The Truth About Stretching
Stretch Mobility Coach Founder, Kim Nartker, Stages a Stretching Intervention
When the body pops, creaks, and aches, it’s trying to tell us something. Kim Nartker, Founder and CEO of Stretch Physical Therapy and Total Wellness, interprets the body’s language of pain and gets to the root of what is causing it. Kim’s innovative stretch methods lead to healthy, pain-free living, and prevent injury, injections and even surgery.
“I want to dispel the myths about stretching and help people in pain fix their problems,” she says.
Tight muscles mean trouble—they can cause injury, discomfort and weakness. When it comes to stretching, many of us rely on outdated science. Kim is on a myth-busting mission for mobility.
“It is a myth that getting older causes pain,” she says. “Stretching will help you move more freely, so that you can function at your best as you age.”
“We’ve had complete success putting people on the road to recovery without surgery,” she says.
Kim stages a stretching intervention to guide us through three critical questions about stretching:
Q: Why do I feel tight?
KN: You are not the cause of your tightness. We have hundreds of joints in our body. When a joint gets restricted, it communicates with the muscle to tighten and you feel progressively tighter. When that cycle continues, the body compensates and builds up scar tissue.
When we stretch you, we reprogram everything. Our techniques find and unlock the joints that are sending the wrong messages and refire the deep muscles so they perform the way they should.
The sooner you handle a tight muscle, the more injury and pain you can prevent. We’ve helped people avoid knee, hip and back surgeries.
Q: When should I stretch with exercise?
KN: It’s best to stretch before and after exercise. A warm-up stretch, before exercise, should be dynamic—that means you should be moving while you are performing it. Search Google for dynamic stretches. There are plenty of routines out there. You want to get the joints moving to prepare the muscles to start doing what they are supposed to do so you prevent injury.
After a workout, you should do static stretches, where you hold a stretch for 30, 60 or 90 seconds without movement.
When we do a stretch session with you, we stretch you. We are able to stretch the joints, muscles, tendons, and the myofascial component that’s holding you tight so that it relaxes the muscles. Then, we give you some exercises to strengthen those muscles and keep you flexible longer.
Q: When should I stretch daily?
KN: We recommend daily mobility stretches, moving your joints through a range of motion as you stretch. If you wake up with tightness, you need to be doing mobility stretches before you go to bed and again when you wake up. You shouldn’t spend more than five minutes on it. If you are having to spend more time than that, then there’s a bigger, underlying problem that needs to be addressed.
Learn more online about Kim Nartker and the programs for healing at The Stretch Mobility Coach 4851 Wunnenberg Way, West Chester. https://thestretchmobilitycoach.com/
Making Excuses
Too often we make small excuses that can lead us down the road to frustration from unmet goals. We think that making a small excuse today for not moving our bodies, not strengthening our bodies or not eating well is okay and we justify by telling ourselves that our bodies need rest. While rest days are a major component in good health, they can sometimes lead to the lack of motivation to move at all. It is easy to put off our workouts, stretching or to ignore pain signals, but are you really helping yourself by making excuses?
Our bodies need mobility, strength, sleep, nutrition and mindfulness to work the way we need them too.
But our lives have become more fast paced. We place many demands on ourselves to be the people our minds say we should be. We cram our schedules with tasks and use business as an excuse to put off taking care of ourselves. These excuses prevent us from being truly authentic to ourselves and how our bodies need us to live.
Take a look at your daily life…
Do you allow time for movement, flexibility, stress relief, good sleep and mindfulness daily?
If not, take baby steps today to implement one of these into your daily life. Do a few stretches in the morning to help you wake up and loosen up any tightness before you start your day. Add in a simple 10 minute workout ( you have 10 minutes to spare)! Or, if you work at a desk, make a point to stand up, stretch, and walk around every 30 minutes to an hour during your work day.
Having a hard time keeping yourself accountable in these areas?
Here are some courses that may help you:
Back Pain Relief Course https://www.stretchptondemand.com/back-pain-relief-course
Knee Pain Relief Course
https://www.stretchptondemand.com/knee-pain-relief-course
On demand Stretch and Mobility Class this Friday 2/12/21 at 11:00 LIVE only $5.00
https://stretchptondemand.punchpass.com/classes/7693360
Upcoming Webinars and Events
https://stretchptondemand.punchpass.com/classes
Give yourself some grace today!
Shin Splints- What they are, how they develop and how to get rid of them
Have your shins been painful during and after running lately? You may be dealing with medial tibial stress syndrome, more commonly known as shin splints. Let’s discuss what shin splints are, how they develop, and how you can get over them so you can get back to your favorite activities pain-free!
What are shin splints?
Medial tibial stress syndrome or shin splints can be defined as pain or discomfort along the edge of your tibia (the bone that runs down the front of your lower leg) that primarily occurs during exercise. Shin splints are especially common with activities that require repetitive loading such as running, jumping, or dancing. Shin splints are one of the most common painful syndromes among athletes and are the most frequent injury among runners1.
How do shin splints develop?
When you run or jump during athletic activity, your bones, joints, and muscles in your legs have to absorb the ground reactive force, which is the impact of your feet returning to the ground with each stride or jump. When the amount of impact that you’re absorbing during exercise OR the total amount of exercise is more than your legs can currently handle, you may begin to experience discomfort during the activity. One of the most common areas where this discomfort develops is in the shin bones and their surrounding muscles, because they help absorb a significant amount of the ground reactive force. Shin splints develop over time due to these excessive forces on your lower legs and can be classified as an overuse injury. This condition is one of the most common lower leg injuries among runners.
Overuse injury
Overuse injuries commonly occur when someone begins a new activity or are returning to an activity after a long break. Oftentimes, overuse injuries can be described as “too much, too soon, at too high of an intensity.” “Too much, too soon” refers to the volume (how much exercise you’re performing) and frequency (how often you’re exercising) of exercise. For example, if you are a beginning runner, doing too much too soon would be going from running 1 mile on 3 days one week (3 miles total) to 3 miles on 5 days the next week (15 miles total). This would be a 500% increase in running volume and a 67% increase in running frequency. Your body is likely going to have a hard time adjusting to the sharp increase in the amount of stress that you are placing on your legs.
“Too high of an intensity” refers to how fast you’re running, how high or far you’re jumping, or how difficult your dance moves are. Let’s go back to the running example. You recently ran a mile at max effort in 9 minutes. An abrupt increase in intensity would look like transitioning from running 1 mile each session at 11 minutes per mile to running 3 miles per session at 10 minutes per mile. The faster you run, the more force that your muscles and bones have to absorb. It’s important to make small changes to your exercise routine over time to progressively overload your body so that your performance improves.
How can I determine whether I have shin splints or some other issue?
When dealing with lower leg pain, one of the most important aspects is determining the difference between shin splints and a bone stress injury. A bone stress injury or stress fracture is a serious running injury that can have long term effects on your ability to exercise if it is not dealt with properly. I’m going to outline a couple of self-tests that you can perform to help determine whether your pain is coming from shin splints or something more serious.
- Test 1: Find the bony border of your shin. Press on this bony border and on the area where your muscles and the bony border meets. Press along the whole length of your shins, starting at your knee and down to your ankle.
- Test 2: Take a look at your shins – are there any areas where the color of your skin has changed, any redness or swelling?
- Results of tests: For Test 1, if you had a painful area along your shin that was about 2 inches in length or more and this is the same area that hurts when you run, this indicates that you may have shin splints. However, if you pressed along your shin and had one very specific painful spot in the bone, this may indicate a bone stress injury. If you have this specific painful spot and noticed a skin color change and/or swelling, this may further indicate a bone stress injury.
What should I do for my injury?
If after reading this article, you suspect that you have either shin splints or a bone stress injury, you should get evaluated by our physical therapists as soon as possible. If you suspect that you have a bone stress injury, you should immediately stop running, jumping, and dancing activities until you can confirm whether there is a true bone injury. Here at Stretch, we are happy to help you with any running-related information. Give us a call at 513-874-8800 to set up an appointment Today!
References
- Winters, M. The diagnosis and management of medial tibial stress syndrome. Unfallchirurg 123, 15–19 (2020). https://doi.org/10.1007/s00113-019-0667-z
- Burrus, M. Tyrrell & Werner, Brian & Starman, Jim & Gwathmey, F. & Carson, Eric & Wilder, Robert & Diduch, David. (2014). Chronic Leg Pain in Athletes. The American Journal of Sports Medicine. 10.1177/0363546514545859.
Rotator cuff impingement: Treat the cause not the symptoms
The use of posture management and scapula stabilization exercises to improve rotator cuff impingement outcomes.
What is Rotator Cuff Impingement?
Impingement occurs when the rotator cuff tendons get pinched in the space between the arm bone (humerus) and the arch of the shoulder blade (acromion) in a region within the joint which is called the sub acromial space. Pain is felt at the front of the shoulder due to irritation and inflammation of the tendon at the point where it becomes trapped. This pain is usually aggravated by overhead or twisting movements of the shoulder.
Causes of rotator cuff impingement
There are a number of reasons to which this problem can be attributed, these might include:
- Wear and tear of the joint between the collar bone (clavicle) and the shoulder blade,
- Structural abnormalities of the acromion
- Weakness of the rotator cuff muscles
- Trauma or direct injury
However one very common reason relates to poor posture which affects the position of the shoulder and the body’s ability to maintain control through movement. The shoulder joint is a ball and socket joint and is the most mobile of any joint in the body. To achieve such large ranges of motion, the socket is quite shallow which means the joint itself is inherently unstable. Complex ligament, muscle and tendon structures (soft tissues) work together to provide the stability that would otherwise be lacking. The rotator cuff is extremely important in providing this balance between mobility and stability.
Postural abnormalities including forward head position, rounded shoulders, internal rotation of the shoulders and an increased curve in the middle back (kyphosis) are commonly seen in patients with rotator cuff impingement (1). The soft tissues at the front of the joint tighten and the soft tissues at the back of the joint lengthen. This adaptation may simply be as a result of prolonged poor posture or could have been caused by poor training methods which have created what is known as a muscle imbalance.
Treatment of rotator cuff impingement
Pain is one of the major symptoms of rotator cuff impingement. It can be treated with a variety of modalities and by a range of clinicians and thus the irritation associated with impingement can be fixed with relative ease. However failure to address the cause of the problem i.e. the imbalance which has caused the impingement in the first place will only lead to a recurrence of the injury and persisting pain.
To achieve long term relief of rotator cuff impingement syndrome, posture management and scapular stabilization exercises must be implemented.
Posture Management and Scapular Stability Exercises
The shoulder has a ‘neutral zone’ much like that commonly described in the lumbar spine. This is the point at which the shoulder joint complex is aligned in such a position that all the supporting structures (muscles, ligaments and tendons) are able to work together to maintain control of the joint throughout the required ranges of motion. The ability to maintain this ‘neutral zone’ is lacking in impingement cases. It can only be restored through correcting postural defects (stretching tight structures, strengthening weak muscles) and stabilizing the scapula to provide a strong base of support around which movement can occur. An exercise program can be implemented very early on the recovery phase. There is no need to wait for pain to settle, in actual fact working within a pain-free range at a load that does not provoke symptoms, will only serve to relieve pain (2).
Unfortunately, there is no universal blueprint of exercises that can be given to correct this problem. The imbalances that lead to the development of impingement are often complex and interlinked. The skill in prescribing the correct exercise program lies in the exercise professional’s ability to fully understand the issues which have led to the onset of the problem. Only through delivery of such an exercise program will long term relief from rotator cuff impingement be achieved.
References
- resting positin variables at the shoulder: evidence to support a posture-impairment association. Bostard, J D. 2006, Physical Therapy, Vol. 86, pp. 549-557.
- Dynamic evaluation and early management of altered motor control around the shoulder complex. Magarey, ME and Jones, MA. 4, 2003, Manual Therapy, Vol. 8, pp. 195-206.
Posture Correction Exercises to Treat Neck Pain
Neck pain affects many people; it can be the result of a range of conditions that affect the muscles, joints, ligaments, discs or nerves. Frequently poor posture contributes to this problem. Postural correction exercises are therefore used in the treatment of this problem.
There are a range of posture correction exercises but they can be broadly grouped into 4 areas:
- Chin Tucks
These exercises aim to restore alignment of the head relative to the torso. It is common particularly in neck pain sufferers for the chin to poke forwards when standing or sitting. - Breast Bone Lift
Avoiding too large a curve in the middle back can be achieved through ‘opening the front of the chest’. - Shoulder Blade Squeeze
Retracting the shoulder blades prevents the shoulders from rounding. - ‘Spine Neutral’
Finding the middle range of pelvic tilt helps to activate the core muscles and ensures the spine is in its most efficient position.
The spine should naturally follow a shallow ‘S’ shaped curve. In this position the joints are stacked one on top of another. The muscles are orientated in their most mechanically advantageous position and there is minimal stress through the spine. Any abnormal curves will perpetuate neck pain through stress on muscles ligaments and joints.
Posture correction exercises aim to strengthen the muscles that support the spine and control the weight of the head so that normal spinal curves can be maintained.
Chin Tucks
It has been shown that neck pain sufferers demonstrate weakness and lack of endurance of the deep neck flexor muscles. Chin tuck exercises help to restore function of the deep neck flexors and even if used in isolation can be helpful in reducing neck pain.
Breast Bone Lift
This approach is also called thoracic extension or ‘opening through the front of the chest’. The thoracic spine (middle back) naturally has a slightly forward curve, however, where this curve is excessive it creates an imbalance between the muscles at the front of the chest which adaptively shorten and the muscles at the back which weaken.
Shoulder Blade Squeezes
Pulling the shoulder blades backwards is called retraction. Retraction exercises are used in conjunction with improving thoracic extension to reduce muscle imbalance. By strengthening the muscles which pull the shoulder blade onto the chest wall, one of which is the lower trapezius, it is possible to reduce stress on the upper trapezius. If the upper trapezius is overactive it can lead to the development of trigger points. Trigger points are tight bands or ‘knots’ within a muscle they cause pain in a particular distribution and are very often factors for consideration in neck pain of any source.
Spine Neutral
Spine neutral refers to the awareness of a mid range position between maximum tilt forwards at the pelvis and maximum tilt backwards. Where people exhibit poor posture often they have a tendency towards too far forwards which creates a big arch in the lower back or too far tilted backwards as is seen in slumped posture. The position of the pelvis is key to the alignment of the curves of the spine. Improving the strength of the ‘core’ muscles helps to maintain this position allowing the spine to follow the normal natural curves which are observed in good posture.
The use of posture correction exercises have been shown to improve neck pain (2). Not only will they reduce the stresses on ligaments, muscles and joints that may have caused the problem initially, they will also help to prevent further episodes of pain and movement restriction.
References
- The effeect of therapeutic exercise on the deep cervical flexor muscles in people with chronic neck pain. Jull, GA, Falla, D and Vicenzino, B. 2009, Manual Therapy, Vol. 14, pp. 696-701.
- Evidence for exercise therapy in mechanical neck disorders. Sarig-Bahat, H. 2003, Manual Therapy, Vol. 8, pp. 10-20.