Founder and Director of Yoga Moves MS, Mindy Eisenberg spoke with MS Specialist Physical Therapist Dr. Gretchen Hawley on the Topic of:
Stretching from a Physical Therapy and Yoga Therapy Perspective
Watch the entire presentation
Below are some key takeaways from the event.
Benefits of stretching
Dr. Gretchen: Most clients think of stretching as something you do only when your muscles feel tight. Any amount of tightness can restrict mobility. If it feels like you’re walking through mud, it might be because of spasticity or muscle tightness. Stretching also increases blood flow and helps with swelling in the feet and ankles. Stretching helps reduce the risk of injury when moving – especially in the lower back, hips and knees.
Precautions to take when starting to stretch
Dr Gretchen: Stretching should never be painful. Most of us grew up being told to “stretch until you feel it.” But you don’t need to feel a big stretch. It might be a bit uncomfortable as you’re stretching, especially if you’re tight, but it shouldn’t be painful. Don’t hold your breath while stretching. Being aware while you’re stretching to know if you’re feeling the stretch in the right spot, do you need to push forward or back off?
Mindy Eisenberg: We recommend to start at 20-30% of your max and once you feel the stretch move further into it over time. Knowing your “edge” and how not to go over it, it key. We talk a lot about body awareness in yoga and checking in with the body.
How often should we stretch?
Dr. Gretchen: You should stretch before you exercise, especially if you’re going to do a strength training. It’s also important to stretch after exercise. Strengthening exercises shorten the muscles. Stretching after helps lengthen them. The longer you go without stretching, the muscles contract. If you only stretch once per day, you’ll really feel the tightness the next day. Instead stretch every one to four hours over the course of the day. The more you stretch throughout the day the less likely your muscles will get back to that fully shortened positioned.
How can I stretch if I can’t get to the floor?
Mindy Eisenberg: You can stretch from a chair. You can stretch your feet by placing your fingers between the toes. You can use blocks, a strap, a leg lifter or another chair as props to help you stretch.
Dr. Gretchen: You can stretch in any position. You can do it seating or standing, from the couch or in any position.
Preventing knee hyperextension
Mindy Eisenberg: If you’re on the mat, put a rolled towel or blanket under the knee so it can’t hyperextend. Pressing into the heel to keep the knee lifted.
Dr. Gretchen: Place a towel under the knee, or not putting our leg out too far so your knee is still bent as you go into the stretch. You can still feel the stretch in the quad, hips or hamstrings without fulling locking the knee and risking hyperextension.
Preventing or dealing with spasms while stretching
Mindy Eisenberg: Warm up the muscles with massage using the hands, or a rolling pin then slowly stretch and stop when you feel it. If you spasm in class, breath and talk nicely to your body. Take a break and come back when you’re ready.
Dr. Gretchen: Relax the muscle, change position, and go slow (1cm at a time) and ease yourself very slowly into each stretch, which may take more time but you’ll be less likely to have spasms kick in.
Can you hold a stretch too long?
Dr. Gretchen: If you’re cold, meaning you haven’t moved much, dynamic stretching is better. A static stretch is holding a stretch for 20-30 second with two to three repetitions. A dynamic stretch holds the stretch for about 3 seconds then relax for 3 seconds and then goes back into the stretch. Repeat this cycle 20 to 30 times. Prolonged static stretching is holding a stretch for several minutes. Prolonged static stretching has shown benefits for spasticity.
Mindy Eisenberg: Props are not a sign of weakness, they help us get into poses. Restorative yoga and yin yoga include longer holds of poses supported by props.
Ways to stretch the quads
Dr. Gretchen: When we’re stretching we don’t want to be focused on strengthening or balance, only the stretch. You can stand within a staggered stance one leg back one leg forward both knees are bent so for that person asking about hyperextension you’d actively bend your knees and then again tuck your butt under as far as you can.
Mindy Eisenberg: On the mat you certainly could do this as well. So you start in what we call sphinx pose and then bring one arm parallel with the mat so it’s under and just a little bit forward to the shoulders and then bend one knee and you either grab the pants or the ankle or the foot or use the strap.
Stretching for chronic pelvic floor pain
Dr. Gretchen: Everyone has a pelvic floor, men and women. When we’re talking about releasing tension some people have too tight of pelvic floors others have too loose of a pelvic floor. Some have a lot of strength some have no strength and there’s any combination you can be tight and weak you can be tight and strong. You can be any combination and so I highly recommend anyone with any type of pelvic floor condition actually go to a pelvic floor PT because you might feel like you’re tight but it’s actually just contraction or weakness posing as that way because if you’re weak your muscles have to tighten and so if you focus on strengthening instead of stretching the pelvic floor it might improve.
Most people hold their pelvic floor tight and contracted. Take a moment to relax and let go and let your belly relax. Mentally relax everything, especially if you have a tighter pelvic floor rather than a relaxed pelvic floor. Core strengthening can also help with the pelvic floor for better bowel function, urination and pelvic floor strength.
Mindy Eisenberg: In yoga class we spend a lot of time on looking whether we’re taking a functional breath. We want a diaphragmatic breath. There is another diaphragm: the pelvic floor diagram and so we want that breath to be flowing in a functional way or that will cause some pelvic floor concerns and dysfunction.
Stretches for lower back pain
Mindy Eisenberg: Stretching the legs can help with the back. One of my teachers said that the legs are the governor of the back. You can try cat cow pose. Exhale taking the chin to the chest and cow pose is the opposite direction. The shoulder blades come together.
Dr. Gretchen: A seated twist is good. We don’t get enough side bending or twisting throughout the day. Watch your posture and if you’re leaving forward that’s a sign of hip flexor tightness. If you are just more rounded it’s is a sign of hamstring and glute tightness so you might want to do some of those hamstring or glute stretches because before you stand so you’re warming the spine up but you’re also stretching whichever muscles are the ones that kick in when you start getting that low back pain.
Stretching cold muscles
Dr. Gretchen: Use dynamic stretching with a 2-3 second hold and then release, but don’t “bounce” the stretch. There are many ways to wake up your muscles. You don’t need to do a full exercise routine. Massaging or shaking are quick and simple things you can do to wake up your muscles before a stretch.
Mindy Eisenberg: We often do shoulder rolls or pick up your leg and circle it around before going deeper into stretches.