Role of Flexibility - Avoid Pain & Injuries plus Improve Range of Motion

First, what do we mean by the term flexibility? You might think that flexibility is something that you either have or don't have. A well known cyclist once told me that he was very flexible, and he proved his point by reaching down without bending his knees and touching his toes with the palms of his hands. His long-legged girlfriend complained that she was inflexible and, sure enough, she found it impossible to reach past her ankles with her fingertips. However, when I asked each of them to reach one hand back over their head and touch the opposite shoulder blade, the cyclist could barely reach past the base of his neck, but the young lady could easily touch the bottom of her shoulder blade.

This incident illustrates that flexibility can vary in different parts of the body. The cyclist was obviously flexible in his hip joints and in his lower back, but relatively inflexible in his shoulders. On the other hand, his girlfriend appeared to be flexible in the shoulders but inflexible in her hips and low back.

However, when I asked them to stand side by side, another important factor became apparent. The cyclist was several inches taller than his girlfriend, but their legs were actually the same length. In other words, the cyclist's relatively short legs and long upper body made it easier for him to reach the floor than the young lady, who had a short upper body and long legs.

It is obvious that there is no single test that can be used to assess flexibility. Each joint is designed to allow a certain range of motion in each direction that it can move. A healthy joint will allow a full range of motion in each of those directions. A joint which allows excessive motion is unhealthy. A joint which restricts motion is also unhealthy. The only way that we can obtain a good estimate of overall flexibility is to check the range of motion of all of the major joints of the body. This is done routinely by many orthopedic surgeons, physical therapists and athletic trainers.

Unhealthy joints are undesirable for three reasons: 1. They adversely affect your physical appearance; 2. They adversely affect your physical performance; and 3. They usually cause pain and injuries.

Physical Appearance

Brent is 5'8" and 215 pounds, and built like a Mack truck. He works out with weights every day, watches his diet very carefully, and has fantastic muscle definition. Unfortunately, he looks kind of odd. In spite of the fact that he has done more work on his abdominals than anyone else I know, he seems to have a beer belly. He has spent thousands of hours working his upper body, but in his normal stance his arms seem to be pulled towards the front of his body, which gives him a round-shouldered appearance.



When I checked the range of motion of his hip joints I found that it was restricted. The muscles that pull his thighs to his chest (hip flexors) were extremely tight. One of these muscles connects the top of the thigh bone to the front of the vertebrae of the lower back region. Over time, the tightness in this muscle has pulled his lumbar vertebrae forward and down towards the front of his thighs, causing a 'sway-back' posture. This position pushes his belly outwards, and no amount of strengthening of the abdominal muscles will flatten his stomach.

When I checked the range of motion of his shoulders I found that his pectoral muscles were also very tight. He has spent a great deal of time strengthening his pecs, and as they have become progressively stronger they have gradually pulled his shoulders forward.

Good posture is the foundation for a healthy and good-looking body. I mentioned earlier that Brent is built like a Mack truck. Right now he is like a Mack truck with a bent chassis. Unfortunately, it took Brent a number of years to change his posture, and it will take time and dedication to stretch those tight muscles back to a healthy length. Fortunately he has a great attitude, and now that he knows what he has to do, he is determined to get the job done.

Physical Performance

Rob is an aerospace engineer who works out regularly in a corporate fitness facility in San Diego. He has run a couple of half-marathons, and is a keen cyclist. Rob would like to try a triathlon, but his swimming leaves a lot to be desired. When he tries to swim the front crawl his elbows enter the water before his hands. He also lifts his chin up out of the water every time he takes a breath of air, instead of breathing at the side.

When I checked the flexibility of his shoulders I found that his range of motion was restricted, especially in the direction known as 'internal rotation' of the shoulder joint. Anyone who has a full range of motion can place one hand behind his back at the waist and then reach up and scratch his back between his shoulder blades. This simple test should be repeated for both the left and right shoulders.

In order to lift his elbow out of the water at the end of each arm stroke, a front crawl swimmer must be able to internally rotate the shoulder joint until the elbow is much higher than his hand. Because Rob cannot do this his elbows are dragged forward through the water, which slows him down. The forces exerted by his arms on the water also cause his face to lift up to the front when he breathes. Therefore Rob's inflexibility prevents him from maintaining the streamlined body position necessary for efficient swimming.

With a good stretching program Rob can expect to gradually improve the range of motion of his shoulders. As the range of motion improves he will be able to improve his swimming mechanics. He is planning to try his first mini-triathlon next year. I am sure that it will not be his last.

Pain and Injuries

Larry has a tough job in the Dallas real estate market. He used to work out with weights at his club every other day for about four years, and he found that a good workout was the best way to relieve stress. Now he has constant pain in his low back, so that he can barely make one workout a week, and he feels depressed.

It turns out that Larry's problem is similar to the one that Brent has. His lumbar spine has been curved forwards by the constant tightness of his hip flexor muscles. Even though Larry thinks of himself as being active, he actually spends most of his working day sitting at a desk and in his automobile. In other words, there are very few activities in his present lifestyle which will tend to stretch these tight muscles. The constant psychological stress of his occupation and lack of exercise seem to have made the situation even worse. He appears to have lost his zest for life and this is reflected in his slumped sitting and standing posture. His poor posture has tended to put additional stress on his low back.

The healthy spine protects itself from injury through the action of shock-absorbing discs that cushion the effects of forces on the body. Each disc forms a cushion that prevents the hard bony vertebrae from banging and rubbing against one another. An X-ray of Larry's low back showed that the spaces between a couple of his vertebrae have become narrower towards the rear of his body. His physician has told him that his pain is probably caused by pressure on nerves that are being trapped in the narrowed disc spaces.

Larry has been shown a stretching exercise that is designed to stretch his tight hip flexor muscles. He stands upright with his left foot a couple of feet in front of his right, with most of his weight centered over his left foot. Then he slowly flattens out the curvature in his low back so that his belly button is straight ahead. When he does this he feels tightness in the righthand side of his groin area. He holds this at the point of mild discomfort (not pain) for 30 seconds, and then repeals the stretch with his right foot forward.

Larry's physician has recommended other stretching exercises, and he has also suggested that Larry should do sit-ups with his heels supported on a chair. The combination of improved flexibility in his hip joints and improved tightness of his abdominals will tend to partially flatten Larry's low back and relieve pressure on the nerves causing the pain.

Over-Stretching

Mike played intramural basketball all through high school and college. Unfortunately, he did not always get the best advice. For years he has made a habit of stretching his hamstrings by bouncing up and down to touch his toes. In the past two years he has had a lot of pain in his knees.

A physical therapist who examined him at a sports medicine clinic in Boston found that Mike could easily hyperextend his knee joints. That is, in a standing position Mike could push his knees back beyond the point at which his thigh and shin formed a straight line, so that he stood with his knee joints behind his ankle and hip joints. The stretching exercise that Mike has used for years (toe-touching with his knees locked) probably contributed to his problem. This exercise can over-stretch the ligaments protecting the knee joints instead of stretching the hamstrings. There are safer and more effective ways to stretch the hamstring muscles.

The best advice for people who need to improve flexibility is 'Use it or lose it.' In Mike's case the opposite is true. If he makes a long-term effort to avoid hyperextension he will probably gradually reduce the undesirable range of motion of his knees. At the present time he is placing stress on his knees in a position that the joints are not designed to cope with.

So who does need flexibility?

The answer to the question raised at the beginning of this article should now be obvious to you. A lack of range of motion in one or more joints can create changes in posture that will adversely affect your appearance. Insufficient range of motion can also restrict movements that are essential for efficient mechanics. Most vigorous activities require the full range of motion of one or more specific joints. Consequently, lack of range of motion will prevent some people from achieving their potential in sports and games.

A lack of flexibility can also lead to pain and injuries. However, it should now be clear to you that for each individual the problems lie in a lack of flexibility in one or more specific joints. In each case the remedy is specific stretching exercises that gradually improve those specific deficiencies.