by Carol Michaels
Stretching is one of the basic components of fitness. Stretching improves your range of motion, which is the degree of movement that can be achieved without pain. Elongating the muscle and fascia by stretching improves circulation, increases elasticity of the muscle, increases oxygen to the muscles, and helps the body to repair. It increases the circulation of blood to the muscles and prevents tight muscles, which have less blood flow. The blood carries oxygen that the muscle needs for energy. Blood flow also removes lactic acid and carbon dioxide, which cause inflammation.
Stretching should be performed every day, after receiving medical clearance. The older you are, the more important daily stretching is to maintain flexibility. Commit to stretching regularly so that you gradually improve your posture, range of motion, and flexibility. It will help you manage the stress and anxiety of the disease.
First, warm up for 5-10 minutes by marching in place or use a stationary bicycle while swinging your arms. Stretching is more effective when warm. The muscles and tendons are easier to lengthen when warm. Then perform the stretching exercises daily in the beginning of your recovery if possible. Use only smooth, controlled non-bouncy movements.
All movements should be done slowly and with great concentration. Try to reach the maximum pain-free range of motion possible for you. Do the stretches slowly and allow the tissue to lengthen. Hold the stretch until you feel a little tension, but not to the point of pain. The goals are to restore joint mobility and break down residual scar tissue.
At first, you might suffer from fatigue and low endurance and might only be able to exercise for a short period of time. Every day you can lengthen the session. Patience and practice will pay off. As you get stronger, you can increase the length of your sessions.
Once you have achieved an acceptable range of motion, it is usually necessary to continue your stretching program so you can maintain that range of motion. If you have had radiation, stretching is very important to help keep your body flexible. Radiation typically causes additional tightening and can impact the affected area for a year or longer after the treatment is finished.
The Recovery Fitness® program uses a combination of active stretching and static stretching. In active or dynamic stretching, the stretch is held for 1-2 seconds and repeated 10 times. In static stretching, the stretch is maintained for approximately 10-30 seconds and can be repeated several (2-3) times. You should move in and out of each stretch slowly and smoothly.
The following is an example of shoulder flexion active stretching: Bring the arm upward and hold for 1-2 seconds and then lower it back to your starting position. Repeat 10 times. With each repetition, raise the arm higher until you feel tension, but not pain. Exhale as you bring your arm up and inhale as you bring your arm down.
Active stretching is used in the beginning of your session. You can then begin to hold the stretch longer and alternate between static and active stretching. Our muscles work in pairs: one muscle works or contracts, while the other relaxes or lengthens. As your stretching session progresses you will determine how long to hold the stretch. The amount of time one should hold a stretch depends on the individual. By listening to your body and using common sense, you will be able to determine what feels good and what works best. Stretching, especially active or dynamic stretching helps you to get ready for any physical activity. Examples of dynamic stretches are walking lunges, squats, and arm circles. Dynamic stretching acts as a warm-up to reduce injuries, get the muscles warm, and improve performance.
- The brain and nervous system work together in every stretch, and every repetition causes neuromuscular education. By thinking about the movement and concentrating on the affected muscle, we rewire the injured or tight muscle. Be mindful of the movement and its purpose.
- Slowly lengthen the muscle to a comfortable length while using relaxation breathing
- The stretches should feel good. Hold the stretch until you feel tension. As you hold the stretch the muscle will relax and you will be able to increase the stretch. Each day it will get easier and you will see your flexibility improve.
- Modify the stretches to take into account your day-to-day pain and fatigue levels. Do not worry if you are less flexible on a particular day. Just do your best and modify the stretch as needed. You might only be able to perform a few of the stretches on a particular day, or you may need to decrease the length of your session. You may also modify your flexibility routine by reducing the amount of time the stretch is held or changing the number of repetitions performed.
- Stretching can be performed while standing, sitting, or lying on the floor. Most can even be done in bed.
- Add a variety of angles to each stretch. For example, if you perform a shoulder stretch with your arm parallel to the floor, try doing the same stretch with the arm at an angle pointing toward the ceiling.
- Stretching improves posture.
- Each movement helps to move lymph through the body.
- Stretching improves movement patterns and decreases the chance of developing over-use injuries.
- Stretching with relaxation breathing reduces stress.
- Stretching increases feelings of well-being. You are able to perform your daily activities more easily and with less pain.
Radiation treatment can cause additional tightening. Ongoing flexibility exercises are always recommended to those who have had radiation so that they are able to maintain their range of motion and all of the benefits that good flexibility brings.
Learn more about fitness for cancer patients in our previous articles by Carol Michaels: First Steps to Starting an Exercise Program and Relaxation Breathing, Stretching, and Initial Exercise Precautions.
Carol Michaels is a cancer exercise specialist and creator of the Recovery Fitness cancer exercise program. Recovery Fitness is taking place at Morristown Medical Center and several other facilities in New Jersey. Michaels also wrote “Exercise for Cancer Survivors,” a resource for cancer patients going through surgery and treatment.