How Stretching Will Improve Your Life!

By Kate Serodio, DPT
Why Stretching will improve your life - By Kate Serodio, DPT

From childhood, we’ve all been reminded to sit up tall, not slouch, stretch, and pull your shoulders back for good posture. If you engage in a sport or even go for a walk, it has embedded in your mind “make sure you stretch before, after, and maybe even in between”. If something hurts, “just stretch it out.” We have all accepted this as common knowledge and most of us have never questioned this advice. But why haven’t we questioned this? We do not question it because stretching is an instinct.

Stretching is instinctive for both animals and humans. You wake up in the morning, what do you do? You stretch, it feels good. You yawn, what happens? Naturally, you stretch. You sit on a plane for hours wondering why an airline that would ever make seats this tight. You finally stand up, what do you do? You stretch! And swear you’ll consider buying extra leg room next flight! Your body knows what you need. You need to stretch! We all intuitively know that stretching is good for us.

Pain reduction, increased mobility, posture improvement, better sleep and even weight loss are all benefits of regular stretching.

Numerous supportive research articles support the benefits of stretching. The literature has concluded that the three main stretch types (static, dynamic and pre-contraction facilitation (PNF)) are all beneficial for increasing range of motion or mobility. In fact, a 2011 randomized control trial by marshal et al. found a 20% increase in H.S flex after a 4-week stretching program, that’s a lot! A systematic review performed by Harvey 2002 resulted in an increased flexibility across several joints. They concluded that regular stretching can increase joint range-of-motion by a mean 8 degrees for >1 day after stopping stretching! This is very encouraging; your stretching gains are still present over a day later. It is important to note that PNF stretching, in comparison to static and dynamic stretching has been found to cause larger magnitude of gains within subjects range of motion both active and passive (Hindle et al). Therefore, PNF has been shown to be the superior stretch type for increasing joint mobility.

stretching

There is no doubt that stretching increases flexibility but the more recent controversial question has been does stretching increase performance? The recent literature has suggested that PNF stretching and static stretching prior to exercise has been found to decrease performance when maximal muscle effort is requires such as during sprinting, plyometrics, cutting, weightlifting, and other high intensity exercises (Hindle et al). However, key et al 2012 did a systematic review and found that performance was only compromised with longer duration of stretch holds >60 seconds. Dynamic stretching, on the other hand, has been found to increase performance prior to sport in numerous studies (Page 2012). Therefore, it is fair to say that all stretch types are appropriate for increasing mobility and performance in submax activities such as jogging but when your goal is to enhance performance for a maximal muscle effort you should opt for a dynamic stretch prior to the event.

Stretching for Injury recovery has been well documented to be beneficial and is used in almost every post injury rehab protocol. The literature is limited on stretching alone as most studies have stretching combined with strengthening and other modalities.

As a Physical Therapist, I can tell you that stretching is extremely beneficial and nearly always a needed intervention for recovery. When you have an injury the resulting scar tissue is weaker, less elastic, and highly prone to re-injury since it does not have the same elasticity as your prior healthy tissue.

Stretching during the healing process and remodeling phase allows for the scarring to be minimal and the damaged tissue will be able to function as it is designed. If stretching is not introduced you will most likely suffer fibrotic tissue that will lack the mobility needed to function.

So, why stretch?

You’re aging:

As most of us know, as we age we lose mobility. Bassey et al 1989 found that flexibility has been shown to decrease up to 50% in some joint areas with chronological age. From a population base of 1000 elderly men and women and they found 10 deg loss of flexibility per decade! It is unfortunate but as we age, we lose mobility. Without stretching, loss of motion and function is inevitable.

You have Poor Posture:

Poor posture over time leads to injuries due to poor alignment of your bones and soft tissues. The result are muscle imbalances and potential impingement from abnormally biomechanics. You need to stretch in order to maintain correct alignment, which will ultimately prevent injury and keep you upright and moving with full strides

You want superior Performance:

Perhaps you are an athlete looking for that cutting edge. Stretching with PNF has been shown to have a significant increase in both stride rate and stride length (caplan et al) Routine stretching could be the difference for a runner winning a silver or a gold. Perhaps you do CrossFit or you are a body builder. As you build strength the result is small micro tears in the muscles in order to build more muscle, this is a natural process of building muscle but over time, you will see mobility loss without incorporating stretching

You have Pain:

Stretching increases blood flow to your joints and muscles. It opens the fascia and helps pump blood so it can flow more freely through. This helps alleviate pain and helps expedite the healing process

You want a relaxing experience that benefits your body:

Stretching feels good. As we discussed, you instinctively want to stretch, your body knows it is good for you. Regular stretching either self or assisted can be relaxing and therapeutic. It can help improve hydration, improve circulation, elimination of waste, reduce stress, and improve sleep.

Professional One-On-One Assisted Stretching is sweeping the nation!
kate-stretch

Now available in the Seacoast!

We all know we need to stretch but unfortunately we either don’t make time for it, we’re afraid to injure ourselves, we don’t know how to stretch, or we struggle stretching ourselves due to lack of mobility. Those that are not disciplined or simply aren’t flexible enough should seek out a professional stretcher. Even someone that can independently stretch would benefit from a professional stretcher, since it is impossible to stretch yourself as good as someone else can. Fortunately, there is a a new PROFESSIONAL STRETCHING BUSINESS in Portsmouth that can do your stretching for you! Rezilient a stretch studio providing individual assisted manual stretches for the full body. Rezilient has trained stretchers that provide one-on one hands on stretching in a comfortable spa like environment. The various techniques are backed by science and created by highly trained Physical Therapists: Dr. Kate Serodio (owner of Hampton Physical Therapy) and Dr. Dan Fleury. For more information, please visit www.Rezilientme.com

REZILIENT

Bassey, E.J., et al. 1989. Flexibility of the shoulder joint measured as range of abduction in a large representative sample of men and women over 65 years of age. European Journal of Applied Physiological and Occupational Physiology, 58 (4), 353–60.

Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function. Kayla B. Hindle, Tyler J. Whitcomb, Wyatt O. Briggs, and Junggi Hong

Med Sci Sports Exerc. 2012 Jan;44(1):154-64. doi: 10.1249/MSS.0b013e318225cb27. Effect of acute static stretch on maximal muscle performance: a systematic review. Kay AD, Blazevich AJ.
A randomized controlled trial for the effect of passive stretching on measures of hamstring extensibility, passive stiffness, strength, and stretch tolerance

Paul W.M. Marshall. Anthony Cashman, Birinder S. Cheema. School of Biomedical and Health Science, University of Western Sydney, Australi Int J Sports Phys Ther. 2012 Feb; 7(1): 109–119.

Current Concepts in Muscle Stretching for Exercise and Rehabilitation. Phil Page, PT, PhD, ATC, CSCS, FACSMER

Ankle Sprains: How Physical Therapy Can Help!

by Kristin Keafer DeRousse, PT, DPT
Hampton PT Helps with Ankle Sprains
Ankle sprains are one of the most common musculoskeletal injuries. Often times this injury is brushed aside as “I just rolled my ankle and it’s sore” and unfortunately goes untreated. How many people do you know that have “rolled” or sprained their ankle? How many people do you know that have done this over and over again?

Research demonstrates that 25% of lateral ankle sprains results in time lost, potentially 1 week off from school or work. Very often those who sustain a lateral ankle sprain experience residual symptoms, leading to longer term chronic ankle instability. Essentially you are at high risk of rolling your ankle again in the future if it goes untreated. This has shown to significantly alter an individual’s health causing a less active lifestyle in addition to accelerating the arthritic process.4 With the high percentage up to 75% of initial lateral ankle sprains leading to repetitive sprains and chronic symptoms, it is imperative to treat and rehabilitate the FIRST occurrence of these injuries.(3)

What does it actually mean to sprain your ankle?
A sprain is an overstretching or tearing of ligaments. Ligaments are connective tissue that attaches bone to bone to support a joint. There are 3 types of ankle sprains. The most common ankle sprain is called an inversion or lateral ankle sprain.(2)
ankle-injuries-hpt
Inversion (lateral) sprain
Your foot rolls inward which can stretch or tear the ligaments on the outside of the ankle

Eversion (medial) sprain
Your foot rolls outward which can stretch or tear the ligaments on the inside of the ankle

High (syndesmotic) sprain
This is caused by a rotational stress with the foot moving outwards which stretches the ligament above the ankle between the tibia and fibula bones

When should you seek help?
Screening is the first step. Seeking the help of a medical professional as soon as possible to evaluate the need for treatment is very important. This will accelerate the healing process and reduce the risk for recurrent injury in the future. With all of our physical therapists holding a doctorate degree, we are able to directly assess the musculoskeletal injury and determine a need for treatment or referral out to a medical doctor if X-rays are indicated.

What are the signs that you may need treatment?
Difficulty bearing weight on that foot, limping, swelling, difficulty performing daily functional activities such as walking, climbing stairs, and managing uneven ground.

What to expect for treatment?
A full evaluation of your injury will determine a need for referral to a medical doctor or orthopedic specialist. Otherwise many times an ankle sprain can be treated with physical therapy alone.
The first step of treatment is focused on reducing swelling (RICE: Rest, Ice, Compression, Elevation), improving walking mechanics, and possible immobilization. The more you limp on an injured joint the longer the healing process will take. Typically there is a need for hands on treatment by the physical therapist to improve the mobility of your ankle joint, to loosen up tight muscles around the joint, and help reduce the pain.

The next steps of treatment will focus on improving flexibility and strength of your entire leg. Each individual will be assessed for their own impairments and which muscle groups need to be addressed with specific stretching and strengthening exercises. Typically this involves stretching the calf and strengthening the stabilizing muscles on the medial and lateral sides of the joint.
balance-hpt
The last steps of treatment focuses on primarily balance training. This is where we are working on improving your proprioception to increase the stability of the joint and prevent re injury in the future. Proprioception is the ability to sense the orientation of your body in your environment. There is a constant feedback loop in her nervous system where the sensory nerve endings in your joint and muscle send a signal to your brain. Joint position and how much stretch or strain is on your muscle is interpreted by your brain and your body will adjust for this subconsciously. For instance, if you are walking on a sidewalk and turn to walk on grass, your body knows how to adjust for this without your vision because of proprioception. However, with an injury to the joint and muscles of your ankle after a sprain, proprioception is impaired and the risk of rolling your ankle again increases up to 75% secondary to a problem with this feedback loop.3 This is probably the most important long term treatment to prevent re injury in the future.

So what have you learned?
Next time don’t wait to have your injury screened. Deficits in range of motion, strength, and proprioception sustained with an ankle sprain are all factors that can lead to long term chronic ankle instability.5 Physical therapy can help to normalize all of these factors, so why not seek out treatment. Let’s help to get you back on your feet faster and prevent problems with ankle instability in the future!
Visit either of our Hampton Physical Therapy locations in both Hampton, NH and Seabrook, NH for an assessment of an old or new injury.

  1. References
  2. (1) Al-Mohrej O,  Al-Kenani N Chronic ankle instability: Current perspectives. Avicenna J Med. 2016 Oct-Dec; 6(4): 103–108. doi:  10.4103/2231-0770.191446
  3. (2) Doherty CDelahunt ECaulfield BHertel JRyan JBleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. 2014 Jan;44(1):123-40. doi: 10.1007/s40279-013-0102-5.
  4. (3) Hubbard T, Wikstrom E. Open Access J Sports Med. Ankle sprain: pathophysiology, predisposing factors, and management strategies. 2010; 1: 115–122. Published online 2010 Jul 16.
  5. (4) Shweta Shah, MHA, Abbey C. Thomas, PhD, ATC, Joshua M. Noone, PhD, Christopher M. Blanchette, PhD, MBA,  and Erik A. Wikstrom, PhD, ATC, FACSM. Incidence and Cost of Ankle Sprains in United States Emergency Departments. Sports Health. 2016 Nov; 8(6): 547–552.  doi:  10.1177/1941738116659639.
  6. (5) Thompson CSchabrun SRomero RBialocerkowski AMarshall P. Factors contributing to chronic ankle instability: a protocol for a systematic review of systematic reviews. Syst Rev. 2016 Jun 7;5:94. doi: 10.1186/s13643-016-0275-8.
  7. (6) Verhagen RAde Keizer Gvan Dijk CN. Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg. 1995;114(2):92-6.

Sciatica Pain – Causes and Remedies

sciatica pain - hampton ptby Katherine Younes, PT, DPT- Hampton Physical Therapy – Hampton, NH Clinic

Do you have a nagging pain that radiates down the back of your leg? These are the symptoms that everyone refers to as “sciatica”. Did you know that these symptoms can be a pain pattern referral coming from your lumbar spine? This is a condition referred to as lumbar radiculopathy.

  • There are several factors that can cause referred pain into one leg:3
      • Herniated/Bulging disc
        • irritates/pinches nerve root at the lumbar spine

      • Degenerative Disc Disease
        • natural process that occurs with aging that causes a decrease in disc height which can irritate/pinch nerve root at the lumbar spine

      • Spinal Stenosis
        • narrowing of spinal canal compresses/irritates nerves of lumbar spine

      • Piriformis Syndrome
        • tightness of the piriformis can result in pinching/irritation of the sciatic nerve as the nerve is located right under the piriformis muscle

        • these symptoms can replicate lumbar radiculopathy symptoms

    sciatica-painSymptoms You May Feel:

    • -Pain is typically located in 1 leg

      • -Pain will radiate down the back of the hip/buttock and into the leg, can go as far down as the lower leg and foot

      • -Pain will worsen with sitting or standing

      • -Pain described as sharp, shooting

      • -May or may not experience numbness/tingling

    How can physical therapy help?

    Research has supported the use of physical therapy and application of the traditional lumbar stabilization exercises with mobilization techniques for the sciatic nerve to improve the function and health of patients.1 “Both hamstring stretching and nerve mobilization can be usefully applied for the therapy of patients with lower back pain and sciatica related symptoms.”2

    At Hampton Physical Therapy, we have several treatment options to address your symptoms, such as neuromobilization techniques, soft tissue massage, dry needling, lumbar traction and exercise. Also, in conjunction with previously mentioned treatments, we also provide spinal manipulation to the appropriate candidate. If your symptoms do not radiate below your knee, you are a candidate for spinal manipulation. We can provide education about position modifications for your desk, car and furniture at home, as well as proper transitional mobility techniques and lifting techniques to reduce symptom exacerbation and risk of further injury.

    Here are a couple exercises you can try to address your symptoms.

    but-lift-sciatica-hamptonptBridges: While lying on your back, both knees bent, tighten your lower abdominals, squeeze your buttocks and then raise your buttocks off the floor/bed as high as you can comfortably, however do not go high enough to create arch in your low back. Hold and then lower yourself and repeat.4

    piriformis-stretch---hamptonptPiriformis Stretch: While lying on your back and leg crossed on top of your opposite knee, hold your knee with your opposite hand and bring your knee up and over across your midline towards your opposite shoulder for a stretch felt in the buttock. Hold for 10 seconds, repeat 10 times.4

    If you have any questions regarding this condition feel free to call or stop by one of our two Hampton Physical Therapy locations in either Hampton or Seabrook, NH to speak to one of our physical therapists.

  • Citations:
    1. (1)Jeong U-C, Kim C-Y, Park Y-H, Hwang-Bo G, Nam C-W. The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain. Journal of Physical Therapy Science. 2016;28(1):46-50. doi:10.1589/jpts.28.46.
    2. (2)Lee J, Kim T. The treatment effect of hamstring stretching and nerve mobilization for patients with radicular lower back pain. Journal of Physical Therapy Science. 2017;29(9):1578-1582. doi:10.1589/jpts.29.1578.
    3. (3)Sciatica Symptoms – Spine-Health. https://www.spine-health.com/conditions/sciatica/sciatica-symptoms
    4. (4)HEP2go – Build a HEP Home Exercise Program For Free, https://www.hep2go.com/exercises.php