Dominic Stone
Lengthening muscle inserts is a complex topic that involves understanding the interplay between muscles, bones, and the body's overall structure. While stretching is commonly associated with increased flexibility, it does not change the fixed origin and insertion points of muscles. Instead, resistance training with eccentric contractions is considered more effective for lengthening muscles. Additionally, limb lengthening surgery, often done on the arms or legs, can also impact muscle length. This gradual process involves cutting bones and using internal or external devices to lengthen them, which in turn affects the attached muscles. The recovery process is lengthy and requires physical therapy, stretching, and strengthening exercises.
| Characteristics | Values |
|---|---|
| Muscle stretching | Increasing the distance between where the muscle originates and where it inserts |
| Muscle lengthening | Increasing the distance but the muscle is putting its brakes on to prevent overstretching |
| Muscle tightness causes | Lack of movement, e.g. sitting down too much can tighten the hip muscles |
| Muscle stretching vs lengthening | Stretching increases flexibility but does not change the distance between origin and insertion points |
| Muscle lengthening method | Resistance training with eccentric contractions and stretch-activated muscles |
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What You'll Learn
Resistance training with eccentric contractions
During eccentric contractions, the muscle is working against resistance, which is known as negative work. This is achieved when the external force acting on the muscle is greater than the force produced by the muscle itself. For example, walking down a hill or lowering a heavy object with control are everyday activities that involve eccentric muscle contractions. In the context of resistance training, this translates to exercises where the emphasis is on the lowering or downward phase of the movement.
One of the key advantages of eccentric training is its potential for muscle strengthening. Studies have shown that eccentric resistance training can lead to greater muscular hypertrophy when compared to traditional strength training methods. This is because eccentric contractions can create more force with less work, resulting in increased muscle power and speed. Additionally, eccentric training has been found to increase distal muscle size more effectively than concentric training, which tends to favour median-muscle hypertrophy.
Despite the benefits, it is important to approach eccentric resistance training with caution. Eccentric contractions have traditionally been associated with muscle damage and injury, particularly when the muscle is stretched beyond its capacity. However, research has shown that by progressively increasing the duration, frequency, and intensity of eccentric training sessions, symptoms of damage can be minimised or even avoided. This makes eccentric training a safe and suitable alternative to traditional resistance exercises, especially for individuals who may not be able to perform high-intensity workouts.
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Yoga asanas and stretching programs
Yoga and stretching are great ways to increase flexibility and range of motion. However, it is important to note that stretching does not actually lengthen the muscles. The increased flexibility can create the illusion that the muscles have lengthened, but muscles have fixed origin and insertion points, and the distance between them does not change through stretching.
That being said, yoga asanas and stretching programs can still help to target specific muscles and create the feeling of lengthening. For example, when rounding the back forward, the para-spinal muscles along the spine are stretched. Similarly, a deep back arch will lengthen the abdominal muscles. Additionally, yoga poses can target the hip flexor muscle, such as the Crescent Moon pose.
To increase flexibility and create the feeling of lengthening, it is important to hold each pose for at least 30 seconds but no longer than a minute. This allows the brain to send a message to the muscles that it is okay to loosen up. Adding movement to a pose can also increase the range of motion, especially if a particular position is challenging.
Breathwork, or pranayama, is also an important component of yoga. Inhaling and exhaling at the right time while in a posture can help control where energy should flow and also aid in getting a good stretch. For example, in a high plank or tabletop position, one can step one foot forward to the outside of the hand, lift the back glute, press through the back heel, and lengthen the arm on the same side of the foot to the sky, twisting the chest open. To get the full benefit of the stretch, exhale while lunging and inhale while reaching the arm to the sky.
In addition to the physical aspects, yoga is also a deeply spiritual practice with mental health benefits. Flexibility training is demanding on the body, and proper nutrition is important. Yoga students are encouraged to eat sulfur-rich vegetables, omega-3s, and vitamin C-laden fruits.
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Leg-lengthening surgery
There are two types of devices used in leg-lengthening surgery: internal and external. Internal devices, such as the Precice nail, are inserted into the bone and lengthened with a magnetic device. External fixators, on the other hand, are worn outside the leg and held in place with metal pins and screws. Over time, the screws and pins are tightened, slowly pulling the bones apart. Examples of external fixators include the Taylor Spatial Frame and the Ilizarov device.
The choice between internal and external devices depends on various factors. Internal fixators are more commonly used for leg lengthening as they do not require pins, reducing the risk of infection. However, the bone needs to be wide enough for an internal rod to be safely inserted, which may not be the case for children who are still growing. Before surgery, the patient and their doctor will decide which type of device is most suitable.
Limb lengthening is a gradual process that can take several months to complete. It involves the growth of new bone and soft tissues like skin, muscle, nerves, and blood vessels. This process, known as distraction, requires physical therapy to stretch the tissues and maintain joint mobility. Patients will need to be seen by their surgeon frequently for X-rays and examinations, and they may experience pain, soreness, and tight muscles during the recovery period.
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Internal lengthening devices
The surgery is a major commitment, requiring a long recovery period of several months. It is important to be aware of the risks involved, which can include pin-site infections, joint or muscle stiffness, and damage to muscles or nerves. Before the surgery, it is recommended to plan for the aftercare, as the patient will need help with everyday tasks such as getting dressed, bathing, and doing their home exercises.
After the surgery, the patient will stay in the hospital for about 1-2 days. During this time, the patient or their caregiver will be instructed on how to use the remote control for the lengthening device. The patient will also need to attend physical therapy and do stretching and strengthening exercises at home. It is important to follow the orthopedic team's instructions on when the patient can put weight on the lengthened limb. Follow-up visits with the surgery team are typically scheduled every 4 weeks, with X-rays done at each visit to monitor bone healing.
The time it takes to reach the desired limb length varies but is usually within a few months after surgery. Once the desired length is achieved, the use of the remote controller is stopped, but the lengthening device remains in place to support the growing bone. Most patients can return to their usual activities about 6-9 months after the rod was placed, and the implant is typically removed 1-2 years after surgery.
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Aquatic therapy
The viscosity of water provides resistance, which helps to strengthen muscles and improve body awareness. Additionally, the hydrostatic pressure of water facilitates deeper breathing, aiding in lung expansion and improving respiratory control. This can be beneficial for children with muscular dystrophy, as it helps them improve their respiratory control while also enjoying the benefits of being in the water.
Some specific exercises that can be done in the water include walking, which can be started in shallow water to get a feel for creating resistance. Walking in water has been found to be more effective for improving leg muscle mass compared to walking on land, and it also targets the arms and core. Another exercise is to hold onto the pool ledge, tuck the knees into the chest, and then press the feet into the wall. Pushing off from the wall, the individual can glide or float on their back, draw their knees into their chest, and then press their feet down to the bottom of the pool to run back to the wall. This exercise can be continued for 5 to 10 minutes and helps activate the muscles in the core and lower body.
Overall, aquatic therapy is a beneficial form of exercise that can help individuals improve their muscle strength, increase their range of motion, and enhance their rehabilitation progressions, all while providing a soothing and comfortable environment.
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Frequently asked questions
When stretching a muscle, the distance between where it originates and where it inserts is increased. However, the muscle filaments will move back to their original place after the stretch. On the other hand, lengthening a muscle also increases the distance, but the muscle puts its "brakes" on to prevent overstretching.
Resistance training is said to be the most effective way to lengthen muscles. For example, when in a deep lunge, the hip flexor muscle is stretched. If you consciously tighten the hip flexors and hold that position, the soft tissue around the muscle will gradually reorganise and the joint will become more flexible.
Yoga asanas and other stretching programs can help mitigate muscle tightness. However, stretching a muscle has limited long-term effects as the muscle filaments will move back to their original place after the stretch.
Tight, inflexible muscles may be caused by a lack of movement. For example, sitting down for too long can tighten the muscles in your hips.
Lengthening has been found to have better results for rehabilitation purposes.
