Muscle Tendon Stretching: Expert s truths and realities
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1 & INTERNATIONAL SPORT MEDECINE SYMPOSIUM Muscle Tendon Stretching: Expert s truths and realities Dr. Serge Mesure ISM - Aix Marseille Université
2 Are stretches interes+ng in preven+ng injuries or reducing DOMS??? Colson (2012) Nicol (2017) - Prevost (2005) Duchateau (2008) - Portero & Mc Nair (2016) & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 2
3 Definition: Stretching comes from the English verb "to stretch". The aim of stretching is the acquisition of the quality of flexibility allowing to "make a gesture or a sequence of gesture with maximum amplitude and harmony" - Waymel T (1999). For Canal M. (2005) the term "stretching": "... covers all sorts of practices, but historically corresponds to the popularization of reflex techniques developed by Kabat, Knott and Voss in the Name of Facilitation Proprioceptive Neuromuscular... ". - The usual term in English that corresponds to the physical quality flexibility associated with ease, fluidity, economy and amplitude of movement - Elimination of tensions likely to limit the amplitude of the movement & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 3
4 In the field of sport, the constraints inherent to the efficient performance of certain technical gestures impose in particular extreme amplitudes at the musculo-tendinous level Age (growth, senescence), various joint pathologies, immobilization and daily postures are factors that can alter the amplitude of movement Stretching: - Takes in consideration «the neuro-physiological» dimension of flexibility - Traditionally used to designate the start and end exercises. - For many, stretches apply only to the muscles - Long range training for increase joint amplitude & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 4
5 Their interest before and after performance? For better "preparation"? For better "recovery"? To increase "flexibility"? To avoid injury? To increase the perf.? For??? Many things have been and are being said... What can we say today? & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 5
6 The different Methods... Dynamic Method MOVEMENTS LAUNCHED to lengthen muscle Method widely used in the "sporting" environment... Inconvenience Rapid Stretch => triggers the myotomic reflex (stretched muscle protection) myotatic => Activation of the stretched muscle & Synergistic muscles (Eg ischios and twins) Physiological response that goes against the goal It s BETTER to make A SLOW STRETCH To try to obtain a maximum relaxation... rather than integrated the myotatic reflex..! (Moore & Hutton 1980) & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 6
7 Rapid Stretch (ballistic) => Elongation, micro-lesions, breakdowns... Dynamic mobility may be required for some Physical Sport Activities which use «movements launched» Anderson (1984), Noakes et Granger (1990) OK... but after warm-up + other forms of stretching! & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 7
8 Static Methods a) PASSIF stretching (SS: Static Stretch) SINGLE TENSION of muscle and tendon Stretching by mobilizing the joint + Maintaining the position Elongation due to gravity or the action of a partner C Advantages C No motor drive problem => "Total release" C Technique with relaxing effect Inconvenience Passive mobility that differs from sporting gesture "Relaxation"... & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 8
9 Muscle Stretching - Breaking residual bridges but: (Guissard 2007) - ä - Resistance of conjunctive structures (Sarcolemma, aponeurosis, fascias) - ä Resistances of structural proteins (Titine, connectin, desmin) Passif stretching Couple de force (Nm) Muscle Déplacement distal (cm) - The behavior of the muscle is a function of Its connective tissue composition - The speed of stretching (Better elongation at slow speed) - Little or no intervention of the myotatic reflex in slow speed æ «tonic activity» found immediately a>er & INTERNATIONAL SPORT MEDECINE SYMPOSIUM
10 b) Techniques known as PNF: Neuromuscular Facilitation Proprioceptive => aim to decrease the excitability of Mn α (AC): ANTAGONIST CONTRACTION active stretching Agonist stretching caused by SLOW & PROGRESSIVE CONTRACTION of ANTAGONIST muscle (Associated with intervention of reciprocal inhibition) May be associated with a passive stretch (Release) Advantages Active motor control: solving coordination problems Close to sporting gesture Motivating Duration of passive stretching? compromise: Activation of stretched muscle tends to diminish after 10s Viscoelasticity of stretched muscle increased... si> 30s & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 9
11 c) (CARC): Stretching by CONTRACTION - RELAXATION Of the AGONIST followed by a phase of CONTRACTION of the antagonist In the 4th step of the CR, stretching of the agonist A CONTRACT of the ANTAGONIST to relax the stretched muscle... Advantages Opinions differ as to its effectiveness Efficient whatever the joint of the body concerned (Moller et coll. (1985) "Improve": Joint stability, Muscular balance, Coordination Relaxation capacity Warning: Micro-muscle lesions => Not in addition to intense bodybuilding and recovery. From 36h & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 10
12 Inconvenience Efficiency of stretching depending on location, position (<=> The effectiveness of reciprocal inhibition is not always evident... Stretching and Injury Prevention? Relaxation does not seem to Have effect!! Injuries at 2500 soldiers In 80 days Revues Herbert & Gabriel (2002) Thacker et coll. (2004) Shrier (2004) & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 10
13 Effects on DOMS? The static stretches practiced 24 to 48h post-exercise do not decrease the DOMS muscles!! Revue Herbert & Gabriel (2002) Groups stretching vs. normal / DOMS after W eccentric Intensive static stretching can even cause it in untrained subjects!! Smith et coll. (1993) & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 10
14 Conclusion - Stretching during warm-up decreases muscle strength production, - Reduce reflex activity and decrease performance during power activities. - Not preventive role of stretching in muscle injuries. - Warm-up and production of high levels of muscle power = Minimal use of stretching exercises. - Advocate a gradual rise in the internal temperature of the muscles. Stretching (static, PNF, etc.) = not before a training or a competition, but rather after the activity & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 10
15 What you must remember: If you practice stretching before your training (the intense part of the training) precede them with a phase of dynamic heating Do not stretch after a session that is known to cause DOMS Do not stretch a muscle with DOMS to increase the lesions Insert relaxation sessions within your training program to increase your joint range & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 10
16 Thank you for your attention... & INTERNATIONAL SPORT MEDECINE SYMPOSIUM 10
17
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