The Need for Therapeutic Stretching
One disadvantage of some stretching books is they assume the people for whom the stretches are recommended are fit and healthy and flexible enough to get into what are sometimes quite challenging positions. Consider the popular image of someone dressed in fitness clothing performing a hamstring stretch: The person is standing on one leg, reaching over to touch the toes of the opposite foot, which is resting on a gatepost or park bench. This position necessitates not only a straight leg raise of at least 90 degrees but also the ability to place almost the full weight of the body onto the supporting leg whilst remaining balanced. Although we should avoid pigeonholing elderly people as being frail and physically incapacitated, it is fair to say that the minority of seniors would be able to get into such a position to stretch the hamstrings. Most older adults lose strength in their lower limb muscles and experience joint stiffness, and they often have poor balance. So, too, might a person recovering from a knee, ankle or foot injury. A standing hamstring stretch is therefore not the best stretch to recommend to this group of clients, and alternatives are needed.
How might we as therapists help seniors and clients rehabilitating musculoskeletal conditions reap the benefits of stretching? The answer lies in our ability to modify stretches. Physical therapists, sports therapists and fitness professionals are used to designing exercise programmes tailored to the individual. Similarly, we need to identify and to modify stretches so they may be applied in such a way as to be both effective and safe for older adults and those recovering from musculoskeletal conditions. We need to embrace the concept of therapeutic stretching.