I recently had an interesting e-mail exchange that I'd like to share. I obtained permission to post the e-mails sans name.
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1st e-mail received:
-------------------------------------------------------------------------------------Dear Mr. Erickson,
I read your response on stretching at Crossfit.com. You seem to be quite knowledgeable about different stretching approaches, and I have a question on streching for you.
I have started doing some stretching to overcome the effects of some leg injuries experienced decades ago. I bought Aaron Mattes book Active Isolated Stretching, and Robert Cooley's book The Genius of Flexibility, and have developed a hybrid approach combining both techniques. I was achieving very modest gains after a few days of this hybrid technique. However, I had a stretching experience last week that bordered on the miraculous, and I would be very interested in understanding the mechanism. Perhaps you can make some sense out of this, and relate to known stretching approaches.
After a few days of AIS and Resistance Stretching, I started adding some of the Mensendieck exercises from the 1973 version of Karen Perlroth's book that I have. In particular, I thought the Central Knee Bend would be helpful for my particular problems (in this exercise, the feet are positioned parallel, about 2-3 inches apart, and the abdominal muscles tightened such that the lower back is flat, vertical, and held by the muscular 'corset'. Then a knee bend is performed, where the knees are pointed straight ahead.).
I did it for a few days at home and in the office. I found it very uncomfortable and painful for even a minimal amount of bending, especially experiencing severe pain in the thighs. If the angle between my upper and lower legs, when straight, is 180 degrees, I was able to bend and close it to, at best, 150 degrees. Last Tuesday, I set a goal for myself that I would aim for a complete knee bend (all the way down) by the end of 2005.
On Wednesday, I went for my daily walk. After about fifteen minutes, I stopped to do the Central Knee Bend. I did a set of about six, with very little bend, and much resistance and pain (mainly in the thighs). I walked for five more minutes, and repeated the knee bends. This time, I closed the angle between the upper and lower legs to perhaps 130 degrees. I walked another five minutes, and did another set of ten knee bends. This time, the angle closed to perhaps 110 degrees. I kept repeating the process until, in the eighth set, I was able to do a full knee bend, all the way down to where I was sitting on my heels (feet maintained flat on the ground).
I was absolutely shocked! I had never seen such a gain in my life. Obviously, on Thursday, my thighs were sore. On Thursday afternoon, I went walking again, and repeated the walk-knee bend cycle. While the first set was restricted and painful, by the third set I was doing full knee bends. And the interesting thing was that I felt absolutely no resistance or pain. I did ten sets of knee bends, and the last eight of these were full and painless. And they were in strict form: feet 2-3 inches apart, perfectly parallel, lower back perfectly flat, held in by tightened abdominal muscles, knees pointing straight ahead. Friday repeated Thursday's experience. On Saturday, due to inclement weather, tried to do same at home, walking on flat surface between knee bends. Was only able to bend about half way, and probably over-strained. On Sunday, walked out side and went to almost full knee bend again, but this time felt strain at lowest position, and felt substantial soreness as a result.
I don't know how to explain these results, especially the times I was able to do a strict full squat without pain or resistance. The only thought that occurs to me is that the specific muscles to be stretched were very warmed up by the walking. I was not able to achieve any increases in bending when I had previously tried multiple sets in my office without warmup.
Have you seen any gains like this in your experience? To what would you attribute these gains? In particular, do we really require intensive warmups for the specific muscles to be stretched, with no lag between the warmup and the actual stretching? Or am I extrapolating too far from one data point?
It will be interesting for me to see when the thigh soreness stops, and how my walking and sitting are re-aligned (if at all) at that point.
Any insights you have will be greatly appreciated.
Sincerely,
<<name omitted>>
P.S. What books on stretching would you recommend?
My reply:
-------------------------------------------------------------------------------------That's quite a remarkable gain in such a short time! Nice job!
I am NOT an "expert" in stretching, but I'll answer your questions as best I can. I've tried a lot of different methods to see what works for me, both for rehab and for performance enhancement. I've experienced injuries from improper stretching and fantastic rebounds from proper stretching.
There are several schools of thought on warming up before stretching. The traditional Western notion is that you should always warm up before stretching. Many proponents of "Soviet exercise science" disagree, stating that warming up is unnecessary. In my own opinion, I think that terminology is the primary cause of this dispute. Many people confuse mobility with flexibility, but the two concepts are not one and the same. Here's a short article that nicely summarizes why I have my own clients work on their joint mobility prior to worrying about overall flexibility:
http://www.circularstrengthmag.com/28/mattjones.html
In an athletic person, the joints are generally healthier and more mobile than in a sedentary person. Barring an injury, the athletic person is always more likely to tolerate stretching well. In a less active or injured person, it is important to make sure that they have pain-free full range of motion at each involved joint prior to initiating an ambitious stretching regimen.
Proponents of traditional Western stretching concepts generally do not draw a distinction between mobility and flexibility. Until the last 10 years or so, this point was rarely discussed. Exponents of "Soviet" methods are very clear in differentiating between mobility and flexibility. It is certainly possible to practice many joint mobility exercises without a prior warmup. I do so nearly every day. In my case, practice of Warrior Wellness opens my ROM and also serves as a warmup for the day, or for the more intensive activity I'm about to engage in. As your overall mobility increases, you can safely do a great deal without warming up first.
An important point to understand about stretching is that there is no need to make a muscle or your connective tissues longer. Unless you have a congenital disorder, they are already plenty long enough for you to be extremely flexible. A completely relaxed muscle can easily be extended to about 150% of the possible ROM of the joints it is attached to. Thus the key to becoming flexible is enabling your muscles to relax. Since the muscles only hold tension while your nervous system directs them to, flexibility training must be structured to target the neuromuscular control mechanisms.
Does warming up the muscles help? Sure, studies have shown that raising temperature and increasing blood flow helps prep your tissues to relax. This is one reason Bikram yoga is practiced at temperatures of around 100 degrees.
One thing about your stretching story that intrigued me is that you describe feeling discomfort in your thighs, but you didn't say what part of the thighs. As you are on the Crossfit forum, I'm assuming that you are reasonably active, but I don't know to what extent. The fact that you had such discomfort in achieving the squat position is indicative of excess muscle tension held in your hips and low back as well as your thighs. Since many large muscles are involved in the movement you describe it's hard to say which ones were the primary source of your discomfort without more info. I am curious about whether you feel similar discomfort when squatting with your feet further apart.
Aside from walking to warm up, the other reason I feel you experienced such gains is the repetition. When your body is not used to moving in certain ways, it tends to be tighter when you first attempt something new. This is generally experienced as reduced ROM, reduced flexibility, decreased stability and sometimes discomfort. Your practice of the movement with very limited knee bend started the learning process for your nervous system. When you went walking and started trying it again, you reinforced the motor learning process. As you continued to try it, your nervous system was finding that it could safely permit a greater ROM. By the time you achieved the "sitting on heels" full squat, you had effectively reprogrammed your neuromuscular controls.
Because your body was so accustomed to holding tension in those positions, you felt residual soreness the following day. I've experienced this many times after a big release of tension. I'm also studying this phenomena as a future massage therapist. Clients who receive successful therapy are frequently sore for a day or two as their body releases the excess tension.
As you continued practicing the movement on subsequent walks, you continued to reinforce the motor learning component of the movement. However, you also say that you often went to the point of discomfort. I am somewhat concerned that continually pushing yourself to the point of discomfort in this stretch will delay the point at which you can assume it comfortably. The nervous system will seek to disallow movement where you often experience pain, so trying to force the full squat is not in your best interest. You would be better off to slow the squats down, and build comfort and strength in the partial squats. As the partials become more comfortable, you will find yourself gradually able to go deeper without discomfort. By taking a more measured pace towards recovering this ROM, you will give your body time to adapt to it so it doesn't feel the need to tighten up.
To me the process of gaining flexibility is very similar to that of building speed or strength within a movement. Here's a short article I wrote a while back about my approach:
http://www.circularstrengthmag.com/27/erickson.html
In my own practice, I generally use joint mobility exercise such as Warrior Wellness to prep my body for motion. Following a workout, I do my stretching while my body is still warm and loose from moving around. Due to some injuries I had years ago, my stretching method of choice is PNF (proprioceptive neuromuscular facilitation) stretching. Designed for spinal injury patients, it has grown into a large body of work that is highly effective. However, PNF stretching is not sufficient for all purposes. To develop extreme flexibility, you also need to build strength within the increased ROM. This is where isometric holds and certain types of resistance training (such as clubbells) are invaluable.
I use clubbells both for gentle expansion of my extreme range strength as well as for regular strength endurance training. I use various isometric holds to build specific strength for various bodyweight exercises, such as bridging, headstands and handstands. The best possible combination of methods and exercises depends on your physical status, limitations and goals.
For a comprehensive discussion of various stretching methods and how to combine them for various needs, I recommend Thomas Kurz's "Scientific Stretching" (4th ed.) book. His web site is www.stadion.com . For PNF stretching, my favorite reference is Kit Laughlin's "Overcome Neck & Back Pain" book, and his prior "Stretching & Flexibility" is also excellent.
I've looked at "The Genius of Flexibility" and found the meridian theories a bit convoluted for immediate implementation, but the basic concept seems sound enough. It's basically a modified approach to PNF stretching, but I haven't worked with it enough to comment on how it compares. I very rarely use traditional static stretching or resistance stretching methods now, as I have found better results with the other methods mentioned above.
One book that is not specifically about stretching that you may want to get is "Body-Flow: Freedom from Fear-Reactivity" by Scott Sonnon. You can find plenty of info on Body-Flow concepts and practice via my web site. The reason I bring it up is that it explores how the body holds tension, why it holds tension, and various means of releasing that tension. We are born without the excess tension that now limits us, so our practice isn't so much "gaining" as "recovering" our full potential. A number of movements and positions that can be used to explore and recover your full-body mobility are described as well, but I generally recommend getting the companion video to facilitate the learning process.
I hope that is a sufficient answer to your questions. Feel free to ask any additional questions as they come up, and keep up the good work!
Would you mind if I posted your questions (without your name) and my reply on the Crossfit forums?
Take care!
2nd e-mail received:
------------------------------------------------------------------------------------Jason,
I really appreciate your response. It targets precisely a number of concerns that I had. You can use our exchange (sans my name) for your forum. However, let me give you an additional data point that I generated yesterday. It is even more impressive than the previous data point. You might want to add this to your forum, and comment further if you so choose.
BACKGROUND
I had been doing deep knee bends in strict Mensendieck style (feet parallel, about 2-3 inches apart, lower abdominal muscles held tight, back flat, knees straight ahead while squatting) for a few days. I would walk fifteen minutes to warm up, perform one set of ten knee bends, walk for five more minutes, perform a second set of ten, walk for five more minutes, etc., for a total of eight sets of ten. It took about three sets before I was able to do a full squat, and I experienced much pain and discomfort in the thighs (upper front and side) before being able to do the full squat. Additionally, I have experienced much soreness in these parts of the thigh after the exercise.
OBJECTIVE
Develop a method of doing full knee bends without the initial resistance and pain, and without most of the subsequent soreness.
APPROACH AND RESULTS
I developed a multi-stage PNF approach. I walked for fifteen minutes to warm up, as before. I then did the first knee bend, in strict Mensendieck style. I descended about 20% of the way, and met with resistance and the onset of discomfort. Rather than force further squatting through the discomfort and experiencing pain, as I had done previously, I contracted/ tensed all the thigh muscles isometrically, for a count of six. I then removed the tension, and continued the descent to perhaps 40% of the distance to the lowest point. At the 40% point, I felt resistance and the onset of discomfort again, and I tensed the thigh muscles isometrically again for a count of six. I relaxed the muscles, and continued the descent. I kept repeating this cycle until I hit the bottom point of the squat, then stood up straight. I rested about two seconds, then did a full controlled deep knee bend with no resistance or discomfort, and no need to do any tensioning isometrically.
These two repetitions constituted my first set. I then walked for about five minutes, and did a second set of two, exactly like the first set. I repeated the knee bend-walk cycle for a total of eight sets. Thus, in contrast to my previous approach, I was able to achieve a full deep knee bend on the first repetition of the first set, and on every repetition of every set. As long as I stopped at the point of initial discomfort before tensing the muscles isometrically for a count of six, I felt no pain at any time. In every case, I was able to do the second repetition of each set in a continuous controlled manner (slowly, no bouncing) with no pain or resistance.
As a positive side effect of this new approach to deep knee bends, a hamstring soreness (resulting from a strain a month earlier) disappeared after I completed the eight walking/ squatting sets. This hamstring problem had prevented me from incorporating some running during each walking cycle. After the eight walking-squatting sets, I then was able to include some running within an additional eight walking sets (no squatting during these additional sets), and felt no hamstring problems at all. I felt no hamstring soreness afterwards, as well.
CONCLUSIONS
The multi-stage PNF approach is more predictable than the approach I had used previously. It involves less pain, and feels more controlled. While I am experiencing soreness in the upper front and side thigh muscles afterwards, some of that may have been due to the residual soreness from the previous method.
The important features of the present method are:
1) following a strict Mensendieck protocol;
2) performing isometric tensioning at onset of discomfort;
3) continuing descent after tensioning;
4) repeating the isometric tensioning at onset of next point of discomfort, and repeating until full descent has been achieved, and
5) following this first set by a controlled full deep knee bend experiencing no pain or resistance during descent.
It should be noted that the stretching is not an end in itself, but a means to an end. The end target is removing the muscular imbalances resulting from a femur injury and subsequent surgery decades ago, and improving my comfort in sitting and walking with feet straight ahead. This is already happening to a very small extent, although certainly not proportional so far to the magnitude of improvement in stretch.
Overall, the multi-stage PNF approach described here appears to be a discrete approximation to the continual Resistance Stretching approach of Robert Cooley (The Genius of Flexibility). How well the multi-stage PNF approach can be extrapolated to stretching other muscles with other warm up scenarios remains to be seen.
As a final note, I follow the walking-knee bend-running scenario above with a rounded hybrid AIS-Resistance Stretching routine for the lower body. Hopefully, this will help reduce the soreness in the future.
I hope you find the information shared in this exchange useful and enlightening. It's given me some interesting ideas to try in my own practice once I've obtained more specific information on some of the methods he's using now. 8)
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8) The "CST vs The World" mindset helps no one. 