This is probably one of the most common questions I get from clients. Or, more likely, it’ll come in the form of a statement, as in:  “I know I should probably stretch after our sessions.  Right?”

Not surprisingly, the answer is: It depends on the context (betcha weren’t expecting that one). 

If this were the 1970s, extortations of stretching, warming up, before and after exercise might have ensued.  However, it’s 2008, and we know better now.  We know that stretching prior to exercise does little to nothing, since cold tissues don’t stretch, and you’re likely to overstretch and compromise joint integrity in doing so.  We also know that stretching after exercise is pretty useless as well, at least for the benefits often stated: injury prevention and decreased soreness.

So what is stretching good for?

Well, if you’re like this person, probably nothing.

However, if you’re one of these guys, then yes; you should stretch. 

Confused?  Don’t be.  Here’s why:

In the sports depicted above, greater-than-normal ranges of motion (ROM) are required.  If you didn’t have the excessive joint mobility required to succeed at these sports, you can’t play the game well.  Is it beneficial for long-term joint health?  Probably not (definitely not if sufficient strength isn’t developed in the muscles that surround those joints).

If course, the weightlifter in the above example shouldn’t stretch before his max attempts.

How else may stretching be beneficial?  Injured individuals may benefit from stretching as they experience a “true” shortening of muscle and connective tissue, as a result of the injury.  This is an adaptive response, meant to protect you from greater harm (e.g., you blow out one of your lumbar discs; your lower back muscles instantly seize, effectively ”locking up” your back, preventing further movement, and further injury).  Or, in cases of trauma, the scar tissue that replaces healthy tissue is more fibrous and much less elastic, so stretching is necessary just to maintain normal ROM.

Note that this adaptive shortening is different from the “tightness” most people feel as a result of inactivity (i.e., weakness).  What seems like “tight hamstrings” isn’t tightness as a result of shortening, but results from something else.

Summary:

• If your goal is fat loss, general health, or muscle gain, then you don’t need to stretch.
• You should stretch if a) your sport demands high (read: greater than normal) levels of flexibility, or b) you’ve sustained an injury and are trying to return to “normal” ROM.

A comment by a reader over the weekend reminded me of a topic that is little understood but comes up with surprising frequency: exertional or exercise-induced headache (EIH). 

I previously blogged about EIH here but here’s the skinny on it: EIHs occur due to either increased pressure in the venous sinuses around your brain, excessive tension in your head and neck muscles, or a combination of both (it is possible that another mechanism may be at work, but those are the best explanations for exertional headaches as of rigth now).  Before you get images of blood spurting out of your ears and worry about sustaining a stroke while performing an overhead press, don’t worry.  Most EIHs are mild and transient - they cause some degree of pain acutely, and tend to leave a dull ache/pressure for a day or two afterwards, but as far as I know most cases aren’t causing any long-term damage.

What is problematic is that if the trainee doesn’t resolve the form issues that cause EIH, they may give up on strength training (or intense exercise, as any activity requiring high level of effort can result in EIH) altogether.

There are three main causes of EIH (as far as strength training is concerned), and the first is overwhelmingly the biggest factor:

1. Valsalva:

Valsalva is simply extertion against a closed glottis, i.e., holding your breath and bearing down (think #2 in the bathroom).   It’s not hard to imagine how bearing down in this manner causes blood pressure to increase, which in turn causes the pressure in the sensitive venous sinuses to increase…

The easiest “cure” for EIH is to overbreathe while lifting.  I’ll often instruct clients to hyperventilate while performing a set; that during their most intense efforts, their breathing should resemble Lamaze.  This helps by preventing blood pressure increase during a set, since trainees are unable to sustain pressure inside their abdominal cavity if they’re constantly taking breaths.  Some clients argue that it feels silly or that they feel a little light-headed afterwards, to which I normally respond, “It’s better to be a little light-headed than to have a headache.”

No, this isn’t the best method for attaining one-rep maxes, but if you’re getting EIHs then you’re not ready to try maxing out anyway.

2. Excessive neck tension:

Hand in hand with breath-holding is scrunching up the face and excessively tightening the muscles of the neck.  This creates tension in the neck and head muscles, which can contribute to a headache.  While breathing in the above manner (see #1) helps to ameliorate this somewhat, consciously relaxing the face and neck areas helps as well.

3. Incorrect posture:

Whenever possible, the spine should be kept in anatomical neutral, which is a fancy way of saying that the natural curves of the spine should be maintained and the head should be kept forward.  There’s a strong tendency (for novices, at least) to whip the head around when giving your best efforts on an exercise.  This kind of behavior should be kept to a minimum, since the more stable your torso (read: spine) is, the easier it’ll be for you to lift a weight with max effort.  A good rule of thumb is to imagine yourself holding an extra large egg underneath your chin; think of neither dropping the egg nor cracking its shell.

Most trainers have never heard of EIH but I can bet you they’re worked with someone that had one.  It’s important to note that while they’re uncomfortable, EIH are not life-threatening and highly preventable.  If you or someone you know gets these kinds of headaches, you now know how to deal with them.

Before you put on that pair of Manolo Blahniks, consider for a moment the ramifications:

Consider the unnatural joint position you must attain with your ankle just to stand in them. Now, consider movement - the range of motion (read: flexibility) requirements are stretched even further.

Hope your joint capsule can support it.

With all that stretching going on, you’ve got to have some heavy duty joint stresses on the ankle - shearing force on the small bones of the foot, unusual compressive forces, etc.

Not only that, but there’s the rest of the body to consider as well. Such an unusual ankle position affects gait, causing your knee and hip to relate differently, and over time this can cause joint issues as well (Harvard’s Dr. Casey Kerrigan found that women who wear high heels are at increased risk for osteoarthritis of the knee due to the increased knee torque).

Not to mention the effects on your lower back.

So, what can a gal do? Suffer the consequences of high fashion, or give up chicness forevermore?

I’m not one to tell you what you can or can’t do with your life. So if you want to wear high heels, then go ahead and wear ‘em. But make sure you take these precautions as well:

1. Strength train. A stronger joint (resulting from increased connective tissue strength and improved stability from stronger leg muscles) will be better able to resist the increased forces on your foot/ankle/knee/body.
2. Wear stilettos rather than chunkier heels. Surprisingly, Dr. Kerrigan’s studies found that there was greater knee torque (read: rotational stress on the knee joint) when wearing high, chunky heels as opposed to high, thin heels (26% vs. 22%). This suggests that stilettos are “safer” than their thicker counterparts (of course, Dr. Kerrigan found that low and no heeled shoes were safest).
3. Minimize grains and starches in your diet. There’s evidence that suggests a diet high in grains and starches increases inflammation, causing a greater chance of developing arthritis. By minimizing your ingestion of these foods, you may be able to stave off joint problems caused by arthritis and continue wearing your stylish footwear.

For 4 of the last 6 days, I have subjected my body to one of the most enjoyable stresses on this planet (at least in my eyes) - training in Brazilian Jiujitsu.

Above: Harai Goshi is now my new favorite throw.

Most health and fitness professionals would look at my activity level from this past week and think, “Well, that’s great!” While from a skills-acquisition POV I’d agree, I’d immediately chastise any client of mine who did that “for the sake of being active.” You see, I advocate applying exercise as you would medicine, i.e., use the minimal dosage needed to achieve the required response.

Professional organizations like the American College of Sports Medicine would have you believe that daily or near-daily exercise is a good thing. However, new findings from the folks at the University of South Dakota suggest otherwise.

Published in the journal Hypertension, Dr. Rebecca Schultz and colleagues found that “excessive amounts” of exercise in hypertensive rats resulted in a hastening effect towards heart failure. In other words, rats with high blood pressure made themselves worse by regularly exercising.

Too much exercise isn’t a good thing, it seems, but this isn’t breaking news. Other research has found that mortality increases when exercise activity goes past a certain point. Exercise loses its protective effect if carried on too long, too often.

What guidelines should you use?

Well, there is one thing that is correlated with living longer: muscle strength. The stronger your muscles, the longer you live - and you don’t have to worry about getting too strong (too much strength doesn’t increase your chance of dying, unlike too much exercise). And luckily, the amount of strength training required to improve strength levels isn’t much - at most 2-3 hours a week (to put it in researcher language, less than 1000kJ of exertion per week).

I’m not saying don’t pursue activities if you like them and derive pleasure from them. Whatever your chosen sport is - rock climbing, running, competitive tango - if you enjoy it, then do it. But if you do it because you think you need to, then don’t. Do something you enjoy and stay off the hamster wheel, ok?

Why breathe when weight training? I mean, why not just hold your breath for the entire set and pass out at the en….oh. Guess I answered my own question.

Ask a fitness professional why you breathe during a set, and you’ll get a number of great reasons, like:

• Your blood pressure will rise sky-high.
• You’ll sustain an Exercise-Induced Headache.
• You’ll burst a blood vessel.

…all of which are proper, valid explanations. Easily understood reasons.

And yet, when the rubber meets the road, your instinct is to hold your breath, especially when things get tough. Why is that? Why would you want to rocket your blood pressure sky high?

Well, of course, you don’t. And that’s not what Valsalva’s all about anyway.

What’s Valsalva?

Scientists, doctors, and highfalutin’ snobs like myself refer to the phenomenon of holding one’s breath and exerting as the Valsalva manuver. When holding your breath to complete a rep, you are performing a Valsalva manuver (most people perform a Valsalva daily when sitting on the throne, especially if they aren’t drinking enough water or eating fruits and veggies).

Valsalva is all about protection.

When you hold your breath and tense, you create an air pressure “ball” inside your abdominal cavity. This pressure ball serves to stabilize your spine by acting as a support beam (more like a pillar) for your spine, minimizing anterior stress when you’re trying to lift something.

Valsalva is a natural, preprogrammed instinct. It’s actually good, when you think about it - after all, if Neolithic man (or modern day Cindy Morrison) is trying to lift a humongous boulder, a little extra spine support could come in handy.

The problem arises when you sustain Valsalva for a long period of time.

That same protective pressure ball presses firmly on the large vein (the inferior vena cava) that returns blood from your legs back to your heart, cutting off bloodflow. This has two huge implications:

1. Since your circulatory system is a closed system, blood pressure dangerously rises, especially in the arteries.
2. Your heart gets minimal blood return and pumps harder and faster in a futile attempt to keep your muscles oxygenated.

If this continues, expecially under conditions of lifting heavy things, it’s no wonder athletes and amateurs alike burst blood vessels, turn beet red, and (in extreme cases) pass out and/or die (although to be fair, the majority of deaths occurred because the lifter wasn’t using the rack or a spotter, passed out during a lift, and crushed his ribcage and heart with the weight he was trying to lift). It’s clear that Valsava just wasn’t meant to be employed for a long time (more than a few seconds).

What does this mean to you? Breathe freely. Don’t hold your breath at all during a set. Powerlifters hold their breaths all the time you say? Yes - and their max attempts last no longer than a few seconds (and even then, Andy Bolton exploded blood vessels in his nose during his record-setting squat).

Breathing freely during a set will minimize impact on blood pressure, keep you focused, and prevent headaches. And, you won’t get blotchy eye, like this guy:

Above: One good reason to breathe when weight training is to avoid a subconjunctival hemorrhage (i.e., burst a blood vessel in your eye).