Stretching: Who Should Avoid It and Why

Who Should Avoid Stretching?

While stretching is widely recognized for its benefits in improving flexibility, range of motion, and reducing muscle stiffness, it is not universally beneficial and can be contraindicated or even harmful for certain individuals or under specific circumstances.

Acute Injuries or Inflammation

Stretching should be strictly avoided in the presence of acute injuries or significant inflammation, as it can exacerbate the condition and delay healing.

• Recent Sprains or Strains: Attempting to stretch a recently sprained ligament or strained muscle can worsen the tear, increase pain, and prolong recovery. The tissue needs time to heal and stabilize before gentle, controlled movement is introduced.
• Fractures or Dislocations: Stretching near a suspected or confirmed fracture or dislocated joint is highly dangerous and can cause further damage, displacement, or impede proper bone healing.
• Acute Muscle Tears: If you suspect an acute muscle tear (e.g., a sudden, sharp pain during activity), stretching the injured muscle can enlarge the tear and increase internal bleeding.
• Inflammation (e.g., Tendinitis, Bursitis): During the acute inflammatory phase of conditions like tendinitis or bursitis, stretching can irritate the inflamed tissues, increase pain, and hinder the healing process. Rest and anti-inflammatory measures are typically recommended first.

Hypermobility or Joint Instability

Individuals with excessive joint laxity or hypermobility should approach stretching with caution, or avoid certain types altogether.

• Generalized Joint Hypermobility: People with conditions like Ehlers-Danlos Syndrome or generalized joint hypermobility often have inherently loose ligaments. Aggressive or end-range stretching can further destabilize joints, leading to increased risk of subluxations, dislocations, or chronic pain. The focus for these individuals should be on strengthening muscles around the joints to improve stability, rather than increasing flexibility.
• Specific Joint Instability: If a particular joint is known to be unstable due to previous injury (e.g., recurrent shoulder dislocations, knee instability), stretching that joint beyond its stable range can be detrimental.

Recent Surgery

Stretching around a surgical site should be avoided until explicitly cleared by a medical professional or physical therapist.

• Healing Tissues: Surgical incisions, repaired tendons, ligaments, or muscles need time to heal and regain tensile strength. Stretching too early can disrupt stitches, tear newly formed scar tissue, or compromise the surgical repair.
• Individualized Protocols: Post-operative rehabilitation protocols are highly specific, and stretching will be introduced gradually and safely by a healthcare provider when appropriate.

Severe Osteoporosis

Individuals with severe osteoporosis, a condition characterized by significantly weakened and brittle bones, are at an increased risk of fractures.

• Risk of Compression Fractures: Forceful or end-range stretches, particularly those involving spinal flexion or rotation, can place undue stress on osteoporotic vertebrae, increasing the risk of compression fractures.
• High-Impact or Ballistic Stretching: These types of stretches are particularly risky and should be avoided. Gentle, controlled movements within a safe range of motion, often guided by a physical therapist, are more appropriate.

Certain Neurological Conditions

Some neurological conditions can affect muscle tone, sensation, and control, making stretching potentially risky or ineffective.

• Spasticity: While gentle, sustained stretching can sometimes help manage spasticity (muscle stiffness) in conditions like cerebral palsy or stroke, aggressive stretching can trigger increased spasticity, pain, or even injury if sensation is impaired. Professional guidance is crucial.
• Altered Sensation: If an individual has impaired sensation (e.g., due to neuropathy), they may not be able to accurately perceive the stretch sensation or pain, leading to overstretching and injury without awareness.

Unexplained Pain or Numbness

Stretching should never cause sharp, radiating pain, numbness, or tingling. These are red flags that indicate a potential underlying issue.

• Nerve Impingement: Pain or neurological symptoms during a stretch can signify nerve compression or irritation. Continuing to stretch could worsen the nerve impingement.
• Underlying Pathology: Unexplained pain during stretching might point to an undiagnosed injury, structural problem, or inflammatory condition that requires medical evaluation.

Active Infections or Blood Clots

Systemic conditions or localized issues can make stretching dangerous.

• Active Infections (Localized or Systemic): Stretching can potentially spread localized infections or exacerbate systemic inflammatory responses.
• Deep Vein Thrombosis (DVT): If a blood clot (DVT) is suspected or confirmed, stretching the affected limb can dislodge the clot, leading to a life-threatening pulmonary embolism. Immediate medical attention is required.

When to Seek Professional Guidance

If you have any chronic health conditions, a history of injuries, or experience pain during stretching, it is crucial to consult with a qualified healthcare professional. A physician, physical therapist, or certified exercise physiologist can assess your specific situation, provide personalized recommendations, and guide you on safe and effective movement strategies. They can help differentiate between beneficial flexibility work and movements that could pose a risk to your health.