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A Dangerous Stretch? (03/03/06)

Roundtable Discussion #6

"Is this a beneficial or risky stretch?"

Panel:

Dr. Kwame Brown:

Honestly, this could be risky over the course of many repeats. We are taking a long lever arm and suspending it largely from ligaments, which may stretch and cause dysfunction later. I don't see where anyone would need to perform this stretch, or how it would give them anything that wasn't better served by a safer stretch.

Chaney Weiner:

The yoga plow, as it’s called, used to be a pretty popular stretch and one you would see in many gyms. Personally, I have done it in the past just to stretch and never had any problems with it. However it has been attributed to several deaths due to the position it puts you in. In fact in these deaths the carotid artery was cut off due to the pressure it puts on it based on the position of the stretch. I don’t see where it would be helpful due to its high risk to benefit ratio. I still see it done every now and then and just wonder why people are even doing it. My thinking is that people think it somehow stretches the back, and it might, but it also places other several areas at a major risk. I’m sure many people could do it and do it safely but is the risk really worth it?

Steve Payne:

I personally do not use or advocate these stretches for two reasons:

1) This stretch appears to put undue stress and excessive cervical strain by the extreme flexion of the area and therefore, potentially, could cause a potential herniation, subluxation or disc rupture to the cervical region. The excessive flexion of the movement, in my opinion, could also, potentially, cause an increased degree of laxity in the joints and/or weaken the connectivity and sureness of the various processes of the vertebral joints. By the extreme flexion of the "stretch" I can also envision pinching of the nerve root, restricted breathing, and so on.

2) This sort of stretch also appears to cause extreme flexion of the lower lumbar, and therefore the aforementioned concerns also apply.For these reasons (as well as the fact that it just looks dang painful) I do not see the risk to reward benefit of this form of stretch.

Roger White:

This is a situation in which "it depends." Does the individual need to perform this stretch for health reasons, or even performance reasons? A diver may need to be able to hold this position for dives so it would be a relevant stretch. Average Joe may not need to do this extreme of a stretch, unless he has a fitness Rx from a therapist to do so.

This question is similar to those who use one leg training and progress to the unstable surface. Is one leg squats on a airex pad dangerous? If the individual went through proper progressions, and if the training is required for a certain purpose, then it would be. Otherwise, it's best to stay away from things without properly building up to them.

Matt Shuebrook:

For the average American these 2 stretches are a sure way to end up in the ER. But for the "yoga lifestyle", dancers, entertainers or Pilate's this stretche is a common task. I would only use this stretch where I have a client who is flexible enough to handle it. 99% of the time I would'nt attempt to ask a client to do these stretches. It is my opinion that these stretches are like any other stretches, use when needed. If used otherwise it may lead to extreme injury.

Wayne Burwell:

When assessing a movement we look at the risks versus the benefits. In addition, we should always look at the functionality of a movement. I would ask the question, "how many times in life are we actually in the position?" There is a difference between stretching to end range of motion and stretching in a position that we're never in. I think that in this particular stretch there is more risk than benefit, especially in the erectors and hamstrings. This is more of an advanced movement and someone who is not very experienced may injure his/herself.
In a sports-specific approach, I could see how one may think this would be an appropriate stretch for a diver that may have to perform a pike off the board. Other than that I don't see us in this position anytime soon, and I think it's a movement that we can chalk up as "all show no go."

John Izzo:

I love this question because this stretch exemplifies either accomplishment (flexibility) or risk. I see alot of recreational basketball players use this stretch in pre-game warm-ups, and I wondered if it was beneficial or dangerous. Obviously, if it can be accomplished pain-free it MAY be beneficial in increasing flexibility in the lower body and lumbar spine. Howvever, I can see risk in the thorasic and cervical spine due to the pressure. Chaney makes a great point of compromising internal organs with the extra weight and position.

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