Apostolopoulos | Stretch Intensity and the Inflammatory Response: A Paradigm Shift | Buch | sack.de

Apostolopoulos Stretch Intensity and the Inflammatory Response: A Paradigm Shift



1. Auflage 2018, 231 Seiten, Gebunden, Book, Format (B × H): 160 mm x 238 mm, Gewicht: 534 g
ISBN: 978-3-319-96799-8
Verlag: Springer, Berlin


Apostolopoulos Stretch Intensity and the Inflammatory Response: A Paradigm Shift

In this manuscript, practitioners and students who are concerned with sports and rehabilitation medicine, kinesiology, as well as coaches and athletes, are introduced to numerous concepts, including mechanotransduction, inflammation, pro- and anti-inflammatory cytokines, calpains, the extracellular matrix, neutrophils and macrophages, and their relevance to stretching, particularly stretching intensity. Although the quantitative parameters of training, duration, and frequency are important, it is the qualitative criterion of intensity (“how much”) that the author suggests is ultimately of greater concern. Intensity, the rate and magnitude of force, may be responsible for the proper recovery, regeneration, and adaptation of the musculoskeletal tissues from training, competition, or rehabilitation from injuries. Research suggests that too much force results in the stimulation of an inflammatory response, one associated with a biochemical feedback emerging from a mechanical stimulus. The intent of this manuscript is twofold: to initiate the discussion of the importance of stretching intensity with regard to proper recovery, regeneration, and adaptation, and to suggest that researchers need to explore its potential role in addressing numerous inflammatory (RA) and non-inflammatory (OA, recurrent tendinitis etc.) musculoskeletal conditions as well.

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This book represents a paradigm shift examining the relevance of stretching, specifically stretching intensity and its importance for the proper recovery of musculoskeletal tissue. Stretching, and it various forms, has been associated with sports (warm-up, warm-down), with delayed onset muscle soreness (DOMS) post activities, as well as a modality in rehabilitative medicine. Similar to most forms of activity (i.e., strength and cardiovascular training), stretching is defined by the parameters of training: intensity, duration, frequency, as well as body position, with numerous investigators attempting to identify whether stretching pre-, during, and post-exercise was beneficial. Based on eligible randomized controlled trials, a Cochrane Collaboration systematic review suggested that stretching did not exhibit any clinically important benefits with the reduction of DOMS, a decrease in creatine kinase values (a measure of muscle damage), and soreness. This review mentioned the duration and frequency, but not the intensity of the stretching exercises. Unlike duration and frequency which are quantitative in nature, stretching intensity is qualitative, thus difficult to measure, accounting for why it is relatively under-researched.

Stretching, defined as movement applied by an external/internal force used to increase muscle flexibly and/or joint ROM, stresses the connective and muscle tissues mechanically. It depends on the active and passive tension of the muscle, the musculo-tendinous unit, as well as the proprioceptors of the musculoskeletal system (i.e., muscle spindles and Golgi tendon organs). Although duration and frequency are important, the rate and magnitude of force (stretching intensity) is of greater significance, with too much force possibly being responsible for stimulating an inflammatory response. This is associated with both a mechanical and biochemical response, with the former characterized by a 'local reaction' at the site of stress resulting in the accumulation of leukocytes, and the latter referring to the release of pro-inflammatory cytokines signaling acute inflammation. In conjunction with stretching intensity, the influence of body position may directly or indirectly influence stretching intensity, for muscle and tendon tissue and their components (i.e., collagen) are known to respond to altered levels of activity.


Apostolopoulos, Nikos C.
Nikos C. Apostolopoulos PhD, a recovery and regeneration specialist, is the founder of microstretching® and stretch therapy®. He received his PhD and MPhil from Wolverhampton University (UK) and his BPHE (sports medicine) from the University of Toronto (CAN). Nikos has worked and continues to work and consult with professional, elite, and amateur athletes, and with numerous sports organisations (NHL, NBA, NFL, EPL, MLS, NCAA, ERL). Presently, he is affiliated with the Faculty of Kinesiology and Physical Education, University of Toronto (CAN), is an editor for numerous international sports journals, and is a member of IASP and ISEI.


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