Flexibility relates to the range of motion of a joint or joints. It is the degree to which our joints move freely, in their various directions and planes. We are each genetically predisposed to some overall level of muscle tightness or flexibility. On average men are less flexible (and have more muscle strength) than women. In addition each of us has variable flexibility in different areas of the body. For example, some people can do forward bends much more easily than back bends, while for others the opposite is true.
In Alexander yoga practice our first priority is always on coordination rather than flexibility. Those who are not dancers or gymnasts require only a modest degree of flexibility to comfortably engage in daily life activities, but the ability to coordinate appropriately is highly beneficial for our comfort, well-being, and health. In Fig 1 is an image of a child bending. Many adults have the flexibility to perform this movement, but even with their flexibility can;t find the coordination to perform it, having lost what was initially an innate ability to do so. In the case a few Alexander lessons will help them to recover this ability. And many adults have become too stiff to do this movement and in that case it is well worth working to regain that flexibility using both yoga and the Alexander technique.
Practicing the range of yoga poses gives people an opportunity to be mindful of how they are moving, so that they can catch and refuse to respond to constricting habitual impulses (inhibit) and coordinate themselves more appropriately (direct) within those poses. This work is beneficial for self-awareness and proper use, whatever a person’s level of flexibility.
Fig 1 Fig 2 Fig 3
There are two major factors governing our flexibility. First, there is the physiological state of our muscles and connective tissue. And second, there is our neurological make-up, which determines a “set point” for our muscles, a point at which the stretch reflex kicks in and initiates contraction against a stretch. In the case of some people with hyper-mobility the connective tissue is so lax, that this reflex happens far too late, which can put joints into extreme and damaging ranges of motion as illustrated with this knee joint in Fig 2.
The relationship of neurology to flexibility is demonstrated by the fact that under anesthesia, even in people who are not hypermobile all muscle tone is lost and the tightest body can be manipulated into a whole range of extreme contortions. Fig 3
People coming to yoga classes have a greatly varying flexibility, from hypermobile to very tight. People can, and do, increase their mobility and range of motion by practicing yoga. But for many who have very tight musculature and ligaments there is a limit, and sometimes quite a modest one, to the increased range of motion they can attain. These are the sort of people like the man in Fig 4, who say “I’ve tried yoga but I can’t do it,” meaning there is no way they can get anywhere near the poses demonstrated in the yoga class they attend. It is quite simply harmful and counter-productive for the man in Fig 4 to attempt this sitting forward bend. Those who have been put off from attending yoga classes are in fact the ones who would benefit highly from gaining more flexibility. But they need to be introduced to modified poses that they can manage in a coordinated way.
Fig 4
Without going deeply into the topics of muscle and connective tissue physiology and the workings of the nervous system, the issue of flexibility is an interesting one. The reason stretching works is not that the muscle or fascia is permanently lengthened (at least not over the course of only a few weeks) but that our sensation of the stretch is modified so we are able to tolerate further stretch. We can notice this effect ourselves: if we stay in a stretch for a length of time, or if we repeat a stretch a number of times, we will tend to stretch further, even though there obviously hasn’t been time to alter length of the muscle or connective tissue. There have been no studies longer than eight weeks on the effectiveness of stretching regimes and yoga for changing muscle and connective tissue. But an alteration in our nervous system is the major factor in our ability to gain more flexibility.
Those who are naturally tight may never end up on the front cover of Yoga Journal or gain the ability to bring their head to their legs in a forward bend, or experience the end point of many poses. However, gradually easing the body out of over-contraction with intelligent practice will bring more ease and comfort to everyday movement and release built-up tension. Indeed, those who are stiff (or reasonably stiff) can take comfort from the fact that having tighter muscles and ligaments prevents their joints from moving into the harmful extremes of their range of motion. People with limited flexibility have less reason to envy those who can maneuver their body like a pretzel in the yoga class than they might at first believe.
At the other end of the scale are those who are hypermobile, which means having a level of connective tissue laxity that allows them to move their joints through excessive ranges of motion. Hypermobility can be more problematic than extreme tightness, because if joints are held in extreme positions, either as part of everyday posture and movement or as a result of intense stretching, then joints and ligaments can be damaged. Those with hypermobility that causes pain and other symptoms may be diagnosed with “hypermobility syndrome.” But joint hypermobility also gives dancers and gymnasts the means to excel in these activities.
Hypermobility may also be associated with relatively rare disorders in which the collagen is over-elastic, such as Ehlers Danlos Syndrome and Marfans Syndrome, which may sometimes be undiagnosed. Because these disorders are associated with other disorders, including very serious cardio-vascular issues it is important that these be diagnosed. We will look further at the issue of hypermobility in a separate article.
A good medical overview of joint hypermobility syndrome notes, “Research has identified that posture, proprioception, education; strength and motor control are important components in achieving enhanced joint stability, as is physical activity and general fitness.” This looks like a pretty good description of what is involved in both the Alexander Technique and yoga! The article gives an estimate that one in five musculoskeletal pain referrals are associated with hypermobile joints. (2)
Many hypermobile people are attracted to yoga because, unlike those who are less flexible, they can do the poses easily. But for safety their emphasis needs to be on achieving overall coordination and strengthening, rather than increasing range of movement. Usually in hypermobile people, there are areas that are being held very tightly to compensate for lack of support in the rest of the body. They may need to work on increasing flexibility in those particular areas as the coordination and stability of their postural support improves.
Some things to keep in mind in yoga practice for those with hypermobility:
• Hypermobility may not affect all of the joints. In a case where some joints are more mobile than others, be mindful of the safety of the less-mobile joints.
• Extreme stretches may be easy to achieve though without awareness of how much the joints are being stressed. It is important to develop a level of sensory awareness that enables you to identify these sensations of overstretch.
• Hypermobile people have feelings of muscle stiffness just as much as, if not more than, other people.
• Hypermobile people frequently hold some joints, especially the knees, in permanent hyperextension. Therefore, strengthening the surrounding muscles to support joints is often recommended. This is best achieved by working with good coordination in strengthening yoga poses, in addition to well-coordinated everyday activities to increase joint stability. The problem is less one of strength and more one of faulty kinesthetic awareness.
• Balance can be a challenge with hypermobile ankles, knees, and feet. Poses that challenge balance can be highly useful for such people, because they develop reflex coordination, which helps support these joints.
In the end, whether we are very tight, hypermobile, or somewhere between, we need to make sure that we practice yoga in accordance with the conditions present rather than trying to impose some outside idea of perfection.
Reducing Unwanted Flexibility
Even those who are not hypermobile may have particular joints that are habitually flexed or extended well beyond their healthy range. Here are a couple of examples.
Spine
Thirty-five years ago I could bend forward and almost place my head on my knees. I am very happy to say that I can no longer do that. The movement was achieved by bending through my thoracic spine, which flexed and worsened an already severe kyphosis. After many years of doing forward bends by flexing from the hips instead of the back, and remembering to use the hip joint for bending in everyday activities,(see Fig 1) there is no way I could take my spine into that extreme position today. Or maybe I should say, from what we now know about flexibility, my nervous system (as well as my common sense) would refuse to accommodate the muscles and ligaments in this area being stretched to that extreme.
Over those years I have also worked at gaining flexibility in the opposite direction, working with the Alexander directions to maintain length through the spine in everyday activities, practicing the semi-supine position to gain more softening and release, and exploring twists and some back bends to gain more flexibility in extension.
Knees
Another area in which many people are habitually hypermobile are the knees. Knee hypermobility manifests as a locking of the knee joints by hyperextension and inward rotation, causing long-term consequences such as knee problems, and very often foot and lower back problems. (Fig 2)
As their knees unlock, their quadriceps have to turn on and take over the work that was formerly being done passively by the bones and ligaments of the joint. And they find that these muscles tire amazingly quickly. But exercises to strengthen the quadriceps are not so effective unless we make sure that we are using these muscles functionally in day-to-day upright activities.
How Do We Become More Flexible?
As discussed above, increase in muscle extensibility observed after stretching was traditionally ascribed to a mechanical increase in muscle length. A growing body of research refutes these mechanical theories. At least in studies of single sessions or three-to-eight-week stretching regimes, increases in flexibility appear to be due predominantly to “modification in subjects’ sensation.”3 This makes sense when we think that at the end of a single yoga session we have the ability to move further into stretches, yet we couldn’t have done enough to change the underlying structure in the hour or two of that session.
And How Do We Become Stiffer?
If we can train the nervous system to allow muscles to stretch, we can also train the nervous system to allow muscles to develop more tone. Particular strengthening exercises clearly do develop muscle strength and stiffness. This is what we want for the particular muscles or groups of muscles that are failing to adequately stabilize joints or give us sufficient support in our upright poses. Our aim then should not be just flexibility, but rather a proper balance between flexibility and strength, which we can develop through proper coordination.
Flexibility and Stretching as Part of Warm-ups for Sports Activities
Stretching and the importance of flexibility are some of the most contested subjects among sports experts, coaches, and athletes. Some claim the widespread belief that stretching before exercising or playing sports will “warm up” the body and reduce injuries is wrong, and that stretching prior to engaging in speed or power sports actually decreases athletic performance by temporarily reducing muscle strength! In fact you can test this claim for yourself is you go for a run after a session of passive stretches in a practice like Yin Yoga.
There is no consensus at this point. Given the fact of individual variability, it may be that the truth varies among people and depends on the activity one is preparing to do. The Australian Institute of Sport, which has obviously followed this discussion very carefully, has these guidelines listed below.
Stretching activities can be included in the warm-up and cool down. There is now less emphasis on static-stretching during the warm-up, so stretches should move the muscle groups through the full range of movement required in the activity being performed (active stretching).
Static stretching is still appropriate during the cool down and can be used to improve flexibility.
· Warm-up the body prior to stretching.
· Stretch before and after exercise (active stretching during the warm-up, static stretching during the cool down).
· Stretch all muscle groups that will be involved in the activity.
· Stretch gently and slowly.
· Never bounce or stretch rapidly.
· Stretch gently to the point of mild discomfort, never pain.
· Do not hold your breath when stretching; breathing should be slow and easy.
· Do not make stretches competitive.4
Notes
1. Hypermobility may also be associated with relatively rare disorders in which the collagen is overelastic, such as Ehlers Danlos Syndrome and Marfans Syndrome, which may sometimes be undiagnosed.
2. Hickmott: Joint Hypermobility Syndrome: Medical Observer, Australia June 4, 2013.
3. Weppler and Magnusson: Increasing Muscle Extensibility: A Matter of Increasing Length or Modifying Sensation Physical Therapy (2010).
4. Australian Institute of Sport (2010).