Flexibility is the ability for muscle to lengthen under tension and isn't a term that is synonymous with "mobility". Mobility, in fact, is the range of motion available to a joint one you factor in flexibility, strength, joint shape and structure, neural mechanisms, and more.
With that being cleared up, here are five recent posts of mine on stretching, flexibility, and mobility. For those health and body-conscious individuals or for performance-oriented athletes and coaches, these are must reads!
Is There A Case Against Stretching?
Taking a look at the up-to-date research as the literature begins to finally reexamine static stretching after years of universal acceptance.
Fascia: Not Your Enemy
Fascia has become demonized as the end-all culprit for pain and dysfunction, but is this fair?
Flexibility Isn't Always (Or Often) The Solution
After understanding how flexibility works, let's consider whether or not it's the true issue that needs to be addressed when pain or dysfunction are apparent,
Why Do Muscles Get Tight?
The "tight" feeling of muscles; what is it and why do we feel it even when not restricted in range of motion?
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How often did your last therapist tell you to do your rehab exercises? Twice a week? Three times? Every day?
If you answered 'every day', then you're likely of the majority of individuals. There's a trend among health professionals to make this rule absolute. If you want to get better, then the more you adhere to your exercise plan, the fast the recovery will be. Makes sense!
However, how often do you see someone make a seven-day-per-week behaviour change in a snap simply because a medical professional told them to do so one time?
Sorry, what?
A lot of my clients are self-motivated fitness enthusiasts, so if I tell them to do their rehab exercises every single day, adherence is high! However, expecting perfect compliance is rare among most demographics. I'm not talking about unhealthy shlobs who are unused to taking care of their bodies at all. I'm talking about recreational athletes, weekend warriors, avid gardeners, blue-collar labourers, and more. Telling just about anyone to add a 20-minute routine to every single one of their days might not sound like a lot, but it can be quite the feat.
A lot of therapists are aware of this and will still stick to the "daily dose" model, however, figuring that clients will still do a lesser amount of exercise when prescribed the more. But is this an effective measure? Or does the higher expectation lead to a greater rate of failure? If a client feelsguilty because they did less work then they were instructed to, this could lead to a quicker loss of motivation and eventual overall noncompliance.
For this reason, I find it important to get a thorough understanding of each of my clients' lifestyles, schedule, and inherent motivation. If I feel like someone is going to be perfectly happy to exercise as told every single day, then great! For most, however, setting high standards is an easy way to make clients feel disappointed. Instead, I tailor each plan to each individual, whether it's alternating exercises on each day, having them exercise every other day, or simply doing their rehab plans just as warm-ups for their activities and sports.
We're not sacrificing quality of the program by decreasing the frequency. We're ensuring overall success by helping to create gradual habits. Besides, just a couple days of exercise per week is enough to start providing beneficial effects for just a wide varietyof physical ailments.
I'll say this again before Nike sues me: "Just do it" doesn't work.
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Disclaimer: This is purely a personal opinion post, not an accepted fact or opinion of the medical community.
"Your shoulder is unstable."
We've heard this one before. I've used it before, myself. When speaking on the "stability" of a joint, we're referring to the muscles, passive structures (ligaments) and neural systems that surround the joint to maintain its structure and integrity.
Stability can become compromised for a number of reasons, with muscular weakness, lack of proprioception, and physical tissue damage among them. In many cases, the instability is real. A previously-dislocated shoulder pops out again very easily with very little force. A post-ACL reconstruction patient experiences buckling and failure of the supporting muscles. A rolled ankle that has a much easier time of rolling again after the first injury.
But what about when this severe lack of integrity isn't present. What about the person who simply has an achey shoulder? "Multi-angular instability!" The client with low back pain? "Core instability!" Neck pain? "...Neck instability?"
It may seem like a trivial thing, but words have a lot of power, especially when used on individuals who may be in pain and coming to professionals for help. Using terminology that instills more fear about one's own condition can increase pain expectation and potentiate avoidance habits. This is why many clinicians are being more selective of their language. We're not being hopeless optimists about a problem; we're simply preventing psychology from making it worse! If the back isn't at risk of dislocating, then why are we telling people that their cores are unstable?
That being said, when a joint isn't truly at risk of injury, especially when it comes to chronic pain clients and those who might not be in situations that put their joint in danger, then should "instability" be one of the terms that's vaulted and reserved for those truly-unstable situations that I spoke about above? Lately, I've found myself naturally gravitating to the word "insecurity". Yes, just like when we were awkward teenagers in high school.
It does make sense. A lot of times, in chronic pain, muscular tone is high and pain outputs are driven due to the conditioned state of the body to think that the joint is at risk and to respond as such in order to protect the area. My metaphor for clients, often, is that the muscles are angry and on strike, not allowing the joint to function as needed. To treat, we simply provide sensations to the tissue to get it to relax and exercise it to create a better sense of security, removing the reason for the body to think that those negative responses were necessary.
I'm open to discussion from clients and colleagues. In the meantime, I'll continue to play around with this word and see what kind of feedback and success I can garner.
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Ok, so maybe aggressive stretching isn't the answer to muscles being tight, and I've delved into some alternative methods for helping to increase flexibility in the past, but why do muscles get tight in the first place?
Does tightness occur simply due to high amount of use? True, muscles may become stiff when they become conditioned to high demand, such as your spinal muscles or the calves of runners, but let's make sure we realize that stiffness is one thing and that the sensation of a muscle being tight is another.
For the record, muscles require stiffness to function and that stiffness should not be a cause for discomfort. If you disagree, go ahead and try to loosen up your neck and come let me know how it's working for you if you achieve it.
For this reason, I try to avoid even using the word "tight" when in practice, as it sends the message that any tension and stiffness is a negative thing. But if we were loose all over, we'd be pretty useless meatsacks.
So when things DO feel tight, what's happening? Well, that is usually due to muscle tone.
We now understand that flexibility is a mechanism driven by the nervous system and has to do with the level of passive contraction that the muscle is holding when at rest. That level of contraction and tone will change based on the body's physical condition, work demand, and also simply by what it's trained to do.
"Tight" muscles occur when the nervous system is given a reason to hold an excessive amount of tone. These reasons can include acute injury, of course. However, they can also include the muscle simply not being strong enough to do it's job, resulting in increased tone to compensate. This being said, when I find a particularly tonic and tender muscle on a client, while I do treat it for that tension, my immediate next step is start exercising it. (Not stretching it!)
The sensation of tightness, I find, also occurs in those who specifically condition and train themselves to avoid stretching a muscle into certain ranges. The classic example is individuals who religiously avoid any spinal flexion, whether it be due to injury or training in the gym, resulting in the tense feeling through the back by the time they do happen to bend over.
If we can understand the messages that our bodies send us, then it helps us to remedy the discomfort that we are in much more effectively. Targeting the symptoms of tightness often gives us some relief, but mindfulness about addressing those root causes is equally or more important.
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