This is the first of three articles I read on the plane yesterday. I have two patients with knee flexion contractures (one ambulatory, one not), so this was of significant interest to me. What is happening when a stretch is applied? Apparently it is not a mechanical change in tissue but likely in a change in the participants sensation. Much more research is needed and this provided more questions than answers for me, but it was thought provoking and provided a good discussion with my wife.
Holzman Weppler C, Magnusson SP. Increasing Muscle Extensibility: A Matter of Increasing Length or Modifying Sensation? Phys Ther 2010; 90:438-449.
Various theories have been proposed to explain increases in muscle extensibility observed after intermittent stretching. Most of these theories advocate a mechanical increase in length of the stretched muscle. More recently, a sensory theory has been proposed suggesting instead that increases in muscle extensibility are due to a modification of sensation only. Studies that evaluated the biomechanical effect of stretching showed that muscle length does increase during stretch application due to the viscoelastic properties of muscle. However, this length increase is transient, its magnitude and duration being dependent upon the duration and type of stretching applied. Most of these studies suggest that increases in muscle extensibility observed after a single stretching session and after short-term (3- to 8-week) stretching programs are due to modified sensation. The biomechanical effects of long-term (>8 weeks) and chronic stretching programs have not yet been evaluated. The purposes of this article are to review each of these proposed theories and to discuss the implications for research and clinical practice.