One of the five health-related components of fitness is flexibility. Flexibility relates to the ability to move a joint through its full range of motion (ROM). Developing a complete fitness program requires taking time to emphasize this component by stretching. Unfortunately, as the American Council on Exercise points out, “Most people neglect flexibility training, limiting freedom of movement, physical and mental relaxation, release of muscle tension and soreness, and injury prevention.”
Perhaps the reason it is so easy for people to overlook flexibility is because its benefits, while significant, are felt more than seen. However, failing to address this component of fitness can have serious consequences, especially as a person ages. Without flexibility, everyday tasks, such as sweeping the floor or even getting out of bed, become difficult. A reduced mobility of joints increases the risk of injury during regular activities, sports, and exercise routines, as well as the risk of occasional and chronic back pain.
Types of Flexibility
Flexibility is classified into two types: static and dynamic.
Static Flexibility. This type of flexibility is a measure of the limits of a joint’s overall range of motion. It is measured by stretching and holding a joint in the position of its maximum range while using a measuring instrument to quantify that range. To achieve the maximum range, passive forces, the force generated from an external source, are required.
Dynamic flexibility. This type of flexibility is a measure of overall joint stiffness during movement. Unlike static flexibility, dynamic flexibility requires active force production, or your own muscles contracting. Because quantifying “stiffness,” is difficult, dynamic flexibility is measured more subjectively. Assessment is based on how easy or difficult it is to perform certain tasks, such as swinging a tennis racket, climbing steps, or getting in and out of a car.
The aim of any good stretching program is to improve both static and dynamic flexibility so that normal range of motion (ROM) can be achieved. The definition of normal in this context is one developed from population studies that measured various areas of the body and established an average degree of movement for a particular joint.
Benefits of Flexibility and Stretching
Regular stretching provides many benefits, the most important of which is simple: flexibility provides freedom of movement and the ability to complete activities with greater ease and lower risk of injury or discomfort.
Healthy Joints and Pain Management
Many adults report pain and stiffness in joints. The number increases dramatically with age, and women are more likely to develop joint symptoms.
For adults, arthritis is one of the most common conditions, with approximately half of people 75 years and older diagnosed with arthritis.
Regular exercise, including stretching, is essential for people with arthritis to maintain function and manage joint pain. Even for those not affected by joint conditions, stretching increases joint mobility and function, and decreases joint stiffness and pain.
Imbalances in the muscles can cause discomfort and pain. For example, if the front of a person’s thighs and hips gets too tight from a lack of flexibility, the tension will pull on the hips, where the muscles are attached. The result is the pelvis may be pulled forward and cause greater sway in your lower back. This affects posture and can eventually lead to pain and stiffness in the neck, shoulders, and lower back. Stretching all major muscle groups and joint areas regularly promotes good alignment and balance.
Muscle Relaxation and Stress Relief
Staying in one position for long periods of time, repetitive movements, and other everyday stressors can result in stiff muscles and knots, also called trigger points. Regular stretching decreases anxiety, blood pressure, and breathing rate, which help to relax muscles and aches and pains related to neuromuscular tension (stress). Flexibility exercises have also been prescribed successfully to treat dysmenorrhea, which is painful menstruation. It also relieves muscle cramps that can occur during exercise or participation in sports.
In addition to the benefits listed above, research has documented additional benefits that provide good reasons for maintaining a routine of stretching.
Increased Blood Flow. Blood carries vital nutrients and oxygen to muscles and tissues. Stretching increases blood flow to the muscles being stretched, which helps them recover from exercise faster.
Reduced Risk of Developing Future Lower Back Pain. Although research is still inconclusive, most experts agree that muscle fitness and stretching exercises reduce the risk of developing lower back pain by counteracting the natural loss in muscle and connective tissue elasticity that occurs with aging.
Flexibility and Aging
For many college students, maintaining long-term flexibility is not a concern. For young adults, bending over to tie their shoes is painless. Walking around campus with a backpack requires minimal effort. However, ROM declines with age. Simple activities like rotating the head and neck to glance over the shoulders, getting in and out of a vehicle, or carrying groceries can become painful. Therefore, flexibility is critical in maintaining a high quality of life throughout the aging process.
The Inactivity-Mobility Cycle
Anyone who has suffered an injury and had to wear a splint, cast, or brace to immobilize a joint knows how important mobility is to overall health. Unfortunately, when ROM becomes restricted by arthritis or other injuries, activity declines. As activity declines, ROM continues to diminish as a result of inactivity, and a vicious cycle ensues. A simple stretching program can help alleviate this problem and break the cycle.
Improving Range of Motion
Joint ROM results from a combination of factors, which are classified as either internal or external. Internal structures relate to the physical structures of body tissue. External factors are non-structural and include gender, age, excess fat mass, muscle mass, environmental temperature, and restrictions in clothing or equipment.
Internal factors include joint structure/joint mechanics and the connective and soft tissue surrounding the joint. Because muscular actions, such as muscular contractions and stretching, are controlled by the nervous system, another internal factor can be attributed to the neuromuscular system and how the stretching and tension is managed.
A joint is defined as a location on the skeletal system where two or more bones intersect and interact. For example, the humerus (upper arm) intersects with the radius and ulna (lower arm) at the point of the elbow. The bony formation of each joint structurally limits its ROM. For example, the shoulder joint, which is structurally a ball-in-socket joint, can rotate in multiple directions, giving it a wide range of motion. However, the knee joint is a modified hinge joint, which is limited to essentially a forward-backward direction of movement.
Additionally, ROM may be limited by excessive fat mass or even large muscle mass surrounding a particular joint. Although the amount of muscle mass and fat mass surrounding a joint can be altered by diet and activity levels, joint structure is permanent. As a result, little can be done to improve flexibility in this area.
Not only is range of motion related to the joint structure, but flexibility exercises are joint-specific. Stretching the hamstring will not improve flexibility in the shoulders. Likewise, flexibility in the shoulders may be excellent while fingers or ankles remain “stiff.” As such, a complete and effective stretching program includes multiple stretches for various joints.
Connective and Muscle Tissue
Joints are surrounded and connected by muscles, tendons, ligaments, and skin. The head of the humerus fits into a small cavity to create the shoulder joint. However, those bones cannot remain in that position without the muscles, tendons, and ligaments that keep the joint tight and hold it in place. In addition, muscle tissue is surrounded with connective tissue, primarily collagen and elastin. As a joint moves through its normal range of motion, all of this soft tissue must stretch to accommodate the movement. Therefore, static and dynamic flexibility is probably most limited by the flexibility of the surrounding soft tissue, specifically the connective tissue.
While the exact mechanisms of how flexibility is changed is not well understood, they do appear to be related to the elastic and plastic properties of the connective tissue. Elasticity is defined as the ability to return to resting length after passive stretching (i.e., elastic recoil). Like a spring, soft tissues stretch and then recoil to their resting position. Plasticity is the tendency to assume a greater length after passive stretching (i.e., plastic deformation). Stretching that spring composed of soft tissues will change its resting position to a new longer length. The goal of a flexibility program is to repeatedly overload the elastic properties of the muscle to elicit plastic deformation over time. Experts suggest that a slow, sustained stretch for 30–90 seconds is necessary to produce chronic plastic deformation.
Modern cars come equipped with a central computer and sensors to troubleshoot problems with the vehicle. Sensors in the engine monitor temperature. Sensors on the wheels gauge tire pressure while sensors in the gas tank alert the driver when fuel is low. Much like a car, our bodies are equipped with sensors, called proprioceptors, that help us manage movement and prevent injury.
Muscles have two specific types of proprioceptors that determine the length and tension of the muscle. These proprioceptors are called muscle spindles and Golgi tendon organs (GTOs).
Muscles spindles lie parallel to the regular muscle and help determine the length of muscles when they are being stretched. When a muscle is stretched, it sends signals to the central nervous system causing the stretched muscle to contract. This resistance to the stretch, called stretch reflex is generated by the nervous system’s reflexive stimulus sent to the stretching muscle. That same signal also causes the antagonist, or opposing muscle to relax, called reciprocal inhibition. As such, when the upper thigh (quadriceps) are stretched, the hamstrings (antagonist to the quadriceps) relax.
The Golgi tendon organs (GTOs) are located near the muscle-tendon junction, the end points of the muscle, and relay messages to the central nervous system regarding muscle lengthening and tension of the muscle. When activated, these signals will override the stretch reflex causing a sudden relaxation of the stretching muscle. This is called autogenic inhibition or the inverse myotatic reflex. This inhibitory reflex can only occur after the muscle has been stretched for 5 seconds or longer. This is why, to effectively stretch, movements must be sustained for long, slow increments of time. Otherwise, the resistance encountered from the stretch reflex will not be overridden and lengthening cannot occur. Whether signaling the muscles to contract or relax, the neuromuscular system manipulates the stretched muscle, presumably as a protective mechanism to prevent injury.