Welcome again to another edition of Refreshing Rehab!  I hope the snow was fun, though inevitably it became annoying. Now the weather is slowly improving and the days are getting longer we can put it behind us!

           On Sunday 30th May, my friend and I are holding a charity 7-a-side football tournament and raffle in aid of cancer research and St. Francis hospice in Berkhampstead. If you (or you know anyone) are interested in entering a team or buying some raffle tickets, please contact me. Teams are £50 and raffle tickets £1 a strip. Prizes include food hampers, meal vouchers, beauty vouchers, wine, amongst others! If you would just like to make a donation, you can pass it on to me at AFC Kempston.

Stretching

Stretching has been a vital part of preparation and maintenance of a persons well being for many years. The main point of argument is what stretches to do, when and why. It is, after all, the most tedious part of activities, even if it is also one of the most important so its important to know a little about it!

The idea of stretching is to increase muscle control, the flexibility, length and pliability of a muscle, reducing the risk of the muscle becoming strained during exercise, or any sort of activity for that matter.

A stretch is when you elongate a muscle to its longest possible length. It is often done unintentionally, for example, stretching when yawning in the morning as soon as you get up. Athletes should stretch prior and after activity as it reduces the risk of injury during performance. It aids in keeping a better range of motion in the muscle and could prevent the onset of muscle soreness (DOMS) after activity¹.

Stretching the whole body is the most beneficial thing to do thought the majority of people do not have the time for this, so stretching the main muscles that will be used is the most vital thing. For example, a footballer would concentrate their stretches in the legs.

There are different types of stretching that can be performed, whether individually or with assistance from another individual. Individual stretches can be static (without moving) or dynamic/ballistic (with movement). Research is inconclusive on which stretch is best to do before and after activity. Personally, I prefer dynamic stretches prior to exercise, but only following a cardio-vascular exercise to increase blood flow in the body. I prefer dynamic stretches as they mimic the actions to be performed in the activity. Static stretches in my view should be performed after activity as the body is trying to recover to its normal resting condition. Research also suggests static stretches prior to activity could be detrimental to performance for an individual¹. Holding stretches for a long enough period is also important and this is generally regarded as 15-20 seconds per stretch. It is also thought that doing each stretch 2 or 3 times is the best thing, though it has also been suggested that some stretches only find benefits after the first repetition².

There are many assisted stretches, also called passive stretches. Common varieties performed in massage sessions or for rehabilitation purposes can include proprioceptive neuromuscular facilitation (PNF), postisometric relaxation (PIR) or muscle energy tecniques (METs). They are all slightly different with different ways to stretch and restore the muscles most efficient function. To find out more about any of these techniques and if you would like to encorporate them in your therapy sessions, please feel free to get in touch and find out further details.

Knee Ligaments

The knee is a very complex structure, held together by strong ligaments to provide support and stabilize the joint. The 4 main ligaments that do this are the anterior and posterior cruciate ligaments and the medial and lateral collateral ligaments. Put simply they are 2 in the middle and 2 at the side.

The 2 cruciate ligaments are so called as they cross over in the joint capsule(some texts also refer to them as intracapsular ligaments). The anterior cruciate ligament (ACL) begins at the anterior intercondylar area of the tibia and passes backwards, outward and upwards and attaches to the femur on the inside of the lateral condyle. The posterior cruciate ligament (PCL) is the opposite. So it starts at the posterior intercondylar area of the tibia, goes forewards, inwards and upwards to the outside of the medial condyle of the femur. The PCL is the stronger of the two³. The most common way of injuring these very strong ligaments is to over extend the knee (damages ACL) and over flex the knee (damages PCL), usually through an impact of some sort, ie. Falling powerfully on a hard surface and bending the knees very quickly.

Quick Facts

“Every hour 1 billion cells in the body need to be replaced”

“Every squre inch of your body contains 19 million skin cells”

“The adult human body reqquires 88 pounds of oxygen daily.”

 References

1. Nelson, A.G., Kokkonen, J., & Arnall, D.A.,  Acute Muscle Stretching Inhibits Muscle Strength Endurance Performance, Journal Of Strength And Conditioning Research / National Strength & Conditioning Association Vol. 19.2 (2005), pp 338-343.

2. Sharman, M.J., Creswell, A.G. & Rick, S., (2006), Proprioceptive Neuromuscular Facilitation Stretching, Sports Medicine, Vol. 36 (11), pp. 929-939.

3. Marieb, E.N., Human Anatomy & Physiology, 5th edition, Benjamin Cummings, London.