Stretching: Miracle Cure Or Source Of The Pain?

As I browse the forums there is one concept that seems to be extremely well entrenched in the running community:  Stretching is good.  And if a little stretching is good, a lot is even better.  Often the faith in stretching goes beyond being just “good”, but therapeutic – medicinal even.  “I’ve got this pain.  I’ve taken a few days off and stretched, but the pain just won’t go away.  What could possibly be wrong?  If stretching won’t cure this I’m totally stumped.”  

Sure – flexibility is important for easy, smooth movement, and stretching helps improve flexibility.  However there is evidence that suggests that stretching may not always be the route to eliminating pain.  In fact, there may be situations where the pain being felt is a result of the muscle being too lose, and that stretching adds to the pain instead of helping to resolve it.

Damien Howell is a Physical Therapist that frequents the active.com running forums.  He has raised this topic in a number of postings and I’ve found the concept/perspective fascinating.  Recently a poster (who was dealing with Plantar Fasciitis) was perplexed because, while he’d been executing the mainstream PF regimen for quite a while (calf stretching, Plantar Fascia stretching, wearing a night splint, etc.) he wasn’t seeing progress.  He noticed that when he stopped doing these things his pain disappeared.  The results the poster experienced flew in the face of mainstream thinking and treatment for Plantar Fasciitis.  This certainly was a case that supported Damien’s point:  Stretching can sometimes be bad.

The key, clearly, is determining whether a given painful situation is one that requires stretching or, rather, is one that dictates rest and leaving it alone.  Sometimes the clue to whether we need to stretch or not can, literally and figuratively, be right in front of us.  In the case of the foot, Damien has written an interesting article to get the reader thinking about common foot positions and whether they’re contributing to a contracted or lax state for the Plantar Fascia.

In my own situation, after reading this article, I really thought about some of the ways I spend my day.  I sit a lot for my job.  My work time is spent either on the phone or on the computer – 100% of the time.  I’ve been struggling to get rid of this last bit of Plantar Fasciitis pain, and I wanted to see if the information in Damien’s article could help me figure out some things.  I realized I do a few things which really contribute to a plantar-flexed position:

• While sitting at my desk I often put my feet out in front of me (feet ahead of the knees) and leave my ankles in a neutral or slightly plantar-flexed position.  This position results in the Plantar Fascia being in a chronically contracted position.  
• Another position I take while sitting is to cross my ankles underneath my chair.  This is interesting, additionally, because depending on how it’s done, you may be stretching the Plantar Fascia in one foot (if that foot has the toes and ball of foot on the floor) while contracting the Plantar Fascia of the other foot (if that foot is resting on the opposite ankle and suspended in air).
• While sitting at home I’ll often be on the couch with my feet up on the coffee table.  Again, feet are in a chronically-tight Plantar Fascia position.  (No comments, please, regarding the couch and my back – that’s another program.  )

I concluded (guessed) my pain was originating from a scenario where additional stretching could be of help.  So the other day I set up a board under my desk and put it on an angle – for a foot rest.  For most of the day, while I was at my desk, my feet were on this foot rest that was at a roughly 45 degree angle.  As a result my feet were slightly dorsiflexed, which means the Plantar Fascia and calves were stretched, not tight.  The positive impact that behavior change had was astonishing.  By having a continuous stretch through the day my pain level improved.   Damien’s article helped me conclude that tightness might be an issue, therefore stretching could be beneficial.  Compare my story with the story told earlier:  Both of us have Plantar Fascia pain.  The steps to resolve that pain were completely opposite.

In addition to the article already mentioned Damien has assembled a very impressive set of articles on a wide variety of very interesting topics.  You can find his library here.

So before quickly concluding or assuming that stretching is the right thing to do, think about that specific muscle and what you do with it:  While driving.  While walking.  While sitting.  While standing.  While sleeping.  If you analyze your daily routine you may get some clues as to whether you should stretch it or not.  And don’t forget to adjust your routine accordingly to help that muscle get into some different positions.

Jim