Proprioceptive Neuromuscular What?

May 2, 2004
Outside Magazine

Outside magazine, March 1999

Proprioceptive Neuromuscular What?
These days, there's a lot more to stretching than feeling the burn

By Andy Dappen

A month or so before the 1989 U.S. summer National Championships, swimmer Ron Karnaugh suffered a muscle strain just beneath his right shoulder. Ordered to stay out of the water in favor of three weeks of rehabilitative stretching, he was sure his imminent performance was doomed. But the injury healed in time, and when he hit the water ù to his great surprise ù he posted a personal best in the 200-meter individual medley and finished in second place. "The name of the game is getting across the pool in the fewest strokes," says Karnaugh, "and in all four disciplines I had reduced my stroke count. I attribute that to the stretching."

Now 32 and studying to be an orthopedic surgeon, Karnaugh is still going strong, thanks to the increased range of motion in his upper body. "Stretching has not only kept me in the game," he says, "but it actually gives me a shot at competing with the rug rats I'm up against." Indeed, just last year, Karnaugh became the oldest swimmer in history to win a medal in the world championships when he took third in the 200-meter IM.

Ironically, the competitive edge that Karnaugh discovered is the one that gets short shrift among most athletes. Just ask Kim Rostello, founder and director of the Human Performance Laboratory at the University of Illinois at Chicago, who works with thousands of athletes each year. "If overall body conditioning is a stool made up of three legs ù flexibility, strength training, and aerobic conditioning ù flexibility is the short leg," says Rostello. "Most athletes skip it, and that's a real loss."

A major reason for this may be that there are as many schools of thought on stretching as there are ab trainers being hawked on late-night cable. Twenty years ago, it was simple: Ballistic stretching (bouncing past the point of resistance) was out because it was deemed unsafe, and static stretching (holding still in a pose) was in, to be done before every workout. Today, however, the athlete wanting to get the most out of his body has to sort through the intricacies of static, dynamic, and active-isolated stretching, as well as yoga and something called proprioceptive neuromuscular facilitation. And he has to tack the routine of choice onto the end of his workout, which is when most experts now recommend that you stretch. "When muscles are hot, they're more elastic," explains Rostello. "That's the time to extend your range of motion." Given all this, it's no wonder so many people blow off stretching. To help keep you from doing the same, we've divided the various methods along the three major philosophical lines and provided a rundown on each, in the hopes that one of the styles ù or a combination of them ù will suit your needs.

Classic Stretching

The two best-known types of stretching are static and dynamic, which are united in that they both focus solely on flexibility. In static stretching you strike a pose until the muscles feel a stretch ù but not pain ù and hold it. This is intended to override a muscle's reflex to contract when it's stretched to its limit, gradually pushing that point back and thus increasing flexibility. It's a great approach for athletes who move their limbs in a single plane, such as runners and cyclists, rather than all over the map. And because it requires so little concentration, it's a pleasant way to wind down post-workout.

Though static stretching is old school by now, it's still the biggest school. Doctors and trainers prescribe it almost automatically because it's hard to botch. To wit: For the hamstrings, lie on your back with one leg bent and the other leg straight up. Pull the raised leg toward your chest until you feel the stretch, and hold it. Simple. So if you want a conservative approach that does the trick ù albeit gradually ù and doesn't feel like homework, this is the one.

Dynamic stretching, on the other hand, relies on repetitions of slow twirls or leans to gently ease muscles to their comfortable limit. The movement builds up heat, which improves muscle elasticity and thins a joint's synovial fluid for better lubrication. Consequently, it's ideal for ball-and-socket joints, such as the shoulders and hips, because those areas house so many layers of muscles. Swimmers, cross-country skiers, and kayakers should try dynamic stretching for their shoulders, but they could easily rely on static stretching for the legs, which don't require the same mobility (with the exception of breaststroke swimmers).

And because of the warming effect dynamic stretching has on your muscles, it's the rare form that you can do before exercise. To stretch the hamstring using this method, you would lie on your back, raise one leg overhead, and slowly trace circles in the air with your foot, enlarging them as you go.

Complex Stretching

Two other popular forms ù Ashtanga yoga and active-isolated stretching ù aim to stretch one muscle while simultaneously strengthening its opposing muscle. They're ideal for athletes whose sports force their bodies into improbable positions, such as rock climbers and gymnasts. And since these methods can also be considered general body conditioning, if you adhere to complex stretching you can probably afford to skip a weight session every now and then.

In Ashtanga you work against the stretch in every pose to improve strength. "Half the battle of any sport is getting in the proper position and holding it," explains trainer Tom McCook, who works with the Stanford swim team and runs The Center of Balance, a fitness facility in San Francisco. "You need both flexibility and strength to do that." To stretch the hamstrings and simultaneously strengthen the quadriceps, stand straight on one leg and extend the other as high as possible in front of you.

Active-isolated stretching, one of the latest techniques to come into vogue, differs in that, as the name implies, it isolates individual muscles. Popularized in 1996 by exercise physiologist Jim Wharton and his neuromuscular therapist son, Phil, in The Whartons' Stretch Book, the method clashes with conventional wisdom. They posit that with static stretching you can never actually override the muscle's reflex to contract when it's taut. "Even if you hold the stretch, the reflex doesn't give in," argues Phil. "And you can't stretch a tense muscle." In contrast, the active-isolated technique has you sneak up on the targeted muscle in a series of short, forced stretches followed by relaxation.

For example, to stretch the hamstrings, lie on your back with one leg bent and the other pointing straight up with a towel looped around its arch. Next, draw that leg toward your chest on its own strength, and after stalling out, pull it farther with the towel and hold it for two seconds. Then lower the leg and repeat the cycle. Though the Whartons have little scientific proof to back them up yet, they do have results. In the last three editions of the Summer Games, their clients (including sprinter Michael Johnson) collected no fewer than 25 Olympic medals.

Proprioceptive Neuromuscular Facilitation

In contrast to active-isolated stretching, PNF, as it is blessedly known in the trade, is a proven technique long used by physical therapists to attack problem areas. Maybe you're a runner whose tight hamstrings are hanging up your stride, or perhaps a bout of Achilles tendinitis has you limping when you get up in the morning. Either way, PNF is the tool ù a sledgehammer next to the rubber mallet of the classic methods.

Actually, PNF combines elements of different styles: You stretch a muscle statically, contract it against resistance, relax it, and then stretch it a bit farther. While most PNF stretches can be done solo, you'll want to grab a partner if you can. For the hamstrings, you'd start from the same position as in the active-isolated stretch, but this time, when you pull (or your partner pushes) your leg toward your chest, resist, and maintain the standoff for eight seconds. Then ease the tension, take the static stretch a few degrees farther, and hold it for 20 seconds. "It improves range of motion faster than static stretching," Rostello says. "But it's harder to stick with PNF, which takes about three times longer. And done wrong, it can be injurious."

Deciding which method to go with is mostly a matter of personal preference. Ultimately, any of these will reap rewards; the important thing is to do something. "Athletes like to rock and roll. They want to feel that endorphin high," says Phil Wharton. "But think of it this way: You can just go out and run for an hour, and it's a gamble as to how long you'll keep it up without a problem. Or you can run 45 minutes and spend 15 minutes stretching, and know that you'll be able to run every day without trouble."

Andy Dappen is a skier, climber, and canoeist who lives near Seattle.

Photograph by David Roth

More at Outside

Elsewhere on the Web

Not Now

Get tips. Get stories. Get fit.

Looking for the best in fitness? We got you covered.

Thank you!