Flexibiliy: Stretching vs Self-myofascial Release. From research to practice in the fitness industry

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Flexibility: stretching vs SMFR PRESENTED BY: Max MARTIN BAppSc (Hons) AEP

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Presentation for WAFIC 2011 by Max Martin AEP, Director of Corrective Exercise Australia. This workshop will equip you as an exercise professional to understand the impact, relevance and correct application of flexibility, stretching and self myofascial release (SMFR) on musculoskeletal health, function and performance. At the workshop you will establish a strategic approach to dealing with muscle tightness affecting injury, posture and movement, based on clinical evidence and current research, theories and practices.

Transcript of Flexibiliy: Stretching vs Self-myofascial Release. From research to practice in the fitness industry

Page 1: Flexibiliy: Stretching vs Self-myofascial Release. From research to practice in the fitness industry

Flexibility: stretching vs SMFRPRESENTED BY:

Max MARTIN BAppSc (Hons) AEP

Page 2: Flexibiliy: Stretching vs Self-myofascial Release. From research to practice in the fitness industry

@iNformMax

Martin

CorrectiveExerciseAustralia

Please keep your phone ON!!

This is a Friendly session!&

Page 3: Flexibiliy: Stretching vs Self-myofascial Release. From research to practice in the fitness industry

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

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Flexibility vs Stability

Do flexibility and stability sit at opposite ends of a continuum?Are we confusing stability and stiffness??

Flexibility Stability Stiffness

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Why do people stretch

Overall flexibility

Muscle lengthening - Joint mobility

Release tension

Prevent delayed onset muscle soreness (DOMS)

Injury prevention

Performance preparation

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Stretching:

To elongate, increase in length. The implied meaning is that the muscle is not beyond its normal length

Kendall et al. 2005

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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.

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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

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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

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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.

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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

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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

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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

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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

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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

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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.

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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

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Fascia

Continuous structure that surrounds and integrates tissues and structuresCan affect relationship amongst structuresComposed of collagen and elastin, providing tensile and elastic properties.

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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.

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Myofascial restriction:Restriction in normal muscle function due to injury or biomechanical force imbalance

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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

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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).

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Exercise and myofascial release

Exercise is vital for myofascial release treatment

Resets neurological programming

Both needed for permanent change

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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.

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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

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PRESENTED BY:Max MARTIN BAppSc (Hons)AEP