At the clinic we use a lot of yoga to complement what we do. We release you off so you are able to move more freely. Yoga is a great way to maintain this and even reach the parts we physically can’t. Yoga is of course known for its stretching. Physiotherapy is also known for stretching as part of its approach to easing your condition. However the two approaches are very different. But which approach to is more effective?
With our extensive knowledge of physiotherapy and our increasing knowledge of yoga we thought we’d pit the two against each other to see which discipline wins. The irony of a competition involving yoga is not lost on me! It does however give me a convenient narrative for this article…
What’s The Difference Between Physio Stretching And Yoga?
Where does one start and the other begin? As with most ‘competing’ disciplines the boundary is very grey indeed. For me physiotherapy style stretching is more specific to targeted muscle groups. Most yoga stretches are named after animals! More relevantly they are also more whole body.
By this I mean that yoga ‘stretching’ takes into consideration how the muscles interact throughout the body – along meridians – rather than considering only the pure anatomy of a muscle goes from here to there. We know that meridians have been considered quite ‘woo woo’ by many for a long time. You might be one of those people.
However, we are seeing more and more evidence to suggest there is a lot of truth in these meridians. Thomas Myers in his amazing book Anatomy Trains looks at anatomy with new insight. As a gross simplification he looks at ‘layers’ of muscles, ligaments and connective tissue to show how they are connected throughout the body. Surprise, surprise, when you map these out they look a lot like meridian lines.
That said many of what I would term physiotherapy stretches i.e. ones taught and used in such circles look remarkably like some yoga poses. Frankly if it works who cares what discipline it comes from. If it feels good go for it! Below we’ll consider which is the best of the best stretches from across the board.
Is there much research into stretching and yoga? I’ve known for many years that research about stretching from a physiotherapy perspective is wildly varied and and is generally inconclusive. A view which inspired me to question whether there was any point to stretching at all in my post from 2015: Stretching: How, Why, When, How Long And Should You Bother! I’ve since mellowed considerably.
Dipping into the physiotherapy research once more I found a nice review piece here which simply states that more research is required to understand whether stretching has a positive impact on reducing injuries. A similar piece with a similar conclusion suggests the same here. However, this piece reviewed some literature which suggested there was a potential reduction in ligament injuries.
This would make sense when you consider that muscles are continuous with ligaments. If we improve the function of muscles through stretching, then we improve their ability to protect the joints they act across.
A very positive piece of research here suggests that it is possible to reduce PTSD symptoms with ‘Mindfulness Based Stretching and Deep Breathing Exercise.’ Stop me if I’m wrong but this sounds an awful lot like Yoga! Insightful research but it doesn’t really mention a link between stretching and injury prevention or recovery.
There also doesn’t seem to be any research that I could find exploring the link between yoga practice and a reduction in injury problems. I find this staggering! There is however plenty of research which backs up the positive well-being implications of Yoga. Positive impacts on depression, reduction in cardiovascular disease and reduction in blood pressure.
For me it’s no too much of a stretch (no pun intended) to see that if our wellbeing is better this will actively help our current injuries and likelihood of developing new ones. But then I have seen 18 year’s worth of very individual evidence. Surely if we are more relaxed our muscles are more relaxed and perform to a better level. If we are wound up and tense surely there is more likelihood of muscles going twang.
For those who haven’t been a muscle geek for as long as I have let’s consider a more high profile anecdote. Ryan Giggs playing football to the highest level beyond the age of 40. He attributed his regular yoga practice as a large factor in this longevity. We’ll make no comment about his personal life!
Sadly however, in terms of large scale studies I’m going to have to declare the first round of Yoga vs Physio and boring nil nil draw. There is simply not enough evidence to conclude that it makes a difference. Perhaps we should stop the article right here? I think not. Don’t be put off by the lack of research. Give stretching and / or a yoga regime a go. Simply see how you feel. If you ‘feel’ good on it or feel benefits then carry on. If you don’t, look for something else!
For one final word on stretching there’s an excellent piece from The Times newspaper which gives some interesting thoughts on research and the gap between research on reality.
Yoga 0 – 0 Physiotherapy
Duration Of Stretches
So how long should you stretch for? The honest answer is there is no conclusive evidence either way. In physiotherapy terms there are various schools of thought. I’ve always followed the principle you should hold each stretch for at least 30 seconds to 1 minute. The idea being, as I was taught, to give the brain chance to adapt to the ‘new length’ of the muscles.
But what does yoga do? Well I’d say it pretty much has all bases covered. The more flow styles of yoga are less about stretching and more about challenging the body to perform complex movements that merge into to each other. Vinyasa yoga being a classic example of this kind of yoga.
At the opposite end of the spectrum we have Yin Yoga. Stretches, and these are most definitely stretches, are held for 3-5 minutes each. This is my personal favourite type of yoga. Properly mellow. Good for beginners and all ranges of flexibility. Very good for stiff old boats like me!
For me this is a ‘back of the net’ for yoga. I’ve done all kinds of physio stretches over the years. Admittedly I’ve never been especially disciplined at doing them, but then I’ve never had to be thankfully. But for me relaxing into stretches for 3-5 minutes just feels like the right things to do. Give it a go. See what you think. There’s some great Yin workouts at our favourite Yoga website DoYogaWithMe.com. And lots of classes on YouTube one of our favourite providers being Yoga With Kassandra.
Yoga 1 – 0 Physiotherapy
Flat out Yoga’s got this one down. It has the reputation for a start. Breathing is great for relaxation as we explore in our previous article: Does Relaxation Breathing Really Ease Pain And Improve Your Mood? But can you specifically use it to help your stretching? Regular Yogi will of course know the answer is yes. Those who’ve not tried it will need to keep an open mind and give it a go. For the non-yogi readers we’ll explain how you use breathing to help your stretching…
We’ll start with the easy bit. Concentrating on relaxing the muscles as you breathe out. Specifically the ones you’re stretching but actually all the muscles in your body. Just try it now sat where you are. Take a big deep breath in through your nose and then a big sigh like exhale out through your mouth. Notice how different your muscles feel after that out breath.
The inhale is little bit more ‘woo woo’ if you’re not a practicing Yogi. It’s the concept of being able to breathe into specific muscles. Just close your eyes, keep your mind open and give it a go. Most people can easily breathe into their diaphragm and ribs – that’s what they are there for. But can you breathe into you quads, hamstrings, neck muscles even your backside (glutes)?
This concept of course works for all kinds of stretching not just for Yoga practice. I’ve tried with all of my favourite physio stretches and honestly focusing on the breathing makes them so much more effective. It makes you feel like you can ‘work into’ the stretch so much more – rather than feeling the muscles just aren’t going to move!
Well played Yoga…
Yoga 2 – 0 Physiotherapy
Hamstring vs Head To Knee Forward Bend (Janu Sirsasana)
We now move into a more head to head style stretch off… or in this case head to knee (see what I did there?). Have a watch of these two quick videos both of which are great for stretching hamstrings. One of the people featured in the video is a super flexible yogi… the other one is me.
So I’m actually going to give this one to me. (Pats self on back). Well done me. The reason I’ve gone for this I just personally find it better to specifically stretch the hamstrings. Especially using the rotation of the foot. I personally find that with the arms over the top I can’t get as good a stretch on my hamstring.
Ironically if you’re not making progress with your hamstring stretches you may find the Janu Sirasana helps improve your flexibility than when doing the more targeted hamstring stretch. This is because the yoga position stretches what in Anatomy Trains terms we refer to the superficial back line. Our interpretation of which is shown below:
It’s horses for courses really. I recommend you try both and see what works best for you.
Yoga 2 – 1 Physiotherapy
Lat Stretch vs Modified Child’s Pose (Balasana)
If you have any kind of shoulder problems get involved in these stretches. Tennis elbow. Asthma. Any of that stuff give it a go.
This one is a real tough call. Both are fantastic stretches. I’m going to give it to my favourite stretch of all time. But on the premise that you use breathing to enable yourself to get further into the stretch as shown in the video above. Normally in yoga you use diaphragm breathing to get the relaxation. Here for both yoga and the more specific stretch I find it best to concentrate on breathing into the rib cage after initially focusing on the breath into the stomach. Sometimes referred to as wave or 360 degree breathing.
Yoga 2 – 2 Physiotherapy
Hip Flexor vs Dragon (Utthan Pristhasana)
In my video below I introduced this as the best hip flexor stretch option. I have since discovered Dragon. You really have to keep your wits about you and focus on breathing and relaxation with dragon. I recommend going really easy with it. A generous edge as I like to call it.
The Dragon for me gets it as it explores the continuation of the hip flexors into the adductors on the inside of your thigh. You can almost feel your body un-peeling from itself as you do this. My new favourite stretch! We talk about the continuation of the hip flexor into the adductors in our previous article on the Deep Front Line. For those short on time below is our pictorial representation of the deep front line so you can get a visual idea of the connection:
Yoga 3 – 2 Physiotherapy
Quad Stretch vs Hero Pose (Virasana)
So many people carry tension in their quads. This is often caused by lack of optimal function in the Deep Front Line above leading to an increased sensitisation or tension in the femoral nerve shown below:
Here’s the best Physio and yoga stretches we’ve found to date to affect this tension:
Here I am again showing you all the best tips from physiotherapy to give your quad stretch that something extra. However, I’m going to give yoga the score again here. Simply because the relaxed hero takes into account the relationship of the hip flexors and quadriceps to stretch a whole connective tissue line as you can see in the femoral nerve picture above.
Of course relaxed hero isn’t for the fainthearted. You wouldn’t want to be performing it after a ligament reconstruction for example. So the more standard isolated quad stretch is great post injury to gradually increase mobility and also for those of us who can only dream of getting into a relaxed hero position.
Yoga 4 – 2 Physiotherapy
Glutes vs Pigeon (Kapotasana)
What is the best way to stretch the often neglected backside? Pigeon is one of the most commonly used yoga poses to stretch the glutes out but there are a multitude of yoga options. Equally from a physio perspective there are a multitude of options. Many of which of course look a lot like some yoga poses. There are so many glute stretching options in fact it prompted me to record a video, two part video in fact, of our favourite glute stretches, including of course pigeon:
This one I simply can’t call. It’s a Nil-Nil draw, I generally say to people use whatever feels best for you. It might be different on different days. The pigeon, as with all yoga is more of a whole body experience. But sometimes a more targeted stretch just feels like the right thing to do.
Yoga 4 – 2 Physiotherapy
Pec Stretch vs Camel Pose (Ustrasana)
So how do we get that chest feeling nice and open?
This one I’m going to have to give to good old Physio. A good old bit of anatomy knowledge of this muscle going from here to here has done us proud. The pec is such an important postural muscle that I feel it warrants specific attention. Whilst the Camel is a great full body stretch for me it doesn’t hit the pecs in a specific enough way.
Yoga 4 – 3 Physiotherapy
Wow what a thriller. Just the one ‘goal’ in it. Of course the real winner is wellbeing and injury treatment / avoidance. As I mentioned up top it doesn’t matter where something comes from it’s whether it works for you and feels right for you. For us at the clinic it’s more about empowering you to explore your body and what it is capable of.
In a day to day context this is in the interest of helping you to simply feel less of whatever injury ails you. Beyond that it’s onto a greater sense of wellbeing and a better life. We bring everything we can to our physiotherapy and sports therapy to help you achieve this. Reaching beyond the obvious to get the best solution for the people in front of us. It keeps us more interested and gives you a better treatment.
I was heartened to find a nice piece of research which suggests bringing Yoga into Physiotherapy seems to be a good idea. We believe it is. Sometimes it’s nice to find some research to back up what you believe… but it’s just as important to consider research that challenges what you believe.
If you’d like more information about how our approach to physiotherapy incorporates yoga and a multitude of other treatment angles to give you the best possible outcome please refer back to our Brighton Physiotherapy & Sports Therapy homepage. If you’d like to chat with us about how we might be able to help with your condition please click the Get In Touch button below
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