Have you ever noticed that many of the patterns of dysfunction that are brought to our practices repeat themselves regardless of how many sessions we might perform with them? I am going to propose how using stretching, in its many approaches, can change that pattern and create lasting healing in our clients.
I don’t care if someone has come to you for Cranial Sacral therapy, Rolfing, Feldenkrais, Alexander technique, myofascial release, acupuncture, chiropractic and on and on. Most have come because they are suffering a painful condition. In many or even most cases, stretching in some form would have either helped to prevent the condition or accelerated its healing.
First let me make something very clear. They function for which our homo sapiens structure evolved is diametrically opposed to how that structure is being used today. Just take a moment as you read this at your computer, and become totally aware of the way your body has formed in order to accomplish this task. Then factor in the amount of time we are asking our physical structure to accommodate our new lifestyle. Now fast forward to someone on our treatment tables whose body has been placed in an H like position with the arms locked in a forward position for HOURS! To be able to use our techniques to alleviate those myofascial patterns in an hour or so is asking a great deal.
I believe our discipline’s approach, coupled with focused stretching to be used as homework between the sessions, can bring incredible results. We can determine the necessary stretches for our clients based on our knowledge of anatomy, and expand our success rate by investing in our client’s need to do a stretching routine that fills their needs.
Many of my client have a yoga practice and will ask me if I consider this to be sufficient. Yoga is great, maybe the most important discipline/tool for wellness and aging available to us, but I believe there are a number of stretches, and a specific manner in which they are performed, that are easier for my clients to “own”. I say this based on nearly 30 years of observation. The clients who follow my instructions, regardless of their age, almost always get wonderful, lasting changes in their dysfunction.
If the stretching exacerbates the condition, I make sure they are doing them properly. If the dysfunction and pain continue after 5 sessions (5-10 weeks) I will send them out for diagnostic tests as often there is an underlying structural issue that is beyond the scope of my practice.
Let me also admit that there may be newer information out about stretching that might make mine obsolete, but the methods that I pass on definitely work. I am open to being educated on some newer discoveries. Since we all will admit the ancient art of yoga has its value, I think what I am about to share with you can also be valuable.
Let me share what I have learned over the years. There are essentially 3 types of stretches that can be developed safely.
Dynamic Active is the ability to perform dynamic movements with a full range based on the ability to combine relaxation and extension. Like moving an arm in rotations but not throwing it. Or supporting the upper body and moving a leg forward, backward and sideways while controlling the movement through its entire range of movement.
Static Active is the ability to hold extended positions by using tension of the agonists and synergists. Holding the leg out as high as you can without any support would be an example. It is often in direct relationship to the strength of the muscle and the static passive range of motion at that time in training.
Static Passive (below the pain threshold) is the movement which can be maintained for extended positions, think yoga. The difference between static active and static passive would be holding the leg out in front without support, and holding the leg with your hand.
From our perspective as therapists, the most important thing is knowing which type of stretch and what methods will be most valuable for the pattern of pain that is being presented. It is up to you to study the various forms of stretching and figure out which ones apply to each client’s needs. Static active needs more strength and I don’t use them in my practice. I don’t want more problems. Most of the time I use static passive combined with PNF and get great results. I use dynamic stretches for areas that need movement to open up the joint space.
There is a movement these days to stretch your clients, which I don’t do. I know that doing so can be very useful, but it must be done with great focus and touch so as not to do harm. I am not saying they shouldn’t be done. There are experts in our field that are adept at stretching their clients and are very aware of the end feel, so as not to cause more damage. This is not about that. What we are talking about in this article is your clients’ owning the concept of a stretch techniques and feeling comfortable performing their own stretches between sessions.
More to follow soon about the forms of stretching and how to create a routine for your clients.