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Sunday, 16 November 2008

Are physical therapists ignoring the evidence about stretching?

After some significant hamstring problems, I recently saw a physiatrist at a sports medicine clinic, followed by a physical therapist. The P.T. came highly recommended, and seemed knowledgeable, explaining the why, not just the what, of the prescribed exercises. Emphasis throughout my treatment was on stretching the hamstring -- 3 times a day, for up to 3 minutes at a time. I've always advocated stretching, so was happy to comply with that advice.

Turns out, my problems were related partly to the chair I was using -- evidently lots of people with desk jobs develop hamstring problems. My exercises and stretches (combined with a new chair) have helped tremendously, and my faith in stretching is stronger than ever.

Is dynamic stretching the new black? Then along comes the article Stretching: The Truth in the New York Times' excellent sports magazine, Play. Judging from what they said, I was doing it all wrong: "The old presumption that holding a stretch for 20 to 30 seconds — known as static stretching — primes muscles for a workout is dead wrong. It actually weakens them.... Stretching muscles while moving, on the other hand, a technique known as dynamic stretching or dynamic warm-ups, increases power, flexibility and range of motion."

They've got studies (but true to New York Times tradition, they're not going to tell you where they are). "In a recent study conducted at the University of Nevada, Las Vegas, athletes generated less force from their leg muscles after static stretching than they did after not stretching at all. Other studies have found that this stretching decreases muscle strength by as much as 30 percent."

What does *all* the evidence say? Does this mean my doctor and physical therapist are ignoring the current, best evidence about stretching? I don't think so, necessarily. The Play article is about warming up and strengthening muscles for a workout or athletic activity, and that's not why I went in for treatment. They advised me to stretch because the area where my hamstring connects to my joint was aggravated (it was rather angry, actually). So based on what I've read, I think this is an apples-vs-oranges thing. I'm gonna keep on stretching. Statically, not dynamically.

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