To stretch or not to stretch: The role of stretching in injury prevention and performance

Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York 10075, USA.
Scandinavian Journal of Medicine and Science in Sports (Impact Factor: 2.9). 04/2010; 20(2):169-81. DOI: 10.1111/j.1600-0838.2009.01058.x
Source: PubMed


Stretching is commonly practiced before sports participation; however, effects on subsequent performance and injury prevention are not well understood. There is an abundance of literature demonstrating that a single bout of stretching acutely impairs muscle strength, with a lesser effect on power. The extent to which these effects are apparent when stretching is combined with other aspects of a pre-participation warm-up, such as practice drills and low intensity dynamic exercises, is not known. With respect to the effect of pre-participation stretching on injury prevention a limited number of studies of varying quality have shown mixed results. A general consensus is that stretching in addition to warm-up does not affect the incidence of overuse injuries. There is evidence that pre-participation stretching reduces the incidence of muscle strains but there is clearly a need for further work. Future prospective randomized studies should use stretching interventions that are effective at decreasing passive resistance to stretch and assess effects on subsequent injury incidence in sports with a high prevalence of muscle strains.

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Available from: Malachy Mchugh, Dec 16, 2014
    • "It is well known in people that gymnastic training (GYM) involving muscular stretching and/or strengthening exercises contributes to the prevention of occupational diseases and enhances rehabilitation from injuries [9]. Muscular stretching performed before athletic activity reduces the risk of muscular strain although muscular strength and power may be impaired [10]. Strength training not only improves muscular force and power, it also protects against injury by activating and strengthening the deep stabilizing musculature [9]. "

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    • "It is well known that both acute and chronic stretching exercise improve lower extremity ROM (for review, see Behm and Chaouachi, 2011; Decoster et al., 2005). Furthermore, recent reviews of literature suggest that stretching could be effective in reducing muscle strains (McHugh and Cosgrave, 2010; Small et al., 2008). However, there is compelling evidence that pre-exercise static stretching could also impair neuromuscular performance (Behm and Chaouachi, 2011; Simic et al., 2013). "
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    • "Since the original work of Kokkonen et al. (1998) and Fowles et al. (2000), many authors have examined the acute effects of stretching on various measures of muscular performance. Recent reviews (Kay and Blazevich 2012; McHugh and Cosgrave 2010) have suggested that prolonged passive stretching may temporarily compromise the muscles' ability to produce maximal force, a phenomenon that has been termed the " stretchinginduced force deficit. " As a result of these findings, the American College of Sports Medicine (ACSM 2010) recently revised their stretching guidelines and suggested that " …for sport activities where muscular strength, power, and endurance are important for performance, it is recommended that stretching be performed following activity rather than during the warm-up period " (p. "
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    ABSTRACT: The acute effects of stretching on peak force (F peak), percent voluntary activation (%VA), electromyographic (EMG) amplitude, maximum range of motion (MROM), peak passive torque, the passive resistance to stretch, and the percentage of ROM at EMG onset (%EMGonset) were examined in 18 young and 19 old men. Participants performed a MROM assessment and a maximal voluntary contraction of the plantarflexors before and immediately after 20 min of passive stretching. F peak (−11 %), %VA (−6 %), and MG EMG amplitude (−9 %) decreased after stretching in the young, but not the old (P > 0.05). Changes in F peak were related to reductions in all muscle activation variables (r = 0.56–0.75), but unrelated to changes in the passive resistance to stretch (P ≥ 0.24). Both groups experienced increases in MROM and peak passive torque and decreases in the passive resistance to stretch. However, the old men experienced greater changes in MROM (P < 0.001) and passive resistance (P = 0.02–0.06). Changes in MROM were correlated to increases in peak passive torque (r = 0.717), and the old men also experienced a nonsignificant greater (P = 0.08) increase in peak passive torque. %EMGonset did not change from pre- to post-stretching for both groups (P = 0.213), but occurred earlier in the old (P = 0.06). The stretching-induced impairments in strength and activation in the young but not the old men may suggest that the neural impairments following stretching are gamma-loop-mediated. In addition, the augmented changes in MROM and passive torque and the lack of change in %EMGonset for the old men may be a result of age-related changes in muscle-tendon behavior.
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