Dr. Wasserburger
7756 Northcross Drive, Suite 203
Austin, Texas 78757
Phone: (512) 358-0500
Fax: (512) 358-0520

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The major components of fitness are: strength, power, aerobic endurance and anaerobic endurance and flexibility. However, flexibility is probably the most "under trained" and most forgotten part of fitness.

As we age, the elastic part of our connective tissue (the framework of our muscles, tendons and ligaments) has less rebound capability. Due to this, it becomes easier to injure and more difficult to recover from injuries to our muscles, tendons and ligaments. Often, the activities we do cause subtle injuries to these tissues that are not symptomatic. These injuries heal by the natural process of scarring, and sometimes by tightening up. These asymptomatic injuries can accumulate to the point that they become symptomatic. This usually occurs when the tissue has shortened to the point that the joint can't move through its normal range of motion. This can be true of someone that is constantly placing subtle, repetitive overloads on their tissues (like someone sitting at a computer all day with improper posture or a baseball pitcher who's thrown too many pitches). It can also happen with fewer, larger loads or more explosive loads (like a heavy laborer or sprinter). It is not enough to treat the symptoms of pain and the inflammation caused by this tightening. If the biomechanics (the way that the muscles and joint move) are not rehabilitated, inflammation and pain will reoccur with return to full activity.

Hopefully you can now see why stretching is an important component to fitness. It is important to prevent injuries, and to help recover from injuries. For some people, it yields the added benefit of enhancing performance. For example, good hamstring flexibility has been shown to increase vertical leap and stride length. Stretching reduces muscle tension, assists in relaxation, helps improve body awareness and promotes circulation. Stretching keeps the muscles supple and helps to prepare you for movement. For those that are continually in abnormal postures, stretching throughout your workday helps to prevent pain from these postural stresses.

Stretching is easy, but when done incorrectly, it can actually do more harm than good. Stretching should feel good (though it may initially feel quite unusual for those of you that never stretch) when done properly. It should be relaxing, help you get in touch with your muscles and help prepare you for active movement of your muscles. You do not have to push yourself to go further each day. Concentrate on reducing muscle tension and freer movement, rather than extremes of flexibility. The latter can result in over stretching and injury.

To stretch, hold a relaxed, sustained position with your attention focused on the muscle being stretched. Spend 10-30 seconds in this position. DO NOT BOUNCE! Go to the point where you feel mild tension (but NOT pain). The feeling of tension should decrease as you hold the position. If it does not, back off slightly until you find a level of tension that is acceptable. When you stretch too far, a reflex causes the muscle to protect itself. You end up tightening the very muscle you are trying to stretch. After you can hold this stretch comfortably, move just a bit further until you again feel the mild tension for 10-30 seconds. This cycle can be repeated another time if you desire. Remember to breathe regularly and deeply during your stretches.

A variation on this stretch is the "contract-relax" stretch. This is best done with a partner. Once you are in your relaxed, sustained position, gently contract the muscle you are stretching for 4-6 seconds while maintaining your position. As you contract the muscle, resist that muscle or joint from moving by pushing against something stationary (your partner, the floor, or one of your body parts). After 4-6 seconds, relax, take a deep inhalation, and then exhale as you stretch to the point of tension again. Maintain this level for a few seconds, and then perform another gentle 4-6 second contraction against resistance. Relax, and then repeat one more cycle of stretch-contract-relax. By doing the gentle contraction against resistance, you facilitate "resetting" of the muscle stretch receptors. You will typically find that you can stretch a little bit further by this method.

In difficult muscles, the stretching process can be facilitated by other methods too. Application of warm, moist heat or therapeutic ultrasound by your therapist, can improve the connective tissue extensibility. It is best applied during the stretch, but obviously for convenience it can immediately precede the stretch. Another method is to combine it with deep connective massage techniques (myofascial release) or application of pressure to acupuncture or trigger point areas during the stretch. This can be more uncomfortable during the treatment, but it should not make you feel uncomfortable or cause increased tightness for hours to days afterward. If it does, make sure you are icing after the massage session, continue to intermittently stretch the muscle, and ask your therapist to back off on the pressure used.

You should now be aware of the importance of stretching and flexibility, and a couple of methods of improving your flexibility. The actual muscles you stretch or emphasize will depend on your particular problem. Your doctor, therapist or trainer will indicate which ones are necessary. However, everyone can benefit from a general total body stretching program.

Restoring normal SOFT TISSUE FLEXIBILITY is an important part of fitness AND rehabilitation. Only you can do it, through a regular consistent program of stretching. You will not get better through passive modalities and medications alone. It is just as important as restoring normal, balanced strength.

Lori B. Wasserburger, M.D.

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