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: 4.46). 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, Aug 03, 2015
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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; 13:559-565. · 0.90 Impact Factor
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    • "Stretching , following submaximal aerobic activity, has been shown to further increase range of motion (Bandy et al., 1998; Magnusson and Renström, 2006; Magnusson et al., 1996) and to enhance performance (Young and Behm, 2002) while it may also reduce the incidence of injury (Cross and Worell, 1999; Hartig and Henderson, 1999; McHugh and Cosgrave, 2010). However, there is evidence that pre-exercise stretching may not decrease the risk of injury (Pope et al., 2000; Small et al., 2008; Thacker, et al., 2004) or may even be harmful (Shrier, 1999; Weldon and Hill, 2003). Thus, although preexercise stretching is common practice for many athletes, its effects have been questioned (Shrier, 2004; Haff, 2006). "
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    ABSTRACT: This study examined the effects of baseline flexibility and vertical jump ability on straight leg raise range of motion (ROM) and counter-movement jump performance (CMJ) following different volumes of stretching and potentiating exercises. ROM and CMJ were measured after two different warm-up protocols involving static stretching and potentiating exercises. Three groups of elite athletes (10 male, 14 female artistic gymnasts and 10 female rhythmic gymnasts) varying greatly in ROM and CMJ, performed two warm-up routines. One warm-up included short (15 s) static stretching followed by 5 tuck jumps, while the other included long static stretching (30 s) followed by 3x5 tuck jumps. ROM and CMJ were measured before, during and for 12 min after the two warm-up routines. Three-way ANOVA showed large differences between the three groups in baseline ROM and CMJ performance. A type of warm-up x time interaction was found for both ROM (p = 0.031) and CMJ (p = 0.016). However, all athletes, irrespective of group, responded in a similar fashion to the different warm-up protocols for both ROM and CMJ, as indicated from the lack of significant interactions for group (condition x group, time x group or condition x time x group). In the short warm-up protocol, ROM was not affected by stretching, while in the long warm-up protocol ROM increased by 5.9% ± 0.7% (p = 0.001) after stretching. Similarly, CMJ remained unchanged after the short warm-up protocol, but increased by 4.6 ± 0.9% (p = 0.012) 4 min after the long warm- up protocol, despite the increased ROM. It is concluded that the initial levels of flexibility and CMJ performance do not alter the responses of elite gymnasts to warm-up protocols differing in stretching and potentiating exercise volumes. Furthermore, 3 sets of 5 tuck jumps result in a relatively large increase in CMJ performance despite an increase in flexibility in these highly-trained athletes. Key PointsThe initial levels of flexibility and vertical jump ability have no effect on straight leg raise range of motion (ROM) and counter-movement jump performance (CMJ) of elite gymnasts following warm-up protocols differing in stretching and potentiating exercise volumesStretching of the main leg muscle groups for only 15 s has no effect on ROM of elite gymnastsIn these highly-trained athletes, one set of 5 tuck jumps during warm-up is not adequate to increase CMJ performance, while 3 sets of 5 tuck jumps result in a relatively large increase in CMJ performance (by 4.6% above baseline), despite a 5.9% increase in flexibility due to the 30 s stretching exercises.
    Journal of sports science & medicine 01/2014; 13(1):105-13. · 0.90 Impact Factor
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