// Comparing facilitated and other types of stretching

by Robert E McAtee

As a specialist in facilitated stretching, I am often asked by personal trainers to explain the differences and similarities between facilitated stretching and other kinds of stretching techniques. Athletes use a variety of stretching techniques, some of which are variations developed for specific sports or activities. Stretching can be broadly categorised as passive, active, or a blend of the two. These categories can be further subdivided into two types of stretching: ballistic and static.

Ballistic stretching

Ballistic stretching uses rapid, bouncing movements to force the muscle to stretch. This type of stretching is generally out of favour because it may elicit a strong reflex shortening, leaving the muscle shorter than its pre-stretch length. Compared with a static stretch, a ballistic stretch may create more than twice the tension in the target muscle muscle because the external force stretching the muscle opposes the shortening force produced by the stretch reflex, resulting in excessive tension in the muscle and tendons.

Static stretching

Static stretching, popularised by Bob Anderson in his book Stretching is probably the technique most familiar to athletes. In static stretching, the muscle to be stretched is lengthened slowly (to inhibit firing of the stretch reflex) and held in a comfortable range for 15 to 30 seconds (see photo 1). As the position is held, the feeling of stretch diminishes, and the stretcher moves gently into a deeper stretch and holds again (see photo 2). Static stretching can be done actively or passively.

Passive stretching

In passive stretching, the stretcher relaxes and the partner moves the limb being stretched to gain new range of motion (ROM). This is the stretching technique most often used by personal trainers with their clients, either as a static or ballistic technique. Passive stretching is also used to increase flexibility at the extremes of ROM, as in gymnastics, where maximum flexibility can be crucial for optimal performance.

Passive stretching requires good communication between the client and the trainer. If passive stretching is done carelessly or with poor form, the risk of injury to the client increases, because the trainer assisting the stretching cannot feel the sensations of the stretcher and may overstretch the muscle.

Active stretching

Active stretching means that the stretcher, rather than the trainer, does the work. Active forms of stretching are generally considered safer than the passive variety because the chance of overstretching and causing injury is greatly reduced when the stretcher controls the force and duration of the stretch.

Active-assisted stretching

Active-assisted stretching combines active movement by the stretcher with help from a trainer, either to add some passive stretch at the end, or to provide resistance to motion, thus blending active and passive stretching types.

Active isolated stretching

Active isolated stretching (AIS) was developed by Aaron Mattes and is detailed in his book by the same name inhibition, but not isometric work, to achieve greater flexibility. AIS can also be performed with a partner as an active-assisted technique. Mattes recommends isolating the muscle to be stretched, then actively lengthening it to a point of ‘light irritation’. Hold this position for no more than two seconds, then return the limb to the starting position. This sequence is usually repeated eight to ten times. This stretching protocol is thought to prevent the stretch reflex, while activating reciprocal inhibition, thereby allowing the target muscle to lengthen more easily.

Facilitated stretching

Facilitated stretching is active-assisted stretching, and uses active motion and isometric work to improve flexibility and enhance motor learning. This method is based on the principles of PNF (proprioceptive neuromuscular facilitation), a physiotherapy technique developed to help rehabilitate patients with brain injuries and other neurological disorders.For many years, athletes, coaches, and health and fitness professionals have been using the stretching protocols of PNF to effectively improve flexibility, with an eye to enhancing overall sports performance.

Athletes using facilitated stretching techniques often achieve dramatic gains in flexibility in a short period of time. As with any flexibility training, however, long-term gains are only possible with consistent practice.Facilitated stretching sequence: simplified version.In this method, the stretcher performs all the work, and the personal trainer acts primarily as the facilitator, guiding the stretcher through the appropriate steps.

Simplified, the three steps involved in facilitated stretching are:
1. The stretcher actively lengthens the target muscle to its pain-free end-range.
2. The stretcher isometrically contracts the target muscle for 6 seconds. This isometric contraction prepares the muscle to lengthen more easily in the next step.
3. The stretcher actively lengthens the target muscle to a new range of motion.

Facilitated stretch for the hamstrings

This is an effective general stretch for the hamstrings group. Lengthening short, tight hamstrings will help increase the athlete’s hip flexion (see Diagrams 1 and 2).

1. From the supine position, the stretcher begins by actively lifting their leg into hip flexion as far as is comfortable, keeping their knee extended, to stretch the hamstrings to their pain-free end-range. The trainer’s role is to remind the stretcher to keep their knee straight as they lift.

2. The trainer assumes a biomechanically correct position to offer resistance to the isometric contraction of the hamstrings (see photos 3 and 4). The stretcher must keep their hips flat on the mat during the entire sequence. The trainer may need to work with the athlete on body awareness until they are able to stabilise their hips properly prior to performing this stretch. The stretcher may bend their opposite knee and rest their foot flat on the mat instead of having the leg outstretched, if this is a more comfortable position.

3. The trainer directs the stretcher to begin slowly pushing the heel toward the floor, isometrically contracting the hamstrings for 6 seconds (cue; ‘Push against me as if you’re trying to put your heel on the floor’). Be sure the athlete breathes normally during this isometric phase.

4. After the isometric push, the stretcher relaxes and inhales deeply. During this time, the trainer supports the leg in the starting position.

5. As they exhale, the stretcher contracts their hip flexors (quads and psoas) to lift the leg higher, keeping their knee straight. This actively stretches the hamstrings to a new range of motion. As the stretcher lifts their leg higher, the trainer again reminds them to keep their knee straight, but does not push on the leg to passively deepen the stretch.

6. As the stretcher lengthens the hamstrings, the trainer simply follows along to provide resistance at the start of a new round of isometric contraction.

7. Repeat the sequence two to three times.

Robert E McAtee, NCTMB, CSCS, C-PT
Bob is a sports therapist with over 27 years experience and the author of Facilitated Stretching, published by Human Kinetics. He is certified in therapeutic massage and bodywork, and is a certified strength and conditioning specialist and certified personal trainer. Bob regularly presents workshops on facilitated stretching, soft-tissue injury care and prevention, and sports massage throughout the USA and internationally. For more information, visit www.stretchman.com