065: Review of the Functional Patterns Article in Men's Journal

Jul 20, 2022

Introduction

This post is a review of an article that appeared on the Men's Journal website this week, which you can read by clicking here. (Quotations taken directly from the article will appear in italicised light-blue font.)

According to the Functional Patterns website, the company teaches a method of fitness training that was first conceptualised in 2009 by the company's founder, Naudi Aguilar. I have had several run-ins with Mr Aguilar on social media in which I questioned his dubious claims about stretching. My requests for data to support his statements ended with him deleting my comments and blocking my account.

Therefore, when I was sent a link to the Men's Journal article - the title of which may be interpreted as a clear expression of Mr Aguilar's anti-stretching bias - I was highly doubtful that it would offer anything of substance in terms of the science of stretching.

I was not wrong.

Hallmarks of Self-Promotion

The first red flag in the article appears in the first line: “Written in partnership with Waverly Agency.”

Waverly is a PR company that submits brand-authored content to various media outlets. The Men’s Journal article I am reviewing in this post is suspiciously similar in tone to another that was published by Waverly Agency on Digital Journal.

Most notable is the header beneath the main image of that second piece: “This content is brand produced.” The Men’s Journal piece appears to be a self-promotion that was potentially written, at least in part, by the staff at Functional Patterns themselves.

The Un-Science of Stretching

"Stretching is often considered the best method to regain physical flexibility. People also feel that stretching can alleviate muscle conditions and help them get rid of pain and muscle discomfort. However, the science behind stretching has a different perspective. Stretching deals with passive potential that can either temporarily offer comfort to the body or aggravate any muscular discomfort or pain. Functional Patterns, currently considered a leader in the fitness industry, explains the concept behind it to help people understand whether their muscles need to be stretched or not."

The article's opening paragraph reveals the lack of awareness of stretching research among Functional Patterns trainers. Like many other personalities and entities that promote an anti-stretching bias, they fail to differentiate between the different types of stretching.

Stretching is often considered the best method to develop joint flexibility because research routinely demonstrates that stretching – static passive stretching in particular – is an effective method for improving range of motion (Decoster et al., 2005; Wyon et al., 2009; Stafilidis & Tilp, 2015; Konrad et al., 2017; Thomas et al., 2018).

Regarding the use of stretching to alleviate pain, the (real) science behind stretching does not offer a different perspective. On the contrary, research supports the use of acute and chronic stretching to produce significant reductions in pain. For example, Valenza et al. (2016) demonstrated increases in pain pressure threshold in the rectus femoris, vastus lateralis, and vastus medialis muscles of people with anterior knee pain following the use of contract-relax static active stretching. Furthermore, 10-second static passive stretching holds of the neck reduced headache pain in nurses at 30 minutes and 60 minutes after stretching (Lin & Wang, 2015).

Chronic stretching has been shown to significantly reduce pain in the neck (Tunwattanapong et al., 2016; Park & Park, 2019; Ayhan et al., 2016; Häkkinen et al., 2008; Ylinen et al., 2007; Ma et al., 2010), shoulder (Turgut, 2018), chest (Rovetta et al., 2009), lower back (França et al., 2012; Chen et al., 2014; Chen & Hu, 2019), knee (Peeler & Anderson, 2007), ankle (Porter et al., 2002; Hyland et al., 2006; Radford et al., 2007; Digiovanni et al., 2006), and the musculoskeletal system as a whole (Marangoni, 2010).

One assumes that by the term "passive potential", the authors meant to imply that stretching produces only temporary increases in range of motion. However, Rancour et al. (2009) demonstrated that stretching only 2 to 3 days per week is needed to maintain improvements in ROM gained during a previous bout of stretching. Meroni et al. (2010) reported that flexibility gains following a 6-week course of static active stretching were almost completely maintained up to 4 weeks after the cessation of the stretching programme. Similarly, increases in flexibility were retained for at least 3 weeks following just a 5-day stretching programme (Rubley et al., 2001).

"Biomechanics"

"Functional Patterns is a health & fitness company that started a whole new approach to addressing imbalances on the human body and correcting the way people move. Founded over 12 years ago, the company has been transforming lives through its Functional Patterns methodology. It focuses on creating a sustainable body by making biomechanical adaptations that relate to the way humans evolved to move in space. Through this methodology, people can better prepare their bodies to respond more appropriately to stressors they face in the environment. Functional Patterns also helps in correcting posture and muscle imbalances.

"To date, the company has trained and educated thousands of health professionals in Functional Patterns around the world. At present, they have 20 licensed gyms spread across different continents. Through a more scientific approach to stretching, Functional Patterns has proved to rival physiotherapy, chiropractic, and other such treatments. The company has assisted the famous Johnny Eblen through FP to become Bellator’s #1 middleweight contender. Kyle Dake, the renowned freestyle wrestler from Cornell University, has benefited from following this methodology that helped him win 3 world championships and an Olympic bronze medal after he was set to retire dealing with career ending injuries."

I actually think Functional Patterns looks like it could be fun. However, it is interesting that the company makes many proclamations about biomechanics when its founder never received a formal academic education in the subject and yet claims to certify "Human Biomechanics Specialists" on courses that last only a couple of days. Ask any genuine student or teacher involved in the actual scientific discipline of biomechanics, and they will tell you it cannot be learned in just a few days.

Furthermore, the approach to stretching and movement that is presented on the Functional Patterns public pages does not appear to contain any exercises that have not already been done before. Since the methodology has not been compared to physiotherapeutic, chiropractic, or other such disciplines under controlled conditions, and the results subjected to interrogative peer-review, claims of superiority are largely baseless. Considering the tens of thousands of social media accounts run by physiotherapists, chiropractors, osteopaths, and other health and fitness professionals not trained in the Functional Patterns method, many of whom share patient and client success stories, it is difficult to believe that "Functional Patterns has proved to rival" any of them.

Muscles Don't "Shut Off"

"Functional Patterns explains that stretching can ruin the function of your muscles by completely shutting them off. It can also lead to chronic pain or deteriorate an existing muscle condition. For instance, consider a rubber band. When it is overstretched, the rubber band loses its elasticity. Similarly, muscles in the human body respond to stretching by contractions or, as science describes it, reciprocal inhibition."

A consistent theme I have encountered with Functional Patterns is their use of ambiguous terminology that sounds "sciencey" but which can be difficult to extract the precise meaning from because no elaborations are provided. It is anyone's guess what exactly they mean by "ruin the function of your muscles" or "completely shut them off." However, I will provide evidence that counters how an average reader might reasonably interpret those phrases.

No empirical data exists to support the claim that stretching "ruins" muscular function. On the contrary, the literature provides plenty of examples of stretching restoring function to the musculoskeletal system (Kim et al., 2004; Feldbrugge et al., 2019; Behm et al., 2021; Paek, 2022).

Stretching does not turn muscles off. I assume that the authors of the article were referring to the decrease or disfacilitation of reflexive excitation of motor neurons - although this is probably an overly generous assumption given the lack of understanding of stretching physiology exhibited in the article.

Inhibition (the activation of inhibitory postsynaptic potentials in motor neurons) and disfacilitation (hyperpolarisation of motor neurons caused by the absence of excitatory synaptic activity) occur mostly while a stretch is sustained, and the discharge frequency of the nuclear bag and nuclear chain fibres within the muscle spindles would increase as soon as movement is reinitiated.

And even when neural inhibitory or disfacilitatory processes are at play, a muscle is not completely "off" or "hyperflaccid," as the Functional Patterns staff like to say. "Hyperflaccid" is a term that was seemingly coined by them, and I have taken it to mean an extreme example of flaccidity (to be soft or unfirm). However, each muscle has a resting muscle tone representing the tissues' intrinsic molecular viscoelastic tension. This passive tension increases relative to muscle elongation, which means it resists more with greater stretch and so will not be soft or unfirm during a stretch (Masi & Hannon, 2008).

Reciprocal Inhibition

"Let’s use a bicep curl as an example. The length you create on the triceps when the bicep contracts, is what then enables the triceps to contract after it has been lengthened. This is what happens in movement with muscles all over the body. Although as its traditionally done, stretching is a passive process, which doesn’t promote reciprocal inhibition in the body. Over time your muscles will lose their ability to contract, causing instability and tightness in your joints."

The problem with using a biceps curl as an example of effective stretching is that the antagonist can only be stretched as far as the agonist can contract. Basic muscle physiology informs us that muscles can generally be contracted to 70% of their resting length but elongated beyond 130% of resting length (Vander et al., 2001; Kenney et al., 2021). This is why the ascending limb (representing muscle shortening) on a typical force-length graph is shorter than the descending limb (representing elongation).

There is no evidence to support the claim that stretching causes muscles to lose their ability to contract over time. The only time that a muscle loses its ability to contract is following trauma or pathology to the nervous system, which rational flexibility training does not cause.

"If you have muscles that don’t function correctly, this can lead to increased strain on your ligaments and tendons when you move, which can aggravate existing conditions. We also have to consider that muscles don’t function in isolation. There are chains of muscles in the body that must function together for you to move efficiently. This is where stretching can have an adverse impact on the body because it is based on passive motion, and not active motion. Moving correctly is ultimately what’s going to promote the right types of stretches in the body."

Here one finds yet another example of an ambiguous phrase that lacks clarity - what exactly do the authors mean by "muscles that don't function correctly"? Regardless, the claim that stretching has an adverse effect on the body is false: passively stretching a muscle can increase activity in the opposing muscle, thus enhancing performance in the latter (Miranda et al., 2015).

"Functional Patterns has a completely different approach to healing pain and other muscular conditions. The method focuses on correcting physical imbalances in the body by teaching you how to move better. Functional Patterns focuses on 4 primary functions, which are called the FP First Four: standing, walking, running, and throwing. They use the most basic forms of human movement to help to measure functionality, physical imbalances causing discomfort, and tightness in the body. The FP First Four provides a code to dictate a way of programming flexibility that respects the human biological blueprint."

Considering that postural assessment and correction (Sahrmann, 2002), gait mechanics (Whittle, 1996), and throwing mechanics (Fleisig et al., 1996) have been part of conventional physical therapy practice for decades, it is difficult to believe, based on watching publicly-available content, that Functional Patterns offers a "completely different approach" to improving function in these areas.

"So far, Functional Patterns has helped many people with chronic pain function better. The list includes double amputees, people with neurological conditions, people with disc herniations, and many more. This is a proven method that is challenging the dominant concepts in the fitness industry worldwide. With a fail-safe approach and lifelong results, it is only a matter of time before Functional Patterns becomes the household name in the training and healthcare sectors."

I applaud Functional Patterns trainers for helping their clients get out of pain and lead more active and fulfilling lifestyles. However, with no evidence other than the claims made by Functional Patterns themselves that they are "challenging the dominant concepts in the fitness industry" or that they are achieving better results than conventional interventions, it remains to be seen whether the methodology offers anything of substance beyond what is already available in the industry. As far as their claims about stretching go, they offer no evidence to support their claims and fail to respond in when presented with ample evidence to counter their claims.

References

Ayhan, H., Tastan, S., Iyigün, E., et al. (2016.) ‘The Effectiveness of Neck Stretching Exercises Following Total Thyroidectomy on Reducing Neck Pain and Disability: A Randomised Controlled Trial.’ Worldviews on Evidence-Based Nursing volume 13, number 3, pages 224-231.

Behm, D. G., Kay, A. D., Trajano, G. S., et al. (2021.) 'Effects of Stretching on Injury Risk Reduction and Balance.' Journal of Clinical Exercise Physiology volume 10, number 3, pages 106-116.

Chen, H. M. & Hu, H. M. (2019.) ‘Randomised Trial of Modified Stretching Exercise Program for Menstrual Low Back Pain. Western Journal of Nursing Research volume 41, number 2, pages 238-257.

Chen, H. M., Wang, H. H., Chen, C. H., et al. (2014.) ‘Effectiveness of a Stretching Exercise Program on Low Back Pain and Exercise Self-Efficacy Among Nurses in Taiwan: A Randomised Clinical Trial.’ Pain Management Nursing volume 15, number 1, pages 283-291.

Decoster, L. C., Cleland, J., Altieri, C., et al. (2005.) 'The Effects of Hamstring Stretching on Range of Motion: A Systematic Literature Review.' Journal of Orthopaedic and Sports Physical Therapy volume 35, number 6, pages 377-387.

Digiovanni, B. F., Nawoczenski, D. A., Malay, D. P., et al. (2006.) ‘Plantar Fascia-Specific Stretching Exercise Improves Outcomes in Patients with Chronic Plantar Fasciitis: A Prospective Clinical Trial with Two-Year Follow-Up.’ Journal of Bone and Joint Surgery volume 88, number 8, pages 1775-1781.

Feldbrugge, C. M., Pathoomvanh, M. M., Powden, C. J., et al. (2019.) 'Joint Mobilisation and Static Stretching for Individuals with Chronic Ankle Instability - A Pilot Study.' Journal of Bodywork and Movement Therapies volume 23, number 1, pages 194-201.

Franca, F. R., Burke, T. N., Caffaro, R. R., et al. (2012.) ‘Effects of Muscular Stretching and Segmental Stabilisation on Functional Disability and Pain in Patients with Chronic Low Back Pain: A Randomised, Controlled Trial.’ Journal of Manipulative and Physiological Therapeutics volume 35, number 4, pages 279-285.

Häkkinen, A., Kautiainen, H., Hannonen, P., et al. (2008.) ‘Strength Training and Stretching Versus Stretching Only in the Treatment of Patients with Chronic Neck Pain: A Randomised One-Year Follow-Up Study.’ Clinical Rehabilitation volume 22, number 7, pages 592-600.

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Kenney, W. L., Wilmore, J. H., & Costill, D. L. (2021.) ‘Physiology of Sport and Exercise (8e).’ Champagne, IL: Human Kinetics.

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