Tuesday, 23 April 2013

Stop stretching?

Athletes would seem to stop at nothing to justify not to warm up before an event and to avoid stretching altogether.

The current controversy rages as various parties debates the value of stretching and when to do what form of stretching. It seems like the American College of Sports medicines 2010 guidelines recommending that athletes rather stretch after training than before training has caught on. (American College of Sports Medicine. 2010. ACSM’s Guidelines for Exercise Testing and Prescription. Philadelphia, PA: Lippincott Williams & Wilkins)

The above recommendations appear to stem from a number of studies that do report a decline in performance after stretching in activities that require maximal muscle effort. However there are quite a few studies that do not show this effect.

The difference in results seems to be explained by the duration of how long the stretch was kept. Stretches kept for longer than 60sec decreased performance, stretches lasting 30-45sec showed inconsistent decrease in performance and stretches kept for less than 30sec showed no decrease in performance. http://www.ncbi.nlm.nih.gov/pubmed/21659901 

I personally don’t know a lot of athletes that typically keep their stretches that long though!

In practice I have seen a lot of benefit from the Active Isolated Stretching (AIS) method of Aaron Mattes where he propagates repetitions of 2sec. This technique is typically perceived by athletes as less boring and thus subsequently improving their compliance to stretching as well.

Please note: Stretching does not directly equate to warm-up and my current best recommendations would be to stick to an active warm-up that:
  • Progressively build intensity to increase muscle temperature
  • Prepares the athlete for the activities and intensity of competition or training
  • Include some AIS for the major muscle group utilized in your sport.

Utilize sustained stretches for problem areas after training and keep the stretches long enough to achieve permanent lengthening in the area. I do however have a question in my mind about how effective sustained stretching really is vs. techniques like Pilates, Yoga and Gyrokinesis. These techniques promote actively mobilizing the body as a whole and I currently recommend those more.

One benefit from sustained stretching seems to be that if you are a "cramper" during endurance events that stretching can postpone the occurrence of cramping. http://www.sportsscientists.com/2007/12/muscle-cramps-part-v.html  I would really like someone to investigate if the other techniques mentioned have the same result in this regard.

I  will in future write a post on fascial release techniques that achieve lasting effects when it comes to improved range and biomechanical/posture corrections. This can in my mind to a certain extend replace passive sustained stretching altogether. (Not the active full body techniques mentioned above)

I hope I provided some clarity on the question. Hang in there and don’t neglect your training altogether during the approaching days of winter.

Friday, 22 February 2013

Barefoot running?

Many patients have asked me about converting to barefoot running.
It is clear that the shoe industry’s default recommendation has progressively shifted from an anti-pronation shoe to a neutral cushioned shoe over the past few years. There is however several scientific studies that do show that despite all the claims manufacturers do make about changing technology the percentage of runners getting injured annually is fairly constant. It is important to remember that it is a very competitive industry and companies are doing their utmost to differentiate themselves from their competitors often with unsubstantiated claims.

There is far more correlation between the variance and volume of your training to the incidence of injuries and most runners can thus benefit with a more structured approach to their training.

The argument  that running barefoot is natural and thus the correct way to run is definitely winning ground and several physiotherapist & podiatrist are gradually shifting their stance supporting this movement. I’m one of the physiotherapist that do promote shoes closer to barefoot since I believe if you can function with minimal “crutches/support/braces” you are generally better off. The big challenge is to manage your progression back to a more neutral shoe in small doses (as actually mentioned by a lot of manufacturers). Please don’t leap from the one extreme to the next.

Researchers have shown us that your connective tissue might take as long as 18 months to completely remodel and our bodies to thus adapt to major changes but that biomechanical interventions focussing on stability training & soft tissue release can assist in this process.

My final advice then is that you would probably be better off in the long term with shoes closer to barefoot. As with everything in life there is no quick fix and you must be committed to a gradual change. Start walking more barefoot at home & wearing minimalistic shoes for activities of daily living before changing your running shoes. Take your current pair of running shoes to a specialist running store with knowledgeable staff than can guide you through what will be a few consecutive models of shoes closer to barefoot, especially if you have been running for years.