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Microstretching-A practical approach for recovery and regeneration.


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Intense training and competition regularly expose the athlete to stresses and strains exceeding the normal capacity to recover. Making sure of recovery and subsequent regeneration is an integral part of maximising the ability to perform and should be the basis for planning in the training programme. microStretching is a recovery-regeneration technique of the connective tissues. It is a comprehensive approach involving the neural, endocrine, and immune systems. The fundamental aim is to correct any negative physical changes created by training loads and previous injuries. After an extensive background section, which includes an outline of how microStretching addresses the micro-trauma and inflammation created by intense physical activity, the author provides an explanation of the practical application of microStretching based on the practice at his clinic in Canada. He then gives detailed descriptions of seven key stretches used in microStretching. This is followed by two case histories, which are practical examples of how coaches, medical support personnel or athletes might use microStretching guidelines and stretches to develop a recovery and regeneration programme.
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New Studies in Athletics · no. 1/2010
© by IAAF
raining an athlete is a complex ende-
avour. It involves the stimulation and
development of numerous allostatic
systems and their relationships to the parame-
ters of training (physical, tactical and mental),
to the variables of training (intensity, volume
and density), and to recovery. Allostatic refers
to allostasis, a term that describes the various
neurobiological processes in an organism and
how they adapt to change and maintain the
homeostasis of the individual. It is directly rela-
ted to the wear and tear (catabolism) and reco-
very (anabolism) of the body.
Intense training and competition regularly
expose the athlete’to stresses and strains
exceeding the normal capacity to recover.
Making sure of recovery and subsequent
regeneration is an integral part of maximi-
sing the ability to perform to the best of the
athletes potential and should be the basis
for planning the training programme. mi-
croStretching® is a recovery-regeneration
technique of the connective tissues. It is
a comprehensive approach involving the
neural, endocrine and immune systems.
The fundamental aim is to correct any ne-
gative physical changes created by training
loads and previous injuries. After an exten-
sive background section, which includes an
outline of how microStretching® addresses
the micro-trauma and inflammation crea-
ted by intense physical activity, the author
provides an explanation of the practical
application of microStretching® based on
the practice at his clinic in Canada. He then
gives detailed descriptions of seven key
stretches used in microStretching®. This is
followed by two case histories, which are
practical examples of how coaches, medi-
cal support personnel or athletes might use
microStretching® guidelines and stretches
to develop a recovery and regeneration
25:1; 81-97, 2010
Nikos Apostolopoulos is the founder of
stretch therapy and microStretching®. He is
the director of the Serapis Stretch Therapy
and microStretching® Clinic in Vancouver,
British Columbia, Canada. He graduated
from the Faculty of Physical and Health
Education at the University of Toronto with
an emphasis in Sports Medicine. He is a re-
search fellow with the International Colla-
boration On Repair Discoveries (ICORD®),
a member of the International Association
for the Study of Pain (IASP) and the Inter-
national Society of Exercise and Immuno-
logy (ISEI).
microStretching® -
A practical approach for
recovery and regeneration
by Nikos Apostolopoulos
New Studies in Athletics · no. 1/2010
ture, function, physiology and behaviour. This
process places a great demand on the athlete.
The patterns may be tentative at the begin-
ning, however if advantageous and beneficial
in maximising the athlete’s performance, be-
come inherent and intuitive. This evolution is
correlated with changes in connective tissue,
blood physiology, metabolism, the endocrine
system, nerve circuits and the brain’s cortex.
Proper training is a multi-level process,
which includes analysis of patterns and their
effectiveness with regards to the transfer of
energy (“E”). By “E” we are referring to kine-
tic as well as potential energy, the “E” for an
athlete to successfully compete in his/her cho-
sen milieu. Training can be loosely defined as
a pseudo-evolutionary process, determined by
the repeated cycles of catabolism and anabo-
lism. These cycles are transient in nature, un-
stable and ever changing, with the sole purpo-
se of refining the physical development of the
athlete. In short, the mechanisms responsible
for the development of the athlete, physicaly,
mentaly and emotionaly, are in essence a pat-
tern of how “E” is efficiently created and trans-
ferred throughout the body.
An athlete is trained to develop and distribute
“E” in a fluid-efficient manner. In fact, we might
ask what is possible with this available “E” and
how is it distributed in order to process and
create movement? The answer lies in the con-
cepts of adaptation and recovery. From an early
age, an athlete is exposed to a plethora of phy-
sical patterns slowly transforming the body to
specific movement patterns established in res-
ponse to the efficient coordination and integrati-
on of connective tissue and the nervous system.
Connective tissue adaptation to physi-
cal stress is significant for normal function
and development. Proper recovery of this
tissue during and after training is essential
for a seamless increase in the level of fitness
and performance. Maximal performance de-
pends on a balance between the adaptation
to “physical exertion” and “recovery”. If training
produces an imbalance between these two
parameters, athletes will show symptoms of
over-training and an impaired coordination of
the musculoskeletal and nervous systems, po-
tentially creating micro-trauma to the muscu-
Recovery is of particular interest. Intense
training and competition regularly expose the
athlete’s body to stresses and strains excee-
ding the normal capacity to recover. Making
sure that recovery and subsequent regenera-
tion (Rec-Reg) take place effectively is an in-
tegral part of maximising an athlete’s ability to
perform to the best of his/her potential. It is
well known that here have been, and continue
to be, attempts to shortcut this process with
illegal methods that jeopardise the athlete’s
health as well as the purity and integrity of
sport. Therefore it is important that coaches
and others who support athletes be given
techniques to promote Rec-Reg that are both
effective and ethical.
The mentality in the past has been that
Rec-Reg is part of training. However, it is now
viewed in a different light, particularly at the
microStretching® Clinic. The new view is that
proper Rec-Reg ensures the restoration of the
connective tissue, making maximal perfor-
mance possible, and that the quality of Rec-
Reg actually determines how the parameters
and variables of training can be modified. In
other words, the planning of training cycles
(micro-, meso- and macro-) is based on the re-
sults of Rec-Reg and not the other way around.
microStretching® is a Rec-Reg technique
of the connective tissues, specifically the os-
seoligaments, tendons and muscles1. It is a
comprehensive approach involving the neural,
endocrine and immune systems. The manipu-
lation of these systems determines the integrity
of the connective tissue.
The purpose of this article is to provide
an explanation of the practical application of
microStretching® and, in particular, to de-
scribe seven key stretches in detail. An un-
derstanding of the principles and guidelines
microStretching® will help coaches and athle-
tes to develop a suitable Rec-Reg programme,
one focused on proper muscle adaptation and
minimising the catabolic effects of training.
The acquisition of movement skill begins
by introducing the athlete to new physical pat-
terns, involving a complex interaction of struc-
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
needs to be given to the adaptation of the
connective tissues because of their extremely
long recovery times (specifically tendons and
ligaments) as well as a balance between the
antagonists and synergist muscles. Otherwise,
a compromised system could develop due to
a heightened imbalance between the discre-
pancies amongst the connective tissues with
respect to the load demand.
microStretching® is a systematic recovery
routine, a passive flexibility technique develo-
ped in response to changes in the biological
condition of the athlete and the general ba-
lance of the metabolic processes. The adap-
tations of the connective tissues cannot be
stored. They are specific changes due to cata-
bolism – the realm of the SNS - and anabolism
– the realm of the PNS. If an athlete is loaded
too quickly or is injured, the associated abilities
will begin to grow weaker as they are not used
regularly. In other words, without proper reco-
very the benefits of adaptation are minimised
both at the micro and macro levels.
microStretching® deals with the clinical ma-
nifestation of training stress, and how it affects
the allostatic systems - the cardiovascular, im-
mune, endocrine, neural and musculoskeletal
systems - manifested by the development and
perpetuaion of inflammation. The fundamental
aim of microStretching® is to correct any ne-
gative physical changes to the athlete’s body,
created by training loads and previous injuries
thereby diminishing inflammation.
The specificity of training defines the deve-
lopment of the physical parameters that the
athlete needs to perform. Likewise, the speci-
ficity of the Rec-Reg programme enables the
athlete to best prepare for the ensuing training
load(s). This cooperative is critical and needs
to be developed at a young age. By coopera-
tive we are referring to the existence of some
feedback loop, the interaction of the athlete
with his/her physical state and how a change
to this state changes the interaction. This is
auto-informative, establishing unification bet-
ween effort and result.
The stretching protocol used as a pre- and
post-method of preparation for physical exerti-
on has changed little over the years. The main
loskeletal system. Micro-trauma is defined as
fatigue failures, that is failures in response to
repetitive stress or strains. The pathogenesis
of these is in direct response to an increase in
intensity and functional load and a decrease in
recovery pre-, intra-, inter- and post-exercise
and training.
Cumulative micro-traumas lead to inflamm-
atory responses due to localised damage to
muscle fibre membranes and contractile ele-
ments. These responses result in an allostatic
load, the constant wear and tear of the body
without any relief. This load may be as a result
of a single forceful mechanical event, such as
lifting, catching or jerking during a maximal lift,
or an accumulated strain associated with less
forceful but repetitive loading of the musculos-
keletal structure.
Two physiological systems playing a promi-
nent role in allostasis are the autonomic ner-
vous system, which comprises the sympathe-
tic nervous system (SNS) and parasympathetic
nervous system (PNS), and the Hypothalamic
Pituitary Adrenal (HPA) axis. If stimulated in a
positive or negative manner, the result may be
a pathophysiological consequence leading to
the process of “habituation”. If the habit for-
med is beneficial, the athlete will maximise his/
her performance; however, if the habit is inade-
quate and thereby stressing the body, a com-
pensatory response will occur, perpetuating a
negative load. This influences the development
of a functional movement pattern determining
how “E” will be generated and transferred for
the maximal execution of a movement.
Proper distribution of the parameters and
variables of training and recovery serve as a
blueprint for the development of form and
function with the intention of maximising the
development and efficient transfer of “E”. The
regular use of a proper recovery routine can
correct departures from the normal course of
the health of the connective tissue.
Knowledge of the connective tissues and
their function, the action of the agonists and
antagonists muscles, as well as joint structure
and function is necessary for a complete as-
sessment of the athlete. In order to maintain
physiological homeostasis, special attention
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
The variables of training (Table 1) are used to
define the execution of the microStretching®
exercises described below. The aims and ob-
jectives of the athletic disciplines determine the
order while the correct selection of the exer-
cises ensures the unrestricted development of
the potential of the athlete.
Table 1: Summary of the training variables of
Training Explanation
Intensity 30% - 40% of a maximum
perceived stretch
(very light gentle stretch)
Volume Each stretch should be held
for 60 seconds
Density Each stretch should be re-
peated 3 times per muscle
group a minimum of once
per day
As mentioned above, training can create
trauma. Intense training can stimulate the SNS,
the system of mobilisation and action. This
sympathetic mediated experience is respon-
sible for increased tension in the musculoskel-
etal system, preparing it for activity. The SNS is
also activated when an individual creates pain
and discomfort, as the body’s mandate is to
remove itself from such a stimulus. Therefore,
it makes no sense to stimulate the SNS when
an athlete is trying to recover and regenerate.
The first training variable (intensity) pertains
to the subtle manipulation of the SNS. When
an athlete is microStretching® the sensation
should be as if he/she is placing a hand in lu-
kewarm water. This metaphor is the closest
definition of the intensity of the microStretch
exercises. Remember, the mandate is to re-
lax the SNS thereby activating the PNS - the
system of recovery and healing. Objectively,
on an intensity scale of 0% (no stretch sensa-
tion) to 100% (aggressive pull sensation) the
microStretch should be between 30% or 40%.
feature is the use of active static stretching
after a dynamic aerobic warm-up. Coaches
and athletes have been led to believe that this
manner best prepares the body for the ensu-
ing activity or activities. In fact, no definitive
approach has really been established and the
accepted protocol was adopted without any
Often, we see that after performing a proper
dynamic aerobic warm-up, coaches and ath-
letes make a mistake by introducing an active
static stretch routine. The issue with such a
practice is the relaxation of the nervous sys-
tem. After investing time and effort to excite the
nervous system and subsequently the musc-
les, it makes no sense to calm them down.
Another practice that can be questioned is
the passive stretch routine trainers use on ath-
letes prior to an activity. The intensity of such
stretching is aggressive causing pain and dis-
comfort. This results in an increase in motor
unit recruitment, which in turn increases the
sensitivity of the tendon. More importantly, it
will stimulate the SNS resulting in a somato-
sympathetic response to pain arising from the
stimulation of receptive nerve endings in deep
tissues, including limb muscles and joints.
So, how can we best prepare the athlete?
The answer resides within the interrelation-
ships of the musculoskeletal and neural, endo-
crine, cardiovascular and metabolic systems.
The muscle-tendon units are complex biolo-
gical actuators. They generate force in order
to move, stabilise joints and absorb energy.
These units are highly adaptable to changes to
environmental stimuli. Their adaptability deter-
mines their preparedness.
microStretching® and its Application
To use microStretching® correctly, it is vital
that coaches and athletes familiarise themsel-
ves with its concepts and guidelines. There-
fore, a brief synopsis principles and stages
will be given here. This will focus on the major
muscle groups in the lower body that are im-
portant to the proper execution of athletic dis-
ciplines (for a more thorough explanation see
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
ferred to as an aerobic flush (AF). This prepares
the athlete for the ensuing stretching exercises.
We have noticed maximal benefit from mi-
croStretches when the athletes held each
stretch for 60 seconds, repeated three times
per muscle group once per day. This anecdo-
tal evidence has been confirmed empirically in
a study by FELAND et al. (2001)4. The authors
compared the duration of 15, 30 and 60 second
passive stretches repeated five times per mu-
scle group. The subjects using the 60-second
stretches showed the greatest gain in range of
motion (ROM). If the stretch is held for longer,
an increase in tension due to the Golgi Tendon
Organ’s sensitivity to local tension may result in
an increase in the contracting motor units affilia-
ted with a fatigue response during the stretch. In
other words, the athlete will feel tighter holding a
stretch for more than 60 seconds.
The difference between the study protocol
and the recommendation at the microStret-
ching® clinic is that the athlete is only required
to repeat each stretch three times, the issue
being one of compliance. We are aware that
athletes will often neglect the Rec-Reg portion
of their programme, unless they are recovering
from an injury. They often complain about how
mundane, boring and monotonous the stret-
ching can be. Coaches and support personnel
need to make their athletes aware of the im-
portance of Rec-Reg with regards to muscle
adaptation and maximal performance, parti-
cularly how proper Rec-Reg will diminish the
onset of injury and the length of time needed
to recover.
In order for an athlete to properly mi-
croStretch he/she should be in a position elimi-
nating muscle contraction. Stretching is rarely
applied to a relaxed muscle as this connecti-
ve tissue has an inherent stiffness associated
with it. The degree of stiffness is a function
of the stimulation reflexes, active contraction
or structural changes due to a compromised
tissue about a joint. By controlling the envi-
ronment (stretching position) you can control
the influence (the stretch force) and ultimately
the outcome (decrease in stiffness or increa-
se in ROM). This is in accordance with the mi-
croStretching® principle of stability balance
and control (SBC®).
This is a perception scale, for all athletes differ
with regards to their perception and tolerance
of pain and discomfort. It is important to note
that if the athlete creates pain and discomfort
while having a pre-existing injury or trauma, the
result could be further protection, a somato-
sympathetic response, thereby increasing and
intensifying the compensation for the injury.
The variables of volume and density define
both the duration and frequency of microStret-
ching®. Mobility is about load bearing and ad-
aptation. Skeletal connective tissues are load-
bearing structures that adapt to meet functional
demands placed upon them. Exposure to phy-
sical, mental and emotional stress leads to vari-
ous degrees of wear and tear. Repetitive stress
or strain influences and is influenced by both the
muscle spindles and the Golgi Tendon Organs.
These proprioceptive tissues influence the ath-
lete and his/her response to the environmental
cues. The duration and frequency of exposure
to any amount of stress can change these neu-
robiological structures and processes, nega-
tively affecting arousal thresholds and the ability
to cope with subsequent stress or stresses.
In order to facilitate full recovery, athletes
need to be exposed to anabolic stressors (i.e.
relaxation response (RR), active recovery (AR)
and PNS) repeated for a reasonable amount
of time. This is in accordance to the paradox
recognised by SELYE, (1956)3 that the physio-
logic systems activated by stress can protect
and restore as well as damage the body. Phy-
sical exercise exerts physiological effects as
reflected by the activity levels of creatine kinase
(CK) and lactate dehydrogenase (LD). These
enzymes indicate the extent of cell membrane
damage, and their activities are known to in-
crease in response to strenuous exercise. The
gradual stress deactivations of these enzymes
coupled with the disappearance of blood lacta-
te (La) are important factors to consider when
designing a Rec-Reg protocol for the athlete.
Active recovery (AR) helps speed up the
process of Rec-Reg. An example would be a
light concentric exercise such as cycling on a
stationary bicycle, or very light jogging after
intense training or competition. AR continues
blood circulation with a diminished production
of La. At the microStretching® Clinic this is re-
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
removal of as much of this from the body as
possible. The body will naturally remove lactic
acid 30 – 60 minutes post training. By perfor-
ming light aerobic work, such as light jogging
or cycling (aerobic flush), the body’s ability to
remove these products is enhanced. This AF
should be at least 15 to 20 minutes in duration.
Stages two and three are quite similar to each
other. Intense training and competition results
in the depletion of glucose from both the ner-
vous and muscle systems. Therefore, after the
AF phase the athlete needs to replenish this
glucose. This may be in the form of a sports
drink or a complex carbohydrate food. Stage
four, if available, involves the use of contrast
baths or showers. We have found the use of
30 seconds of cold followed by two minutes of
heat repeated five times to be most effective.
Stage five, the final stage, is the use of a proper
Rec-Reg technique such as microStretching®.
Table 2: Summary of the microStretching®
5-Stage Process (mS5-SP) post-training pro-
Stages Description of the
microStretching® 5 Stages
Process (mS5-SP)
Stage One Aerobic Flush
Stage Two Glucose replenishment –
Nervous System
Stage Three Glucose replenishment –
Muscle System
Stage Four Contrast Baths
Stage Five microStretching®
Our practice has been to introduce mi-
croStretching® exercises two hours after in-
tense physical activity. This ensures that the
body has fully cooled down. An athlete does
not need to warm up in order to do the mi-
croStretches. The intensity of the stretches is
quite low (see Table 1). It has been suggested
that the best time to stretch is just before the
athlete goes to sleep, ensuring a greater re-
Pre- and post-workout stages
Proper function of connective tissue is re-
lated to the transfer of “E” from the muscle to
the tendons. The functional ROM of the musc-
le groups related to an athletic discipline and
how they relate to one another determines
their ability to accelerate through the full ROM.
The nervous system provides the input signal
to modulate the timing and intensity of the ac-
tivation signal to the muscle. The function of a
muscle is to contract. An effective contraction
utilises all the muscle fibres from the origin to
the insertion. If this contraction is impeded by
any means, full functional range is not achie-
ved and the athlete will not maximise his/her
Athletes at the microStretching® Clinic are
discouraged from doing any form of static
stretching after their warm-up. They progress
from a dynamic flexibility regime (hopping and
bounding, arm twists, ABCs, etc.) straight
into their training or competition. In fact, pre-
training can be used as a means of increasing
the athlete’s physical abilities, the only manda-
te being that the dynamic flexibility exercises
used in the warm-up phase should be simple
and not complex in nature. Proper pre-training,
with the use of dynamic flexibility provides a
gradual stimulus of the connective tissue pri-
ming it for the ensuing activity. If the athlete
proceeds into static stretching after a warm-
up it defeats the purpose of the warm-up. He/
she may exhibit a greater range of motion of
the connective tissue because of warming up
but this stimulus may in turn relax the tissues.
In essence, it may have the effect of “putting
the nervous system and ultimately the muscle
to sleep”. Worse, this archaic procedure may
predispose the athlete to injury.
The synergy of all these structures is also
key focus for a proper Rec-Reg programme.
As mentioned above, for athletes to recover
properly they need to diminish pain or discom-
fort during recovery. This is achieved by intro-
ducing them to the microStretching® five sta-
ge process (mS5-Sp) after strenuous training
or competition (see Table 2).
After intense exercise, the muscles and ner-
vous system are fatigued with a greater con-
centration of lactic acid. Stage one involves the
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
contribute to the increased work ability of the
muscle. These include neuromuscular adapta-
tions such as increased inhibition of antagonist
muscles after training, better co-contraction or
increased activation of synergistic muscles, in-
hibition of neural protective mechanisms and
increased agonist motor neuron excitability.
The equation below summarises the rela-
tionship of the various facets of training and
Rec-Reg. In the past Rec-Reg was thought to
be part of training, however, we have recently
realised that in fact it determines training. Wi-
thout proper Rec-Reg, the musculoskeletal
system will not be ready for the next training
session or subsequent competition(s):
(Improved Muscle Force, Velocity, and Power)
+ (Neuromuscular Adaptations)
+ (Body Awareness)
+ (Coordination)
+ (Endurance training)
+ etc
microStretching® (proper Rec-Reg)
Adherence to the guidelines and the mS5-
SP after training (Tables 1 and 2) enables pro-
per Rec-Reg of the connective tissue. The
deactivation, limitation and influence of the
SNS, the rapid removal of lactic acid with AR
and AF and the subsequent activation of the
PNS increases the capacity to recover and it
will improve and maximise the efficient crea-
tion, distribution and use of “E”. This, in turn,
is necessary to maintain the athlete’s ability to
train and compete at a high level.
The microStretching® exercises
This section contains the core seven exercises
for the lower body that are used at the mi-
croStretching® Clinic. We make the assumpti-
on that an athlete is able to perform the exer-
cises described without any chronic pain,
discomfort or muscular tension. For situations
where this assumption is not the case see the
following section.
covery from training or competition due to the
natural activation of the PNS.
We have noticed that sequencing, pro-
per body position and progression of the mi-
croStretches are very important. Movement is
associated with a certain kinetic chain. As the
athlete generates force from the ground up,
the summation of the muscle groups would be
calves, hamstrings, glutes, adductors, iliotibial
band and hip flexors. However, opposite to this
kinetic chain is the microStretching® chain.
The stretches progress from a calf, followed by
a glute-piriformis then by a hamstring stretch.
The remaining sequence will then follow that of
the kinetic chain with adductor, Iliotibial band
and then hip flexor stretches.
No muscle group can be stretched in isola-
tion. In order for an athlete to properly stretch
the hamstring muscle he/she would need to
focus on stretching one of the calf muscles
(gastrocnemius) followed by the glute-pirifor-
mis. This ensures that the origin and inserti-
on of the hamstring muscles will be indirectly
stretched during the stretching of the other
muscle groups (calf and glute-piriformis) facili-
tating a greater stretch of the hamstring musc-
le group. The placing of the body in the proper
position will maximise the length of the muscle
being stretched (microStretching® principle
SBC®). We have found that the most effective
way to stretch is to place the body in the ana-
tomical position. This position requires that the
shoulders and hips are square and the legs are
shoulder width a part.
Analysis of most athletic disciplines shows
that six main muscle groups are over-empha-
sised and therefore over-worked. These are
the calves, hamstrings, glute-piriformis, ad-
ductor group, iliotibial band and the hip flexors.
Optimisation of Rec-Reg with microStret-
The optimisation of the Rec-Reg of the
connective tissues between strenuous trai-
ning and competitions is crucial in order to
successfully reapply the frequent workouts
necessary to improve and maximise perfor-
mance. Improving muscle force, velocity and
power is of great importance. However, other
muscle adaptations are important in order to
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
microStretching® Exercise #2 –
Gastrocnemius Stretch
Muscle(s) being stretched
Description of how to microStretch
Facing a bench or a chair, make sure that your
hips and shoulders are square, with your feet
shoulder width apart. Move your right foot
backwards while still maintaining contact with
the ground ensuring that your leg is still shoul-
der width apart and has not strayed inwards
medially towards the medial side of the other
leg. Once your leg is behind you bend at the
knee of the leg in front while the rear leg is kept
straight. Lower yourself towards the ground.
Make sure that you support yourself with your
hands on a bench (see diagram) or a chair in
front of you. This is to relieve tension on the
gastrocnemius muscle. Once you have this
position hold the stretch for 60 seconds and
then slowly switch legs and repeat the stretch
on the opposite leg. Repeat this stretch for a
total of 3 times per leg.
Variables of microStretching® training
Intensity 30 – 40 percent of a maxi-
mum perceived stretch
Volume 60 seconds
Density 3 times per muscle group
once per day
microStretching® Exercise #1 –
Soleus Stretch (sitting down)
Muscle(s) being stretched
Primarily the Soleus muscle group of the lower
Description of how to microStretch
Sitting down in a chair make sure that your feet
are shoulder width apart and you are sitting
squarely on the chair. Place the ball of one of
your feet on the edge of an object (in the clinic
use a thick book, we allowing us the ability to
vary the height). With the ball of your foot on
the edge of the object, position your lower leg
in a manner that the heel of your foot is tou-
ching the ground. By changing the angle of the
ankle (bringing the foot closer to you or away)
you will begin to perceive a stretch in the calf
region. Hold this stretch for 60 seconds switch
legs and repeat the stretch 3 times per leg.
Variables of microStretching® training
Intensity 30 – 40 percent of a maxi-
mum perceived stretch
Volume 60 seconds
Density 3 times per muscle group
once per day
* this microstretch is extremely helpful with an
athlete who has extreme tightness in the So-
leus. It makes no sense to try to stretch such a
muscle standing up for the Soleus muscle is
activated in the standing position and how can
one stretch a muscle - that is also active?
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
microStretching® Exercise #4 –
Hamstring Stretch
Muscle(s) being stretched
Biceps Femoris (long and short head), semi
membranosus, semi-tendinosus
Description of how to microStretch
Place one leg through a door jam and the other
onto the wall. Place a pillow underneath your
head to facilitate a flat lumbar. The leg up on
the wall should have a slight bend in the knee
and the stretch should be felt in the middle of
the muscle belly. If there is a sensation in the
hip flexor region of the straight leg on the
ground place a pillow underneath the knee to
alleviate this sensation. Hold the stretch for 60
seconds and then switch sides and repeat the
stretch for a total of 3 times per side.
Variables of microStretching® training
Intensity 30 – 40 percent of a maxi-
mum perceived stretch
Volume 60 seconds
Density 3 times per muscle group
once per day
microStretching® Exercise #3 –
Glute – Piriformis Stretch
Muscle(s) being stretched
Gluteus maximus, medius, minimus and pirifor-
Description of how to microStretch
Place both your feet on the wall making sure
that your hip and pelvis are firmly on the ground
and not floating in the air. Place a pillow under-
neath your head ensuring the flattening of the
lumbar spine. Cross one leg over the other ma-
king sure that your ankle is passed the knee
joint and hold the gentle stretch for 60 se-
conds. Switch legs and repeat the stretch for
the other side. Repeat each stretch 3 times per
Variables of microStretching® training
Intensity 30 – 40 percent of a maxi-
mum perceived stretch
Volume 60 seconds
Density 3 times per muscle group
once per day
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
microStretching® Exercise #6 –
IT Band Piriformis Stretch
Muscle(s) being stretched
Piriformis and the iliotibial band as well as the
other external rotators of the hip (Superior and
Inferior Gemelli, Internal and External Obtura-
tors as well as Quadratus Femoris)
Description of how to microStretch
Start with several pillows under both knees.
Bring one leg over the other side of the other
knee and place it on the pillow. If you find that
you have to strain in order to reach the knee of
the leg being stretched (in diagram the right
leg) place more pillows under the knee of the
leg not being stretched. You will need a pillow
underneath your head in order to flatten out
your lumbar. Gently pull the leg over and hold
the stretch for 60 seconds repeat on the other
side. Make sure that each stretch is repeated 3
times per side. This stretch is particularly be-
neficial for athletes suffering from sciatica.
Variables of microStretching® training
Intensity 30 – 40 percent of a maxi-
mum perceived stretch
Volume 60 seconds
Density 3 times per muscle group
once per day
microStretching® Exercise #5 –
Groin Stretch
Muscle(s) being stretched
All 5 groin muscles (Gracilis, Pectineus, Ad-
ductor Magnus, Adductor Brevis, Adductor
Description of how to microStretch
Sitting on the floor place your back (upper and
lower) up against a wall making sure that it is
supported from the lower back up towards the
shoulders. Sitting in this position place the so-
les of your feet up towards you until you feel a
gentle stretch on the inside of the thighs. At
this point hold the stretch for 60 seconds and
then extend your legs out for 20 seconds and
repeat the stretch a total of 3 times. If during
the stretch you are experiencing discomfort
within the groin muscles place pillows under
each knee and ease into the stretch. The pil-
lows provide support and stability.
Variables of microStretching® training
Intensity 30 – 40 percent of a maxi-
mum perceived stretch
Volume 60 seconds
Density 3 times per muscle group
once per day
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
Treating Athletes Unable to Perform
microStretching® Exercises Properly
If an athlete is unable to perform the exer-
cises described above properly, that is, if he/
she is in pain and discomfort, is very tight or
is unable to place his/her body in the required
stretch position, it is indicative of a chronically
compromised system. In other words, he/she
is in constant sympathetic mode - the sym-
pathetic nervous systems are on more than
they are off. Such extreme cases need to be
progressed in a manner emphasising range of
motion (ROM) with the initial exclusion of any
other form of training. Once the athlete has
shown a slight increase in ROM then a trainer
and therapist may introduce other forms of
training but in a slow and progressive manner.
We do this with a six-stage process throug-
hout which the athlete is treated by a therapist
who guides the Rec-Reg, the use of the mi-
croStretching® technique and the assignment
of microStretching® exercises. The main aim
is to reach a point where it is possible to com-
plete the given microStretching® exercises wi-
thout any pain or discomfort.
Stage One of the process involves the treat-
ment of the athlete with the microStretchin
technique. After each treatment, the athlete is
required to do cold-hot contrast baths to mo-
dulate any inflammation that might have occur-
red during the exercises. As the ROM increa-
ses, the athlete is moved to Stage Two - water
therapy. The intent is to introduce some weight
bearing exercises, encouraging the athlete to
move through a full ROM. Stage Three consists
of active ROM exercises, none weight bearing
but with some tension. These exercises, usu-
ally in the form of cycling, are designed to con-
tinue active movement of the joint(s) through
their full ROM. In this stage we begin to int-
roduce the core microStretching® exercises
as described above. Stage Four comprises
weight bearing exercises in the form of tread-
mill work or walking on a track to have the ath-
lete actively move his/her joints through the full
ROM. In Stage Five the athlete starts running
and strength and conditioning exercises with
body weight for resistence. For Stage Six we
add strength training exercises with weights.
microStretching® Exercise #7 –
Hip Flexor Stretch
Muscle(s) being stretched
Psoas Major (minor) and Iliacus. This stretch is
sometimes referred to as iliopsoas stretch
Description of how to microStretch
Start with both knees on the ground making
sure that your hips and shoulders are square
and that your knees are shoulder width apart.
Place a chair on the side of the hip flexor that is
going to be stretched. In the diagram this will
be the right side. Place your right hand on the
chair. While supporting yourself with your right
hand, extend your left leg away from your
body. Make sure your lower back and upper
body are straight and you are not leaning for-
ward. From this position lower your body to the
ground making sure that your left leg forms a
90º angle at your knee. You should begin to
feel a gentle stretch in the right upper thigh hip
region. Hold the stretch for 60 seconds and
then switch legs repeating the stretch a total of
3 times per side.
Variables of microStretching® Training
Intensity 30 – 40 percent of a maxi-
mum perceived stretch
Volume 60 seconds
Density 3 times per muscle group
once per day
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
mary, both the circulatory and neural systems
where effected.
She was diagnosed with Osgoode-Schla-
ters Syndrome and the increased tightness
was associated with a decrease in flexibility
and range of motion (ROM) about the joints
of the lower body. A stretching routine and
strengthening programme were recommen-
ded to deal with the acute onset of her knee
pain. After several weeks there was a slight de-
crease in the sensation of pain in the knee and
a slight decrease in muscle tightness coupled
with a minimal increase in ROM. However, the
problem of fatigue did not change.
When she presented to the microStret-
ching® Clinic, neither the pain in her right knee
nor the physical fatigue had been alleviated.
She appeared to be mentally and emotionally
distressed. Such a situation is a very critical
stage for an athlete and coach. How the ath-
lete is manipulated throughout such period of
frustration could determine whether he/she will
continue to train and compete or quit.
Upon examination, the athlete exhibited very
tight hip flexors, hamstrings and IT bands bilate-
rally, with the left side greater than the right. Her
right leg was slightly shorter than her left. This
is indicative of a functional but not a structural
shortness. She commented on how her running
gait had been affected and she did not have the
ability to generate enough strength and power
to train and compete. We also noticed that she
was compensating to the left side, protecting
the right knee, therefore her sensory input with
regards to locomotion was skewed. The chronic
injury affected her ability to generate, adapt and
predict her automatic musculoskeletal respon-
se to the training and competitive environment.
She was unable to properly compensate for any
load as her bodily motion affected the proper
functioning of her stretch reflexes.
Upon reviewing the athlete’s case histo-
ry our immediate recommendation was the
removal of the strength component of her
training in order to alleviate muscle tightness
and increase ROM. Why should we develop
more tightness in the athlete through the use
of strength training exercises? In order to de-
velop the body awareness needed to process
Table 3: Six-stage process for treating athletes una-
ble to perform microStretching® exercises properly
Stages Description of Stage
of Progress
Stage One microStretching® therapy
Stage Two Water therapy
Stage Three Active ROM
non-weight bearing
Stage Four Weight bearing exercises –
treadmill work (body weight)
Stage Five Strength Exercises –
body weight resistance
Stage Six Strength training exercises
with weights
This process has been used to treat many
athletes with chronic pain. It is a vital tool for
the proper Rec-Reg of the connective tissue,
and diminishing the effect of the SNS while
stimulating and activating the PNS. By remo-
ving the protective intent inherent in a compro-
mised or chronically injured body, we decrease
the muscle tension that predisposes the body
to an allostatic load as described above.
Case histories
The two case histories below provide
practical examples of how coaches, medical
support personnel or an athlete might use the
microStretching® guidelines and stretches to
develop an appropriate Rec-Reg programme.
Case 1: Young Female Middle-Distance Runner
A young female who competed in middle-
distance events had increased muscular tight-
ness and pain in her right knee, which was
associated with a recent growth spurt. In addi-
tion to these symptoms, she also experienced
fatigue during and after workouts. This may
have resulted from an inability of the connec-
tive tissues to flush out the metabolic wastes
created during training, and then absorb oxy-
gen and nutrients. Associated with this fatigue
was a decrease in power and strength. In sum-
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
Table 4: Comparison of stretch routines
leus, gastrocnemius and plantaris) are contrac-
ting to keep the athlete in the upright position.
Therefore in order to stretch a tight calf the re-
commended exercise would be the sitting down
calf stretch (Exercise #1). This will ensure that
the calf muscle will be relaxed and stretched
effectively. Table 4 summarises the differences
between the stretch routine given to the athlete
and the microStretching® routine recommen-
ded at the clinic.
Proper sequencing of stretches is very im-
portant. In this case, the athlete had issues of
tightness in her lower body combined with an
issue in her right knee. The recommended mi-
croStretching® routine shown in Table 5 was
assigned. She was instructed to perform the
stretches prior to sleep. It was noticed that her
hip flexor region was very tight and sensitive to
discomfort when performing the recommended
IT Band stretch (Exercise #6 – Piriformis IT Band
Stretch). Based on the hypersensitivity of the hip
flexor, she was instructed to perform a Hip Flexor
Stretch (Exercise #7 – Hip Flexor Stretch) prior to
the IT Band Stretch. The principle of sequencing
is based on the viewpoint that if a particular mu-
scle group is targeted during a stretch routine,
another muscle group is activated. Until this se-
cond muscle group is addressed and stretched
it will impede progress in the target group.
the sensory inputs properly, she was introdu-
ced to microStretching® to develop a proper
Rec-Reg restorative approach for the muscu-
loskeletal system.
We noticed several inherent flaws with her
old stretch routine that contradicted the proce-
dure for Rec-Reg outlined in this article. In fact,
her old programme may have contributed to her
chronic condition. Each stretch was held for a
minimum of 15 and a maximum of 30 seconds
with no particular sequencing. The intensity of
each stretch was slightly below pain and dis-
comfort. As mentioned above, when the SNS
is activated through pain, it does not help the
body heal but keeps it in a perpetual state of
catabolism and anabolism. In other words, the
athlete continues to exhibit inflammation and
an inflammatory response with an increase in
tension of the musculoskeletal system.
The old stretch routine did not conform to the
microStretching® principle of stability, balance
and control (SBC®). This principle recommends
that in order to effectively stretch the muscle-
tendon system, one must eliminate muscle con-
traction during the stretch. In other words, if the
athlete has a very tight calf region it makes no
sense to stretch the calf muscle standing up.
During a standing stretch, the calf muscles (so-
Variables of Training Old Stretch Routine microStretching®Routine
and Principles
Intensity of Stretch 70% or 80% out of 100% 30% to 40% out of 100%
(very aggressive (very gentle stretch)
pulling sensation)
Volume of Stretch 15 – 30 seconds 60 seconds
Density of Stretch Before or after training Once per day three times
once per day per muscle group
Stability, Balance and
Control (SBC®) No Yes
Proper sequencing
of Stretching No Yes
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
cing pain in the anterior region of his right hip. He
was examined for hernia as well as sports her-
nia. The results from both the CAT scan and the
ultrasound were negative. The pain was more
pronounced after sitting for extended periods,
or after doing lunges and other forms of exer-
cise involving flexion of the hip region. In fact, the
symptoms appeared to be consistent with a hip
flexor strain. The range of motion about the hip
region was quite limited with pronounced tight-
ness in the IT Band, glutes, hamstring and the
external rotators of the lower leg.
A review of the exercises recommended for
both stretching and core stability suggested
that these might have been responsible for the
chronic pain. Some of the exercises consisted
of the athlete stimulating his core while balan-
cing. One of the stretches given for the lower
back - bringing the knees to the chest while
lying in the supine position - created pain and
discomfort, irritating the region.
After several weeks of microStretching®
therapy and the use and proper sequencing
of the recommended exercises the athlete was
back to training. In addition, through this pro-
cess she was given the tools to monitor and
help to continue her recovery in conjunction
with the treatment at the clinic. The inherent
compensation experienced by the body was
reversed and the athlete developed a higher
sense of body awareness.
Case 2: Adult Male Javelin Thrower
A javelin thrower suffered a broken right ank-
le during the approach run before a throw. His
right ankle was casted for eight weeks. Upon
removal of the cast he was introduced to rehabi-
litation work. This consisted of light cycling with
some weights in order to begin to encourage
weight bearing. The work progressed to the sta-
ge where he was able to run on the treadmill and
then the track. Throughout the process he was
introduced to some active static stretching. Eve-
rything was going well until he began experien-
Table 5: Recommended microStretching® exercises for a young female middle-distance runner
microStretching® Exercise
Exercise #1 -
Sitting down soleus stretch
Exercise #3 –
Glute-Piriformis Stretch
Exercise #4 –
Hamstring Stretch
Exercise #5 –
Groin Stretch
Exercise #7 –
Hip Flexor Stretch
Exercise #6
IT Band Piriformis Stretch
Variables of Training
30 – 40% of a maximum
perceived stretch
30 - 40% of a maximum
perceived stretch
30 - 40% of a maximum
perceived stretch
30 – 40% of a maximum
perceived stretch
30 – 40% of a maximum
perceived stretch
30 – 40% of a maximum
perceived stretch
Volume Density
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
(QL), erector spinae) as well as the lower leg
muscles. The left hip and lower limb were also
involved in response to the injury.
Our rehabilitation of the athlete focused on
limiting the core stability work and removing
the stretches that activated the hip flexor mus-
cles. The athlete was treated with microStret-
ching® and prescribed microStretching®
exercises (Table 6). The sequence of the stret-
ches given was important. The purpose was
to modulate the inflammation prevalent in the
muscle group. It was also important for the
routine to be bilateral in nature. In other words,
the muscle groups of both the right and left
side both needed to be stretched in order
to reverse the inherent compensation of the
body in response to the injury. After following
the routine for several weeks, an increase in
ROM and a decrease in the chronic discomfort
of the right hip flexor region was noticed. At
this point the routine was altered (Table 7) to
address the increased working capacity of the
athlete prior to increasing the intensity, volume
and density of his training.
The review also suggested a constant sti-
mulation of the hip flexor region. The exercises
targeted mainly the hip flexor to the exclusion
of the other muscle groups involved in con-
junction with the issue of the right hip flexor.
Some of the recommended exercises ap-
peared to be counter productive. The exercise
of greatest concern involved the athlete lying in
the supine position at the edge of a plinth with
his right leg hanging over the edge. The left
leg is flexed at the knee with the hands wrap-
ped around the belly of the hamstring muscle
group with the athlete pulling the left thigh to-
wards the chest. The issue with this stretch is
that the right hip flexor is contracting in order
to support the hanging leg. This constant sti-
mulation of the hip flexor muscle may cause
further inflammation.
When we studied how the athlete compen-
sated for his injury, we noticed that there was
an increase in tension in other muscle groups,
particularly the IT Band, glutes, hamstrings
adductors external rotators and the quadri-
ceps. In addition, there was involvement of
the lower back muscles (quadratus lumborum
Table 6: microStretching® routine addressing the right hip flexor issue of an adult male javelin thrower
microStretching® Exercise
Exercise #7 –
Hip Flexor Stretch
Exercise #3 –
Glute-Piriformis Stretch
Exercise #4 –
Hamstring Stretch
Exercise #6
IT Band Piriformis Stretch
Exercise #7 –
Hip Flexor Stretch
Variables of Training
30 – 40% of a maximum
perceived stretch
30 - 40% of a maximum
perceived stretch
30 - 40% of a maximum
perceived stretch
30 – 40% of a maximum
perceived stretch
30 – 40% of a maximum
perceived stretch
Volume Density
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
Table 7: General microStretching® routine addressing the increased work capacity an adult male javelin
thrower with a right hip flexor injury
site response needed for recovery and regenera-
tion of the connective tissue.
The use of microStretching® as well as the
proper preparation before and after training and
competition will provide the coach and the athlete
with a recovery regeneration programme aimed
at increasing the integrity of the connective tis-
sue. The ability of the tissue to recover and re-
generate quickly will ensure that the coach can
confidently increase the training load of the ath-
lete. If the athlete has an injury, which may have
caused a compromise in the musculoskeletal
system, it needs to be addressed and brought
back to “balance”. This is established with the
athlete focusing on increasing the range of moti-
on before being introduced to a strength training
regime. From this balanced position, the athlete
will be able to generate a greater amount of force
for they will be able to move through a full range of
motion thereby increasing the acceleration of
the muscle about a joint. Ultimately, this trans-
lates into the ability to maximise performance.
The development and the transfer of “Ener-
gy” are paramount for success in athletics. Every
neurobiological process is designed to support
such an endeavour for maximal performance.
Since training can be defined as a form of trauma,
it makes sense that we need to aid the athlete in
fully recovering from training. Therefore a proper
recovery and regeneration protocol needs to be
introduced to the athlete, ideally during the for-
mative years.
The recovery programme should not cause
pain and discomfort for this will result in tissue da-
mage with the subsequent development of scar
tissue. Scar tissue will affect the proper mobilisa-
tion of the connective tissue affecting its ability to
move through a full range of motion about a joint.
This will affect the ability a muscle to accelerate.
Pain is a sympathetic nervous system response,
one that primes the body for action increasing
tension in the connective tissue, the exact oppo-
microStretching® Exercise
Exercise #2 –
Gastrocnemius Stretch
Exercise #3 –
Glute-Piriformis Stretch
Exercise #4 –
Hamstring Stretch
Exercise #5 –
Groin Stretch
Exercise #6
IT Band Piriformis Stretch
Exercise #7 –
Hip Flexor Stretch
Variables of Training
30 – 40% of a maximum
perceived stretch
30 - 40% of a maximum
perceived stretch
30 - 40% of a maximum
perceived stretch
30 – 40% of a maximum
perceived stretch
30 – 40% of a maximum
perceived stretch
30 – 40% of a maximum
perceived stretch
Volume Density
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
60 seconds 3 repetitions per
muscle group
once per day
microStretching® - A practical approach for recovery and regeneration
New Studies in Athletics · no. 1/2010
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microStretching® - A practical approach for recovery and regeneration
Stretching prior to an activity is a common practice amongst recreational and elite athletes, with practitioners believing that pre-exercise stretching may reduce the risk of injury, muscle soreness associated with DOMS, improve flexibility and performance. However, studies investigating the effects of pre- and postexercise on DOMS found no preventive effect on muscular soreness, tenderness, and force loss from unaccustomed eccentric exercise. In this study, effect of passive static stretching intensity on recovery from unaccustomed eccentric exercise of right knee extensors was investigated. Thirty recreationally active males were randomised into three groups: low- and high-intensity passive static stretching and control. The stretching groups performed three sets of passive static stretching exercises of 60 s each for hamstrings, hip flexors, and quadriceps, over three consecutive days, post-unaccustomed eccentric exercise. Perceived muscle soreness was collected immediately (time 0) and after 24, 48, and 72 h postexercise with muscle function (eccentric and isometric peak torque) was measured before (baseline) and after (24, 48, and 72 h) unaccustomed eccentric exercise. Low-intensity passive static stretching showed a significant increase in eccentric peak torque and was associated with a beneficial effect for both isometric peak torque and muscle soreness compared to high-intensity passive static stretching and control.
Stretching, defined as an external/internal force, is responsible for determining the range of motion (ROM) of the connective tissue [muscles, tendons, and the myotendon unit (MTU)]. The magnitude and rate of stretching may be responsible for inducing a mechanical response of the musculoskeletal system, such as trauma, or increases in ROM. Since mechanical forces provide fundamental physiological stimulus in living organisms, the degree of stretching intensity, such as low-intensity versus high-intensity stretching, may either optimise recovery from muscle damage by ameliorating inflammation or cause damage to tissue. This damage, in response to the stress placed on the tissue by stretching, may induce an inflammatory response. In this randomised crossover trial, 12 participants were exposed to both a high-intensity passive static stretch (discomfort with slight pain) and no stretch. In order to investigate whether high-intensity passive static stretching causes an inflammatory response, inflammatory blood biomarkers were measured [pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and hsCRP]. The right and left hamstrings, glutes, and quadriceps were passively stretched by a trained therapist. Each muscle group was stretched for three sets, held at 60 s each, at an intensity level of 8 out of 10, as measured by a numerical rating scale. The total time was 18 min. The study observed that an inflammatory response was associated with high-intensity passive static stretching when compared to no stretch.
In 1887, Professor Senn remarked that one of the “great objectives in life is to become a contributor to science”. In an attempt to discern activities that would become instrumental in the development of the scientific method, researchers discovered that through systematic observation and experimentation, analysis, and deductive and inductive reasoning, one was able to ascertain relationships amongst conditions. The knowledge garnered from this method was conducive for enlarging and increasing scientific boundaries thereby providing a systematic and deep insight into a problem. Although not always concerned with discovering an immediate solution, research forms the foundation from which to pursue future inquiry. Future research provides an opportunity to investigate any gaps, aiding and allowing for the further development and validation of the present inquiry, stretch intensity and the inflammatory response. It establishes a framework from which to further examine, interpret, and understand the potential role of stretch intensity in relation to other conditions (i.e. recovery and regeneration, relaxation response, etc.). Moreover, the success of any research programme or inquiry employs a mixture of complimentary approaches or methods to address any mechanism(s) contributing to our understanding. This is critical for informing and validating the present text in an effort to improve our understanding of the role of stretching intensity.
Equipment was assembled to record resting muscle action potentials electromyographically at a very high sensitivity level (10 microvolts per cm. of needle deflection). Electromyograms for seven subjects having chronic muscular involvement of the shin splint type were recorded before and after static stretching procedure was administered. In six of the seven subjects muscle action potentials were markedly reduced after the stretching procedure while in one subject an increase was observed. Of the six subjects who showed lowered electromyograms those who had pain symptoms at the time of experimentation also showed some measure of symptomatic relief.
Six chapters are included: structural foundations of behavior, neonatal behavior, development of neuromotor activities, some aspects of early sensory development, individual development, maturation and learning. In the first chapter, exact principles and experimental findings are listed, and a list of assumptions which provide a theoretical framework are stated. Throughout the book the author correlates as closely as possible the behavioral data with the neurological data now available. Most space is devoted to neuromotor activities, and diagrams, tables, and graphs are used wherever possible. In discussing maturation and learning, educational hints are systematically presented as conclusions from experimental studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The target article discusses various aspects of the relationship between the sympathetic system and pain. To this end, the patients under study are divided into three groups. In the first group, called “reflex sympathetic dystrophy” (RSD), the syndrome can be characterized by a triad of autonomic, motor, and sensory symptoms, which occur in a distally generalized distribution. The pain is typically felt deeply and diffusely, has an orthostatic component, and is suppressed by the ischemia test. Under those circumstances, the pain is likely to respond to sympatholytic interventions. In a second group, called “sympathetically maintained pain” (SMP) syndrome, the principal symptoms are spontaneous pain, which is felt superficially and has no orthostatic component, and allodynia. These symptoms, typically confined to the zone of a lesioned nerve, may also be relieved by sympathetic blocks. Since the characteristics of the pain differ between RSD and SMP, the underlying kind of sympathetic–sensory coupling may also vary between these cases. A very small third group of patients exhibits symptoms of both RSD and SMP. The dependence or independence of pain on sympathetic function reported in most published studies seems to be questionable because the degree of technical success of the block remains uncertain. Therefore, pain should not be reported as sympathetic function independent until the criteria for a complete sympathetic block have been established and satisfied.
This brief review focuses on the time course of changes in muscle function and other correlates of muscle damage following maximal effort eccentric actions of the forearm flexor muscles. Data on 109 subjects are presented to describe an accurate time course of these changes and attempt to establish relationships among the measures. Peak soreness is experienced 2-3 d postexercise while peak swelling occurs 5 d postexercise. Maximal strength and the ability to fully flex the arm show the greatest decrements immediately after exercise with a linear restoration of these functions over the next 10 d. Blood creatine kinase (CK) levels increase precipitously at 2 d after exercise which is also the time when spontaneous muscle shortening is most pronounced. Whether the similarity in the time courses of some of these responses implies that they are caused by similar factors remains to be determined. Performance of one bout of eccentric exercise produces an adaptation such that the muscle is more resistant to damage from a subsequent bout of exercise. The length of the adaptation differs among the measures such that when the exercise regimens are separated by 6 wk, all measures show a reduction in response on the second, compared with the first, bout. After 10 wk, only CK and muscle shortening show a reduction in response. After 6 months only the CK response is reduced. A combination of cellular factors and neurological factors may be involved in the adaptation process.
Most muscle stretching studies have focused on defin ing the biomechanical properties of isolated elements of the muscle-tendon unit or on comparing different stretching techniques. We developed an experimental model that was designed to evaluate clinically relevant biomechanical stretching properties in an entire muscle- tendon unit. Our objectives were to characterize the viscoelastic behavior of the muscle-tendon unit and to consider the clinical applications of these viscoelastic properties. Rabbit extensor digitorum longus and tibialis anterior muscle-tendon units were evaluated using methods designed to simulate widely used stretching tech niques. Additionally, the effects of varying stretch rates and of reflex influences were evaluated. We found that muscle-tendon units respond viscoelastically to tensile loads. Reflex activity did not influence the biomechani cal characteristics of the muscle-tendon unit in this model. Experimental techniques simulating cyclic stretching and static stretching resulted in sustained muscle-ten don unit elongations, suggesting that greater flexibility can result if these techniques are used in the clinical setting. With repetitive stretching, we found that after four stretches there was little alteration of the muscle- tendon unit, implying that a minimum number of stretches will lead to most of the elongation in repetitive stretching. Also, greater peak tensions and greater energy absorptions occurred at faster stretch rates, suggesting that the risk of injury in a stretching regimen may be related to the stretch rate, and not to the actual technique. All of these clinically important considera tions can be related to the viscoelastic characteristics of the muscle-tendon unit.
The notoriously limited capacity of articular cartilage to heal or to regenerate plus the author's clinical observations and research on the deleterious effects of immobilization on joints led him to the biologic concept of continuous passive motion (CPM) of synovial joints in 1970. The hypothesis that CPM should stimulate pluripotential mesenchymal cells to differentiate into articular cartilage and should accelerate the healing of articular tissues has been validated by numerous scientific investigations of a variety of experimental models of the knee joint. These models have included full-thickness defects, intraarticular fractures, acute septic arthritis, partial thickness lacerations of the patellar tendon, semitendinosus tenodesis to replace the medial collateral ligament, autogeneic osteoperiosteal grafts in major defects, free autogeneic periosteal grafts, and periosteal allografts. In 1978, the author collaborated with Saringer, an engineer, to develop CPM devices for humans. CPM is clinically indicated following such procedures as open reduction of fractures, arthrolysis for posttraumatic arthritis, synovectomy, drainage of septic arthritis, release of joint contractures, total arthroplasty, tendon repair, and ligament reconstruction. Clinically, CPM is an important stimulus to joint regeneration processes.
Regions within frog semitendinosus muscle that are rich in tonic muscle cells were identified histochemically by myosin adenosine triphosphatase- and succinic dehydrogenase-staining procedures. Bundles of cells still attached to tendinous insertions were removed from those sites, prepared for electron microscopy and sectioned longitudinally through their myotendinous junctions. Tonic cells were identified by electron-microscopic criteria and their myotendinous junctions' morphology evaluated by morphometry. Although junctional components appear identical to those in twitch cells, the degree of membrane folding increases tonic junction area by a factor of 50.2 whereas twitch cells' junctional area is increased 22.2 times by folding relative to cells terminating as right circular cylinders. Calculations show that the tonic cell junction bears average loads of 3.4 X 10(3) N X m-2 during maximum force generation and that nearly all of the load is borne as shear stress at the junction. The junctions of twitch cells bear average loads of 1.6 X 10(4) N X m-2 during peak tension. The findings indicate that the magnitude of loading does not alone determine the degree of junctional membrane folding. Interpretation of the data in view of viscoelastic behavior of membranes indicates that duration of loading may be a functionally important correlate to degree of membrane folding at myotendinous junctions.
Dermal repair tissue shows a progressive increase in collagen content which may be related to the wound tensile strength. Wound strength and extensibility are lower than those found in normal skin. In animals, wounds closed by metal clips are chosen as a model to study the proliferative and remodeling phases of healing from a mechanical and morphological point of view. During the proliferative phase the low wound strength is associated with formation of collagen fibers of small diameter, later, (days 28-45) an acute change appears corresponding to the remodeling phase, with increased collagen fiber diameters observed by scanning electron microscopy and light microscopy, and increased tensile strength and toughness. By 180 days, wound strength and collagen fiber morphology were close to that observed in the normal skin. These observations show a direct relationship between collagen fiber diameter and tensile strength. In addition, packing density of collagen fibrils (determined by the birefringence retardation per unit thickness under polarized light) was unchanged until day 90, although collagen fiber diameters increased during this time.
Nine untrained men (22-29 yr) performed 45 min of downhill running (16% incline, 70% of maximum heart rate). Needle biopsies of the vastus lateralis were performed before, 45 min after, and 5 days after exercise. Immunohistochemical staining of muscle cross sections revealed a 135% increase in muscle interleukin-1 beta (IL-1 beta) immediately after and a 250% increase (P < 0.03) 5 days after exercise. Using a rating scale (0-3) for the presence of neutrophils, light microscopic examination showed a significant accumulation of neutrophils in muscle biopsies taken 45 min after and 5 days after exercise [before: 0.5 +/- 0.2, 45 min after: 1.5 +/- 0.3 (P < 0.01), and 5 days after: 1.2 +/- 0.2 (P < 0.04)]. In addition, electron microscopic analysis showed an increase in the percentage of damaged Z-bands relative to total Z-bands [before: 4.8 +/- 3.5%, 45 min after: 32.5 +/- 8.6% (P < 0.05), and 5 days after: 14.1 +/- 3.2%]. Neutrophil accumulation was positively correlated to intracellular Z-band damage (rho = 0.66, P < 0.001). Immunohistochemical staining for IL-1 beta was related to neutrophil accumulation in muscle (rho = 0.38, P < 0.06) and to plasma creatine kinase levels (rho = 0.416, P < 0.04). These data indicate that after eccentric exercise ultrastructural damage to skeletal muscle is associated with neutrophil infiltration and muscle IL-1 beta accumulation.