Stretching & Mobility: What is the Best Method

Stretching & Mobility 

By Shelley Sheren & Chad Benson http://www.bcpti.ca/team/  

Right off the hop, let’s be clear, the authors of this article are either certified in or extensively practiced in all methods included in this article. That doesn’t mean we are experts in each discipline listed below, but it certainly means we have a reasonably informed opinion. PS. If you haven’t heard of TFM, you will soon enough. Shelley & I are excited to announce that we’ve turned our “moderately informed” opinions on alignment, corrective flexibility and movement into a system of assessment and individualized correction ;)  

Mobility is one of the hottest trends in fitness. The result: dozens of theories, along with 100's of products, promises & certifications on the best ways to improve it. To answer the question: What is the best method?, we have to critically evaluate. But the short answer; they all work but to differing degrees and under different conditions.

In this Blog, we are going to overview and examine a few of the most common PARTNER ASSSISTED methods used & talked about in fitness today. In part 2 of this blog we will review the industry’s leading, non-assisted mobility techniques (i.e. SMR, Muscle Stimulation, Ido Portal: movement culture, primal movement, Move Nat, gymnastics, flow yoga, Robert Schleip: Fascial Fitness). We also asked our resident experts to  take a client through several of the techniques to help you a. see them in action b. give you some insight into the practical application & efficacy of the methods.

Video 1:Active Straight Leg Raise Assessment: Static vs Active Isolated

 

Video 2: 1ft Bridge Assessment: TFM mobility stability protocol

 



Remember, this is an informative / educational blog, not a PhD, so we can’t fully answer all the questions posed below. However, when critically evaluating stretching / mobility techniques and their associated certifications, here are a few things to consider before choosing the best "stretch" method for you:

1.   Is there any scientific, quasi-scientific or extensive practical application evidence to support it?

2.   How user friendly (i.e. self-care or complexity) are the methods?

3.   Is there a way to evaluate the effectiveness of the treatment pre – post or long-term (i.e. is there an assessment). Without assessing the mobility (Vid1 above) & stability (Vid2 above) of a movement or fascial line, it is impossible to fully understand the impact of the treatment.

4.   Do the results last beyond that day or session? Research has shown that various stretch techniques current acute & chronic changes last varying amounts of time. The assessment will also give you a method to re-evaluate the effectiveness for hours, days & months.

5.   Does the technique include suggest supplementation with adjunct mobility practices including: SMR, Muscle Spindle Activation, PNF or tractioning? All of which have been proven to improve the results of mobility training

6.   Does the method improve mobility & stability or primarily one of the two?

7.   Does the increased range of motion help you:

a.    Reduce current pain and / or help you move more freely

b.   Improve ADL (active daily living)?

c.    Reduce likelihood of injury while performing ADL? Fitness, sport, life.

8.   What do long time users report as the major benefits to the method?

9.   How do we know which method to choose and when to use them?

Mobility is the ability to move freely and easily.

Flexibility refers to the absolute range of movement in a joint or series of joints, and length in muscles that cross the joints to induce a bending movement or motion.

Stretching refers to any training technique designed to improve mobility and flexibility.  

Since mobility requires intentional movement, using a combination of motor drive and tissue extensibility, it is considered essential for ADL (active daily living). Total joint motion is also important but has less application to ADL. For this reason, the obtainment & maintenance of mobility is more important than flexibility for life, sport & fitness. 

 Here is an overview of the pros and cons of some of the most popular stretching methods. 


Static Stretching

This is probably the most common method used today. It involves placing the muscle in a lengthened position and holding it there for a variable amount of time ranging from a few seconds to several minutes.

Pros: 



- easy for anyone to perform on themselves

- can be performed anywhere

 - when performed properly (i.e. low to moderate stretch levels and held for 1-3 min per stretch), it aids in post exercise recovery, nutrient absorption and regeneration through relaxation via parasympathetic nervous system stimulation.

 - gentle stretching will stimulate circulation and flow of lymph fluid, which will help to flush muscle contraction interfering metabolic waste products from the area, leading to oxygenation and nutrition of myofascial structures.

 - generally safe, if performed correctly (at an intensity that will not activate the myotatic stretch reflex)

 Cons: 


- must be performed at low tension in order to avoid the myotatic stretch reflex which will prevent lengthening due to activation of the muscle spindles.

 - on it’s own, not the most effective method either pre workout to achieve performance improvement (may have potential negative impact) or post workout for “long-term” restorative length

- since it’s passive, it doesn’t create function or strength at the newly created range of motion.

- does not include a system to quickly or effectively remove fascial adhesions

- may be boring always, particularly pre workout where psychology is important.

- typical dosage (i.e. 30-60 sec) produces only temporary gains in ROM, not effective in increasing connective tissue extensibility for an extended period of time

- in order to be affective, stretch must be held for 2-3 minutes. This may decrease adherence to a stretching routine due to amount of time needed

- doesn’t functionalize or activate strength in the new ranges of motions achieved



Muscle Activation Techniques:

a revolutionary approach to the assessment and correction of muscular imbalances where “muscle tightness is secondary to muscle weakness”. Joint instability, and limitations in Range of Motion within the human body are caused not lack of flexibility of the tight muscle but lack of strength of the muscle opposing them. MAT is a non-invasive (i.e. low level) technique, designed to create joint alignment and symmetry for all ages. In essence, it’s a unique systematic format designed to “jumpstart” the muscles in order for them to function with maximum efficiency. 

Pros:

- uses an extensive system of assessment to determine which muscles and joints should be prioritized for treatment.

 

-new end ranges are established in short amount of time

- improves joint stability not just flexibility and therefore isn’t associated with an increased risk of injury

- targets the entire joint all the muscles surrounding it

- if done properly (i.e. by a certified MAT Therapist), MAT should not be painful and isn’t dangerous

Cons:

- predominantly table based work that cannot be easily performed solo.

- requires a high level knowledge & skill (i.e. extensive education) of anatomy to perform & execute well.

- doesn’t functionalize or activate strength in the new ranges of motions achieved



- doesn’t traction / decompress joint, opens joint space and eliminates jamming of joint while stretching

- focus is on muscle (i.e. isolated muscle) not movement. Session focus isn’t on functional reintegration (i.e. back to play).

- does not include a system to quickly or effectively remove fascial adhesion

- does not encourages breathing to aid nervous system regulation and helps the client improve ROM.

Proprioceptive Neuromuscular Facilitation (PNF)

Not really a stretching method, PNF is a technique used in combination with stretching to induce relaxation of a muscle. This is done by stretching a muscle to it’s current end passive range and then initiating a short (3-10 seconds) isometric contraction of that same muscle in order to temporarily activate the golgi tendon organs. This will cause the muscle to relax so that more ROM can be achieved. This will be repeated until there are no further ROM gains can be achieved.

Pros:


- scientifically considered the fastest and most efficient way to gain range of motion J

- can be performed without a partner (i.e. towel)

- can be performed on every muscle group
 

- can be beneficial for injuries (i.e. post rehabilitative settings)
 

Cons:

 

- may lead to injury if administered incorrectly on detrained or injured client. There is a certain amount of stress put on the muscle which can increase the risk of soft tissue injury
 

- may need help of trainer or therapist to perform safely and correctly
 

- doesn’t functionalize or activate strength in the new ranges of motions achieved



 

Active Isolated Stretching

 

A dynamic method of stretching performed either on your own or assisted. Active isolated stretching involves stretching an isolated muscle using repeated reps that are held for 2 seconds. Reciprocal inhibition is utilized by contracting the opposing muscle, which in turn will relax the muscle attempting to be stretched. The muscle is coaxed through the last few degrees, towards it’s end range (i.e. full extensibility) either by a partner or the use of a length of rope wrapped around the limb.

Pros: 



- can be performed self directed or with therapist

- involves the brain / neurologically stimulating by actively engaging muscles.
 

- due to the use of repetitions & resultant contract relax pumping action, lymph& fluid flow is created. This is of benefit to wound and injury healing as well as removing waste products and toxins
 

- since it is active and requiring participant engagement, it may hold interest as well as provide greater adherence to program
 

 Cons:

- may lead to overstretching if too much force is used at end range.

 

- may need some education/direction/practice to perform as self-care.

- Active Isolated claims that it doesn’t engage the myotatic stretch reflex because it low tension & only holds each repetition for 2 seconds or less, apparently not enough time to activate the stretch reflex. Basic muscle physiology states that the stretch reflex occurs in milliseconds, so are they magically bypassing this somehow?
 

- does not include a system to quickly or effectively remove fascial adhesion
 

- Since the rep is only held for 2 seconds, is it long enough to create strength and neuromuscular re-education at end range and have long lasting effects?



 Fascial Stretch Therapy (FST)





Fascial Stretch Therapy (FST) is an assisted stretching technique performed on a treatment table with the aid of straps to stabilize the non-working limb or body part in order to facilitate complete relaxation. This technique synchronizes breathing and movement while combining PNF, joint tractioning and stretching through multiple angles and planes of movement to achieve end range extensibility.

Pros:

- new end ranges are established in short amount of time

 

- targets entire joint and joint capsule as well as fascia
 

- tractioning decompresses joint, opens joint space and eliminates jamming of joint while stretching

- affects full fascial line not just isolated muscle
 

- if done properly (i.e. by a certified Fascial Stretch Therapist), FST should not be painful
 

- encourages breathing to aid nervous system regulation and helps the client become more receptive to stretching.
 

- post exercise or stand alone: when performed properly, it aids in recovery, nutrient absorption and regeneration through relaxation via parasympathetic nervous system stimulation.
 

- rate of breathing is paired with different rates of movement & types of contractions. (slow stretch wave for recovery and regeneration, fast stretch wave for activity preparation)

Cons:

 

- table work cannot be done unassisted (FST does have unassisted floor techniques that are aligned with FST protocol and are useful in maintaining new ROM between sessions without a therapist) 


- requires a high degree of skill & practice to execute

- requires specialized equipment access (i.e. table & straps)

- doesn’t functionalize or activate strength in the new ranges of motions achieved



- Does not target the entire fascial system or release fascial adhesions.

 

What all of the above methods are missing is useable strength at the end range of motion as well as functional reintegration (transfer to life sport & fitness). Any of the above modalities will get new range temporarily, but how do we keep it? We must use mobility techniques which can alter both physical & neurological barriers to create permanent mobility changes. Once the nervous system is altered, we must train / put motor control into tissue that hasn’t been receiving functional information for some period of time.

·      Step 1. establish range of motion.

·      Step 2. train within the end range to support permanent mobility and pattern stability changes. We need to educate the nervous system so that it recognizes that there is a new ROM.

Stand alone, all of the above methods will create varying degrees of acute (now) success. However, in combination and with end range strengthening, long-term ADL changes will become evident.

Functional Range Conditioning: https://www.functionalanatomyseminars.com/functional-range-conditioning/

There are 3 main goals when training using FRC^® system and all are closely interrelated, and acquired simultaneously. Mobility Development:  mobility refers to the amount of active, usable motion that one possesses. The more mobile a person is, the more they are able to maximize their movement potential safely, efficiently, and effectively. Joint Strength (end range of motion strengthening): while improving mobility and movement potential, the FRC® system also acts to ‘bullet proof’ (or safe-guard) your joints so that movement can be executed safely. Body Control (functional reintegration): training with FRC® improves the function of your nervous system. This leads to a reduction of pain and injury, joint health and longevity, as well as an increased ability to move freely and easily.

Pros: this is a comprehensive intelligent approach to movement solutions that we have adapted into our own system of movement (TFM).

- Their CARS (controlled articular rotations) approach explores movement and control of movement throughout the entire joint capsule.

-new end ranges are established and strength established at. This helps remove the dead zone.  

- therapies are designed to affect movement. Isolated techniques are functionally reintegrated into useable / trainable movement VS isolated muscle

- uses a system of core and grounded tension to improve spinal stability and force translation.

- uses a high tension system of movement which increases nervous system activation and metabolic demand. Very good system pre exercise and sport.

- encourages breathing & nervous system up-regulation and helps the client drive more range of motion.

- post exercise or stand alone: when performed properly, it aids in recovery, nutrient absorption and regeneration through relaxation via parasympathetic nervous system stimulation.

 Cons:

 

- requires a high degree of skill, knowledge of the system + acronyms & practice to execute. There are multiple levels.

 

- system is extensive and requires a lot of time to practice and perform well. It’s a time consuming practice.

 

- does not include loaded rhythmic movement to ensure functional, fascial applications of the newly established range of motion. This prevents proper mechanoreceptor integration.

- Does not target the entire fascial system or release fascial adhesions. Other courses in their system might but not the mobility / flexibility treatment regime.

- Does not include tractioning

- uses high tension contractions and PNF and therefore is best used pre exercise VS post. Due to high tension PNF & movement, unskilled execution creates a risk of injury.

Therapeutic Fascial Mobility (TFM)




 

TFM includes the best of FST (exploratory path of movement, tractioning & low level contract relax cycles), MAT (muscle isolation, synergistic dominance, low level gamma motor neuron activation), FRC (strengthening muscles in their previous dead zone & functional reengagement) flexibility & mobility training wrapped into 1. an extensive movement (active) assessment & corrective movement model, and 2. Partner assisted, highly individualized stretch session.
 

Pros:

- stretch sessions begin with a full functional movement assessment and are individualized based on the results. This method ensures quicker realignment of the nervous and muscular systems.

- new end ranges are established in short amount of time.

- loaded rhythmic movement is added to the end range to ensure functional applications of the newly established mobility.

- targets entire joint and joint capsule as well as fascia

- tractioning decompresses joint, opens joint space and eliminates jamming of joint while stretching

- therapies are designed to affect full fascial line not just isolated muscle

- the low level PNF decreases the likelihood of injury to the client & helps to stimulate the parasympathetic function, TFM should not be painful.

- encourages breathing to aid vagus nerve stimulation and parasympathetic nervous system regulation and helps the client become more receptive to stretching.

- post exercise or stand alone: when performed properly, it aids in recovery, nutrient absorption and regeneration through relaxation via parasympathetic nervous system stimulation.

- rate of breathing is paired with different rates of movement & types of contractions. (slow stretch wave for recovery and regeneration, fast stretch wave for activity preparation)

Cons:

- table work cannot be done unassisted (FST does have unassisted floor techniques that are aligned with FST protocol and are useful in maintaining new ROM between sessions without a therapist) 


-requires a high degree of skill & practice to execute

- requires specialized equipment access (i.e. table & straps)

- doesn’t functionalize or activate strength in the new ranges of motions achieved



In this blog, we have looked at the Pros, Cons & acute movement impact for several assisted stretching methods. In future blogs we will attempt to show you non-assisted techniques and possibly the long-term head to head outcomes; using real clients, with real issues. Stay tuned.