B (1:41)

Touch your toes. So can I. Okay, we're allowed to sit down again now.

D (1:44)

Okay, I'm sitting again. I couldn't do that six months ago, by the way.

B (1:51)

Interesting. Do you think this has to do with your Pilates habit?

D (1:54)

Yep.

B (1:54)

Oh, my gosh. How interesting. Okay, I'm very looking forward to having this chat today, because, of course, we are talking about not just toe touching, flexibility in general here on what's that? Rash Today?

D (2:03)

Which is the podcast where we answer the health questions that simply everyone is asking.

B (2:11)

This week's question comes from Jeff, who says, long time listener, first time emailer. Hi, Geoff. My question, Jeff writes, is about flexibility and its impact on health. I've been very stiff for most of my life. Life. I've never been able to bend down and touch My toes, which I suspect might be related to my X shaped legs and the way X shaped legs. He says he walks a bit like a duck.

D (2:32)

Right.

B (2:33)

Anyway, Jeff writes, I have recently added stretching as part of my exercise routine and set a target to be able to touch my toes in 100 days. My question is, I know flexibility is important to your health, but is being able to touch your toes a good measurement of your flexibility between touching your toes and doing a middle split, which better suffering in improving your flexibility?

D (2:57)

What's a middle split?

B (2:58)

I didn't really think about this, but our producer, Shelby Traynor is a trained well, has been a competitive dancer and started talking about middle splits versus straddle. So I had to go and do some searching.

D (3:08)

Is this the one where you spread.

B (3:09)

Your legs to the side?

D (3:11)

To the side, Right.

B (3:12)

A straddle is where both of your legs are sticking out to the sides and a middle split is where you're in that but you've rolled over your pelvis so that you're actually your tailbone's facing back like your chest could be on the floor. Shelby, have I got that right? You have, yes.

D (3:27)

Can you do it, Shelby?

B (3:29)

No. I think there was probably a period of a week when I was competitive dancing like full time where I could do a middle split.

D (3:37)

So this is a real to use dad joke. This is a real stretch for Geoff to be talking about a middle split.

B (3:44)

I thought I was the one that threw around dad jokes.

D (3:46)

Heel. Yeah, yeah. I had a holiday for a few weeks while you did.

B (3:50)

Okay, well. So, yeah, flexibility. Well, I want to pick up first of all on something that Jeff has said in his email, which he says, I know that flexibility is important to your health. I want to dig into that a little bit today because I feel like it's good for your health, but I don't know what the evidence says.

D (4:07)

So health is a big word here that implies that it's good for maybe your heart and your blood vessels or your weight or maybe your muscle strength. Flexibility and mobility we need to unpick as well. So let's move through it and we will get to those elements later. But I think health is probably not at the top of the list in terms of the benefits of flexibility.

B (4:30)

Well, I don't think it's a bad thing for us to start with some definitions. I think people have a sense of what flexibility might be. Can you touch your toes? Can you do a split? Mobility is something that I hear exercise folks talk about a lot, but they're not really exactly the Same thing.

D (4:45)

The simplest way to look at mobility is your ability to move freely and easily through life. And flexibility in some senses is a component of that.

B (4:54)

So flexibility. We're usually talking about soft tissues. Like I think about my muscles being flexible or my tendons. Is that right?

D (5:03)

Yeah. So it's your muscles, your ligaments, your tendons and other soft tissues that surround the muscles that go around each joint in your body. And if they are shortened and tight, then you just don't get a full range of motion out of that joint or necessarily get the full range of power out of the muscles that power that joint.

B (5:25)

Flexibility. Like we're hearing Geoff talking about touching his toes. We'll talk in a little while about how we can influence our flexibility. But there does seem to be a genetic component here. Some people are just bendy. Some people just seem so much more bendy than others.

D (5:39)

Yeah, they've studied contortions, you know, people who can fit themselves into a shoebox. They've studied ballerinas. So there is a genetic component to it. They found genes that actually do predict whether or not you are flexible in that situation. Small studies. There's a medical condition, a genetic condition called Ehler Danlos syndrome, which comes in various forms. But that hypermobility, hypermobility of the joints and looseness around the ligaments and tendons, which create all sorts of problems for people with the various forms of Ehler Danlos. And there's gender. Males are less flexible than females. And we're not talking about psychology here.

B (6:17)

Well, I want psychological flexibility. I wanted to interrogate that a little bit because I have mentioned probably more times than is cool rock climbing. And I know when I am climbing with my mates who are all blokes, they are all stronger than me, like by orders of magnitude. And I feel like I suck. But there are some things that I can do that they can't do. I can put my leg up higher than they can sometimes. And I've wondered whether it's because of my body's mechanics and a sex based thing or whether it's because I do yoga and they die. I did gymnastics as a kid and they didn't. How much of it is almost like cultural, culturally, gender based and how much is actually about my physiology or their physiology.

D (6:59)

Well, the basic physiology would say that oestrogen, it looks as though estrogen does make your tissues more flexible and your pelvis is probably a slight, is a different shape to a male pelvis, which would partly explain how you can lift your legs to a higher level. Than they can. And you've also trained yourself over the years to have stretched flickering, flexible muscles and tendons.

B (7:23)

So it's a bit of both.

D (7:24)

It's a bit of both. But gender's pretty solid in all this.

B (7:26)

So we've got some underlying genetics, as you've just mentioned. But there also is, like you say, if you stretch it, it's stretchier. Let's talk about what we know in terms of promoting flexibility, because everyone's got their own patented, this will make you more flexible routine. Are there some flexibility routines that are better than others?

D (7:45)

Well, people argue about this till the cows come home, and it depends on what you're looking for. And there are a lot of myths about flexibility and stretching. So what is known, and we can refer people back to one of our early. What's that? Rashes, which was on delayed onset muscle soreness, where stretching makes no difference to delayed onset muscle soreness after a period of exercise.

B (8:06)

It feels like it does, though.

D (8:08)

It feels great when you do it. But when the studies have been done, it makes no difference at all to muscle.

B (8:14)

I know that we researched and recorded and have published that thing. I still don't know if I believe it.

D (8:18)

You don't believe it?

C (8:21)

I.

D (8:21)

God, why do I bother?

B (8:23)

No, sorry, why do I bother?

D (8:26)

But anyway, there's also very little evidence that stretching prevents injury.

B (8:31)

Well, static stretching can be linked to injury, if I'm not mistaken, in certain sports.

D (8:36)

Ah, well, there is a theory with a little bit of evidence attached to it that if you stretch without strengthening your muscles, you may actually expose your joints more to injury because they are more flexible and go through a wider range of movement without necessarily the muscle strength around the joint to protect it. So in theory, there's not a lot of evidence to back this up. But in theory, stretching, independent of muscle strengthening exercise, could actually increase the risk of injury. There's very little evidence that it actually reduces injury. So a group of experts got together on all this and we'll put a link to that on our show Notes to actually look at all the evidence for and against stretching. And the evidence is not great. Apart from that stretching and increases your range of motion and presumably by implication makes you more mobile.

B (9:26)

So that really speaks to Geoff's question. Jeff's kind of getting up every morning 100 days, wants to be able to touch his toes. Amazing. What I'm hearing from you is that stretching like that might get in there, but it might not necessarily be good for him once he gets there.

D (9:41)

I mean, if you can touch your Toes. With straight legs, you are more flexible by definition. It's likely that you will walk more easily because the muscles that you are stretching in order to be able to touch your toes and tendons and ligaments and so on are the ones that you need for smooth walking. So it's quite likely that your walking improves with that stretching. But some people stretch in order to improve their athletic performance. And that kind of stretching has got a particular name because you asked earlier about whether one kind of stretching is better than others. So the basic kind of stretch is the static stretch, which most of us would know about. You know, you get your leg up.

B (10:19)

On the table and you sort of lean into it.

D (10:22)

Lean into it, feel the stretch at the back. And you do it from maybe five breaths, 10 or 30 seconds. And you usually do it after exercise. The other one is called dynamic stretching, which has got less evidence attached to it, which are really you're stretching while you move your muscles. So let's say you're doing an ankle stretch and you're doing it on a stair. You're moving down to stretch your gastrocnemius, your calf muscles, and then you're lifting it up. And that does a stretch as well as muscle movement.

B (10:50)

So you're doing like a calf raise. It's controlled. It's warming up the muscle and also moving it past the body point that you probably would go into in your exercise.

D (10:58)

That's right on the way down. That's an example of a dynamic stretch. The other one is pnf, Proprioceptive Neuromuscular Facilitation.

B (11:06)

I mean, if it's got the word proprioceptive in it, and it's got an acronym that says to me that this is the science one. Right?

D (11:13)

They've all had some studies. So PNF is. Imagine you do a straight leg raise. It's gotta be done with a therapist or somebody who knows what they're doing. You do a straight leg raise, and then the resistance, the isometric exercise is not contracting your hamstrings, but your quadriceps. So you're trying to actually stretch the leg even more against resistance.

B (11:35)

My quads are hurting even thinking about it.

D (11:37)

Well, I was doing that as I was talking, and I was like, oh, my God. Okay, can I talk and do this at the same time?

B (11:42)

Okay, this sounds like yoga to me. This sounds like the type of yoga that I do, where you get into a position that's quite a deep position, but it's a very active. You're holding it very actively. You're not just sort of collapsing into it. It's not so much about stretching as it is holding yourself in quite an.

D (11:58)

Uncomfortable position often and understanding where your joint is in space, which is what the proprioception is all about. So the interesting evidence on this PNF stretching proprioceptive neuromuscular facilitation is that if you do it before sport or exercise, you actually reduce performance. But if you do it after exercise, subsequent performance goes up.

B (12:22)

Is it because you're perhaps tiring the muscle out before you then try to get it to perform?

D (12:26)

Possibly. Look, as with all these things, people try to find reasons for something that they actually haven't got a clue why it works. But there's consistent evidence that PNF stretching before you actually exercise reduces the performance, whereas it improves power to muscle ratios after exercise and the next time you do it. And the other thing about stretching here and athletic performance or muscle performance, is that if you stretch and you increase the range of motion, your muscles and ligaments lengthen over time a little bit and therefore the muscles are contracting over a larger distance and therefore give you more power. Whereas if you are tight and it's a little bit bent, I'm being simplistic here, the muscles aren't getting the full chance to contract properly. So there is a performance benefit to stretching over a period of time, but involves hard work. Some people would say that if you're really trying to get that done, it's four minutes a muscle on a regular.

B (13:31)

Basis, such a long time.

D (13:34)

This is not an easy solution.

B (13:37)

So we sort of brushed past it at the beginning, this assumption that being flexible is good for your health. And what I'm hearing you say is there's certain types of stretching that perhaps seems to be very good for your sports performance, depending on your sport. What about overall health?

D (13:51)

So it's not a replacement for muscle strengthening exercises, but it will, in theory, it could enhance the benefits of muscle strengthening exercises. So what you want as you get older are larger, stronger muscles. Stretching itself probably does not have a significant effect on what's called muscle hypertrophy. It may have a little, but not a lot. It probably facilitates the process of muscle strengthening because you're able to move the joint against resistance through a larger arc.

B (14:23)

So what you mean by that is it's not. The stretching alone isn't going to make your muscles bigger, but it might make your exercise to make your muscles bigger, more effective.

D (14:33)

That's right. And then in terms of health, there is this tantalizing suggestion that it may improve Your cardiovascular health.

B (14:41)

Why?

D (14:42)

How well it may stress the vascular system and reduce because you're stretching all the soft tissue. So imagine you're doing a hamstring stretch. It's not just the tendons, the ligaments and the muscles. It's the arteries that you're stretching as well, so that you might get more flexible arteries, which means your blood pressure would go down. And that's a healthier situation to be in. Not really proven, but there's no evidence that it does you any harm.

B (15:10)

The other thing I'd add to that is quality of life, especially if we're talking about getting older. I'm thinking about stability, like wanting to avoid falls and having a good range of motion is important for that. And also, just like you want to be able to tie your shoes, you want to be able to wash yourself in the shoes. A base level of flexibility is required for those sorts of self care tasks.

D (15:34)

Yes, absolutely. And the more flexible you are, the greater, in theory, your ability is to recover if you trip over, particularly if you're associating it with muscle strengthening exercises. If you're stiff, you just don't have the error margin if you like when you get into strife.

B (15:50)

So you mentioned before, Norman, that you could touch your toes now, but you couldn't have done it six months ago. What are you doing differently?

D (15:58)

I'm going to Pilates twice a week and I'm being put through a series of exercises which strengthen muscles, improve mobility and improve balance. And part of that is showing that you are flexible and you start off each day or finish it off with a roll down and a roll back up.

B (16:17)

Did you set out to change your flexibility? Was that part of what you were hoping to get out of doing Pilates?

D (16:22)

I just wanted my whole body. I've been unko for my whole life and I just wanted to be less unco and less stiff. And by the way, there's not a lot of evidence that some of the static stretching is any better than, you know, getting one of those rough rollers and rolling your muscle along one of those rollers.

B (16:41)

Oh, when you said a roll down and a roll up, I thought you meant like a bend down into a forward fold.

D (16:45)

No, no, that is exactly what I'm talking about.

B (16:47)

Oh, so you're saying you do a physical like bend over, roll down, and then roll back up again. And also you use a foam roller.

D (16:54)

I don't like using a foam roller, so I prefer the actual physical stretching. But the evidence would suggest that a foam roller is pretty good for the Sort of benefits that you get out of stretching, which is about function.

B (17:06)

So we're saying static stretching can make someone perhaps more prone to injury. You should still be warming up before you exercise though.

D (17:13)

There's no evidence that stretching before exercise as part of a warm up routine prevents injury or improves performance. And as I just said earlier, there's some evidence that it reduces performance. So if what you're doing with a warm up is actually match appropriate exercise for that sport, that's a different matter from should I be stretching before exercise? And the answer would be from the evidence, no.

B (17:40)

Okay, all right, cool. So if we're listening to this, like, oh my gosh, Norman Teigen, you're so smart. I'm completely convinced I want to improve my flexibility for my health. I want to do it in an evidence based way. What do I actually do?

D (17:52)

Well, the recommendation from the American College of Sports Medicine, which we'll have a link to on our show notes, suggests that for people who are not doing elite sport stretches, yoga, tai chi. They don't mention Pilates, but I will for all major muscle tendon groups. That's your neck, your shoulders, your chest, your trunk, the lower back, the hips, legs and ankles at least two to three times a week. And if you don't know how to do that, I'm sure there are YouTubes that will help you. Or maybe you check in with a physiotherapist for a couple of sessions just so that you get taught how to do it and that you should spend about a minute on each stretching exercise. So you know, if you can hold a particular stretch for 15 seconds, only repeat it three times. But ideally extend that and extend that. So it's for about a minute. So it takes a while to get done.

B (18:41)

So not just chucking my heel out in front of me and bending over and thinking that stretching my hamstrings and.

D (18:45)

Then for a run, that's my technique.

B (18:47)

But you know, well, Geoff, I hope that that has helped with your X shaped legs and your ambition to touch your toes. Do let us know how you get on.

D (18:55)

And we just cannot help you with a middle split. You're on your own on that one. Just make sure there's a health professional there nearby to help you out of it.

B (19:03)

Yeah, or a phone nearby so you can dial triple zero if you've stretched too far.

D (19:07)

Yeah, don't phone us, we'll phone you.

B (19:09)

Well, Geoff, you have emailed us@thatrashbc.net au it's what you can send your emails as well if You've got a question that you would like us to tackle. And it's also where you can send your feedback to us.

D (19:20)

And we've had a lot of feedback on our. No poo. What's that? Rash.

B (19:23)

Yeah. No poo. If you haven't listened to it, it is not about being constipated.

D (19:27)

No.

B (19:27)

It's about shampoo and people eschewing shampoo and conditioner. Quite a few people have already taken this. We're obviously behind the times, Norman.

D (19:38)

We are, we are. So David writes, I've listened to the argument that frequent shampooing may strip the scalp of useful organisms of oils. Upon hearing the Glover he's mentioning Richard Glover, who used to present the Drive show on ABC Radio Sydney, approached to Hair Care perhaps a year or two ago. I've adopted his approach and used no hair products. He just does a water wash as part of a daily shower. And he's here. He says it's no worse or easier to handle as I go about my day. And there've been no complaints from others.

B (20:04)

And I should point out the David in question is one of our colleagues and we have verified that it's fine.

D (20:11)

Okay.

B (20:12)

It wasn't just. We're not just taking his word for it. People in the office have gone, yes, correct. It's fine, David, you can continue with this.

D (20:19)

They just stop breathing as they go. No, no.

B (20:23)

Another from Helen, not our colleague saying, everything old is new again. Norman, do you remember this? Helen says, an episode of the health report broadcast 30 years ago on 2 October 1995. Helen, how do you know? This included a discussion on this topic with Dr. Norman Swan interviewing Australian dermatologist Dr. Hugh Malloy, who also has published an excellent book titled Good SK with a Forward by Dr. Norman Swan. Do you remember any of this, Norman?

D (20:48)

It was one of the most popular health reports we have ever done in the 40 year history of the Health Report, our sister podcast. And Hugh Molloy, like many dermatologists, issued soap of any kind. He also talked about how you shouldn't have a douna because dounas make you sweat and are bad for your skin.

B (21:10)

I love a cuddly doona.

D (21:11)

So there was a whole radical process and there were lots of our colleagues on Radio national who actually changed their lives. Thanks to Hugh Malloy. So very, very popular health report. And as Helen correctly said, sounds like Dr. Swan may not have followed the.

B (21:29)

Good doctor's advice getting called out here. Well, Helen has followed do as I.

D (21:34)

Broadcast, but not as I see.

B (21:35)

Helen says as recommended by Dr. Malloy. I use conditioner to wash my hair and sorbeline and glycerin cream to wash my skin. And then she signs off as if she needed to specify this. A very appreciative long term listener. Helen, you've been listening to the health report for. I'm not gonna say longer than I've been alive. I'm not gonna lie to people like that. Longer than our producer Shelby Traynor has been alive.

D (22:00)

Remember, I was only 12 at the time. Just, just let's just clarify that.

B (22:04)

Indeed, indeed, of course. Well, thank you so much, Helen, David and anyone who's ever sent us an email thatrashbc, send us a line. I want to hear about it. I want to see your middle split and we'll catch you again next week.

D (22:16)

Yeah, give us a video of your middle split. We just really want to clarify that one. See you next week.

B (22:21)

See you then.