Stretching to prevent or reduce muscle soreness after exercise

Musculoskeletal Division, The George Institute for Global Health, PO Box M201, Missenden Road, Camperdown, Sydney, Australia, NWS 2050.
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 01/2011; DOI: 10.1002/14651858.CD004577.pub3
Source: PubMed

ABSTRACT Many people stretch before or after engaging in athletic activity. Usually the purpose is to reduce risk of injury, reduce soreness after exercise, or enhance athletic performance. This is an update of a Cochrane review first published in 2007.
The aim of this review was to determine effects of stretching before or after exercise on the development of delayed-onset muscle soreness.
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (to 10 August 2009), the Cochrane Central Register of Controlled Trials (2010, Issue 1), MEDLINE (1966 to 8th February 2010), EMBASE (1988 to 8th February 2010), CINAHL (1982 to 23rd February 2010), SPORTDiscus (1949 to 8th February 2010), PEDro (to 15th February 2010) and reference lists of articles.
Eligible studies were randomised or quasi-randomised studies of any pre-exercise or post-exercise stretching technique designed to prevent or treat delayed-onset muscle soreness (DOMS). For the studies to be included, the stretching had to be conducted soon before or soon after exercise and muscle soreness had to be assessed.
Risk of bias was assessed using The Cochrane Collaboration's 'Risk of bias' tool and quality of evidence was assessed using GRADE. Estimates of effects of stretching were converted to a common 100-point scale. Outcomes were pooled in fixed-effect meta-analyses.
Twelve studies were included in the review. This update incorporated two new studies. One of the new trials was a large field-based trial that included 2377 participants, 1220 of whom were allocated stretching. All other 11 studies were small, with between 10 and 30 participants receiving the stretch condition. Ten studies were laboratory-based and other two were field-based. All studies were exposed to either a moderate or high risk of bias. The quality of evidence was low to moderate.There was a high degree of consistency of results across studies. The pooled estimate showed that pre-exercise stretching reduced soreness at one day after exercise by, on average, half a point on a 100-point scale (mean difference -0.52, 95% CI -11.30 to 10.26; 3 studies). Post-exercise stretching reduced soreness at one day after exercise by, on average, one point on a 100-point scale (mean difference -1.04, 95% CI -6.88 to 4.79; 4 studies). Similar effects were evident between half a day and three days after exercise. One large study showed that stretching before and after exercise reduced peak soreness over a one week period by, on average, four points on a 100-point scale (mean difference -3.80, 95% CI -5.17 to -2.43). This effect, though statistically significant, is very small.
The evidence from randomised studies suggests that muscle stretching, whether conducted before, after, or before and after exercise, does not produce clinically important reductions in delayed-onset muscle soreness in healthy adults.

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    Procedia - Social and Behavioral Sciences 12/2014; 159:647-650. DOI:10.1016/j.sbspro.2014.12.441
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    • "These interventions included hyperbaric oxygen therapy (Bennett et al., 2005), contrast water therapy (Bieuzen et al., 2013), cold water immersion (Bleakley et al., 2012; Leeder et al., 2012), stretching (Herbert et al., 2011) and compression garments (Hill et al., 2013). This body of research comprises more than 60 original studies, with the average percentage of female participants ranging from 16% (Bieuzen et al., 2013) to 36% (Herbert et al., 2011). It is difficult to provide a specific rationale for the gender bias in the broader Sports and Exercise Medicine literature, and it is likely that a range of physiological and methodological issues contribute. "
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    • "studying only " muscle soreness, " Herbert and Gabriel (2002), in a systematic review of five studies, and Herbert and Noronha (2007) in a meta-analysis of ten studies, also found that stretching before and after exercise did not confer protection from " muscle soreness, " which corroborates our present findings. Low-intensity exercise is another conventional intervention that is thought to increase the rate of recovery of symptoms after exercise-induced muscle damage (Armstrong, 1984; Cheung et al., 2003). "
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    ABSTRACT: Exhaustive and/or unaccustomed exercise, mainly involving eccentric muscle actions, induces temporary muscle damage, evidenced by delayed onset muscle soreness (DOMS) and decreased muscle function. Different strategies to recover from its signs and symptoms have been studied and, as a result, a significant number of articles on this issue have been published. To assess whether some modalities currently used in physiotherapy such as massage, cryotherapy, stretching and low-intensity exercise are effective for treating the signs and symptoms of exercise-induced muscle damage. Randomized controlled trials (RCTs), written in English or Portuguese, that included physiotherapeutic interventions [i.e., massage, cryotherapy, stretching and low-intensity exercise, on adult human subjects (18-60 years old) of both gender] were searched on electronic databases including MEDLINE, CINHAL, EMBASE, PEDro and SPORTDiscus. "Muscle soreness" and "muscle strength" were the outcome measures included in the meta-analysis. Thirty-five studies were included; nine analysed the effects of massage, 10 examined the effects of cryotherapy, nine investigated the effects of stretching and seven focused on low-intensity exercise intervention. Massage was the only intervention with positive effects, reducing soreness at 24 h, on average, 0.33 on 10 cm visual analog scale (95 percent CI: -0.59, -0.07) and increasing muscle recovery by 1.87 percent (95 percent CI: 0.30, 3.44). Additionally, there is inconclusive evidence to support the use of cryotherapy, while there is little evidence to prove the efficacy of stretching and low-intensity exercise. Massage proved slightly effective in the relief of symptoms and signs of exercise-induced muscle damage. Therefore, its mean effect was too small to be of clinical relevance. There is a lack of evidence to support the use of cryotherapy, stretching and low-intensity exercise.
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