Podcast: Do I Need to Stretch?

Courtney: Welcome to Health Matters, your weekly dose of the latest in Health and Wellness from New York Presbyterian. I’m Courtney Allison.

This week, we return to Lincoln Center for another event in the Art of Wellbeing series, a collaborative effort with NewYork-Presbyterian, the official Hospital for Lincoln Center for the Performing Arts.

I attended a movement session led by the New York City Ballet, where participants stretched and learned poses—and even some choreography—from the professionals. 

Courtney: How often do you get New York City Ballet teaching you some ballet moves?

Mother: Never.

Courtney: Did you learn anything new?

Man: Uh, tons: ballet terms, ballet moves, some of the logic behind the techniques. 

Mother: I absolutely loved it and I was just saying to my daughter too, it’s not just about the physical movements, but the, um, mental capacity.

Alexis: I’m training for the New York City Marathon in the fall. So on days that I’m not running, I’m always looking for new ways to stretch and move my body that are a little bit more low impact.

Courtney: I also spent a few minutes with the dancers who led the session.

Emma: My name is Emma Von Enck. I’m a dancer with the New York City Ballet. 

Ashley: Hi, I am Ashley Hod and I’m a dancer with the New York City Ballet.

Courtney:  Do you enjoy engaging with the community with these kinds of events?

Emma: I love these community based events. Just bringing dance to people of all walks of life. It’s something very dear to us and it’s so exciting to get to share. 

Ashley: I have a really great time sharing what I love doing every single day and what feels so good for me and for my body, and getting to connect through movement and through art and um, through exercise and have a great time together. 

Courtney:  Thank you. It’s such a treat.

Courtney:  A few days later, I sat down with Dr. Katherine Yao, a doctor of rehab and sports medicine, who had introduced the session at Lincoln Center and reminded participants about the benefits of dance and stretching in their everyday lives. I asked Dr. Yao to say more about how important it is to stretch, not only to avoid injury, but for our overall wellbeing. Here’s my conversation with Dr. Yao.

Courtney: Hi, Dr. Yao. Thank you so much for joining us today.

Dr. Yao: Hi. Thank you so much for having me.

Courtney: It was so great seeing you at the event with Lincoln Center and the New York City Ballet. Did anything stick with you?   

Dr. Yao: It was a lovely event it had a great turnout. It looked like everybody was having a lot of fun with the dance lessons. There was a lot of stretches and just getting the body moving. That in and of itself is very beneficial for the body to gain some blood flow to the muscles, regain some flexibility and movement to maintain our agility and ability to stay mobile and active.

Courtney: And so you work with a lot of professional dancers, and Olympic-level athletes. Could you say a little bit more about how you help athletes and artists prepare for the demands on their bodies?

Dr. Yao:  So there’s many ways that we try to help them prepare. Warmups are very important, So we can get the blood flow going, get the muscles warm to decrease the risk of muscle strains and muscles tears, as well as, being able to reach our maximum kind of effect of being able to contract our muscles. Then we can jump higher and bigger.

And then the other part of injury prevention is to just pay attention to the bodies and if you are having pain, to notice it and speak up early, to have it checked out if it is something that is recurring so that we can address injuries early before they become more problematic.

Courtney: Well, so let’s build from the basics. We might all feel like we know what stretching means, but could you define stretching for us? What is stretching and what does it actually do on a physical level?

Dr. Yao: Stretching is essentially elongating a muscle, and a lot of very tiny minuscule fibers make up each individual muscle. By stretching, what we’re doing is we are elongating it and getting it more pliable. 

So the two main types of stretching that I’d like to talk about is first off, dynamic stretching, which is a form of stretching where you are warming the body up and using the muscles as we are trying to stretch and elongate them. This type of stretching is best done as a warmup and before exercise.

And sometimes it’s what we’re doing during exercise as well. An example is doing some high knees or some light kicks with the legs or some arm circles with the arms. So we are actually moving the body as we are stretching and not holding like one long stretch for a long period of time.

The second type that we talk a lot about is what is called the static stretching. That is: just pulling it on a muscle and kind of holding a stretch for a long period of time to try to get it to elongate and be more flexible.

So that is when, say, you want to stretch your hamstrings, you bend forward and hold a lunge position for 30 seconds to elongate your hip flexors and your quadriceps. This type of stretching is usually best done after a workout or at the end because it does help elongate, but holding the positions for long periods of time sometimes can inhibit our ability to contract the muscle. So we don’t like to do too much of that as a warmup, because we may not be able to activate the muscles as well.

Courtney: So in general terms, what are the benefits of stretching?

Dr. Yao: So in general terms, the benefits of stretching is that we are keeping the muscles more elastic and we are actually increasing blood flow to them and it keeps the muscle cells healthier. It keeps them more resilient to activity so that we are suffering less muscle tears and muscle strains.

Even though an everyday person they’re not doing as extreme movements and motions as dancers are, they are still moving around and running from one place to another, and in order to just be able to adapt and adjust and make some quicker movements, if those muscles are warmed up, pliable and resilient, they will respond faster and better and recover much better.

Courtney: I always feel like stretching helps when I’m stressed and tense. Is there anything to that? 

Dr. Yao: Activating muscles and all of the microscopic changes that happen, with blood flow and hormone changes, that all has a lot of downstream effects of mood changes. Both moving the body, having more blood flow to the muscles can increase blood flow to our brains as well and change our mood, but also just being able to focus, completely focus, on something else does change our mindset and can help decrease stress.

Courtney: So should we be stretching every day? How much time should we dedicate to stretching?

Dr. Yao: So there’s no set rule of how much we should be stretching. I would say ideally it would be great if we could stretch every day. It’s impossible to stretch your whole body, every part of the body, every day. However, if people can come up with a short routine that they can alternate one day to the next, of, you know, some days stretching their hamstrings and their back and their calves and another day stretching their hip flexors, their core, and their shoulders and arms, that would be a more realistic way, I’d say, of approaching it.

Courtney: Is it something you’d recommend we do when we wake up in the morning or before we go to bed, or is it just kind of a matter of preference?

Dr. Yao: I think that’s going to be more of a matter of preference. If someone tends to be stiff in the morning when they wake up and stretching in the morning is definitely going to be more helpful. People who tend to get cramps at nighttime will probably benefit more from stretching before bedtime, as well as stretching a few times throughout the day as well, just to keep the muscles a little bit looser.

Courtney: So I think something else that people get confused about is whether we should stretch before we out or after we work out.

Dr. Yao: We definitely want to actually do a little bit of both. Before we work out. We mostly wanna get the body warmed up. We don’t necessarily have to do aggressive stretching. I would say before a workout, warming up is more beneficial than focusing on stretching for a long period of time.

But then after the workout is when you want to focus more on the stretching. So if you’re gonna do a longer stretch, I would recommend doing it after a workout.

Courtney: So when we think about preventing injury and supporting our best long-term health, aside from stretching, how important is posture?

Dr. Yao: Posture plays a very important role in maintaining our health and particularly our spine health, and it is very beneficial for maintaining good balance and preventing falls as well. Posture is related very closely to core engagement and core strength. However, we must note that someone could have the strongest core in the world, but if they don’t practice actually using it and activating it and holding their posture in the best way they can, it won’t do them any good for their spine health or their posture.

Courtney: Do you have any favorite postural exercises you recommend to listeners?

Dr. Yao: Yes. So for the upper back and neck, which is where a lot of people’s posture will break down, I do really like the wall angel exercise, and this is where you line yourself up and stand against a wall where you just press every part of your back, the low back, upper back, head and neck against the wall, and bring the arms and shoulders against the wall out toward shoulder level and then essentially do snow angels, but just angels against the wall while keeping everything pressed up against it. That is really good to activate a lot of the upper back muscles, the periscapular muscles, which are the muscles between your shoulder blades, and it helps keep good alignment of everything. It’s a simple exercise to imagine. In practice it can be harder than what it seems, but at least it has a very low risk for injury and you can build up strength gradually with that.

Courtney: Are there any common stretches or exercises that are popular but that you actually do not recommend?

Dr. Yao: Hamstring stretches are very common and very popular. They are very important to help maintain hamstring flexibility, which can help the low back. However, there’s a lot of different ways that you can see people stretching their hamstrings, and some of them are safer and healthier than others.

The most common one you’ll see is someone. Raising the leg up on a chair or something high and then just reaching forward or even just doing a forward bend, folding themselves in half to stretch. If you have higher flexibility, this can be perfectly fine and safe. However, if you’re extremely tight, it just may not be the best, most effective way of stretching, and sometimes it can cause some increased stress or strain on your back. In those cases, usually what I recommend is laying on your back and actually raising the leg upwards in the air and using either an elastic band, a towel, or some type of rope to pull the heel and leg up towards you lightly, and then you can control that stretch a little bit better while maintaining a straight spine so that you don’t hurt your back.

Courtney: That’s so helpful. Thank you. That sounds like it feels really good too. Any other parting advice or anything else you think it’s important for people to know about stretching and posture.

Dr. Yao: I would say practice makes perfect. So don’t worry about parsing out a very long time to do the stretches or to work on posture. Just the more frequently you can practice it, the more your body will get used to the activity and the movement, and you will build strength as you do it, and endurance. It’s very hard at the beginning to figure out how to hold yourself and you know what muscles to activate, but it becomes easier over time and you’ll build that endurance and then before you know it, build that neuromuscular activity and function to just snap into that position a lot easier.

Courtney: Just like the ballet dancers we saw.

Dr. Yao: Yes.

Courtney: Thank you so much, Dr. Yao. This was so helpful. I really appreciate all these wonderful tips about stretching. Thank you for joining us today.

Dr. Yao: Thank you again for having me. 

 Our many thanks to Dr. Katherine Yao. Ashley Hod, Emma Von Enck, and all the participants of the workshop. I’m Courtney Allison.

Health Matters is a production of New York Presbyterian. The views shared on this podcast solely reflect the expertise and experience of our guests. To learn more about Dr. Yao’s work with patients, check out our show notes!

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