1. THE IMPORTANCE AND THERAPEUTIC EFFECTS OF STRETCHING

BLOG #1: This subject is often discussed with patients, as so many Musculo-skeletal (MS) problems are associated with some manner or form of muscle contracture and/or joint restriction, which—with few exceptions—can be managed through the act of stretching.

Moving and “stretching” after prolonged periods of rest or inactivity is performed by most mammals routinely (witness your dog or cat, after a nap). A stretch regimen that involves major muscle groups with a sustained stretch (> 60 seconds) and promotes spinal extension, rotation, and side-bending (e.g., many forms of yoga) is strongly associated with less MS pain and lessened incidence of injury (in humans).

Stretching repetitiously (at least three times a day) and in a specific way can help directly to reduce regional tightness, pain, and/or motion restriction, and could therefore be considered a form of therapeutic stretch or therapeutic posture.

Making it a priority to spend time and energy to stretch takes a certain amount of discipline –this is basically why a clear majority of people do not do this. Participation in classes (yoga) is a way to facilitate this important activity, but to truly be effective and beneficial, it deserves to be done every day.

Some background information is important when discussing this subject:

As upright mobile animals with body composition that is largely WATER, we are constantly dealing with the effects of gravity. Our cells and tissues that are mostly (~75%) water are given form and function by a large variety of proteins, by DNA and RNA, intra-cellular and interstitial (between cells) collagen, and cell walls. Our various tissues are arrayed on a skeleton made of very hard tissue composed of a matrix of calcium phosphate and collagen, called bone. Bones and muscles allow us to operate within--and resist--the constant effect of gravity on our bodies.

Collagen (a glyco-protein) is a significant component protein of the tissues described above and consequently makes up approximately half of the protein mass of our bodies. It composes tissues that are dense and organized and hold our bones firmly together (ligaments).

Muscle tissue has cells filled with specialized contractile protein, supplied by blood vessels and nerves, surrounded by (less organized) collagen tissue (fascia). This collagen covering partly gives muscle definition and form and is the connecting tissue at origin and termination of the muscle that becomes a dense, organized, and strong collagen structure (tendons).

Collagen can be more diffuse where it fills or maintains spaces between cells, and where it maintains integrity of compartments, neuro-vascular channels, and tissues that support our internal organs. It is also the stuff that holds together fibro-cartilage layers that make up the more solid outer portion of inter-vertebral discs, helping maintain disc “competency” against gravitational strain and postural forces.

Maintenance and repair of collagen structures is a constant, on-going process, in response to the “micro-injury” of our daily living within the field of gravity. However, when we sustain some type of “injury”, we have special cells (fibroblasts) circulating in our body fluids that detect, migrate to, and then repair such injury. We do not have to think about repairing this, but we can certainly assist the repair process by not aggravating / overusing the injured area and by providing micro-nutrients to support fibro-blasts in the repair process.

Most of our body mass is maintained through constant collagen repair. Because forces acting on us (and within us) are not usually symmetric, collagen structures commonly develop asymmetrical loss of function and/or restricted motion, more noticeable to one side. Modifying such restriction through stretching can address the deleterious effects of aging and postural stress, and facilitate recovery from injury. This is why it is so gratifying to work with patients who already have an established regimen of stretching— such patients recover faster, respond to treatments better, and have much less muscle tightness as an associated issue.

Find a way to incorporate this healthful activity into your lifestyle and routines daily!

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