Stretching and Sports Medicine

1. Dr Sahir Pall
Consultant Sports Medicine
Stretching and Sports Medicine- Dr Sahir Pall 1

2. Stretching and Sports Medicine
 Stretching exercise is one of the most significant ways
we can increase our longevity, improve our health, and
decrease our pain and suffering.
 Proper stretching exercise can improve flexibility,
increase strength, and even reduce pain.
 Proper knowledge of the best exercises to improve your
health or decrease your pain is essential to a workout
plan or simply a pain management program.
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3. Stretching
 A form of physical exercise in which a specific muscle
or tendon is deliberately flexed or stretched in order to
improve the muscle's felt elasticity and achieve
comfortable muscle tone.
 This results in a feeling of increased muscle control,
flexibility, and range of motion.
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4. 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 the
basic tenets of physical fitness and commonly an
athlete stretches before and after exercise in order to
reduce injury and increase performance.
 There are benefits of stretching and these are the
reasons why an athlete should improve their flexibility
through stretching exercises.
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5. Benefits of Stretching
 Stretching enhances athletes physical fitness.
 Stretching optimizes an athletes learning, practice and
performing many types of skilled movements.
 Stretching increases athletes mental and physical
relaxation.
 Stretching promotes athletes development of body
awareness.
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6. Benefits of Stretching
 Stretching can reduce an athletes risk of joint sprain or
muscle strain.
 Stretching can reduce an athletes risk of back
problems.
 Stretching can reduce an athletes muscular soreness.
 Stretching reduces the severity of painful
menstruation in female athlete.
 Stretching reduces an athletes muscular tension.
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7. 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 permanent
damage to the tendons, ligaments, and muscle fiber.
 The physiological nature of stretching and theories about
the effect of various techniques are therefore subject to
many questions.
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8. 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, may
include predisposition to injury and possible nerve
damage.
 Some stretching routines will reduce muscle-tendon
viscosity and increase muscle compliancy and elasticity.
 In sports activities where there are little or no short-
stretching cycles.
 Stretching routines may be detrimental to athletic
performance and have no effect on reducing injuries.
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9. 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.
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10. Stretching Types
 Ballistic Stretching.
 Static Stretching.
 Passive Stretching.
 Active Stretching.
 Proprioceptive neuromuscular facilitation.
 Contract Relax technique.
 Contract Relax Contract technique.
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11. Ballistic Stretching
 Involves bobbing, bouncing, rebounding and rhythmic
movements.
 A controversial technique can cause muscle soreness
and injury.
 Disadvantages.
 It fails to provide tissues to adapt to stretching.
 It initiates stretch reflex and thereby increases muscular
tension causing difficulty in stretching connective
tissues.
 It does not provide adequate time for neurological
adaptation to take place.
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12. Ballistic Stretching
 Advantages.
 It is an effective method for developing flexibility.
 It is in terms of specific training appropriate for
developing dynamic flexibility.
 It does not provide adequate time for neurological
adaptation to take place.
 It is useful in sports like Ballet and Karate.
 It can at times be less boring than other forms of
stretching.
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13. 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.
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14. 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.
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15. 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.
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16. 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)
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17. 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.
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18. 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..
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19. 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.
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20. 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.
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21. 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.
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22. 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.
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23. 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.
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