なぜ私がストレッチを勧めないか why I don't recommend stretches

ヨガ人口が増え、柔らかければ柔らかいほど健康的と認識される現在の常識の中で、実は私はその常識を懐疑的に見ている。

ストレッチをすると神経を通して脊髄とやりとりしたり、脳内には神経伝達物質が放出されて気持ちよくなる。そして走ったりエクササイズをするのと同様、筋肉を伸ばしたり収縮させたりするので（筋肉を伸ばすということはその反対の作用をする筋肉は収縮しているはず）、血流やリンパの流れを促す。

それだけなら特に悪いことはない。むしろ良いことづくめに聞こえる。これから動きますよーと脳に伝えるぐらいなら問題ない。仕事の合間に伸びて気持ちいい感覚を休憩時間に味わうことでリフレッシュもできる。

私が勧めないのは、過度なアングルの、靭帯を傷つける恐れがありながらも気持ちいいからやめられなくなる過度なストレッチである。この気持ちよさはエンドルフィンがもたらすものである。エンドルフィンは脳内や中枢神経で作られる神経伝達物質の一つで、特に報酬系に多く分布し、多幸感をもたらすとともに、モルヒネ同様の鎮痛作用がある。ストレッチをするとこれがドーパミン同様、中毒性もある。筋肉組織は糸が束になったような塊であり、骨格筋の筋繊維の方向は起始点と停止点、つまり骨のどの部分とどの骨のどの部分をつないでいるかで決まる。ストレッチは大抵筋繊維の方向と同じ方向に伸ばす。マッサージの技術でいうと筋繊維に沿ってワークするストリッピングだ。私がより重要にかんがえるのは筋繊維に対し垂直にワークする、クロスファイバーフリクション。優しい圧と細かい動きで、重なり合う別の方向を向いた筋肉やその筋膜間の癒着を取り、それぞれの筋肉がスムーズに動けるようにしたり、骨のランドマークを頼りに筋肉と靭帯の位置を確認し、ワークすることで弱ったり伸びたりしている筋肉によりずれた骨格の並びをなるべく重力に対して負荷がない状態（アナトミカルポジション）に持っていくことが私の施術の目的である。余談だが私が所有している骨組みはジョニーという名前だが、彼はいつも笑っているように見える：）

一般的なマッサージで得られる気持ちよさや中毒性と同じ種類のものは私のセッションにはない。もしそれを求めるのであれば他にいくらでもあるのでそちらにいくことをおすすめする。解剖学の知識を元に自分で考えたオリジナルの手技なのでまだまだ完璧ではないが、毎日少しづつ進歩している実感はあるものの、完成することはないのかもしれないと思いつつ、日々その時の自分にできるかぎりのことを精一杯やっている。

ニューヨーク、ロンドン時代、私はマッサージセラピストとして沢山のダンサーやヨガティーチャーに出会った。彼らはそれぞれの関節に申し分のないくらい（それ以上）の可動域があり、関節はゆるくあるにも関わらず、年中痛みと戦っていた。

もちろん私自身、硬いところはゆるめるという常識を疑う考えなど当時は全くなかった。

それを疑い始めたのは、約１５年間痛くなったり辛くなったらストレッチ、指圧、鍼、一般的なマッサージに解決を求めた結果、短期的に痛みをごまかすことはできても根本的に、長期的に改善したとは思えないという事実を認めてからだ。マッサージセラピストになってから出会ったクライアントたちにも自分自身も痛みなどの症状をかかえながらも他に改善方法が見当たらず、カレッジで教わったことをそのまま勧め、責任から逃れているような気持ちを無視する努力をしたことすらあった。

私が働いていたマッサージオフィスに来るクライアントたちは前回来た時と同じ症状を持って再来し、さらに強い圧を必要とし、施術後は満足して帰る。うち、たくさんの人は同じ理由で頻繁に戻ってくるようになり、当時私は毎回セッション後にストレッチをすることを勧めていた。私は”本当にいいことができているのだろうか？”という疑問と無力感を感じ始めた。なぜなら私の周りにいるマッサージセラピストや、健康を売りにする教室で生計を立てるダンサーやヨガティーチャーたち自身が健康ではなかったのだ。そしていかに楽しく健康的に見せるかに力を注いでいた。当時の私自身も含めて。

解剖学の専門用語に、ROM（ロム、Range Of Motion）というのがある。これは日本語にすると可動域だろうか。

それぞれの関節に、正常な可動域の角度がある。例えば柔らかいイメージの代表格、開脚は股関節の外転と言われる動きで、正常なROMは０−４５°、つまりべたっとつくのは正常の域を超えている。その状態はいわゆるインナーマッスルの一つであるももの内側の筋肉、内転筋群が過剰にストレッチした状態で、過度に伸ばされた筋肉は弱くなる。つまり骨を重力に対してうまく立たせるのに必要な筋肉が弱くなったり伸びたりするのだ。弱ってバランスが崩れた状態では怪我のリスクが増えるのも想像できるだろう。骨と筋肉とを繋ぐ筋や、骨と骨とを繋ぐ靭帯が伸びたり切れたりするのは過度なストレッチにおけるリスクとも言える。

それでも気持ちがいいし、症状は改善していなくてもよいものでしかないと信じているから過度に伸ばす。気持ちいいものをいいと思う選択は一つ前の記事で述べたシステム１による判断で、私が実感する改善方法は正常な可動域を超えることなくコアのマッスルを鍛えるシステム２も交えたチョイスでないかと思う。正常な可動域という言葉を画像で検索すると表が出てくるのでそれで正常な可動域がそれぞれの関節においてどのくらいかが見れると思う。確かにストレッチは血流を促したり運動で得られるホルモンを得たり気分をあげてくれたりと利点もあるが、もしストレッチをするにしてもその数値を参考にシステム２を使って、やりすぎに注意するのであれば恩恵をうけるちょうどいいバランスを保つことができるだろう。

The population of Yogi has been increased worldwide, and the people often think the flexible the healthier as common sense though, I have a skeptical view toward it to be honest.

When you do the stretch, there's communication between muscle and spinal cord through nerve, and some neurotransmitters secreted in the brain so you feel good. And as same as you do jogging or exercise, muscles stretches and contracts (muscle stretched means the antagonist muscle is contracted) and it'll help blood vessels and lymphatic system runs better.

These sounds nothing bad. Even sounds good. It wouldn't be any problem if you use stretch as sending signal to tell your brain that you are going to start to do exercise soon. Or you can use stretch as refreshment in between your work to change your mood.

What I just don't recommend is the large angle stretches that possibly hurt your ligament still you hard to stop because it feels good. This "ahh--- feels good" feeling is because of Endorphins in your brain. Endorphins are one of the neurotransmitters (chemical substances) that produced by the pituitary gland in the brain and the Central Nervous System(CNS) and distributed specially in the reward system. Endorphin bring you euphoria and also has analgesic effect similar to morphine. It is addictive as same as Dopamine.

Skeletal muscle tissue is the lump of threads. Direction of the muscle fiber is detected with its Origin and Insertion (muscle attachment). When muscle is stretched, often it's lengthened along the muscle fiber. It has similar effect with stripping in massage skill which is worked toward the same direction along the muscle fiber.

What I would more appreciate is "Cross fiber friction" which is worked perpendicularly against the muscle fiber. With gentle pressure and subtle movement, I palpate and try to identify the unnecessary adhesions that occurs in between muscles, myofascia and/or ligaments that has different fiber directions so the each muscles can work smoothly. Also I concentrate on to image the bone alignment with bony landmarks, the locations of muscles and ligaments compare to anatomical position that has no load against gravity. One of the biggest goal of my session is to create the client's bony alignment easy to stand on the ground, with no load against the gravity like the skeletons in anatomical position. (By the way I own a skeleton named Johnny, and he looks like smiling at all time:))

You can't expect the "Ahhhh. Feels good" moment or addictiveness in my session. If you want it, there're tons of them out there. Mine is the original method that I created based on knowledge of Anatomy and it's still on my way to perfection which might not be reachable until my life closes, though I have a feeling of progress day by day, little by little, with effort of doing what I can do in a day.

When I was in New York and London, I saw many dancers and yoga teachers as a massage therapist. They had more than enough flexibility in their each joints. Even though their joints were loose, they were fighting against the pain most of the time in a year.

Of course I also didn't have an idea of doubting the common sense like "loose the tight area". The better looser idea might be the default idea that we accept intuitively since that's what we actually feel through our nerve.

Why I started to doubt the default idea is because I had to admit the truth that stretch actually gave me the temporal relief but it wasn't the essential solution for longer period of time after I demanded help for stretch, shiatsu, acupuncture or regular massages for over 15 years. Even after I became a massage therapist, I still had some symptoms of pain and still couldn't find the solution for longer term other than the short term compromise, things like stretches I've learnt at college so I recommended them to my clients, even though I've been trying to ignore my feeling of excuses to get away from the responsibilities.

One day I faced to the reality of most of the clients at the massage offices where I worked, came back with the same symptoms that they had last time they visited, often they required stronger pressure, and they were satisfied after the sessions. Many of them came back more frequently with the same issues and I usually gave some advice to my client after the session, and I used to recommend to do stretches often. I started to feel like "Am I really doing the right thing?" with helplessness. Because my coworkers (Massage Therapist), dancers and yoga teachers who is making their lives with health business around me was most likely unhealthy. Still they looked as if they were concentrated on showing themselves healthy, included myself at that time.

ROM means Range of motion in anatomical term. We have normal range of motion in each joints. For example, one of the famous image of flexibility of human can be widely opened up legs. The movement of the one of the leg is called "Abductor of hip joint" which has 0-45 degrees as normal ROM. 45 degrees on each leg. Like this, the splits is way out of the normal ROM. What happening in the splits is one of the core muscle Adductors, the inner thigh muscles are too stretched. If you stretch the muscle frequently and its elongated, muscles get weak. So the muscle that is necessary to tense to maintain the good bone alignment against the gravity get elongated and weak. You can imagine the risk of injury can be increased with weak and imbalanced muscles. The another biggest risk of the excessive stretches out of normal ROM are the injuries of tendons that connect bone and muscle, or the ligaments that connect bone to bone. They have soft collagenous and fibrous tissue which is different from the muscle tissue.

Many people still do excessive stretches because they believe it's good for themselves even symptoms are not improving. You feel good so it must be a good thing idea can be made with the system 1 decision making (Please read the previous article or the book "Fast and Slow by Daniel Kahneman" if you have no idea about the systems), and what I would like to include with my idea to create my session is the system 2 choice that specifically strengthening the inner core muscles maintaining the normal range of motion in each joints. If you want to know the normal range of motion of each joints, you can google them. Sure enough stretch has beneficial effects such as increasing blood flow, improving hormone secretion that you can normally obtain with excises, helps you to change your mood...etc.

You can refer the list of normal ROM and activate your System 2, and you should be careful with angles and frequency if you still love to do stretches, so you could receive the benefit of stretches fully with good balance.