Stretching: The First Line of Defense Against Injury and Pain

Pain is a very persistent symptom and often the main motivator for patients to seek rehabilitative care such as physical therapy, occupational therapy, or athletic training. In fact, pain that becomes more persistent throughout the day and begins to cause sleep disturbances is frequently acknowledged in evaluations as the tipping point for seeking treatment.

When the general population thinks of rehabilitative care, they understandably think of strengthening. Therefore, a large percentage of patients seeking rehabilitative care for their persistent pain automatically assume they need to strengthen around the joint, muscle group, or area of pain. While this is an admirable perspective, pain and symptoms should first be targeted with an often overlooked treatment: stretching.

The Source of Pain & How Stretching Helps

Pain stemming from a musculoskeletal source is likely due to:

• Tendonitis caused by overuse and an imbalance in work and rest
• Peripheral entrapment in tight muscles or connective tissue
• Soft tissue tension
• Neural tension

While strengthening may be beneficial down the road to prevent a recurrence of symptoms, especially if the activity is one that will be continued, stretching the tense, painful areas should be the first line of defense. Stretching relieves muscle tension, neural tension, and tension on entrapped nerves while also easing cramping and assisting the proper alignment of newly formed collagen fibers into a mature pattern. In most cases of pain, stretching will decrease tension and discomfort.

Think of the process of tearing down muscle through therapeutic stress and the subsequent repairs as similar to Lucy and Ethel trying to keep up with chocolates on a conveyor belt in the television show, “I Love Lucy.” When the conveyor belt starts moving too fast, they are no longer able to keep up with the pace. When a muscle has a heightened demand placed on it and repair mechanisms are not able to keep up with that demand, degeneration takes place.

Common Stretches to Address Pain

So what are some common stretches that are beneficial to most patients? Some that I prescribe most often are:

• Standing Upper Trapezius Stretch
• Standing Lower Cervical and Upper Thoracic Stretch
• Doorway Pec Stretch at 90 Degrees Abduction
• Standing Thoracic Flexion and Rotation with Swiss Ball
• Seated Piriformis Stretch with Trunk Bend

Upper traps engage when we’re stressed, cold, handling heavy loads—you name it. Stretch them out! See the Standing Upper Trapezius Stretch below.

We work our paraspinals hard all day, especially isometrically while working on computers. Give them some relief with the Standing Lower Cervical and Upper Thoracic Stretch below.

No matter your patient’s job or the physical requirements of their day, their anterior muscles are likely tight from overuse. Stretching them regularly is a great way to maintain muscle balance. Have your patients grab the nearest doorway for a quick and easy stretch, like the Doorway Pec Stretch at 90 Degrees Abduction stretch below.

Fatigued and irritated lumbar paraspinals are a frequent complaint that drives patients to seek care. I frequently coach patients in stretching them out with the Standing Thoracic Flexion and Rotation with Swiss Ball stretch below. Instruct your patients to imagine there is no ball in front of them. Hang over each leg, with or without support depending on symptom severity.

Posterior hip tightness, with or without sciatic compression, is a very common complaint and easily managed with the Seated Piriformis Stretch with Trunk Bend stretch below, done any time, anywhere, without equipment.

You can find all these stretches and more in MedBridge’s Home Exercise Program (HEP) Builder. Consider using MedBridge to create a personalized stretching plan as a first step to reducing pain for your patients.

Let’s not forget how much stretching, especially as a first line of defense, can do!