Stretching - for Nurses
Well, look, stretching admittedly is not the most stimulating topic in the world, but truth be told, it is definitely one of the most important yet under appreciated components of physical fitness. For anybody - Nurse or not - stretching should be a daily routine item, much like brushing your teeth. But too many times, stretching gets ignored. (I'm definitely guilty of it too!)
Stretching can be awfully boring and be uncomfortably annoying. It takes a solid 10-15 minutes to do it properly - time that most exercisers feel they should spend working up a sweat. So it's no wonder most people forego it all together.
So why should you bother? Why should an RN worry for two seconds about her flexibility? You've probably heard or read about the statistics showing the number of nurses that leave our profession prematurely due to musculoskeletal injuries incurred while on the job. As a group, Nurses who work in Hospitals have the second highest incidence rate for back injuries of any job in the country. Only truck drivers (who load and unload boxes and drive hundreds of miles every day) have a higher incidence rate. Link to Avoiding Back Injuries for the Nurse - for the full details. That is a staggering statistic. Stretching certainly is not the magical cure for this, but a consistent routine will help reduce the chances you'll get injured on the job.
Here's what stretching does:
- It reduces tension
In short, when you can increase the range of motion in your joints, your limbs and joints can move further before injury occurs. Think of it like the old metaphor using the tree branch: the unstretched body is like the old brittle twig; the flexible, loose stretch body is like a young malleable green twig. To beat the tree metaphor to death, like the tree you also don't necessarily visually see the benefits of your stretching. The results can be felt when your limbs and body are stressed and do not injure.
As Nurses, there's so many unavoidable opportunities to tweak our bodies - think about lifting a patient from bed, bracing an older patient's slip or fall, transporting patients throughout the hospital, or even just picking something up off the ground. You know the simple "Bend with your Knees, Not your Back" advice is simply not real life (click for more details on this).
How to Stretch
You always want to stretch opposing muscle groups: in other words, your hamstrings (back of upper leg) with quadriceps (front of upper leg). This helps avoids injury due to muscular imbalance. Always make sure you warm up first - just get the blood flowing somehow.
A Nurse's Routine
Full body flexibility is the key for an RN. You're using your entire body at work, so you can't neglect any area. Maybe some people - like runners - can focus primarily on their lower body, but not an RN! This link has a wonderful routine with photos that everybody can do and benefit from. Print it out and follow the instructions. I would just add one stretch to the routine, for the Chest, which can be found at this link. Do both of these routines every other day and you'll be well on your way to increased flexibility and reduced chance of injury while on the job. All of these can be done at home with no equipment, and many of them can be done even at work.
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While I agree stretching can be beneficial, for the most part, it is highly over rated and over prescribed. Having a lack of flexibility is not necessarily the main reason for back injuries or for any musculoskletal injuries for that matter. It is a matter of muscular weakness. In other words, loading the muscles with more work than they can perform.
Also when you are attempting to strengthen a muscle, or perform any type of post rehab on a previously injured muscle or joint, at times it is good to train that muscle or muscle group then leave it alone and allow the laxness of that weakened area to develop some taughtness. Overly stretched muscles can lead to increased joint laxity creating further problems than not stretching; this is called a dynamic reflex injury.
Granted we all need balanced muscular strength and flexibility but to perform a particular stretch for over a minute at a time is probably going too far. In fact a few years ago the National Strength and Conditioning Association released a position paper stating that they felt that the most you should stretch at any given time would be no more than 30 seconds to 2 minutes max - for everything, not just one muscle group. The key was to perform these stretches several times a day in order to maximize the potential of reducing injury while increasing flexibility but not to over do it due to the dynamic relfex injury I mentioned previously.
Most injuries occur in the first 4 hours at work. Probably the most important time to stretch is just before getting out of bed in the morning when static fixation is at its greatest. A few knee to chest and pelvic rocking stretches will go a long way to reducing the great number of those injuries that nurses or any healthcare worker experiences on the job.
Follow up though with an intensive strength training program that trains muscle groups antagonistically while loading the core, stabilizing the spine and developing strength for a weakened quadrautus lumborum and you will do a tremenous amount of positive good for your body and it can all be done in as little as 20 minutes a day.
Have a strong and healthy day.
J.R.Smith, cft,ssc,spn,mes,clwms
Sport, Fitness and Medical Exercise Specialist
NBFE board registered
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