To Stretch or Not to Stretch?

To Stretch or Not to Stretch?

  • Posted May 06, 2014
  • Rafael Gutierrez DPT COMT

People stretch because it feels good or because they think it will increase flexibility and maybe prevent injury. Static stretching has been shown to improve flexibility, but these effects are usually temporary and may only become permanent with a consistent stretching program. For most individuals, however, stretching before exercise does not have many benefits. Much research has demonstrated an increase in flexibility following a stretching regimen because our bodies, via the nervous system, have adapted to tolerating the stretch; however, stretching did not necessarily increase joint range of motion (ROM) or muscle elasticity.

People wonder if stretching prevents injury or if it decreases muscle soreness, strength or peak sports performance (specifically in sports where flexibility is not required, such as running).

What’s the verdict?
Whether or not to stretch is entirely up to the individual, but based on the literature, it is not necessary unless you are someone who requires consistent flexibility, like dancers or hockey goalies.

There is contradictory information on stretching recommendations, but if you decide to stretch, it should be done following a warm-up or after performing low to moderate activity. It also may be more beneficial to move the joints involved in an activity through the required ROM and movement pattern for that specific activity as opposed to any type of stretching.

Although there are few studies on the correlation of warm-up and injury prevention, some research show it is possible that warming up can assist in preventing injuries. Active individuals who participate in strength or dynamic performance activities should wait to stretch after their activity is finished because of the immediate decreases in strength and performance following stretching. If you do stretch, the American College of Sports Medicine recommends the following guidelines:

• Adults should do flexibility exercises at least two or three days each week to improve ROM.
• Hold each stretch for 10-30 seconds to the point of tightness or slight discomfort (should not be painful).
• Repeat each stretch two to four times, accumulating 60 seconds per stretch.
• Static, dynamic, ballistic and PNF (proprioceptive neuromuscular facilitation) stretches are all effective.
• Flexibility exercise is most effective when the muscle is warm. Try light aerobic activity or a hot bath to warm the muscles before stretching.

Rafael Gutierrez, DPT is a staff physical therapist at Holy Cross Hospital’s outpatient physical therapy facility in Boca Raton. He may be reached at 561-483-6924.

References
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011 Jul;43(7):1334-59. doi: 10.1249/MSS.0b013e318213fefb.

Herbert RD, Gabriel M. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. BMJ. 2002 Aug 31;325(7362):468.

Kamandulis S, Emeljanovas A, Skurvydas A. Stretching exercise volume for flexibility enhancement in secondary school children. J Sports Med Phys Fitness. 2013 Dec;53(6):687-92.

McHugh MP, Cosgrave CH. To stretch or not to stretch: the role of stretching in injury prevention and performance. Scand J Med Sci Sports. 2010 Apr;20(2):169-81. doi: 10.1111/j.1600-0838.2009.01058.x. Epub 2009 Dec 18.

McNeal JR, Sands WA. Stretching for performance enhancement. Curr Sports Med Rep. 2006 May;5(3):141-6.

Pope RP, Herbert RD, Kirwan JD, Graham BJ. A randomized trial of preexercise stretching for prevention of lower-limb injury. Med Sci Sports Exerc. 2000 Feb;32(2):271-7.

Safran MR, Garrett WE Jr, Seaber AV, Glisson RR, Ribbeck BM. The role of warmup in muscular injury prevention. Am J Sports Med. 1988 Mar-Apr;16(2):123-9.

Safran MR, Seaber AV, Garrett Jr WE. Warm-Up and Muscular Injury Prevention An Update. Am J Sports Med Oct 1989, Volume 8, Issue 4, pp 239-249.

Sainz de Baranda P, Ayala F. Chronic flexibility improvement after 12 week of stretching program utilizing the ACSM recommendations: hamstring flexibility. Int J Sports Med. 2010 Jun;31(6):389-96. doi: 10.1055/s-0030-1249082. Epub 2010 Mar 22.

Shrier I. Does stretching improve performance? A systematic and critical review of the literature. Clin J Sport Med. 2004 Sep;14(5):267-73.

Wallmann HW, Christensen SD, Perry C, Hoover DL. The acute effects of various types of stretching static, dynamic, ballistic, and no stretch of the iliopsoas on 40-yard sprint times in recreational runners. Int J Sports Phys Ther. 2012 Oct;7(5):540-7.

Weppler CH, Magnusson SP. Increasing muscle extensibility: a matter of increasing length or modifying sensation? Phys Ther. 2010 Mar;90(3):438-49. doi: 10.2522/ptj.20090012. Epub 2010 Jan 14.


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