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Give 'active-assisted stretching' a try

HEP2GO HAMSTRING STRETCH: This is an exercise Heidi Piccione teaches patients. While lying on your back, hook a towel or strap under your foot and, keeping your knee in a straightened position, draw up your leg until a stretch is felt under your leg and calf area.
Published Aug. 18, 2018

It feels great to stretch your muscles and joints at any age. Perhaps to throw in a yawn or two. Stretching is also great for the entire body, encouraging flexibility of joints and blood flow to the muscles.

For some seniors, though, stretching is difficult or painful. Yet there are techniques and devices to encourage stretching, even for folks who are mobility challenged. Even gravity can be used.

It's called "active-assisted stretching," and while the concept has been around for years, there are new studies that underscore the importance and new devices being designed to help.

In truth, stretching joints and muscles isn't just for seniors, notes Heidi Piccione, a board-certified clinical specialist in geriatric physical therapy at the University of South Florida.

"As we age in life or have jobs that are sedentary, most people don't realize their joints need to be moved in a full range of motion," she said.

Active-assisted stretching can be done solo, using gravity or "an external device like a strap" to flex the joints, or with an assist from a physical therapist or someone else, Piccione said.

If you're doing a solo stretch, you can use a strap to pull on a leg. "You don't have to use a core muscle" to hold that leg up," she explained.

Lying flat in a recliner and allowing gravity to assist the stretching is another way, Piccione said.

The result will be less joint pain and more blood flow. "Each joint has a certain range of motion," she said.

And with increased flexibility comes increased mobility.

"If a person is stretching their joint, increased mobility is much better and that leads to much better function," she said.

For example, a person might be able to reach higher up in the kitchen cabinet to retrieve a coffee cup, or lift a leg more easily to put on clothes or to get into a car.

Active-assisted stretching can be done with a partner, said Piccione, 49, but there is always the risk of someone overstressing a joint. It's better to work with a movement specialist or trained therapist, she said, and usually that can be arranged with a physician's referral.

One warning from Piccione: "If you're not going to a professional, you can injure the joint if you do aggressive stretching. It's important not to injure a joint, a muscle or soft tissue. It's possible to be injured if you don't' know what you're dong."

While therapists have long underscored the need to stretch joints for better function, some more recent studies have focused on the benefits to blood flow in muscles.

A study published last year looked at muscle flexibility in animals, but the results are easily transferable to humans, according to Judy Muller-Delp, the Florida State University College of Medicine professor who led the international team of researchers.

"Our research suggests that static muscle stretching performed regularly can have a real impact by increasing blood flow to muscles in the lower leg," she said in a news release. "This highlights that even individuals who struggle to walk due to pain or lack of mobility can undertake activity to possibly improve their health."

Muscle stretching is often performed as part of a warmup or cool-down, Muller-Delp noted, "and is low intensity compared to aerobic exercise … with minimal risk of injury."

The study found that regular muscular stretching performed five times a week for four weeks can increase blood flow to muscles of the lower legs and improve the function of arteries in the muscles of the legs.

This can be especially helpful to patients with peripheral artery disease and patients with problems of the foot or leg related to diabetes, the researchers determined.

Piccione of USF echoes the connection between joints and muscles. "When you move a joint and increase flexibility, you're increasing blood flow to the muscles."

Contact Fred W. Wright Jr. at


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