Many times patients come in for treatment for strained muscles they have attempted to remedy their selves but continue to be hindered by the problem. These are noble efforts and include a variety of methods. The one method that is a common denominator is stretching. Intuitively, this is proper treatment but the manner in which we need to stretch compromised tissue differs from the manner used to stretch healthy/noncompromised tissue. This brief article will provide a basis for the reasons behind this and the methodology to perform a more beneficial stretch when tissue has been strained or sprained.
Typically when we perform a stretch, regardless of the structure being stretched, we tend to hold the stretch for 10, 20, 30 seconds or more, this is how we have all been taught. For healthy/noncompromised tissue this is completely acceptable and effective. However, for compromised tissue, this method literally adds insult to injury and the physiology behind this follows.
When we perform a typical stretch and hold it for 10 seconds or longer we begin to feel burning, and perhaps mild pain/discomfort the longer we hold it. This is due to the firing of the stretch receptor in the muscle spindle. This stretch receptor sends a somatic signal to the brain, the brain interprets this signal and sends a motor response back to the muscle to contract, but we are not allowing the muscle to contract because we are holding the stretch. This is what causes the burning, discomfort and perhaps mild pain. Ultimately, when the stretch is released the muscle contract or shortens, there is no cramping or Charlie horses that occurs and we don’t necessarily feel this occur, but physiologically the tissue is shortening. Now, for healthy tissue, this is completely fine and effective, but for compromised tissue, it has the opposite effect.
When soft tissue; muscles, tendons, ligaments, and fascia, are compromised the response is for the structure to tighten, thus shorten, in order to protect itself, this is an automatic defense mechanism. So, if we stretch as in the previously described manner, the muscle will tighten/contract further, literally adding insult to injury.
So, how do we avoid this since stretching is an effective remedy? The answer is a method known as Active Isolated Stretching (AIS).
AIS is a specialized stretching method developed by Aaron Mates that isolates and stretches specific structures either passively or actively. For the purposes of this brief article, we will focus specifically on the AIS method and not the isolation. In this manner, you will perform the stretch you would normally use to stretch the structure that is sprained or strained, for example, a quad, hamstring, calf, adductors, hip rotators, forearm, chest, back, etc.
Regardless of the stretch used, we are going to lean into the stretch just to the point where we begin to feel the stretch, NO FURTHER. We are not straining to get the most out of the stretch, just to the point where we begin to feel it. Hold that for 2-3 seconds and release the stretch. Follow this procedure for 15-20 repetitions. By the time the 15th to 20th repetition is reached you will notice a relative improvement in the range of motion. It’s that simple.
Here is what we have accomplished with this method. Since we are not holding the stretch for a great length of time, the stretch receptor does not fire. Therefore, the stretch receptor does not send the somatic signal and no motor response is triggered. Hence, we have eliminated the contraction response. We have therefore accomplished effective tissue elongation without excessive tissue contraction.
Try this stretching method the next time you suspect a sprain or strain. If the sprain or strain does not show signs of relief or improvement then manual manipulation is probably warranted. In which case, Active Release Technique is a highly suggested treatment for repetitive stress and strain injuries discussed in this article.