The image of the contortionist balancing precariously on a handstand pole in a sideshow circus imbuing all manner of feats of dextrous bending, flexing and impossible positioning is a marvel to behold. A gymnast flipping through the air with apparent ease and grace and yet incredible power is a thing of beauty. A martial artist being able to stand and kick at the head of a larger opponent with perfect poise and balance is a thing of beauty and achievement. They are the results of years of dedicated training, commitment, blood, sweat and tears as well as deliberate hours of practice ensuring the body is trained to within a miniscule measure.
But these advanced maneuvers come at a cost to the body and how much is achieved in the name of these results without long term detriment? Some recent practices which were not that long ago have known to have been used without consideration for the athlete. When you get to that elite level of performance where you are literally striving for perfection, how far can you push the body before you suffer? Achieving high degrees of flexibility, power and ability to contort into positions that mere mortals can not necessarily achieve is idyllic and necessary for the chosen fields. But how far is too far? And in applying extremes, how responsible are instructors for ensuring that their protege’s and athletes remain focussed on the long term health?
There are advocates out there who pose that training regimes that involve extreme mobility and manipulation of the body are at times necessary. However, there can be real and damaging long term issues that can arise from pushing too far into extremes. Damage to cartilage, lax tension in ligaments and bone deformations from extended extreme ranges of motion are some of the considerations to think of when considering delving into these exercise regimes.
The neurophysiology of a stretch and getting into end ranges of motions involves two distinct phases of elastic recoil: plastic and elastic stretch. Plastic stretch is the term derived of the permanent tissue elongation after a load has been removed. Elastic stretch conversely allows a temporary elongation and thus asks a muscle to return to its original length when the load is removed. When we work on pushing into greater ranges of motion, the systems of elastic recoil that we want to target are those of the plastic stretch, encouraging permanent elongation of the muscle fibres.
So is there a best practice when it comes to getting increased or extreme ranges of motion. I mean, we all want to get a little bit more flexible? However there can be that quest for the extreme angle or the push to get the same level of split that all the other girls in the cheerleading group are doing? As I’ve mentioned before, stretching takes time and committed repetition to create length. In this way, there is a ‘safer’ approach to getting increased range of motion that doesn’t involve us sitting between chairs and having someone sit on top of our shouders.
“numerous studies representing decades of research have noted the effectiveness of prolonged stretching at low to moderate levels of tension”
Jeff G.Konin and Brittany Jessee: Physical Rehabilitation of the Injured Athlete. There is a growing consensus amongst health professionals that sustained low intensity stretching is best to try and achieve great ranges of motion.
The key to success with prolonged duration low load types of stretches is to allow muscle relaxation and gentle overpressure. If not comfortable, the athlete will contract the muscles surrounding the joint and resist the overpressure, which results in no short or long term gains in flexibility.
Using force or overloading us in positions with weight or load can be detrimental to our end goal as these tend to activate an elastic recoil, whereby the muscles involved begins to contract against the stretch. Sure you are getting into a greater range of motion, but your ability to re-affect that range is diminished according to the science discussed herein. Being forced into end ROM’s by an external load will favour an Elastic Stretch component of a Golgi Tendon Organ (GTO - nerve cell in a tendon) and the muscle spindle itself resulting in non permanent lengthening of muscle fibres.
Range of motion exercise techniques should be designed to primarily produce plastic deformation. Repetitive intervention that incorporates sustained tissue elongation with low loads of stress versus shorter duration aggressive loads may be more beneficial in achieving the clinical outcome of plastic deformational changes.
Flexible Muscles vs Flexible Joints.
It is important in performance that the length and range of motion that you have is supported and strengthened. As I have said in other blogs, flexibility without strength is a recipe for injury. If we are taking our range of motion beyond what our joint spaces are capable of, there is great risk of issues for performers but also for longevity of health.
Enforcing greater ranges of motion works primarily on joint space and muscle length. It is one thing to have log hamstrings to do splits, it is another to have sufficient range of motion in the glenohumeral joint to enable you to sit in sideways splits. There are those that simply don’t have the anatomical ability to achieve this line. Should we enforce regimes of loading plates onto pelvis’ to get them into that all important 180 degree full split? The issue as mentioned above is the type of stretch achieved but there are other more damaging considerations. Pushing joint spaces into excessive ranges can have damaging effects later in life owing to the change in structural damage.
For example, ligament damage. Forcing a joint into a range of motion isn’t just working on the muscular attachments, but it has an effect on the stabilising ligaments. Working these inflexible bands to go beyond what they are capable of can create damage that slackens and irreparably loosens the structure. These structures are there to help support and create stable platforms for movement. Taking them to extremes can mean that bodies placed in those positions no longer have joint integrity. This is fine whilst the person is in training mode and the muscles are strong, dynamic and have a cohesive effect of reinforcing the joint space in these positions, but what happens when that body begins to age, and the training starts to wane and all of a sudden where there was strenght balancing weakness, that strength is not there in the same capacity anymore? Long term instability and weakness is the result and that can come back to haunt a previous athlete later in their active life.
Another consideration is the damage that can be wrought to the deep layers of fascia within the body when engaged in extreme ranges of motion. Fascia is responsbile for much of the length that can be achieved in increasing flexibility and thus can also be subject to damage from overuse.
“When connective tissue is overused, the tissue becomes fatigued and may tear, which also limits flexibility. When connective tissue is unused or under used, it provides significant resistance and limits flexibility. The elastin begins to fray and loses some of its elasticity, and the collagen increases in stiffness and in density.” Brad Appleton: Stretching And Flexibility
Over-stretching with muscular and joint limitations can cause dynamic changes to the deep fascia of the body and thus create fascial adhesions and tensions on supportive structures which the body relies on to help provide stability and platforms for movement. Again this may not be a problem as much during a training career but when that career is over and the body begins to age, the structural damage caused here can be likened to a piece of fabric that has been pulled out of shape. It may still have some give and integrity but the underlying structure and tensile strength is changed.
In the late 1990’s there was a push by national institutions and governing bodies of various professions, health advocacy groups and sporting groups that saw the development of literature and promotion of safe practices for those occupations and activities that rely on these often punishing regimes. Established bodies went on a search for ongoing correct training. National registrations of teachers and formal accreditation boards were set up and standards for practice were brought in such as the Deakin University study in 2001: Balancing the Risk of Injury to Gymnasts, AUSDANCE: Safe Dance Report in 1990, the establishment of bodies such as YOGA AUSTRALIA in 1999, who brought together national recognition of standards and practice from all bodies of yogic philosophy and training. These practices were brought about to reign in some of the ‘old school’ techniques of being forced into positions, punishing regimes and images of bent bodies being strapped into crazed positions. The idea was to agree on how practices can best be presented and discussed and negating the more aggressive and possibly damaging practices of some over zealous instructors.
There are some past participants of elite sporting alumni that hold true to the training of their peers and say that they could never have achieved their prowess, their fitness, indeed their conditioning that took them to great heights and achievements of significant prowess without having endured being forced into positions and brutal physical training.
This is true, some methods may be frowned upon whereas others just grit and achieve it and get the result. It is not for us to judge these methods when they produce such results, however, the attrition rate of those who perhaps did not make it through the trials of these systems is perhaps higher and more damaging than what should be considered acceptable. It is true that every now and then a champion comes along and they endure the regimes. They survive. They don’t break. Unfortunately though - many do. And it is in these interests that we should be clear on how much we should push, how far we should expect and understand that every body has limits and we have to work with them instead of against them.