Remember stretching for the first few minutes of PE class? It might have seemed unnecessary then, but try to think of stretching as a valuable tool you can pull from your toolbox to keep your body fine-tuned and mobile.
Lifestyle and medical conditions, like sitting at a desk for hours at a time or limb loss, can reduce range of motion and/or create muscle imbalances. These problems can result in gait changes or compensations that lead to pain. Regular stretching can prevent or reduce muscle imbalances and, for individuals with limb loss, the more serious condition of contracture at the hips and knees.
NOTE: Always check with your doctor before embarking upon a new exercise routine.
Shortened muscles and muscle imbalances
Shortened muscles and muscle imbalances frequently happen when you spend a lot of time in a single position. For example, sitting at a desk for hours every day can cause the hip flexors to tighten and/or shorten. Consequently, when you stand up, the muscles don’t stretch as much as they should, causing a posterior (backward) tilt of the pelvis that puts extra strain on the lower back. Regular stretching can keep the hip flexors flexible and strong.
What is hip or knee contracture, and why does it matter?
We consulted Greg Mannino, a prosthetist and 22x Paralympic champion, to get a better look at contracture and how it affects individuals with limb loss. Contracture is when the soft tissue, like muscles or tendons, shortens, stiffens, or becomes constricted, preventing the connecting joint from fully extending.
A knee or hip flexion contracture can change your gait (how you walk) or make it difficult to get a good prosthesis fit. “One thing you see in higher contraction (hip) in patients is an effect on stride length. It’s pretty typical to see a short step on the prosthetic side versus the sound side which affects gait symmetry,” says Mannino. Consequently, preventing contracture is a major focus immediately after amputation to preserve future mobility.
It’s important to keep stretching and strengthening the muscles, ligaments, and tendons around and connected to the amputated limb even after you’ve been fitted for a prosthesis. Mannino suggests consulting your prosthetist to prevent future contracture, pain, or loss of mobility.
He also points out that muscle stiffness and contraction aren’t limited to individuals with limb loss. A regular stretching routine can help anyone keep their joints mobile and flexible.
Simple hip and knee stretches
Stretching doesn’t have to be complicated, but it does need to be consistent. The following stretches and exercises focus on the hip and knee. Stretching for five to ten minutes a day or for shorter time periods throughout the day can help prevent muscle shortening and stiffness.
For individuals with limb loss, it’s important to prepare the skin before any kind of exercise. Before donning your prosthesis, apply a moisturizer like VitalFit’s Day Moisturizer to maintain the skin’s flexibility and strength. You can also apply Liquid-to-Powder Plus to create a friction barrier and prevent chafing.
Supine (lying down) stretch
Lie on your back on a bed, couch, or the floor. Protect your lower back by lightly flexing the abdominals. Lying on your back with your legs straight naturally stretches the hip flexors. Lie in this position for 30 to 60 seconds.
Modification(s): Lie on the left edge of a bed. Carefully let the left leg fall off of the bed. You will feel a greater stretch in the left hip flexors. For a great stretch and to stretch the right side glutes, pull the right knee to the chest. Hold for 30 to 60 seconds and repeat on the other side by lying on the right side of the bed.
Lunge
Stand with your feet hip-width apart. Step forward with the right foot while keeping the left foot in place. Lean forward, lowering your hips and placing most of your weight on the right foot. This is called a high lunge.
You can stay here and stretch the left hip flexors or keep leaning forward until the left knee touches the ground for a deeper stretch. Hold for 30 to 60 seconds. Return to standing and repeat on the opposite side.
Pro tip: Align the knee and ankle of the lead foot. If you have bad knees or limited mobility in the knees, go as low as you can and still maintain control of the lunge but not to where it’s painful.
Modification(s): You can start in a kneeling rather than standing position. Step the right foot forward and keep the left knee on the ground, pressing the hips into the ground and leaning forward. Repeat on the left side.
Bridge
Lie on an exercise mat on the floor. Place both palms on the floor with the feet underneath the knees. Tighten the glutes to press the hips toward the ceiling. You should feel like you’re pressing your feet into the floor. Make sure to keep your shoulders on the mat. Hold for 30 to 60 seconds.
Pro tip: Protect your lower back. Keep a straight line from the knees to the shoulders to prevent overarching the back.
Modification(s): Do a one-legged bridge by extending one leg while using a single leg to raise the hips. However, keep the hips aligned with one another.
Lying Butterfly Stretch
Lie on an exercise mat or the floor. Press your heels together, allowing your knees to fall open. Gently pull the heels toward the body and keep the knees pressed toward the floor. Hold for 30 to 60 seconds.
Modification(s): You can also do a butterfly stretch while sitting on the floor. Bring the heels together and press the knees into the floor. Lean forward over the feet to deepen the stretch.
Building your stretching routine
You can perform several sets of a single stretch or go through a series of stretches as part of your routine. In the morning, during your lunch break, and before bed are great times to get a quick stretch. The important thing is to make stretching a regular part of your day to keep your body balanced and mobile.