stretching: can it cause permanent length change in muscle?

[lachlang]

Hi,

I am a 2nd Year physiotherapy student from Australia, recently i have been taught that stretching produces no adaptive lengthening of a muscle unless it is done for 15 seconds 10 times per day.

The resoning behind this was from studies that showed that following a stretch of a muscle; 2 hours later it has returned to its original resting length.

Therefore we were told that if its sitting at its resting length then no adaptive lengthening can occur. However if you stretch 10 times per day with the time spread out then the muscle will never have time to return to its resting length during the day and therefore you would perhaps get adaptive changes.

This does not make a whole lot of sense to me. If someone can eventually do the splits from practicing it each day then doesn't that mean that the muscle length has increased due to stretching?

I was told that normal forces of ADL may be able to increase muscle length.

Has there been any studies that show stretching with 5 sets of 15 seconds per day can cause adaptive changes in muscle length?

Anyway i would like to know your thoughts on this.

The references given were:
McCarter et al, 1971
Bohannon 1984
Moller et al, 1985
Gajdosik 1991

Thanks

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[jerryhesch]

old refernces, do a current search but do not throw out the old-they have value. Get james Dexter's study presented at APTA combined sections in 2005-fabulous data on the value of sustined 10 minute stretches being superior to 10 x 1 minute if memory serves me. He is at Univ of New Mexico in Albuquerque, NEw Mexico, USA.
Also a very good read: Dynamics of Human Biological Tissue, by Currier and Nelson. I changed my stretches to 2-5 minutes and added a new grade to the old 5 grades of joint mobilization, the 6th the Hesch hold at end range for 2-5 minutes. hee hee! But really, we should give our clients accurate info re the lack of sustained value when doing short term stretching, and walk into any PT prqctise over here and I regret to inform you that it does NOT reflect current science.
jerry hesch
the hesch method

[neurospast]

jerryhesch, you refer to benefits from prolonged stretching , 5 minutes or so. This is alike bobath in neurological conditions. And as with bobath you have to repeat it again and again and again otherwise it will have no effect. I assume the reason is very simple: The body responds according to the demands of the moment and there is nothing more about it to my opinion. I know it is not fair to use bobath as an example but I do not think that muscles, bodies as a whole respond differently when has a higher muscle tone due to a neurological condition. To amny researches show no benefits.

[Physiobase]

Just a general comment on stretching. Most people have "increased tone" that we assume is muscle shortening and therefore needs to be stretched. In most people a general anaesthetic will show that in fact the muscle tissue itself is not tight, more over it is the brain that is influencing the resting tone of the muscle when conscious. This is seen repeatedly in cases of post knee replacement clients who go for manipulation under anaesthetic.

So then how does one get the brain to reduce this influence. Clinically I have observed that strengthening a muscle through movement about a joint and therefore familiarising the brain and tissue as to the results (pain, damage or neither etc) seems to result in sustainable gains. More so as the body gain strength in the new range it is able to use this new range and therefore maintain it without such regular "stretching" procedures.

Static stretching, whether maintained for 1,2,5,10,30 minutes might well reveal different results however unless you do this from day one until the end of life as we know it the gains will not be maintained. I suggest therefore working against mild resistance (eccentric and concentric) into the direction you are trying to improve. Pilates, Gyrotonic and even Yoga all provide good mediums to achieve this goal. 8o

[MrPhysio+]

The most recent info I have read suggests that the apparent short term benefits of stretching muscle length increases occurs due to the person actually learning to overcome the discomfort, and pushing further into range. This effect fits into the central tensioning neural control, eliminated in anaesthesia. As a former gymnast, I have noted that I have greater flexibility than my peers, however I need to work at it occasionally or I tighten up again and lose range (or perhaps I get softer and cannot put up the the discomfort as I age). Another fact is that collagen changes during a lifetime, becoming less elastic, which must also affect apparent flexibility / range. Regarding the splits, joint cartilage and ligament distortion also ocurrs, adding to the muscle effects.
Regards, MrPhysio

[Quickstart]

The info Mr Physio was referring to was from Volume 52 of the 'Australian Journal of Physiotherapy'. If you are a registered member of the APA you can access the article <a href="http://www.physiotherapy.asn.au/AJP/vol_52/1/AustJPhysiotherv52i1Folpp.pdf" target="_new">here</a>.
Or you can get a summary of the article at PEDro. Go <a href="http://129.78.28.173/pedro/FMPro?-db=pedrom.fp5&-format=record%5fdetail.html&-lay=web&-sortfield=method&-sortorder=custom%3Dmethod&-sortfield=score&-sortorder=descend&-sortfield=family%20member%20id&-sortfield=year%5fof%5fpublication&-sortorder=descend&abstract%5fwith%5ftitle=Can%20ap parent%20increases%20in%20muscle%20extensibility&-max=20&-recid=42458&-token.0=12725418&-find=" target="_new">here</a>.

[friendlypain]

HI All,

Physiobase has hit it on the head when it comes to stretching. Stretching is an isometric CONTRACTION. Not a lengthening!

I can almost hear the "but I was taught that stretching will help lengthen the muscle and reduce pain by increasing blood flow and reducing splinting." I am sorry to say this to you, and I may sound like a blaspheming Cathar, but stretching does not exist! At least as we have been taught.

Ok... lets first talk about muscle length. Who knows what an appropriate length is? Take the glute med for instance. Can we even measure it? Do we take into account the muscles that support its actions? Do we take into account the muscles that oppose its actions? Is the length measured by range of a joint (and again we must take into account the previous questions). Is the range of an athlete supposed to be different from the ADL recommended range? Is increased tone a sign of shortened fibers? Is a pain sign the absolute limit of a muscles length? It has been discussed by researchers that neither fiber length nor physiologic cross-sectional area can be deduced on gross muscle inspection. Are we wasting our time in trying to answer these questions? I personally believe that the muscle knows what length it has to be at. (see below for why)

Second: Muscles are not rubber bands! There are two components to the muscle, the elastic and the plastic portion. The elastic portion can be considered tendon, cell membrane, fascia, etc. and the plastic component is the skeletal structure of the muscle cell. What is the skeleton structure? That would be the filaments inside the cell of course. Just as you cant make your arms longer by letting them dangle at your sides with 40lbs weights at the end, neither can you change the length of the muscle cell by "stretching" them. (but there is a way around this... READ ON! :b ) THEN there is TITIN! Ahhh beautiful, sweet, enigmatic Titin. Titin is a protein that limits the length of the sarcomere in passive tension. (it can be thought of as the ligaments to the bones so to speak) But here is the rub... in vivo, it only resists low force tension and not high force tension. But can the muscle be forced to experience high force tension before the stretch reflex is activated or bony end feel is achieved... WITHOUT injury?

Third: Mmmmm Brains. What about that long piece of brain that goes down our backs? (ok so it is my opinion that the spine is just a very long piece of brain ) There are reflexes there that inhibit or encourage contraction. So we must not forget that the stretch reflex MAINTAINS the status quo of muscle length. What about posture balance mediated by the cerebellum? The cerebellum controls the balance between the agonist and antagonist muscle contractions. Actually we can talk about the cerebellum's role in muscle contraction and movement for several more centuries before we have a clear idea what it actually does...

So! Can we change the length of our muscles? YES! But probably in a way that you never thought. The way to "stretch" a muscle to change its length is to IMMOBILZE the joint! Animal experimentation clearly demonstrates that when a muscle is immobilized in a chronically lengthened (or shorten) position, sacromere numbers within the muscle cell increase (or decrease) so that maximal force and optimal sacromere length are produced at the position of the immobilized joint.

I dont think our patients would like us casting their neck, arms and legs to lengthen the affected muscles. So... where does this leave us? A tight/short/painful muscle is actually a splinted muscle and needs to have the stretch reflex activated so it can loosen and have fresh oxygen to restart its metabolism and decrease the intensity, or remove all together, the pain spasm cycle.

Ok... I am ranted out and am looking forward to your opinions

Adamo

[alophysio]

Nice one adamo. I agree. What references did you use (so i can read more)...

[friendlypain]

Hi Alophysio,

Hey no worries. I love to share as muscles are amazing in their functions and structure. I remember reading on a website that a muscle was akin to a pseudo-crystalline structure. Going nuts to confirm it. 8o

My favorite site for looking up info is muscle.ucsd.edu/index.shtml
It has awesome links to all sorts of studies. Search for Jan Friden MD on the site and look for "Effect of Muscle Tension During Tendon Transfer on Sacromerogenisis in a Rabbit Model". I believe it was in the Journal of Hand Surgery 1999 or 2000.... or Just type stretch and length I guess. :b

As for Titin:

A. S. Politou, M. Gautel, M. Pfuhl, S. Labeit and A. Pastore, Biochemistry, 1994, 33, 4730-4737.

A. S. Politou, D. J. Thomas and A. Pastore, Biophys. J., 1995, 69, 2601-2610.

A. S. Politou, M. Gautel, S. Improta, L. Vangelista and A. Pastore, J. Mol. Biol., 1996, 255, 604-616.

Trinick and L. Tskhovrebova, Trends Cell Biol.,1999, 9, 377-380.

L. Tskhovrebova, J. Trinick, J. A. Sleep, R. M. Simmons, Nature, 1997, 387, 308-312.

Squire, Curr. Opin. Struct. Biol. 1997, 7, 247-257.

www.biophysj.org/cgi/cont.../75/6/2613

Plus text books (Guyton’s "Medical Physiology", (dont remember author) "Sports Injury Management", etc.) seminars and professional experience (ie. STOP the pain spasm cycle at all costs! :eek )

Another site I usually go to is www.ipsm.org/ for just general sports stuff...

If I remember anything else I'll post it. Have a good one.
Adamo

[Yarok]

Hi all

Good explanation you find in Diagnosis and treatmentof movement impairment syndroms,Shirley A. Sahrmann.

thanks
Yaro