For both the prevention and treatment of acute, recurrent, and/or chronic “hamstring pulls”, “hamstring tears”, etc. the recommendation of medical, rehab, and training professionals (as well as the common knowledge of the populace) is “you need to stretch them”!

The irony (and shear lunacy) is that stretching the one thing that athletes, especially injured ones do more than anything else! Before, during, and after a game; before, during, and after training; before, during, and after practice; before, during, and after cardio; before, during, and after lifting; before, during, and after rehab sessions. The world of medicine and rehab is committed to “evidence based practice”, yet they are ignoring the only vital and valuable evidence… the responses of the individual in front of you! Yes, it’s anecdotal. But the recommendations to stretch have neither empirical or anecdotal evidence. Only tradition.

“It is historical continuity that maintains most assumptions,
not repeated assessment of their validity.”
-Edward de Bono

“Although the human mind likes to believe that it is ‘of course’ dedicated to truth,
in reality, what it really seeks is confirmation of what it already believes.”
–David Hawkins, MD, PhD

“It is human nature to support our current positions rather
than modify, expand, or reverse them.”
-David Hawkins, MD, PhD

Let’s explore:

The correlation is undeniable. It is probably safe to say that virtually everyone with what we might call a “hamstring issue” of any degree is concurrently engaging in some form of stretching. Realize that correlation does not imply causation. It is simply “a relation existing between phenomena or things or between mathematical or statistical variables which tend to vary, be associated, or occur together in a way not expected on the basis of chance alone” (Merriam-Webster).

Restated, stretching and hamstring issues appear to co-exist. And within this correlation we seem to only see this relationship as “the hamstring issue is the reason we stretch”. Yet we seem to ignore that virtually every athlete who developed a hamstring issue was already stretching… as prevention. We don’t seem to question whether or not the treatment is ineffective, and we certainly never even wonder, much less explore, if it’s possible that stretching (or the way it was performed) was one of the influences that precipitated the injury (rarely is there ever just one, lone cause for anything; it’s often the proverbial perfect storm).

In virtually any other discipline (engineering, electronics, sociology, et al.) a reasonable person would recognize the existence of such a correlation… AND QUESTION IT! Very few are willing to question a belief system due to the risk of it being wrong… which would in turn make them wrong. The ones that willingly question such beliefs are those that have not intertwined their identities with the information and have no allegiance or emotional attachment to anything they’ve learned or done (e.g., Galileo, Semmelweis, et al.). Similarly, we are attached to massage, ice, heat, foam rolling, etc. despite the lack of evidence of a direct physiological effect (vs. indirect physiological responses to sensations and perceptions). 

Further exploration:

Perspective via principles
“Stretch” is commonly associated with the property of elasticity… it’s “stretchy”. Elasticity is by definition “the ability of a material to immediately deform under stress, and upon its removal, immediately return to its original shape.” Every tissue has a varying coefficient of elasticity (stretchiness; capacity to deform and return) based largely part upon the composition of the material or tissue and which is hopefully consistent with the role that it plays in mechanical function both locally and/or grossly.

Consideration #1: Improving range of motion
Laymen and practitioners alike seem to think one of the purpose for stretching is to “lengthen tissue”. Which tissue? And relative to ROM the hope often is that if range increases in the very short term, that it will remain for the long term. Wait… so in essence the goal is to reduce or eliminate the elasticity of the tissue? We no longer want it to return, but to deform and stay? We no longer want it to function normally? No matter how small a tissue’s coefficient of elasticity (and while it varies in our tissues, it is generally very small), the degree of elasticity is required in order to do its job. So let’s reconsider that one.

Consideration #2: Reducing tension
Active tension is produced by muscle (as opposed to passive tension which is imposed within connective tissues). Tension production is “orchestrated” by the brain and/or reflexive mechanisms. Either way it is stimulated by electrical excitation producing microscopic “crossbridges” (all of this is painfully oversimplified). The more connections (related to crossbridging opportunity and excitation) the more tension that may be developed. Ultimately, tension is employed to produce movement… or prevent further movement… or prevent any movement at all.

Somehow we have come to see unexpected, uncomfortable, or motion-hindering tension as pathological and wrong, as if the body screwed up. Certainly there is tension associated with CNS pathology like cerebral palsy, etc. But it seems we childishly never consider general muscular tension to be purposeful, because we don’t like it. We might want to consider it not only a key to movement, but also a key to protection. So maybe in this way we view the annoyance and a symptom, for which we should consider exploring what requires the protection, rather than blindly imposing our wills and attempting to eliminating it through direct means.

It seems that directly addressing the tension all too often leads the body reinstate it a few hours later if it’s still required. Conversely, identifying and addressing the source will often alleviate the need for tension and indirectly alleviate the tension itself as it is no longer required. (It should be noted that that time period is rarely immediate and not up our desires and expectations, only the effectiveness of and response time to our efforts to manage the cause). So maybe we stop imposing our wills, stop beating the shit out of things, and learn appropriate progression as well as its signs, and maybe internal protection will no longer be required?

Consideration #3: “Acute conditioning”, “preparatory regulation”, and “current settings”
“Acute Conditioning” describes the relatively short term response to a current activity or lack thereof. Sitting for periods of time encourages an appropriate reduction in available muscle lengths to meet the current needs/requirements.

“Preparatory Regulation” is way of describing the purpose of acute conditioning. Consider the toll if your body were to remain in a constant state of readiness for any activity or challenge of any form or severity. Heart rate elevated, neurological activity heightened, hormones, etc. all prepared to immediately produce maximal muscular response. Not very energy efficient. If energy of every form is drained, then how prepared are we? It is more efficient to make short term adjustments in those factors that are consistent with the current needs.

This regulation of internal readiness in essence prepares us for more of what we’ve been doing, whether that be a down-regulated state or an up-regulated state. This creates our “current settings” of muscular tension and length availability, heart rate, nervous system function, endocrine function, etc. Additionally, protective tension would likely influence the settings as part of an involuntary preparation to protect… just in case you hop up.

So back to the sitting for which you have been “reset”. Does it require aggressive stretching or simply revisiting former ranges, i.e. resetting things. Cats and dogs do it when they get up from a nap, and people do it upon awakening aw well. That first morning movement is often called “stretching”, but is simply active movement to the full available active ranges to “reset” tensions, etc.

So with that in mind, what about “warming up” for a greater challenge like a workout or competition?

Consideration #4: “Progressive preparation for challenge” (or activity)
First of all, let’s get rid of the limited vision, irrelevant term “warm up”, okay? Heat is not the goal. Blood flow is not the goal. Those are products of our motors/muscles being serviced and our internal temperature being regulated. A “warm-up” should be considered for its influence in preparing neuromuscular function (contractile readiness) as well as the orchestration of contraction, in other words, preparation for tension development and the organization thereof.

The lengthening of a muscle that is producing tension alters the available overlap for crossbridging and therein is a reduction in tension (commonly termed eccentric; introducing various degrees of relaxation). Furthermore, when stretching to increase “range of motion” and/or warm up we are commonly encouraged to “try to relax”… to let go of the residual muscular tension from previous activity… or even protection (?). But consider the basic rationale here: prepare for greater muscular demand/challenge by attempting to reduce tension. And the reduction is imposed… artificial if you will, meaning not in response to the body’s own assessment of changing requirements or needs for protection. It seems as though preparation for activity might be best achieved via activity that is appropriately progressed from the current state of rest, step by step, up to the level of that required of the upcoming activity. To borrow a term that I normally find misused and misinterpreted… encouraging a reduction in tension to prepare for developing tension is not remotely “functional” in any sense of the word.

Consideration #5: Injury prevention
Why do we think lengthening tissue will prevent injury? Muscle’s tear mid-range all the time. Of my three hamstring tears two were mid-range concentric with the lightest weight of the day. The other was actually during stretching… and I have always had “normal” (or “better than”) “hamstring flexibility”. Not scientific, but true.

Misinterpretation #1: Am I saying stretching is bad?
Of course not. But it seems that most people are too lazy, don’t have the intellect to get beyond an “either-or”, have no ability to make contextual and detailed decisions and adjustments in application, or they have been so conditioned by a “team” mentality that they demand all information in the form of “good for you” or “bad for you” with no awareness of the vast variety of scenario specific circumstances influencing outcomes.

As with any form of exercise or imposition of force on the body the keys are: who is being stretched? What is the goal? HOW are they being stretched? What are the individual’s range influencing barriers in this specific joint in this specific direction? What is the current status of the joints? What is the current status of the tissue? What are the current protective requirements that the nervous system has put in place? And why the hell would we blindly following tradition and people who don’t ask these questions?

Misinterpretation #2: “Purvis doesn’t like stretching”
Start by re-viewing misinterpretation 1. Then say this over and over until you live it: “Like” and “dislike” have absolutely nothing to do with what a professional recommends to or utilizes for another person. Personal preferences are entirely irrelevant! If you can’t do this, do not counsel others. Only the needs of the individual matter!

The ultimate and primary question: What is “stretching”?
How? How aggressive? How is it progressed? And its name (branding) means and tell us nothing!
There are approximately six general factors that can and should be manipulated in any exercise, and stretching is no exception. And under each of these are numerous decisions and adjustments to be considered and strategically explored, all of which can’t even be considered without the answers to five questions that require ongoing investigation to answer.

Without getting side tracked in these topics, it’s safe to say most “experts” have a very limited perception of the expanse of issues and options, not to mention the tremendous skill required in implementing any of them. And we mustn’t ignore the professional responsibility and liability of imposing forces, ranges, etc. without awareness of the details and individual considerations.

In the end there are about a couple dozen ways to do what people should stop calling “stretching.” Why stop? Because the word conjures up mental images and protocols that have limited and biased our experiences. Experiences that do not include skilled thinking or questioning, rather blind following of those who are also biased either for or against something. The substitution of marketing sound bites and neat, simple packaging for real education and the wisdom to apply it, creates a facade of knowledge.

What I might do now to satisfy the goals for stretching is not based upon what I learned in PT school 35 years ago, nor on any of the articles and journals I’ve read, nor upon the continuing education and conferences I’ve attended over the decades, and certainly not on the latest trendy marketing crap. It’s based upon what I’ve learned through relentless questioning, trial and error (including details that are the opposites of what I learned), and having no allegiance to anything except the outcomes of the individual … and if you observe, you wouldn’t consider to be stretching at all!