When the Tail Wags the Dog — Part I

When the Tail Wags the Dog — Part I

When the Tail Wags the Dog — Part I


“Stretching” Now there’s a word that elicits a variety of reactions from runners, ranging from benign resignation to stubborn resistance to downright disgust. I don’t know that I’ve ever encountered a runner who is truly enthusiastic about this particular activity. Most often, I’m asked in a hopeful whine, “Do I really need to do much stretching? Is it really important?”

Of course, you all know the answer is Yes, you just don’t want to have to spend time and energy on something so, well, boring. So…. slow.

You all “know” that stretching promotes flexibility of muscles and tendons and ligaments, which helps prevent injuries, such as strains and tears, etc. You “know” that tight calf muscles lead to shin splints, tight hamstrings lead to knee problems, and tight hip flexors lead to iliotibial band syndrome. And, it only makes sense that tight muscles increase resistance which slows you down! But still, so many of you seem to lack the incentive to properly and deliberately maintain good flexibility of the lower limbs, while even less pay any attention at all to the upper extremities which are in fact just as important, even for runners. Let me try to provide some additional information to motivate you.

A few months ago, I wrote about low back pain and the runner. The “good news” was that running does not appear to increase degenerative changes in the spine, as many people suspect due to the repetitive “pounding” we inflict on ourselves. But the “bad news” on the other hand, is that running does not necessarily “immunize” us from back pain either. In fact, inflexibility of the limb muscles (often caused by much running and little stretching) may be at least partly responsible for many chronic low back ailments. Why would this be?

For a long time, physicians and therapists believed without question that “flexibility is good,” even when applied to the spine and surrounding muscles. It was thought that most, if not all, back injuries and conditions could be traced back to insufficient flexibility (hypomobility) of the spine. The emphasis of both preventive and rehabilitation programs was on stretching exercises for the spine.

Today however, more and more “experts” are coming around to the belief that excessive flexibility (hypermobility) or excessive repetitive movements are to blame for a large proportion of the back injuries suffered in this country. And often, these conditions can be traced back to inflexibility of the extremity muscles. The reason is common sense: if the required range of motion for a body movement is deficient in the limb, we’ll have to get it somewhere else; namely, the trunk.

For example, if the hamstrings are tight, then when we bend forward to touch our toes or pick something up from the ground, we’ll most likely flex the lower spine to a greater degree to accomplish this since the hip joint will not grant us a normal free and easy range. Make this a repetitive motion, as in a factory job, and it will eventually take it’s toll on the discs, joints and ligaments of the back. With running, tight hamstrings do not require a great deal of spine range in terms of degrees of movement, but the greater repetition may add up to the same result.

The name of the game now is “stability” of the trunk, which allows for a proper base from which the extremities can function optimally and efficiently. Inflexibility of the limb joints and muscles, therefore, can cause hypermobility of the trunk, a condition which has been described as “the tail wagging the dog.”

Naturally, no stretching at all can lead to this condition, but unfortunately, so can improper stretching. Some tips on how to avoid this next month in part II.

Gabe Yankowitz

Gabe is a long-time runner and physical therapist currently practicing in Manlius. Gabe is a physical therapist in Central New York for the past 35 years, specializing in orthopedic treatment and rehabilitation. His website is www.gaberun.com

  • Physical therapy degree from Upstate Medical Center (1983)
  • Doctor of Physical Therapy degree from the Massachusetts General Hospital Institute of Health Professions  (2007)
  • Board-Certification as Clinical Specialist in Orthopedic Physical Therapy (2009).