Stretching and Flexibility

Flexibility is considered one of the primary components of fitness. Stretching not only helps prevent injuries but also helps improve our range of motion in order to perform our daily activities. 

When stretching, it's a good idea to make sure that the muscles are warmed up first. Ten to fifteen minutes of cardiovascular activity before stretching is recommended. Remember not to bounce when stretching. Instead, hold the stretch for 10-30 seconds. You should feel the pull in the center of the muscle, not at the joints. Avoid "ballistic" or bouncing while stretching, movement should be slow and relaxed.

Try these basic stretches aimed at targeting the major muscle groups: 

Lower Back
1) Position: Lying on back
    Hands behind thighs
    Pull knees into chest
    Bring knees in while pressing back down
2) Position: On all fours
    Arch back (letter "C" position) and hold
    Relax back and repeat

Upper Back
    Position: Standing
    Arms and hands extended at shoulder height
    Bring hands together and round through the upper back

Neck
Position: Standing
1) Gently tilt head to one side
    Ear to shoulder
    Slowly roll forward and to the other side
2) Turn head in one direction and hold at the point of tension
    Slowly repeat to the other side

Shoulder
     Position: Standing
     Bring forearm across body

Chest
Position: Standing
1) Placing hands on back of hips
    Open up through the chest
2) Interlace fingers behind back
    Slowly lift arms up

Triceps
    Position: Standing
    Bend at elbow with arm overhead
    Gently pull arm down

Biceps
    Position: Standing
    Extend arms out to sides at shoulder level
    Thumbs up
    Turn thumbs down and hold

Quadriceps
    Position: Standing
    "Flamingo" stretch in standing position
    Grasp one leg above the ankles
    Pull leg up and back

Hamstring
    Position: Sitting
    Inverted hurdlers stretch
    Press chest to thigh

Groin
    Position: Sitting in "butterfly" position
    Heels together
    Press knees to the floor

Calves
    Position: Standing
    Runner's stance
    Back leg is straight, slight bend to knee
    Press hips forward

Plantar Fascia
    Use a tennis or golf ball
    Roll foot over ball  

Stretching by muscle groups

The diagrams accessible from this page illustrate some good stretches for the muscle groups often injured in sports.

Lower extremity stretches

Concentrate on your two-joint muscles: gastrocnemius complex (calf muscles that involve the ankle and knee joints), hamstrings (back of thigh muscles that involve the knee and hip joints), and hip flexors (a component of the quadriceps that flexes the hip and bends the knee).

Hip flexor stretches

Lie on your back on a table or bed with your leg and hip as near the edge as possible. Pull your other thigh and knee firmly toward your chest until your lower back flattens against the table. See illustration. Let your other leg hang in a relaxed position over the edge of the table or bed. Hold for 30 seconds. Switch legs and repeat.

Hamstring stretches

Keep your back straight as you lie in a doorway. Raise one leg against the wall until you feel a gentle stretch behind your knee. Keep the leg on the floor straight, well-aligned with your back. Hold for 30 seconds. Switch legs.

Quadriceps stretches

Stand facing the wall. Place your free hand against the wall for support. Grasp the top of your right foot with your right hand and gently pull the heel toward your buttocks until you feel mild tension in your quadriceps muscle. Tighten your stomach muscles to keep your back from sagging inward. Do not lock the knee of your supporting leg and keep the leg you are stretching directly under you. Relax as you hold the stretch for 30 seconds. Repeat with the other leg.

Calf stretch

Stand at arm's length from a wall with your palms flat against the wall. Slowly bend your elbows and lean toward the wall. Keep the involved leg back with the knee straight and the heel flat on the floor. Hold for 30 seconds.

Upper extremity stretches 

Tightness in the shoulders can predispose you to rotator cuff problems. We emphasize a program of rotator cuff and shoulder group stretches, especially for people involved in throwing or racket sports. Shoulder group stretches.

 Shoulder group stretches

Flexibility: Stretching A Point

Your back is stiff. Your legs are stiff. Your neck and shoulders are stiff. You can’t get even close to touching your toes unless you bend your knees. You believe that this is all just a part of the aging process.........

If you see yourself anywhere in the above description, join the ranks of the Prematurely Inflexible. In fact, there are very few reasons other than inactivity and some severe joint or muscle maladies such as certain forms of arthritis that would render you inflexible. Most people can be a good deal more supple and flexible than they are. Greater flexibility is the only difference between a "stretcher" beginner and a regular "stretcher", someone who stretches regularly, regardless of age. There are older extremely flexible people and younger very inflexible people; visit any yoga class to confirm this. It is a matter of
diligence, not of age.

Why bother to become more flexible?

For the average person, flexibility does not just happen. Certainly some people are naturally more flexible than others, but most of us go about with stiff hamstrings (backs of thighs) and stiff lower backs, necks and shoulders. This hampers everyday movement. Backing out of your driveway with stiff neck muscles need not be the problem it is. Stretching all muscle groups
allows for much more freedom of movement for everyday living. We are not talking here about becoming flexible enough to do advanced yoga postures. Stretching also greatly reduces muscle tension, range-of-movement and pain, especially in the neck and shoulders where so many people hold their tensions. But there is a right and a wrong way to stretch. Most people do not
know how to stretch properly. They think that stretching is not something you need to learn, but it is.

When and how should I stretch?

According to Bob Anderson, the author of Stretching, there are 2 phases to proper stretching. Starting slowly, stretch to a point where you feel a mild tension and hold that position without bouncing (“pulsing”) and be certain you exhale “into” the stretch, then maintain normal breathing while holding the stretch for about 20 seconds. At no time should you feel pain, but you should feel a lessening of the stretching sensation as you continue to hold the stretch. The author calls this the “easy stretch.” If the stretching feeling grows in intensity, you have overstretched and need to back off a bit. Next, slowly move a bit more deeply into the stretch until you feel it increase and hold for another 20 seconds, still breathing normally. Again, the stretching sensation should lessen, not increase. This is the “developmental stretch”, the one that will, over time, afford more flexibility.

What should I look for while and after stretching?

While stretching, the feeling should be a decidedly “stretching” sensation, but easily held in place without pain or discomfort. Over time, barring vertebral or neurological pathology, your painful “hot spots” should become less and less painful. Your tight spots such as hamstrings and lower back should also become much more pliable. One thing to note before attempting to stretch
deeply is that warmed muscles are not only easier to stretch, but safer. Stretching cold muscles could lead to injury, so warm the muscles for about 5 minutes in order to get the blood flowing. Do this with gentle activity that involves the muscles you plan to stretch. For example, if you plan to stretch your hamstrings, walk up and down a flight of steps three or four times. Or stand
in place and lift first one heel toward your buttocks, then the other, about ten times each -  slowly.  If you plan to stretch your neck muscles, gently and very slowly roll your head across your chest toward each shoulder - do this slowly too. Do not roll the head backwards if you hear “crunching” sounds in your neck.

How do I know if I have either tight hamstrings or a tight lower back?

If you sit on the floor with your legs extended in front of you, feet flexed tightly, and if you cannot touch your toes without bending your knees, you most likely have either overly tight hamstrings or a tight lower back, or both. Improvement is easy with a regular stretching routine. Most good fitness classes have stretches both at the beginning and at the end of class, and classes which emphasize stretching such as yoga, Pilates, ballet and Tai Chi will afford greater flexibility and tension reduction.

The circulatory benefits of stretching

Deep stretching improves the circulatory system and facilitates blood flow to the muscles, heart and brain. Stretching, when done properly, opens the energy channels and smooths the way to “unkinking” the various acupuncture meridians, This permits a “grease the skids” flow of blood from one part of the body to another. When one is finished a properly supervised and executed stretch session, one feels warm, light, totally relaxed and tension-free. Find a good instructor to help you with this. Certain video tapes can help too.

Don’t get old before your time. Stretching may forestall the aging process, along with daily exercise, especially for the aging population, which, with luck, includes all of us.

Back Exercises - Level III – Advanced

Exercise emphasis on pelvic stabilization and trunk strengthening.

• One should not progress to this level until leg pain is diminishing and back pain is subsiding.
• Breathing is important, exhaling on the exertion part of the exercise and inhaling on the relaxed stage of the exercise.
• Repeat each exercise 5 times and increase repetitions weekly to maximum number indicated in each exercise. Also, repeat level I and II exercises 2 – 3 times. Exercise daily.

Do not strain to complete the exercise, do the exercise slowly, no fast jerking or snapping (remember the muscles are like rubber bands).

Curl-up Crunches
Lie on your back, legs on ball or chair.
Exhale, do pelvic tilt.
Raise head / shoulders.
Do slowly, do not strain.
Keep low back on floor.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.
Progress to 25 times.

Arm and Leg Extension – Prone
Lie on stomach.
Raise right arm and left leg.
Keep hips on floor, do not rotate hips.
Hold 5 seconds.
Repeat 5 times.
Progress to 10 times.

Arm and Leg Extension – on 4’s
Begin on hands and knees.
Lift right arm and left leg.
Exhale, do pelvic tilt, do not rotate hips, do not arch back.
Alternate arms and legs.
Hold 5 seconds.
Repeat 5 times.
Progress to 10 times.

This level of exercises is for individuals having completed Level II and desire to improve their flexibility further. These exercises should not be attempted by individuals who have had back problems in the past 30 – 60 days.

Hamstring Stretch (Advanced)
Stand upright with one leg raised and resting on an elevated surface.
Exhale, keeping both legs straight and hips squared.
Extend your lower back.
Bend forward from the waist.
Lower the trunk onto the thigh.
Hold the stretch 15 seconds.
Repeat with the opposite leg.

Trunk and Hamstring Stretch (Advanced)
Assume a squat position, hands resting on the floor.
Exhale, slowly extend the knees.
Hold the stretch 15 seconds.

Trunk Stretch (Advanced)
Stand upright, legs straddled.
Back of the heels six inches from the wall.
Interlock the hands behind the head.
Exhale, keep both legs straight.
Extend the upper back.
Bend forward at the waist.
Lower the trunk towards the thighs.
Position the buttocks against the wall.
Feel pelvis rise as you lower down.
Hold the stretch 15 seconds.
Repeat 2 – 3 times.

Trunk and Hip Adductor Stretch (Advanced)
Assume a squat position.
Feet 12” apart and toes turned slightly out.
Place elbows on inside portion of both upper legs.
Exhale, slowly push legs outward with elbows, feet must be flat on the floor.
Hold the stretch 15 seconds.
Repeat 1 – 2 times.

Trunk Side Stretch and Leg Stretch (Advanced)
Assume the stretch position.
Raise one leg on a supporting surface.
Raise the hands overhead, interlock the hands.
Exhale, bend sideways.
Lower the trunk toward the raised thigh.
Keep the legs straight.
Hold 15 seconds.
Repeat with opposite side.

Side Bending Stretch (Advanced)
Stand upright, feet together, your side facing a wall, about an arm’s length away.
Place one hand on the wall, the other hand on the back of hip joint.
Exhale, keep the legs straight.
Contract the buttocks.
Rotate hips slightly forward in toward the wall.
Hold 15 seconds.
Repeat doing the opposite side.

Side Bending Stretch (Advanced)
Stand upright, hands at side.
Exhale, slowly flex the trunk laterally, toward right side, try to touch left heel with both hands.
Hold 15 seconds.
Repeat with opposite side.

Upper Trunk and Back Stretch (Advanced)
Stand upright, feet together.
About 3 feet from a supporting surface approximately to shoulder height.
Keep arms and legs straight.
Bend at waist, flatten back.
Grasp supporting surface with both hands.
Extend the shoulders and press down on supporting surface to produce an arch in your back.
Hold for 15 seconds.
Repeat 2 times.

Back Exercises - Level II – Intermediate

EXERCISES PRIMARILY STRETCHING WITH INTRODUCTION OF STRENGTHENING EXERCISES.

 One should not progress to Level II:

• Until the pain level decreases through out the day.
• You are still experiencing radiating pain, tingling, numbness and neither has decreased.
• Continue with the Level I exercises repeating 2 – 3 times daily along with the Level II exercises. 

Knees to Chest:
Pull both knees to your chest.
Keep head on the floor.
Stretch to the edge with no increased pain.
Hold 15 seconds.
Rest 5 seconds.
Repeat 3 – 5 times.

Hip Outside Thigh Stretch:
Lie on back, place left leg on the outside of the right knee.
Keep shoulders flat on the floor.
Pull left knee down toward floor with right hand.
Avoid over stretching.
Alternate legs.
Hold 10 seconds.
Repeat 3 – 5 times.

Hamstring Stretch:
Lie on your back at doorway.
Place the left leg on side of door, extend right leg through doorway, slide buttock towards wall.
Keep left leg straight.
Stay in pain free range.
Alternate legs.
Hold 1 minute.
Repeat 3 – 5 times

OR
Lie on your back.
Extend left leg upward.
Use belt or towel.
Keep left leg straight.

Bridging:
Lie on your back, hands at your side.
Exhale, complete pelvic tilt.
Push arms into floor.
Slowly lift trunk from floor.
Body is in line ankles with shoulders.
Stay in pain-free range.
Do not arch back.
Hold 10 seconds.
Rest 5 seconds.
Repeat 3 – 5 times.

Wall Slides:
Exhale, do pelvic tilt.
Keep head and back against wall.
Feet slightly wider than shoulder width.
Slowly lower buttock, sliding down wall until thighs are parallel to floor or until pain in back starts.
Slide up the wall keeping your back flat.
Hold 5 – 10 seconds.
Rest 5 seconds.
Repeat 5 times.

Trunk Stability – Unilateral Isometric Hip Flexion:
Lie on your back.
Exhale and tighten stomach (pelvic tilt).
Raise knee to outstretched arm.
Gently push, keep arm straight.
Keep head down and trunk rigid.
Hold 5 – 10 seconds.
Repeat alternate legs 5 times each.

Back Extension Standing:
Standing with hands on waist.
Bend backwards at the waist.
Avoid excessive bending.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

You have now completed Intermediate Level II and you make continue on to Level III – Advanced

Back Exercises - LEVEL I - Beginner

PAIN WITH TINGLING AND NUMBNESS RADIATING TO THE LEG MIGHT BE AN INDICATION OF A DISC HERNIATION. YOU SHOULD AVOID POSITIONS WHICH INCREASE LEG PAIN AND NUMBNESS.

ALMOST ALL BACK INJURIES ARE THE RESULT OF:

1)      POOR POSTURE AND POOR BODY MECHANICS WHEN BENDING AND LIFTING
2)      STRESSFULL LIVING AND WORK HABITS
3)      LOSS OF FLEXIBILTY AND DECLINE OF PHYSICAL FITNESS.

• These exercises are primarily stretching exercises.
• Stretching to the edge is proper. Increased pain is an indication the stretching of the muscles is improper.
• Stretching should NOT cause increased pain 10 – 15 minutes after the stretching is completed.
• Do the exercises 2 – 3 times a day.  

Prone on Elbows:
Rise up on the elbows as high as possible, keeping the hips on the floor.
Do not bend head backward.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

Press-Up:
Press the upper body upward into the position shown, keeping the hips on the floor.
Keep the low back and buttocks relaxed.
Do not bend the head backward.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

Pelvic Rotation:
Assume position on hands and knees.
Exhale and tighten the stomach muscles.
Push the lower back upward.
Do not move the mid-back.
Inhale and let the back sag.
Return to the neutral position.
Raise and lower the pelvis area only.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

Back Stretch on all 4’s:
Begin on hands and knees.
Lean back towards your heels.
Keeping your hand placement, not moving your hands.
Hold 10 – 15 seconds.
Rest 5 seconds.
Repeat 5 times.

Hip Flexor Stretching:
Lie on your stomach.
Wrap strap around the ankle.
Pull the foot to the buttock.
Stretch until you feel slight pulling in low back.
Keep the hips on the floor.
Hold 10 – 15 seconds.
Rest 5 seconds.
Repeat 5 times.

Pelvic Tilt:
Lie on back with knees bent.
Exhale, tighten stomach, squeeze stomach, flatten the low back and tilt it under.
Arch back upward, pushing stomach upward, inhale, return to neutral position.
Hold 5 seconds.
Rest 5 seconds.
Repeat 5 times.

Lower Trunk and Neck Rotation Stretch:
Lie on your back, bending knees.
Keep back flat and feet together.
Rotate knees to left.
Rotate neck to right.
Alternate.
Hold 10 seconds.
Repeat 5 times.

This concludes the Beginner Level I and you may now continue on to the next Level II – Intermediate