(Originally published as an article for Imbue Pain Relief Patch)

It sort of feels risky to me, given how many yoga teachers I know, to say anything negative about stretching.  Luckily, most of them are pacifists, so I don’t think they’ll beat me up.  So here it is: In the past 12 years of my practice, there have probably been at least 20 times that someone has told me they either injured themselves while doing yoga or another form of stretching, or that whatever pain issue they were coming to me for got worse after doing yoga or stretching.

Meanwhile, there have been countless times that a patient has described some pain they’re having, and then said, “I think I probably just need to stretch more.”  Maybe they do, maybe they don’t.  I usually explain that I’m not sure it’s going to solve the problem; I need to know more about what’s going on.

Don’t get me wrong.  I love yoga and other forms of stretching.  (And, just for the record, stretching the body is really just a fraction of everything that encompasses yoga.  I’m just addressing the stretching aspect of yoga here, because it’s much less common to see a patient injured by, say, chanting or withdrawal of the senses.)    But perhaps the popular view – that stretching is always good for any kind of body problem and that more is better – needs to be revised.

The good thing about hearing so many patients express a desire to stretch is that clearly the yoga teachers, coaches, and trainers of the world are getting through to people.  I’ll never forget one of the wise things my first yoga teacher told me almost 20 years ago: You are as young as you are flexible.  Stretching helps keep our bodies the way they were when we were kids – elastic and resilient.  When they’re not behaving this way, we’re more prone to injury, it takes more effort to get around, and we just feel old.

However, there are two points I want to make in this article.  First, stretching too aggressively has the potential to hurt us, just as overdoing it in any form of exercise does.  Second, stretching healthy muscle before or after exercise to keep it vital and flexible is quite a different matter than stretching with the intention of making an existing pain go away.

When trigger points are present – which is virtually always if there is muscle pain, particularly if it began with an injury – stretching can be like pulling on the ends of a piece of rope with a knot in the middle.  No matter how much you pull, the knot won’t go away.  In such cases, stretching often makes little difference, and sometimes it makes the pain worse.

Trigger points are a phenomenon first identified by a doctor named Janet Travell in the mid-1900s.  Injury – usually a form of strain that we’re fairly unaware of, like poor posture or overwork, and sometimes overstretching or aggressive yoga – causes part of a muscle to contract and become irritated.  This results in a shortened segment along a length of muscle.  As a result of this shortening, the whole muscle fiber becomes taut.  Because this region of the muscle is shortened, it also gets a bit bulkier – the same way your biceps gets wider if you shorten it by flexing.  We sometimes refer to the resulting lump as a “knot.” (Frequently, it’s too small for the untrained hand to perceive through the skin, but you sure feel it when it gets pressed on!)  This is a myofascial trigger point (myo=muscle / fascia=fibrous connective tissue).

Because trigger points effectively shorten the overall length of a muscle, reduced range of motion of affected joints is common, and if you try to extend the muscle as far as it used to go (before you developed trigger points), you may cause further injury and more pain.  You’re asking the fibers to stretch longer than they are capable of.

Trigger points often cause complex pain patterns, with pain frequently appearing at a location several inches away from the origin.  For this reason, I developed a tool called the Pain Expert on the Imbue website to help people track down trigger points that may be the source of their pain.  If you click on a body part that is bothering you, you can see all the muscles where the pain may be originating.

The stretching issue isn’t black and white.  I’m not saying stretching can’t work to help release trigger points, it’s just less likely to work than certain other releasing techniques, most of which involve applying direct pressure to the trigger point.  Pressing on a trigger point and holding it – even without any additional technique – is often enough to disrupt its contraction, allowing the individual contractile units (sarcomeres) to re-lengthen. Having this done by someone else – like a massage therapist or an acupuncturist – often works even better.

If stretching is your thing, and you want to stretch muscles that are already tight or painful, you must remember that you’re working with tissue that is taut and reactive.  If you push it too hard, it will be counterproductive. Instead, extend the muscle to its natural limit, and then just wait.  Don’t push it.  Breathe into the muscle and consciously relax it.  Imagine the muscle is lengthening and surrendering.  Often, you will feel the muscle release little by little, getting increasingly longer as it does.

If you feel like taking it to another level, try this:  While in the stretch, focus on the experience of restriction in the muscle and see what thoughts or feelings arise in you.  Quiet your mind and listen internally.  You may notice you feel sad or angry, or that something you’ve been struggling with comes to mind, or the feeling seems old and rooted in a past experience.  Whatever you experience, welcome it completely.  Invite it.  See if you can relinquish all resistance to it.  Allow it to be willingly experienced with your whole being.  Then let it go.  Breathe into it, breathe out, and let it go.  Meanwhile, no matter what, don’t push it.  Just allow the muscle to release.  Maybe it will, maybe it won’t.

In an everyday stretching routine in a body that’s not injured or in acute pain, you don’t have to be quite as tentative.  However, it’s always worth keeping in mind that you’re pushing your muscles to maximum extension.  A little too far and you’ll have a strain to deal with.  I enjoy and prescribe dynamic stretching – stretching while moving – generally moreso than static stretching (yoga being the exception).  But when practiced too rapidly or aggressively, it becomes what is known as “ballistic stretching,” which is known to have a high risk of injury.

My aim in writing this article is not to encourage anyone to stop stretching or doing yoga.  What I want the most is that you establish a habit of feeling your body – throughout the day, in response to difficult situations, when doing exercise, during and after eating different kinds of foods, etc.  Your body registers everything that’s happening on a mental and emotional level.  If you listen closely, you’ll know what its limitations are and what it really needs.

 

Copyright 2012 by Peter Borten. No reproduction in any form without permission.