It’s a Stretch

When she wasn’t helping her patients as a nurse and Hellerwork practitioner, Diane Lewis enjoyed wilderness kayaking off the northwest coast of Vancouver Island, amidst towering evergreens and the remnants of First Nations long houses and villages. She paddled easily, a combination of graceful reach and pull that propelled her through the water.

Lewis still communes with nature, but has had to forego kayaking, backpacking, and even her career since three car accidents started her journey through the hazards of pain and chronic fatigue. She still uses a few of the techniques from her more active life to get a handle on her symptoms — and stretching is at the top of her list.

“I have to stretch every day to feel my best. It makes me more fluid and relaxed [and] less stodgy, and gives me energy.” Like Lewis, you can help yourself feel your best by following advice about stretching from healthcare experts.

“Stretching is one of the cornerstones of treatment for fibromyalgia,” says Pamela Roberts, MD, a family practice doctor at the Northwest Spine and Pain Center in Kalispell, Mont. Roberts isn’t just giving a professional perspective. She developed FM after the birth of her fourth child. She stretches regularly and encourages her patients to do the same, even though she admits that it doesn’t always feel good.

The benefits of stretching are numerous, far-reaching, and interrelated. You can expect improved mobility, decreased tightness, and more relaxation, all of which make activities of daily living easier. Also, stretching interrupts the cycle of pain and counteracts pain posture, and that changes how your body feels from the inside out. In addition, you gain the subtle advantages of greater body awareness and empowerment. What’s more, stretching takes less energy than other exercise and can be done in the comfort of your bedroom.

Although stretching is necessary for a healthy body, any physical activity can cause harm if not done correctly — especially for people with fibromyalgia. Stretching cold muscles or overstretching runs the risk of injury, cautions Brad Roy, PhD, an exercise physiologist and Administrator of the Kalispell Regional Medical Center’s wellness facility, The Summit Medical Fitness Center. Therefore, it’s best to stretch after five to 15 minutes of warm-up exercise like walking (around the block or your living room), cycling (indoors or out), or even moving in a warm water pool or the shower.

Stretching interrupts the cycle of pain and counteracts pain posture.

The purpose of stretching is to lengthen muscles and to help them glide against each other. If you feel a burn, the muscle is lengthening too far and losing its cohesiveness. That’s overstretching, which creates microfiber tears—so it’s important to stay within your range. Roberts further encourages patients to get assistance from an exercise professional, like a physical therapist or personal trainer familiar with fibromyalgia, who can tailor an individualized program.

Eric Mason, a physical therapist in Winter Park, Fla., has developed a special protocol for his patients with chronic pain. After a warm-up, he has them move into and out of a stretch repeatedly before holding it. This further softens the connective tissue and gets it ready to lengthen. Next, he recommends stretching a little at a time, and cautiously introducing a hold—being careful about staying in a stretch. It’s easy to increase a stretch, but you can’t undo it when you stretch too far.

Mason’s final piece of advice: if you feel pain elsewhere (for example, in the right side of your neck when stretching the left), you’re probably impinging joints and should consult a medical professional.

One of the keys to getting the most from a stretch is to be aware of your personal range, so you don’t go too far and cause a flare. Sharon Butler, author of Conquering Carpal Tunnel Syndrome, calls this the “stretch point,” the place where tissues will release. She notes that stretching is an opportunity to tune into your body’s intelligence and rediscover its messages. Does the stretch feel like torture, or a feathery kiss? Anything that’s painful is beyond the stretch point—and a clue to back off. Feel for other sensations, especially the “let go” as one layer of muscle gains new flexibility. These are small, but powerful, changes.

Stretching throughout the day is the most productive. Hal Blatman, MD, president of the American Holistic Medical Association and author of The Art of Body Maintenance: Winners’ Guide to Pain Relief, emphasizes that stretching is required to deactivate trigger points. He recommends stretching in the morning after warming up, and pressing or squeezing the painful points.

Furthermore, you should stretch as needed throughout the day, whether that’s once an hour or every 10 minutes. Professional athletes stretch before, during, and after practice, and Blatman encourages his patients to consider themselves athletes, even if they don’t participate in sports.

If you feel a burn, the muscle is lengthening too far.

BENEFITS OF STRETCHING

1. Decreased tightness
2. Improved mobility
3. Increased circulation and oxygen to cells
4. Interrupts the pain cycle
5. Changes chronic pain posture
6. Empowers you to take control of body sensations
7. Greater body awareness
8. Relaxation

GUIDELINES FOR STRETCHING

1. Warm up your muscles first.
2. Move into and out of the range several times.
3. Use a small amount of pressure
4. If pain increases, back off or discontinue.
5. Hold for five seconds at first, then longer if not painful.
6. Feel for the muscle to “let go.”

SAMPLE STRETCHES

Doorway stretch (excerpted from Conquering Carpal Tunnel Syndrome)

• Place both hands on the door frame, shoulder height.
• Taking tiny steps, begin to move your body forward until you feel a moderate stretch across your chest and upper arms. Keep your chin level.
• Hold this stretch for five seconds, then step back, keeping your hands on the door frame. Wait for 10 seconds, then step forward again to repeat the stretch. Stretch       forward, then back, a total of three times.
• When finished with the third repetition, step back and let your arms drop to your sides. Release any tension in your shoulders as you let your arms hang.

Neck stretch (excerpted from The Art of Body Maintenance: Winners’ Guide to Pain Relief)

• Sit in an upright position with the head rotated approximately 60° to the side.
• Place the hand gently on top of the head with the fingers resting on the top and back of the head. The elbow should be right in front of the nose, with the forearm aligned with the head.
• This stretch is performed as the hand slowly guides the chin down toward the chest with the nose aimed toward the elbow.
• Using relaxation breathing techniques, focus on relaxing the entire neck and move no more than about 15° with each exhalation.
• Slow motion and mindful relaxation will result in deeper levels of stretching.
• Gently guide the head back to an upright position with the hand. Do not use the neck muscles to straighten the neck.

Child’s Pose

• From a hands-and-knees position, bring your buttocks back toward your heels as you exhale.
• Breath comfortably and feel the stretch in your back and/or hips.
• Try to keep both parts of your rear end the same distance from your heels, even if that means one side doesn’t feel a stretch. (Let the tighter side decide how far you go.)
• With a few gentle breaths, see if you can get closer to your heels, if your back can lengthen more, or if the two sides can become more even.
• Inhale to come out of the stretch.

Think of strenuous activities like vacuuming as a workout, and stretch to prepare your body. Take a short break to stretch midway if the activity will last for more than 10 minutes, and afterwards stretch to relax, using breathing techniques and mental imagery to enhance the effect. It’s easy to increase a stretch, but you can’t undo it when you stretch too far.

Lewis notices that her body’s needs change, so her stretching reflects this. Some days, 10 minutes is enough; others, she needs 40. She has collected stretches from yoga and physical therapy, as well as various books, and chooses different daily exercises to work on the places where she feels stiff. She tries to cover her whole body over a week’s time, rather than including everything every day.

Most importantly, Lewis tries to make stretching fun, so it’s not so much work. She may not be able to paddle her kayak at the moment, but she can reach into the cupboard for a dish with the same whole body involvement — from her foot, through her side and arm, to the fingertips. She can pretend she’s on the water and imitate the movements of eagles and orcas. Daily stretching brings her one step closer to the wilderness she loves.

Anita Boser, LMP, CHP is the author of Undulation Exercises and Relieve Stiffness and Feel Young Again with Undulation. To learn more about therapeutic exercise, visit undulationexercise.com.