Flexibiliy: Stretching vs Self-myofascial Release. From research to practice in the fitness industry
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Transcript of Flexibiliy: Stretching vs Self-myofascial Release. From research to practice in the fitness industry
Flexibility: stretching vs SMFRPRESENTED BY:
Max MARTIN BAppSc (Hons) AEP
@iNformMax
Martin
CorrectiveExerciseAustralia
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Why flexibilityAllow joints to align in anatomically correct way.Pain has greater correlation to joint stiffness than misalignment.
➤ changes in ROM affecting pain more than posture
Neuromuscular dysfunction results in: Stabilisers typically become hypotonic/inhibited – ‘allowing’
faulty posture Gross movers typically become hypertonic/facilitated –
‘driving’ faulty posture
Flexibility vs Stability
Do flexibility and stability sit at opposite ends of a continuum?Are we confusing stability and stiffness??
Flexibility Stability Stiffness
Why do people stretch
Overall flexibility
Muscle lengthening - Joint mobility
Release tension
Prevent delayed onset muscle soreness (DOMS)
Injury prevention
Performance preparation
Stretching:
To elongate, increase in length. The implied meaning is that the muscle is not beyond its normal length
Kendall et al. 2005
Stretching for Joint ROM
Harvey, Herbert & Crosbie (2002)13 studies of poor to moderate scientific qualityVarious stretching methods used Range Of Motion (ROM) gains on average of 8% tighter muscles greatest measured improvements. Consistency of >3weeks for ‘plastic’changes.
Stretching and Performance
Fowles et al. (2000), Kokkonen et al. (1998) Stretching reduces maximal strength for up to 1 hr post
stretchingCramer et al. (2004) Decreased velocity of limb movement in leg extension post
active and passive stretchingCornwell et al. (2001) vertical jump performance reduced post passive stretching
Stretching and Performance cont.
Stretching as part of warm up (Young & Behm 2003) prior to jumping tests - concentric & drop jump
Five groups:o control (no stretch)o 4 min runo passive stretcho run & stretcho run, stretch & practice jumps
Result:1. run 1b. run, stretch & jump3. Run & stretch4. control5. Passive stretch
Stretching and Performance cont.
Inconclusive whether or not to stretch before exercise Reliability an issue
Shrier (2004) Timing of stretching may also play an important role
found no effects of acute stretching, but positive effects of regular stretching away from
event on strength, jump height and running speed.
Effects of Stretching on DOMS:
Herbert & Gabriel (2002), LaRoche & Connolly (2006), Dawson et al. (2005) Post exercise stretching not found to be effective in reducing
DOMSDawson, et al. (2005) Also no improvement in performance (AFL players)Reisman et al. (2005) Stretch during DOMS may maintain and or increase
movement allowing athletes to train at higher levels
injury prevention?Difficult to study – unreliable results
Hard to controlNeed very high intensity to produce risk of injury
Most conducted studies suggest no change in injury rates
Different sports require different joint flexibility leading to inconclusive results in literature
Warm ups and injury
Faigenbaum et al. 2006 Warm up often uncontrolled in studies, could effect study
outcome on injury risk Dynamic warm ups increase performance in children and
athletes compared to static stretching alone Dynamic warm up achieved higher anaerobic performance
than static stretching protocols
Sum
mar
yMay help increase joint ROM long-term.Stretching away from exercise environment may increase performance and reduce injury risk (yet to be confirmed)(Pre/post Exercise) No evidence for :
Performance improvement (potential decrease)Prevention of DOMS (post) or increased performanceEffect on injury rates
The Physiology of Tightness
Joint ROM can be limited by the following factors (Hutton, 1992):
1. Joint constraints
2. Subcutaneous connective tissue.
3. Neurogenic constraints (voluntary and reflexive)
4. Myogenic constraints
Muscle Fibres(myogenic effect)
Can stretch to at least 50% greater length that resting (last cross bridges intact).Magnesium deficiency can cause tightness (cramping) as magnesium facilitates actin-myosin release.
Muscle Spindles(neurogenic effect)
Primary stretch receptors in the muscles.reflexive capabilities via alpha-motoneuron.Strong phasic contraction upon detection of stretch, followed by controlled tonic contraction.Regular stretching may decrease sensitivity of muscle spindlesThis may explain acute performance decreases post-passive stretch
Fascia
Continuous structure that surrounds and integrates tissues and structuresCan affect relationship amongst structuresComposed of collagen and elastin, providing tensile and elastic properties.
Fascia cont’d
Contributes >40% of resistance to movementImmobilisation decreases space between collagen fibres- causing a sticking togetherMuscle overactivity can result in increased fibroblast activity (>collagen deposition).Interconnectedness of fascia can result in patterns of tightness in muscle slings.
Myofascial restriction:Restriction in normal muscle function due to injury or biomechanical force imbalance
Trigger points
Discrete, focal, hyperirritable spot in taut band of muscleOccurring in all patients with musculoskeletal painCan be active or latentSymptoms:
Painful on compressionReferred pain/tendernessMotor dysfunction
No evidence for development mechanism of Trigger PointsAcute and chronic trauma, chronic lengthening, sleep disturbance, anxiety
Myofascial release – the alternativeSimilar to massageUses palpation, pressure and tissue stretch to relieve tension and improve:
Muscle tone, Length, Timing, Strength, Endurance, Control
Can be used on various soft tissue abnormalities:
Local increased muscle tone
Trigger points
Muscle shortness
Fascial tightness
Deficits in motor activity or control
Can result in pro-inflammatory effect and decreased fibroblast activity (short-term).
Exercise and myofascial release
Exercise is vital for myofascial release treatment
Resets neurological programming
Both needed for permanent change
Self Myo-Fascial and Trigger Point Release
Interactive soft tissue release requiring feedback from patient to determine correct position, amount of pressure and duration of stretch
Uses body weight on tool i.e. foam roller or tennis ballPenetrates into muscle and or fascia
Easy and effectiveReleases tightness and trigger pointsCan be painfulResearch to prove efficacy is poor and inherentlydifficult to achieve.
Practical programming
Warm up: Self-myofascial release Activation exercises Dynamic warm up with progressive loading
(jog, add speed and direction change, dynamic stretch, agility, skill)Cool Down Decrease metabolic load for waste product clearance Slow dynamic stretching movements SMFR Static stretching later
Look at what is short-tight and facilitated (assess!!)Address Right/left and front/back imbalancesConsider performance effect of chosen modality
PRESENTED BY:Max MARTIN BAppSc (Hons)AEP