The Impact of Stretching on Sports Injury Risk: A Systematic Review of the Literature

Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Medicine &amp Science in Sports &amp Exercise (Impact Factor: 3.98). 04/2004; 36(3):371-8. DOI: 10.1249/01.MSS.0000117134.83018.F7
Source: PubMed

ABSTRACT We conducted a systematic review to assess the evidence for the effectiveness of stretching as a tool to prevent injuries in sports and to make recommendations for research and prevention.
Without language limitations, we searched electronic data bases, including MEDLINE (1966-2002), Current Contents (1997-2002), Biomedical Collection (1993-1999), the Cochrane Library, and SPORTDiscus, and then identified citations from papers retrieved and contacted experts in the field. Meta-analysis was limited to randomized trials or cohort studies for interventions that included stretching. Studies were excluded that lacked controls, in which stretching could not be assessed independently, or where studies did not include subjects in sporting or fitness activities. All articles were screened initially by one author. Six of 361 identified articles compared stretching with other methods to prevent injury. Data were abstracted by one author and then reviewed independently by three others. Data quality was assessed independently by three authors using a previously standardized instrument, and reviewers met to reconcile substantive differences in interpretation. We calculated weighted pooled odds ratios based on an intention-to-treat analysis as well as subgroup analyses by quality score and study design.
Stretching was not significantly associated with a reduction in total injuries (OR = 0.93, CI 0.78-1.11) and similar findings were seen in the subgroup analyses.
There is not sufficient evidence to endorse or discontinue routine stretching before or after exercise to prevent injury among competitive or recreational athletes. Further research, especially well-conducted randomized controlled trials, is urgently needed to determine the proper role of stretching in sports.

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Available from: Julie Gilchrist, Sep 26, 2015
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    • "ghting a variance with the use of and importance of stretching . It should be noted that the general population referenced studies that do not specifically refer to athletes , clinical , and the elderly . Within the athletic group , athletes , coaches , and trainers recommend stretching in an effort to both prevent injury and enhance performance ( Thacker et al . , 2004 ) . In the clinical population , stretching is used to deal with numerous pathophysiological conditions such as ; stroke , contractures , and various musculoskeletal disorders in order to provide relief from pain . With the elderly population , the greatest concern with stretching is increasing the movement of the lower limb in order to"
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    ABSTRACT: Stretching exercises to increase the range of motion (ROM) of joints have been used by sports coaches and medical professionals for improving performance and rehabilitation. The ability of connective and muscular tissues to change their architecture in response to stretching is important for their proper function, repair, and performance. Given the dearth of relevant data in the literature, this review examined two key elements of stretching: stretch intensity and stretch position; and their significance to ROM, delayed onset muscle soreness (DOMS), and inflammation in different populations. A search of three databases, Pub-Med, Google Scholar, and Cochrane Reviews, identified 152 articles, which were subsequently categorized into four groups: athletes (24), clinical (29), elderly (12), and general population (87). The use of different populations facilitated a wider examination of the stretching components and their effects. All 152 articles incorporated information regarding duration, frequency and stretch position, whereas only 79 referred to the intensity of stretching and 22 of these 79 studies were deemed high quality. It appears that the intensity of stretching is relatively under-researched, and the importance of body position and its influence on stretch intensity, is largely unknown. In conclusion, this review has highlighted areas for future research, including stretch intensity and position and their effect on musculo-tendinous tissue, in relation to the sensation of pain, delayed onset muscle soreness, inflammation, as well as muscle health and performance.
    Frontiers in Psychology 09/2015; 1(6). DOI:10.3389/fpsyg.2015.01128 · 2.80 Impact Factor
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    • "Le fait que la majorité des lésions retrouvées au cours d'une saison concernait l'appareil musculotendineux et notamment les IJ est concordant avec les résultats de précédentes études sur le football [12,28–30]. Concernant la validité externe, ce travail se range plutôt du côté des études montrant une absence d'effet protecteur des étirements [31] [32] [33] [34]. D'autres auteurs avaient cité le manque de souplesse comme facteur de risque intrinsèque de blessure musculaire [35] [36]. "
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    ABSTRACT: Stretching are part of the physical and medical preparation of the football players for many years. Their effectiveness for injury prevention is discussed. The objective of this study was to evaluate the effectiveness of stretching on injury prevention footballers.
    Journal de Traumatologie du Sport 02/2015; 32(1). DOI:10.1016/j.jts.2015.01.001
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    • "Several factors could possibly affect muscle activation after passive stretching, such as neuromuscular feedback responses [Golgi tendon reflex, mechanoreceptor (type III afferent)] and mechanical changes [muscle stiffness, force-length relationship] (Avela et al., 2004; Behm et al., 2001; 2004; Behm and Chaouachi, 2011; Behm and Kibele, 2007; Pacheco et al., 2011; Rubini et al., 2007; Shrier, 2004; Thacker et al., 2004). Acute static-stretching protocols can change the length and stiffness of the musculotendinous unit, the sEMG responses, the transmission of forces, the rate of force transmission, and the electromechanical delay and provide a change in an optimal cross-bridge overlap (Behm and Kibele, 2007). "
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    ABSTRACT: The aim of this study was to investigate the acute effects of unilateral ankle plantar flexors static- stretching on surface electromyography (sEMG) and the center of pressure (COP) during a single-leg balance task in both lower limbs. Fourteen young healthy, non-athletic individuals performed unipodal quiet standing for 30s before and after (stretched limb: immedi- ately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch) a unilateral ankle plantar flexor static- stretching protocol [6 sets of 45s/15s, 70-90% point of discom- fort (POD)]. Postural sway was described using the COP area, COP speed (antero-posterior and medio-lateral directions) and COP frequency (antero-posterior and medio-lateral directions). Surface EMG (EMG integral [IEMG] and Median frequen- cy[FM]) was used to describe the muscular activity of gas- trocnemius lateralis. Ankle dorsiflexion passive range of motion increased in the stretched limb before and after the static- stretching protocol (mean ± SD: 15.0° ± 6.0 and 21.5° ± 7.0 [p < 0.001]). COP area and IEMG increased in the stretch limb be- tween pre-stretching and immediately post-stretching (p = 0.015 and p = 0.036, respectively). In conclusion, our static- stretching protocol effectively increased passive ankle ROM. The in- creased ROM appears to increase postural sway and muscle activity; however these finding were only a temporary or transi- ent effect.
    Journal of sports science & medicine 05/2014; 13(3):559-565. · 1.03 Impact Factor
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