Friday, October 23, 2015

The Importance of Stretching Your Hamstrings, IT Band, and Ankles by Dr. Mercola

The Importance of Stretching Your Hamstrings, IT Band, and Ankles

October 23, 2015 | 133,482 views
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By Dr. Mercola
One of the greatest joys of life is to not only be healthy, but also pain-free with unrestricted range of motion. Being able to move around with ease is a factor that plays a major role in your quality of life.
To this end, you'd be wise to incorporate flexibility training in your fitness regimen. For example, did you know that tight ankles might be the cause of knee problems? Ditto for your iliotibial (IT) band. 
As noted in the featured article,1 stretching is not just for athletes and competitive runners:
"... [I]t may come as a surprise that it also helps patients with conditions such as diabetes and depression," Dr. Timothy Miller writes.2 "In fact, recent studies by my colleagues at The Ohio State University Wexner Medical Center show that stretching during yoga classes can even benefit women who are battling breast cancer."
The reason why stretching is an important part of fitness is because it actually does more than just elongate muscles and tendons. It also:
  • Boosts blood flow through your tissues
  • Increases oxygen levels
  • Helps deliver nutrients to your muscles
  • Facilitates the removal of metabolic waste such as carbon dioxide, ammonia, and uric acid

When Should You Stretch?

Here are a few pointers with regards to stretching:
  • Warm up first, then stretch. Avoid using static stretches as your sole form of warm-up. Also be mindful of the fact that static stretching is not as effective and beneficial as dynamic or active stretching. I'll discuss dynamic stretching later in this article.
  • Avoid stretching before strength training, as this may actually be counterproductive.
    • According to a study3 published in The Journal of Strength and Conditioning Research, doing passive static stretches prior to lifting weights could make you feel weaker and less stable during your workout.
    A second study,4 a meta-analysis of over 100 studies, also concluded that pre-exercise static stretching generally hurtsrather than helps your strength performance. Stretches held for more than 90 seconds were found to reduce muscle strength by more than five percent.
  • Do stretch prior to running, doing sprints, or other high-intensity exercise. Failing to warm-up and stretch prior to any kind of sprinting exercise can very easily result in painful injury.
    • Stretching afterward can also help you recover faster and prevent injuries, as by then your muscles are already nice and warm and loosened up.

Important Stretch Routine Prior to Sprinting Exercises

Hamstring stretches are particularly crucial if you're doing sprints. While sprinting is a simple form of high intensity exercise that can be done just about anywhere, any time, it's also one of the most dangerous.
Unless you're nice and limber and have special training in sprinting, it's really important to start gradually, and make sure to warm up and perform the recommended stretches beforehand.
I did not follow this advice when I first started high-intensity interval training. As a result I tore one of my hamstring muscles, which caused me pain for about four years.
The stretching exercises I demonstrate in the video below eventually helped me recover, but I suggest you avoid making the same mistake and just do the stretches before you start sprinting.
The stretches I recommend are so-called Active Isolated Stretches (AIS), not static stretches, and include the following:
  • Hamstring I stretch (straight: 10 reps)
  • Hamstring II stretch (foot twisted slightly left: 10 reps)
  • Hamstring III stretch (foot twisted slightly right: 10 reps)
  • Rolling your hamstrings using a foam roller

How to Stretch Your IT Band, and Why

Your IT band runs along the outside of your leg, attaches at your hip, and just below and on the outside of your knee. It helps stabilize your knee joint during movement.
One of the most common sports injuries, especially among runners, is iliotibial (IT) band syndrome, which occurs when this ligament becomes tight and/or inflamed.
When your IT band is tight, just about any kind of knee movement can become painful as the IT band is pulling your knee out of alignment. Stretches that can help prevent this situation include:
  • Cross-legged stretch: Standing on the floor, hook your left foot behind the right. Bending forward at the waist, and pressing your left big toe down into the floor, twist your body slightly to the left while holding on to your right leg with your hands.
    • Done correctly, you'll feel your IT band stretching on the outside of your right leg. Hold the stretch for a moment, then uncross your legs and repeat on the other side.
  • Wall stretch: Stand about an arm's length from the wall. Step forward with your left leg, and backward with your right. Bend your left knee, pressing down on your right heel. Hold for 20 to 30 seconds, then switch legs.
A foam roller can also be used. Below is a quick Runners World video demonstrating a simple foam roller exercise to loosen your IT band.

Foam Roller Exercise for Your IT Band - Runner's World


Foam rollers are a great addition to your workout equipment. The older you get, I believe the more important they become, as it is common to develop tight and spastic muscles. Foam rollers can play a great role to help relieve this. I personally use one for 10 minutes twice a day. You can review a previous article I did on foam rollers for more information If you have access to a Power Plate, the vibration can easily be transmitted through the roller into your tight muscles and tissues.

Are Your Ankles Too Tight?

If you're like most people, you probably don't pay much attention to your ankles — until or unless you end up with an ankle injury. But, as explained in a recent Time Magazine article,5 stretching your ankles is important for a number of reasons:
"Apparently, not being able to move your ankles in their full range of motion can wreak havoc on your knees every time you pound the pavement… Here's why you should consider your ankles, too, whether you're a runner or not: 'Your body needs to lengthen to absorb force,' explains David Reavy, a Chicago-based physical therapist and owner of React Physical Therapy.
'If your ankles have limited or restricted range of motion, minimal forces are absorbed causing the force to travel up the kinetic chain to the next joint, your knees.' Tight ankles can also affect the range of motion in your hips, calves, and feet as well as prevent you from developing those glutes."
One common cause of ankle tightness is the habit of walking with a forward lean. Many walk with their heads jutting out, which causes tension and tightness in your anterior chain and a weakening of your posterior chain due to chronic overstretching.
This imbalance results in a chain reaction that extends all the way down into your ankles, reducing range of motion and mobility. To determine whether your ankles are too tight, stand with your toes about five inches from a wall, then bend your knees until they touch the wall. If you can successfully do this, you're fine. If you cannot, your ankles are too tight.

Five Simple Ankle Stretches

The featured article6 demonstrates several simple stretches to loosen up your ankles. These include the following (for photos demonstrating these moves, please see the original article):
  • Shin release: Kneel on the floor, and place a lacrosse ball beneath and to the outer side of your left shin (the top of your shinbone should not be directly on the ball). With your hands leaning on the floor in front of you for stability, roll your leg backward and forward across the ball. When you come across a tender spot, stop and flex your foot up and down for 30 seconds until the muscle releases. Repeat on the other leg.
  • Plantar fascia release. Standing on the floor, place a lacrosse ball or golf ball beneath the bottom of your left foot. Gently roll the ball beneath your foot, backward and forward. When you locate a tender spot, stop and flex your toes upward and downward. Continue rolling the ball for about a minute or two. Repeat on the other foot.
  • Soleus release. Sit on the floor with legs outstretched. Place a lacrosse ball or foam roller beneath your lower left calf. Cross your right foot over your left, and roll yourself up and down over the ball/roller. When you locate a tender spot, stop and flex your foot up and down for 30 seconds. Repeat on the other leg.
  • Mid-foot pronation and supination. Stand on your right leg with the knee slightly bent. Keeping your foot flat on the floor, transfer your weight to the front part of your foot. Hold on to the back of a chair or table for balance. Next, twist your body from right to left while keeping your foot flat. Do 10 to 15 repetitions. Then, shift the weight to your heel and repeat the above steps. Repeat on the other side.
  • Calf raises. Holding a workout ball in both hands, rest the ball against the wall, so that you're leaning your chest against the ball. Keep your legs out behind you with heels off of the floor. Shift your weight to your left leg, and hook your right foot around your left ankle with the right knee slightly bent. Your left leg should be straight. Go up on your toes, then come back down. Repeat this motion several times, first with your foot pointing straight, and then with your foot turned outward. Repeat on the other side.

The Benefits of Dynamic 'Active' Stretching


According to conventional wisdom, stretching should last up to 60 seconds. For decades this prolonged static stretching technique has been the gold standard. However, recent research shows that this type of prolonged static stretching actually decreases the blood flow within your tissue, creating localized ischemia (a restriction in blood supply) and lactic acid buildup. This can potentially cause irritation or injury of local muscular, tendinous, lymphatic, as well as neural tissues.
Dynamic or "active" stretching, on the other hand, has been shown to positively influence power, speed, agility, endurance, flexibility, and strength performance when used as part of your warm-up. Active isolated stretching can also help you rehab from injuries.
My favorite type of dynamic stretching is active isolated stretches (AIS) developed by Aaron Mattes. It's a protocol of specialized repetitive stretches, performed in a specific order targeting myofascial (muscle and connective tissue) injury and restriction that allows for the elongation of muscle and fascial tissue without eliciting your body's protective mechanisms that would inhibit safe, effective stretching and overall flexibility.
With AIS, you hold each stretch for only two seconds, which works with your body's natural physiological makeup to improve circulation and increase the elasticity of muscle joints. This technique also allows your body to help repair itself and prepare for daily activity. This stretching technique can be incorporated into even the busiest of schedules, as you can easily stretch your neck, shoulders, legs, and toes while reading, watching TV, or even laying in bed.

Tips for Performing Active Isolated Stretching

First, you need to identify the specific muscles and tissues to be stretched. Sometimes this is obvious but you may require the assistance of a trained therapist, if you have specific problem areas. Next, you use very gentle pressure and hold each stretch for only two seconds. After two seconds, release the tension, and return to your starting position to prevent reverse contractions of the tissues being stretched.
Make sure you're breathing properly by exhaling during the stretch, and inhaling during the release, as this will oxygenate your tissue and fascia. Usually you do sets of 10 reps. Key considerations to using AIS effectively include:
  • Move the joint as far as you can in the direction of the stretch. This is the active part of the exercise, which activates the antagonistic muscles that inhibit the stretch. Many fail to do this and only passively stretch the muscle – and that simply will not work. It is the most common mistake people make when doing AIS.
  • Stretch the muscle gradually, with a gentle stretch of less than one pound of pressure toward the end point of your range of motion (ROM), and then hold it for two seconds.
  • Be careful not to use too much pressure so as not to engage the Golgi tendon and myotatic stretch, which act as safety mechanisms that if engaged will prevent the stretch from working. It is also important to monitor the stretch reflex carefully, as your tissue is stretched to the point of light irritation.
  • Do not push through the stretch; instead do multiple stretches and with each stretch you get more ROM.
  • Always return the area being stretched to the starting position before continuing the next repetition, as this will allow the tissue to receive blood that carries oxygen and nutrients through the movement of your lymphatic fluid, and it will also allow waste products generated during the stretch to be removed.
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