Exploring Why Stretching Isn't Always the Solution for Pain

Exploring Why Stretching Isn't Always the Solution for Pain

It seems like when something is hurting us- the first thing we think to do is stretch it.

Honestly, at face value, it makes TOTAL sense. If you are feeling tension or stiffness- of course you MUST need to just do a little stretching. The muscles are short, so let’s lengthen them.

HOWEVER, the research about pain is pointing out that it is much, much more complicated than that. Stretching isn’t always going to be the best option for those tight calves or stiff neck and back.


What is the cause of pain and tightness?

While there has been a lot of debate around this topic, it’s currently thought that painis a signal from the brain warning of a perceived threat of instability or weakness around a joint that may or may not correlate with actual damage to the tissues.  

Great resources with more information on this topic are the following:

 The book Explain Pain by David Butler and Lorimer Moseley.

The book Why Do I Hurt? By Adriaan Louw

The book Pain Management Workbook by Rachel Zoffness

The book The Body Keeps Score  Bessel van der Kolk M.D. 

Or you can check out our other blog https://www.clashpths.com/blog/PainEducation

When the “pain” signal goes out, the brain tells the nervous system to tense the muscles around the joint to protect you from possibly going into a range of motion you can’t support. However, there could be other reasons as well, but we can stick mainly with this one.

Understanding this, it then makes sense why tightness and pain are poor predictors of what the actual problem is.

The pain could stem from multiple factors in these three categories 

  1. Psychological- like personal stress, death in the family, or traumatic event
  2. Social- being around people or in a certain setting
  3. Biological- illness, restriction in the connective tissue after trauma, an unstable joint that your brain is trying to protect, or a muscle that’s functionally short from overuse.

Let’s stick to the biological factors though for today’s blog in order for it to make the most sense.

I want to provide you with a common example- Many people report tight calves or hip flexors, especially after a challenging workout or run. In this case, the hip flexors or calf muscles feeling “tight” could be because the other smaller muscles around the hip joint or ankle joint are in fact weak. The calf and the hip flexor are creating tension to offset the weakness at the joint. Or….the calf and hip flexor muscles could also be weak themselves!

Therefore, It is not actually a range of motion issue. It is a strength and stability issue. 

So, stretching is contraindicated. 

Why? In this specific case, the muscles are tensing up because of a weakness present, if you are to stretch them, you are actually adding more instability to the affected area. Sometimes this means the tissues will tense up even more afterwards as a protective mechanism.

So, while stretching isn’t inherently a bad option, it may not always be the best option, especially if the pain is due to instability. Stretching might feel good in the moment, but long term it could make you feel worse.

What happens when you stretch?

I found this information in another article and attached it below. I felt it explained it perfectly. It is pretty dense information so read carefully.

“Relative to the process of stretching, it is also important to understand how the brain/neural components of the musculoskeletal system adapt to stretching. (FYI – this is the simplified version, so please just appreciate that there are other factors involved). When the muscle is stretched, so is the muscle spindle (a nerve control point located among groups of muscle fibers). The muscle spindle records the change in length of the muscle and how fast this change occurs.  It then sends signals to the spine, which then conveys this information to the brain.  Initially, this information triggers the stretch reflex, which attempts to resist the change in muscle length by causing the stretched muscle to contract. The more sudden the change in muscle length, the stronger the muscle contractions will be (why you don’t “bounce stretch.”) This basic function of the muscle spindle helps to maintain muscle tone and to protect the body from injury.

Now, if the force and suddenness of the stretch exceed the muscle’s ability to safely contract for protection (a.k.a. exceed it’s strength), another neural component, the golgi tendon organ (GTO), goes into action and takes power over the muscle spindle.  Basically - when muscles contract (possibly due to the stretch reflex), they produce tension at the point where the muscle is connected to the tendon. This is where the golgi tendon organ is located. The golgi tendon organ then records the change in tension, and the rate of change of the tension, and sends signals to the spine to convey this information. When this tension exceeds a certain threshold, it triggers the lengthening reaction, which inhibits the muscle’s contraction and instead causes it to relax and lengthen. The lengthening reaction is possible only because the signaling of the golgi tendon organ to the spinal cord is powerful enough to overcome the signaling of the muscle spindles telling the muscle to contract.  Think of the two systems as a “double fail-safe” that ultimately helps decrease your injury risk.



What do the studies say?

Studies all the way back to the 90s note that there is a loss of contractile power/strength for up to 30 minutes after static stretching and as such, the muscle cannot contract maximally if needed. So it is best prior to sports performance or working out to invest your time into something more dynamic versus static. 


This is also not new news- but several articles support static stretching after activity as it can decrease post workout soreness- the muscles are fatigued as well so they are less likely to fight the stretch. It is also important to note a good strength workout will cause micro trauma to the muscles, which is needed for hypertrophy and strength, so stretching post workout can allow you to prevent the associated loss of flexibility that occurs with muscle fiber growth.


When should you stretch?

When it comes to static stretching, the jury is still out on the best application. If done intentionally under the right guidance, it can be an excellent tool to help you explore new ranges of motion, control that range of motion, and calm the nervous system. 

However, if you’re hypermobile, have a known instability, have an injury, experienced trauma to the area, or you’ve recently had surgery, it is best to avoid stretching the affected areas unless a physical therapist has recommended it.This is where being evaluated by a physical therapist would be necessary so you can determine if it's actually a “tissue issue” or not.

Resources:

https://www.acropt.com/blog/2017/8/10/the-physiology-of-stretching