“I stretch my neck all of the time.” Dr. Iminpain, DDS proudly declares.
“You do? That’s great! How long do you hold the stretch?” I feel a great sense of hope as our consulting session begins. Maybe he has picked up a valuable tool that we can work with to help reduce his neck pain. That feeling of hope fades quickly with is next statement.
“I’m not sure. Just until I feel that it doesn’t need it anymore.”
“Ok. Can you please show me what stretches you are performing?” It seems that he has not had proper training in stretching and I fear that he will soon abandon the practice when there are no results.
Now picture an otherwise distinguished professional man very awkwardly lifting his arm above his head at the same time rotating, twisting and bending his neck in some bizarre fashion that I am sure was a modified version of the infamous exorcism scene.
“Wow, that is some stretch,” I continue, already anticipating the answer to my next question. “How did you learn that one?”
“YouTube. There was an 'exercise expert' that claimed this would help with my neck pain.”
“Then maybe we should look at some proper stretching techniques that may be more effective for you.” And so our work begins.
Unfortunately, this is not an uncommon encounter to have with dental professionals with whom I work. They have the right idea, stretching is an integral part of overcoming musculoskeletal discomfort caused by assuming awkward positions throughout the day. It also seems like such a natural and easy undertaking. What is there to know about stretching? Turns out, a lot.
Stretching is a natural phenomenon. You experience the urge to stretch when your muscles require nutrients and your brain wants to improve circulation. Before you know it your arms are high above your head and your body is moving in all sorts of inexplicable directions rarely observed in a context other than on dancefloors at family weddings as you try to dance the funky chicken.
However, stretching for dental professionals for the purpose of pain relief is much different. It is not so natural. In fact, it has to be learned. It is a skill to be honed after much practice. The more you know how to anticipate your own body’s needs and how to incorporate stretching, the more effective the stretches will be for relieving pain. After spending time practicing and implementing key strategies, the body learns how a stretch should feel and it will start to seem more natural.
Just doing any stretch over and over is not the answer to improving your stretch mechanics. The old adage is very true when it comes to stretching: Practice doesn’t make perfect, perfect practice makes perfect.
Since there are hundreds of stretches available, the goal of this blog is not to introduce you to all of them. Instead, the intent is to provide fundamental principles of stretching which should be applied to all stretches so that they may be effective. For specific stretches, you can visit my website here, or check out Bethany Valachi’s book Practice Dentistry Pain Free. No matter which stretch you choose that is appropriate for you, these principles apply.
1. Form is everything.
Specific and purposeful stretching is necessary to lengthen muscles which have been shortened and are contributing to pain. Of course, this lengthening will only happen if you stretch the correct muscle. Improper form misdirects the force of the stretch to other muscles and structures thus not lengthening the muscle fibers of problematic tissue and leaving you frustrated.
Don’t give up!
Proper form is not always easy to achieve in the beginning. Not only that, but it also may change from day to day. The body is a fickle world that is dynamic and responds to the internal and external environment. These things affect what is going on with the muscle fibers. So form may have to change so that you are getting the fibers in need of the stretch at that moment.
Key: Know your anatomy and your body. Check out this cool site that can help you pinpoint the muscles which need the stretch. Once you know your problem areas, you can then find the stretch that is right for you. Remember, if you are not feeling the stretch in the offending muscle, your form probably needs a little tweaking. Don’t be afraid to wiggle a little until you learn which position is the right one for you in that stretch.
2. Stretches are active!
After you have learned what to stretch, you now need to know how to stretch. Proper stretching requires your presence. In other words, you have to pay attention to what you are doing. Stretching will not be nearly as effective if you simply “assume the position”. Staying focused and active in the stretch allows the natural forces to elongate to muscle fibers effectively. Yoga can work because it requires awareness of the body and a gentle challenge to “move deeper into a pose”. It may not be practical to break out your Downward Facing Dog yoga pose in your office, however, it is possible to apply the same principles of yoga to all stretches.
Key: Once you have found the right positioning, use your breath to guide you deeper into a stretch. Every few breaths try to gently push yourself a little further into the stretch. Stretching SHOULD NOT HURT. So be careful. If you are very restricted, you may find that your body simply does not want to go further. That is ok. Stay in a position where you are able to feel the stretch with a slight discomfort. If the discomfort eases, then try to find it again by pushing yourself a little more.
3. Use the correct dosage.
Stretches take time. There are no shortcuts. In my practice and consultations, I routinely recommend 1 minute hold times once per day. That is a long time to hold a stretch, but see why this time is so important by watching Nikos , the developer of a technique called microstretching, explained here. He recommends performing the 3 sixty second stretches once per day. This frequency of stretching can be time consuming if more than one muscle group is troublesome. Not only that, but when delivering dental care, the muscles you have stretched are returned to their shortened and contracted positions often.
Key: Perform the 1 minute stretch per muscle group in the mornings after a warm shower. When you have brief breaks in care, incorporate “mini” stretches. These “mini” stretches should last from 30-45 seconds. This does not allow for time to stretch the muscle/tendon junction for an extended period of time, but it does allow for a general lengthening of all of the muscle fibers.
4. Be consistent!
Stretch every single day! No need to explain this. Make the time and just do it!
Key: Integrate stretching into your morning routines and practice. Create a habit and encourage others around you to do the same. It is much easier to start something new if you have a support system.
Stretching is an instinctive part of our daily lives. Proper stretching can leave you feeling invigorated, refreshed and pain free. Use these resources and guidelines to perfect your stretching techniques so that you can begin to experience the benefits.
As always, stay healthy and practice safely!
B. Valachi, Practice Dentistry Pain Free: Evidence Based Strategies to Prevent Pain and Extend Your Career, Portland: Posturedontics Press, 2008.
N. Apostolopous, "Micro Stretching," MicroStretching.com, Vancouver , 2008.
"Healthline," Healthline Networks, [Online]. Available: http://www.healthline.com/human-body-maps/. [Accessed 5 November 2015].
mahalodotcom, "YouTube," 3 June 2010. [Online]. Available: https://youtu.be/w43eUOjHkpA. [Accessed 6 November 2015].
.="J. Benedict, "Healthy Solutions for Dental Professionals," February 2015. [Online]. Available: www.jbenedictdpt.weebly.com. [Accessed 4 November 2015].