Functional Flexibility

Here’s a program to give your athletes the flexibility they need to make the big moves.

By Jason Soncrant and Vern Gambetta

Jason Soncrant, PT, is a Physical Therapist with Gary Gray Physical Therapy, in Adrian, Mich. Vern Gambetta, MA, is the President of Gambetta Sports Training Systems, in Sarasota, Fla., and the former Director of Conditioning for the Chicago White Sox. He is a frequent contributor to Training & Conditioning, and can be reached through his Web site, at www.gambetta.com.

Training & Conditioning, 11.5, July/August 11.5, http://www.momentummedia.com/articles/tc/tc1105/flex.htm

Flexibility often conjures images of slow meditative movements, deep breathing, and muscles stretched taut like rubber bands. In describing flexibility, words and pictures are commonly used that convey a static position or still picture.

This is precisely where many misconceptions about flexibility begin. Flexibility for sports is more than maximal lengthening of soft tissue—and it is not a posed, static position. It is about movement and control of multiple positions that must occur rapidly to meet the demands of an athlete’s sport. It is a very important component of sport performance that can be significantly improved if approached correctly.

Sport-specific flexibility requires an integrated expression of joint stability, strength, movement awareness, and soft tissue extensibility. What good is soft tissue flexibility without joint stability? What good are supple muscles if they cannot control segmental body weight as the athlete fights gravity? What good is any of this if the body cannot interpret external sensory input to promptly initiate a coordinated sequence of segmental movements? The muscles must be flexible, but they must also be able to initiate and control the athletic actions sports demand.

In this article, we look at the role of flexibility based on the most fundamental movement, the gait cycle. This is the basis for all movement, from walking to running to jumping, and even throwing. The phases of the cycle describe movement as it passes through weight acceptance and limb advancement in both single- or double-leg support. Each phase of the gait cycle puts different demands on the muscles crossing the various joints that produce movement and joint stabilization. The stretches that we describe are designed to address those demands. They have direct application to all sport activities.

The first thing to understand is that, in gait, all joints are moving simultaneously and in all three cardinal planes. Therefore, stretching to improve gait requires multi-segmental and triplanar movements against gravity with neural excitation. Also, realize that the stretches are not static. Stretches must include joint movement even when the muscle is lengthened, because that is how they function in gait—muscles are stretched to provide eccentric segmental stabilization long enough for forward momentum and concentric muscle action to create segmental mobility elsewhere in the body. Below, each basic phase of gait is listed with a brief description followed by practical stretches that apply to the muscles used in that phase.

INITIAL CONTACT
This is the starting point, where the reference foot contacts the ground, starting a double-leg support phase. Typically, the heel strikes first and ahead of the pelvis. The impact causes the ankle to plantarflex with knee and hip flexion. There is rapid internal rotation of the femur and tibia relative to the pelvis. The hamstring and hip rotators act to decelerate these sagittal and transverse plane movements.

Stretch: Perform a typical standing hamstring stretch with internal and external hip rotation of the limb being stretched. We call this a bottom-up stretch because it is being driven from the ground up.

Start in the standing position, place one foot a comfortable step-length in front of the other, either on the ground or on a six-inch step. The knee and hip are slightly flexed with the ankle maximally dorsiflexed. The stance leg is held in a relatively straight position. In this position, you may feel pulling in the back of the thigh or calf. While maintaining this posture, rotate the leg being stretched in and out. If done correctly you will feel the intensity and location of the stretch change with the rotation. Hold the stretch for 10 seconds.

LOADING RESPONSE
Continuing in double-leg support, the pelvis moves forward and downward toward the lead foot. The lead foot is flat on the ground, which allows the ankle to dorsiflex, while the hip and knee continue to flex and internally rotate. The hamstrings, posterior calf, quads, and hip rotators are all active in controlling these movements.

Stretch: Standing, place one foot on a six-inch step. The front knee is flexed roughly 50 to 60 degrees, with the ankle dorsiflexed. The rear leg should be straight, with toes pointed slightly inward. Reach across your body until you feel a stretch into your lumbar, gluteal, and hamstring regions. Your opposite elbow should come in close proximity to your reference knee. The lead arm should not reach to the floor, but should reach horizontal to the floor. Hold the stretch for 10 seconds. This is a top-down stretch because the arms drive it from above.

MIDSTANCE
The body assumes a single-leg stance as the pelvis moves directly over the reference foot. The opposite foot is off the ground and swings forward past the reference foot. The ankle is relatively dorsiflexed and abducted but the calcareous is starting to invert, the knee is extended, with the hip extending, adducting, and internally rotating. The unsupported side of the pelvis rotates forward past the supporting limb.

Stretch: Start in a single-leg stance, standing tall. With your foot flat, drive your pelvis forward. Your belly button should now move over your toes, thereby lengthening the posterior calf and anterior hip soft tissues. Don’t excessively arch the back. Now, step forward with the opposite leg 12 to 20 inches ahead of the supporting foot. Allow only the heel of the front foot to contact the ground to keep the bodyweight on the back leg. The stretch should be felt in the gluteal and lateral hip area of the stance leg. Hold for five seconds in each position. This is a balance stretch. Allow your pelvis to glide forward over the fully planted foot to mimic continued forward momentum of the pelvis.

TERMINAL STANCE
The opposite foot is on the ground in front of the reference foot, creating a double-leg support phase again. The reference hip trails behind the opposite hip. The reference hip must extend, abduct, and internally rotate to allow forward momentum of the freely swinging limb to continue. While the reference ankle is inverting, it is moving from a dorsiflexed and abducted position into a plantarflexed and adducted one.

Stretch: Assume a stride position, with one foot in front of the other in a straight line. The length of the stride should be about the same as leg length. Be sure to keep the back heel down and the front knee bent. To stretch the psoas, gently rotate your shoulder to the right and then repeat to the left. To stretch the calf, toe in on the back foot 30 degrees. Now, drive your hips forward so that most of your bodyweight is on the lead foot. Repeat the stretch with the rear foot toed out 30 degrees. Hold each position for 10 seconds and repeat five times.

PRESWING
Remaining in double-leg stance, the reference foot is pulled off the ground by forward momentum of the pelvis. Normally, the heel lifts first and then the toes. The moment the toes clear the ground, this phase ends. The hip is still extended, abducted, and externally rotated. The knee flexes to help clear the foot. The ankle plantarflexes, abducts, and inverts. The toes, especially the hallux, must go through a large excursion.

Stretch: Assume a lunge position with the back foot on a four- to six-inch step. Be sure your feet are oriented in a straight line. Now, in a controlled fashion, glide your hips forward to pull the rear heel off the step. Allow the heel to rise until most of the pressure is on the toes and balls of the feet. Be sure to keep the toes planted so they bend sharply.

SWING PHASE
Concentric muscle activity drives this part of gait. The entire time, the reference limb swings forward through the air until the moment before the foot contacts the ground, usually with the heel, thus ending one cycle and immediately flowing into the next cycle. The reference side of the pelvis is unsupported and rotates forward with the swing limb. Forward locomotion is strongly propelled by the swing-limb momentum.

Stretch: Perform leg swings while in single-leg stance. Allow the swinging leg to angle about 30 degrees across midline while pointing the toes straight ahead. The key to this stretch is to, at the same time, exaggerate arm swing to accentuate core rotation in swing phase.

Conclusion
These stretches performed in sequence help to prepare the body for locomotion by addressing multi-joint and triplanar balance and flexibility, in single- and double-leg support. Both open and closed chain events are targeted and the eccentric and concentric muscle activities are addressed. If any of these factors are missing or reduced, then the overall gait efficiency is impaired. If one phase of gait is removed, the body has to create drastic and inefficient strategies to compensate.

For example, to limit the loading response, try walking slowly and perform initial contact with the entire foot. You will feel slow and awkward. Your step length is shortened and you probably will increase your arm swing and hike your hips to compensate. Now try walking fast. The relative extension in the joints reduces effective shock absorption and you may feel more impact into your back and the strain in your hips.

Next, try eliminating the terminal stance and pre-swing phases of gait. Walk in a goose-step fashion by swinging your legs in a limited fashion. The arc of swing is from just under your hips to in front of them. Walk slowly, then fast. You will not feel very swift and you are likely to bound upwards in order to generate forward momentum. You can feel your abdominals and hips straining. Your hamstrings may also feel a little snug. This gait alteration has caused you to fail to pre-stretch the abdominal and anterior hip/thigh muscles to create an efficient and powerful swing phase.

The amazing thing about gait is how each phase of the cycle translates so smoothly into the next phase. Success at one phase of gait is heavily influenced by the previous phase.

Because the gait cycle is the basis for all movement and its components play such an active role in sport performance, basing flexibility training on gait maximizes results. With these few simple stretches, athletes will be able to achieve maximum flexibility with the most crossover to actual sport movements.


Further Reading
1) Norkin, C., Levangie, P. Joint Structure & Function: A Comprehensive Analysis. 2nd Ed. F.A. Davis: Philadelphia, 1992.

2) Tiberio, D., Gray, G.W. “Kinematics and Kinetics During Gait.” In Donatelli, R., Wood, M.J., eds. Orthopaedic Physical Therapy. Churchill Livingstone: New York, 1989.

3) Root, M.L., Orien, W.P., Weed J.H. Normal and Abnormal Function of the Foot. Vol II. Clinical Biomechanical Corp.: Los Angeles, 1977.

4) Gray, G.W. “Chain Reaction Festival Seminar.” Wynn Marketing, Inc.: Adrian, MI. 1996.