Stretch or shorten

Stretching has been a foundation of physical rehabilitation since the early days. Patients often feel a sense of tightness, or a clinician measures a joint’s range of motion and determines it is lacking, and the commonsense answer is to stretch. Muscles are an easy tissue type to pick on, they are easy to see and seem to have an impact on joint mechanics, try stretching them for relief. People often do feel less pain after stretching, they feel good. The question then becomes, what are we stretching and would shortening them work too?

Muscles behave like that of burlap fabric. They can be put on their maximum length, and you can put them on slack. At full length, there really is not much give. They just do not stretch well. Other tissues, like connective tissues, are more elastic in nature. They store and release energy like a rubber band, making them much more amenable to stretching. This may be why stretching does in fact feel so good, elastic tissues have absorbed energy from the movement, charging us up like a battery.

A different method for reducing symptoms in a pain situation, is to actually shorten, or put slack, on the tissues. Often an injury occurs due to a tissue being pushed beyond its capabilities. Tugging on it via a traditional stretch can be an irritant, whereas taking tension off the injured area can allow it to relax and symptoms may reduce.

Treatment strategies for managing pain are in no short supply. Common sense tells us what may be effective, however careful examination may lead us in another direction. When traditional interventions fail, consider inverting the problem and re-evaluating the solution.

Austin Ulrich, Physical Therapist