Flexibility vs. Mobility

As a practitioner, it is my job to assess if a person has limitations in their range of motion, and what I think those limitations are coming from.
1. Is it from the muscles and other soft tissues?
2. Is it from a bony-based restriction?
3. Or is it from adhesions (stickiness of material) in the joint?
Once I figure this out then I can treat you appropriately including soft tissue therapy, rehabilitation, mobilizations and adjustments.
I won’t go into all therapies during this blog post, but today I want to spend a bit more time talking about stretching, flexibility, and mobility. Stretching is used to treat musculature contractures.
Tight muscles are more likely to become strained. They become more painful, weak, and damaged.
When you stretch a muscle, it has been found that the length gain effects of the muscle last only a short time (studies have shown less than approx. 20 min of effect after the last stretch).
The temporary length gain of the muscle from stretching has also not shown to reduce injury, because it does not lead to changes in muscle elasticity (i.e. there is no force dampening), it just improves the stretch tolerance of the muscle.
In regards to this stretch tolerance, it is the nervous system allowing the muscle to lengthen for a short time, not the actual stiffness or work absorption of the muscle that is being affected through the stretch.
“To be effective, a stretching program must elicit permanent changes in the physical properties of the muscle.” To truly improve flexibility this “…can take months of daily stretching to produce the necessary physical changes.”
Soft tissue therapies can improve flexibility. They are especially important after muscle tear occurs (because tearing then goes on to create scar tissue)… breaking down this scar tissue allows the muscle to function more like it did prior to injury.
Foam rollers and other self massage tools may also help in creating flexibility. Use these before stretching.
COMMON QUESTIONS AND ANSWERS:
1. What type of stretching is best? Research does not show 1 form is better than another, however when doing PNF type stretching (explain what this is) it is recommended not to go to maximum resistance as they can “…tighten the muscle by producing a lingering after-discharge that may detrimentally affect muscle tension…”
2. How long should I hold my stretches? This is debatable but a study has shown that no length gains occur past 30 sec so I tell patients between 20-30 seconds of hold.
3. Should stretching be done to the point of pain or just tension felt in the muscle? This is still debatable but clinical outcomes have been more poor in those that put participants to the point of pain.
All in all I would recommend stretching daily and consistently if you want to improve flexibility, holding stretches for 30 seconds or less, and going to a point of tension (maybe a bit past this but it may or may not be necessary), and mixing it up (passive, active, PNF based, controlled ballistic, etc) This way you are covering your bases, and all of this is getting the body moving and taking control of your health, which is always my number one goal with patients.
It has been said that home rehab compliance is a mere 35%, so one has to be very diligent in their stretching to improve their flexibility.
One has to be careful about becoming too flexible, because though flexibility may reduce one’s risk of injury, plus it can be inefficient during body movement.
Why? Because “…stiff muscles store and return energy more effectively…”
Flexibility can also be detrimental in terms of injury risk, because stretching may affect the muscle spindles (sensors in the muscles that detect changes in muscle tension) thereby causing potentially reduced coordination, leading to injury.
Therefore, a stretching program to increase flexibility has been recommended to be used only when it is clinically justified. This is either when there are “…tightness asymmetries following injury and/or when a specific muscle is so stiff it produces a compensatory movement pattern.”
“If the goal of stretching is to improve muscle resiliency prior to exercise, then an active warm-up in which muscles are moved through progressively larger ranges of motion is recommended.”
My focus as a practitioner is usually to promote mobility in my patients.
Dr. Andreo Spina’s definition of mobility is as follows:
“By my definition, mobility and stability are intimately related. Mobility, which is often confused with “flexibility,” can be defined simply as the ability to move or to be moved freely and easily. Another way to think of it is the ability to actively achieve range of motion. Flexibility by contrast is the ability to passively achieve range of motion. It is therefore possible to be very flexible, however have limited mobility. The former implies that you can passively achieve a particular range, while the latter implies neurological control of a particular range as it is being actively attained.”-Spina: http://www.beyondstrengthperformance.com/interview-with-dr-andreo-spina
To put this in the most simple terms, mobility = “flexibility + strength” –Spina https://www.youtube.com/watch?v=4nf-BWJF_p4
“Mobility represents the physical limits of motion, while stability ensures that those limits are maintained.” -Spina
http://www.beyondstrengthperformance.com/interview-with-dr-andreo-spina