of decreased efficiency and performance and it may mean increased stress on certain regions such as a patellar femoral joint now in this group they're really not going to be benefiting much more from lots more stretches they need more stiffness not more flexibility if anything so we might use targeted strength and conditioning approaches to increase cell strength and increase their stiffness we might use plyometric exercises with a short ground contact time to reduce the movement that's occurring at the joint and make them more stiff we might increase their step rate which has also been found to increase stiffness during running so we might try and move them more towards this sweet spot in the middle with an increase in stiffness but if we go down the other end of the spectrum you may encounter athletes that are too stiff and you see decreased joint excursion particularly at the hip knee and ankle now sometimes this can lead to compensatory movements and can result in increase d loading elsewhere if you look at the image at the bottom of the screen you have here this is a runner with a long standing restriction in left ankle dorsiflexion so very very limited ankle dorsiflexion when you measure it clinically so you can see that this runner is compensating by internally rotating the limb and you'll see that she doesn't bring her heel to the ground during that running gait cycle so we're seeing a couple of compensatory strategies and this may well shift the load elsewher e and if the body's not used to it if we increase the load too quickly that may irritate things i will say however that this particular runner runs very well injury-free so let we don't want to demonize these changes in movement this could be a positive compensation also with excessive stiffness we may ask is there enough range for optimal stride length for example if you're very restricted in hip extension can you actually create enough stride length can you extend the limb sufficiently behind you to get that good flight time and stride length so there probably is again a sweet spot with this so if someone has joint restriction that maybe limits their efficiency or links to pain and pathology i think maybe ankle dorsiflexion loss in plantar fasciitis they may well benefit from improving their range of movement to move towards this sweet spot that exists between stiffness and flexibility now hopefully then this is going to be a bit more of a targeted approach rather than throwing stret ches at everyone where some people if they're already flexible it's not going to help at all some people there may be some benefits in specific situations and i would say if you want to use stretches you can but i would use them with a clear goal a clear dosage and a clear timing so if there is a clear goal there let's say a patient is very stiff and tight through their ankle joint and you found that this stretches actually improve their range of movement absolutely fine no problem we can use th at with objective evidence it's helping the patient and it links to their pain and pathology or are patients telling the stretches help their pain again brilliant stretches may well have a role in addressing pain in people we shouldn't dismiss them all together in that regard but there's a clear goal there and we want to think about dosage 2 do you want to do a prolonged static stretch which may have the detrimental effects in terms of power would you prefer to do a shorter duration stretch mayb e more of your dynamic stretching could that be more effective or more appropriate and think about timing too is immediately pre-run the best time to be doing these stretches probably not in many cases could we sit in a stand-alone session to achieve those specific goals for each individual so it comes back a bit more than to specifics and individual requirements rather than a one-size-fits-all approach and we all work with runners that include stretches as part of their warm up and have them fo r many years and enjoy it as part of their routine and i would say don't suddenly stop them from doing it if they enjoy it they find it beneficial the evidence isn't so compelling that we should be telling people to stop them together there's also some suggestion from the research that if you mix stretches with more ballistic plyometric exercises in your warm up it lessens the negative effects so if someone's always done some static stretches they include a bit of plyometrics in their warm up an d it doesn't cause them any bother by all means keep them in there if it's increasing their pain or is having negative effects think about whether you want to replace it with something else or whether you think about dosage or timing a bit differently now my final thought on this is when we think about stretches and their influence on range of movement there is some evidence that stretches will improve range over time but there's also some evidence to suggest the effects can be quite short-lived if you want a longer lasting benefit in terms of improving flexibility it might be that loading in length and positions with eccentrically biased strength exercises is a bit more effective so think about things like maybe calf raises on the edge of the step going into deeper dorsiflexion think about things like straight leg deadlifts loading the hamstrings at length this is going to be probably a bit more effective to improve both strength and flexibility at the same time and if we come back to our spring analogy and again this is a simplification we think that static stretches they may stretch that spring out to make it a little bit more floppy a little bit less stiff which results in a short-term reduction in strength and power where whereas in about half an hour or so that stiffness and everything returns the the spring essentially goes back to where it was however in our eccentric loading rather than stretching the spring out it's adding coils to the base of the spring to make it physically longer so to my mind it's going to be a bit better in terms of improving strength hitting more optimal stiffness and improving length at the same time so i'm more inclined with my patients to spend more time looking at loading at length and less time doing lots and lots of static stretching okay thank you very much for for listening today i'd really like to hear your views on it what do you think do you like stretches do you think that i've given them too much of a bad rep um do you t ink in the title okay bye for now"

ChatGPT

Elite Athletes and Flexibility:

Elite runners and endurance athletes tend to be less flexible.

Limited flexibility, especially around the hip and ankle, is associated with improved running economy.

Performance and Stretching:

The video questions the common belief that stretching helps runners' performance.

Research suggests that neither acute (pre-run) nor chronic (regular) stretching improves economy or performance in runners.

Stretching and Delayed Onset Muscle Soreness (DOMS):

Contrary to conventional wisdom, stretching does not significantly influence or prevent DOMS.

DOMS tends to diminish with time and increased familiarity with the sport rather than through stretching.

Injury Prevention and Stretching:

Static stretching has shown no substantial impact on reducing the risk of running injuries.

The one-size-fits-all approach to stretching may not be effective, and a more targeted approach based on an individual's needs is suggested.

Alternative Approaches to Flexibility:

Instead of extensive static stretching, a more effective approach might involve targeted strength and conditioning exercises.

Loading in length with eccentrically biased strength exercises may provide longer-lasting benefits for both strength and flexibility.

Note: The video emphasizes the need for a nuanced and individualized approach to stretching, considering specific goals, dosage, and timing for each athlete.

4.3K views 3 years ago Training

Should runners stretch?

Stretching is a common and popular activity however, is this always the right approach? Does it help performance, injury risk or muscle soreness? …

Summarize

00:02 TEXT TRANSCRIPT

hi it's tom here from running physio today i wanted to talk to you about stretching now still working with lots of runners a lot of them really focus on stretch stretch stretch as part of their routine and a lot of therapists actually still focus on stretching a lot as part of their treatments and and we know that actually sometimes this can make things worse uh in the lateral hip pain for example we know that when people stretch a lot it tends to just aggravate symptoms and it's one of several common mistakes