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The effect of stretching on sports performance and the risk of sports injury: A review of the literature

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Abstract

It is generally accepted that increasing the flexibility of a muscle-tendon unit allows a better performance and decreases the number of injuries. Stretching is regularly included in warm-up and in cooling-down exercises. However, contradictory findings have been reported in the literature. Since 1980, several authors have suggested that stretching has a beneficial effect on injury prevention. In contrast, since 1990, clinical evidence suggests that stretching not only does not prevent injuries, but can also decrease the level of performance. Some part of these contradictions can be explained by the various sports activities and the eclectic group of athletes studied. Sports activities requesting an increased flexibility, such as gymnastic, dancing, ice skating or diving, necessitate pre-exercise stretching to optimize the level of performance. In contrary, for sports with slow stretch-shortening cycle (SSC) such as jogging or cycling, there is no scientific data showing a positive effect of stretching on performance, injury prevention and recovery. On the basis of the literature this article reviews the interest of the pre- and post-exercise stretching on the different modalities such as range of motion improvement, injury prevention and capacity of recovery.

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... In contrast to this statement, literary data suggests that in collective and power sports the inappropriate inclusion of pre-workout stretching may also have negative effects associated with the reduction of power in explosive activities, speed and endurance, and vertical jump height. This loss of strength depends on the duration of stretching, but it is difficult to accurately determine the effect of their duration as stretching techniques are very rarely performed on their own [16]. ...
... Similarly, with higher energy absorption of the tendon of the muscle, the risk of muscle damage can be reduced. In this connection, after stretching, there is a tension of tendon fibers which lose part of their potential to a shock absorber, resulting in greater vulnerability to damage to muscle fibers [16]. It is assumed that the regeneration of the muscular-tendon ...
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Injuries to the knee complex are one of the most common. In the world, physical therapeutic programs are being applied, adapted to the adequate recovery of patients, including athletes with such pathology. There are well-established physical therapeutic methodologies in accordance with the rehabilitation potential and the needs of the athletes, as in some of the cases of incorrect rehabilitation or their early return to sports activity, recurrences happen. This imposes the development of prevention strategies involving multidisciplinary teams between which there is a systematical exchange of information about the athlete's condition in order to prevent soft tissue damage or to reduce the risk of relapses. In this team, a key unit in the preparation of the preventive program for optimal fitness, performance and reduction of the risk of soft tissue injuries, is the physical therapist who is the main member of the multidisciplinary team. The aim of this article is to present the most common physical therapeutic means for the prevention of injuries in the area of the knee complex.
... Introduction 1 Stretching before physical activities is considered as an important principle in all kinds of sports and is more important than the other daily activities. Stretching is recommended by scientists, physiotherapists and coaches. ...
... Stretching is recommended by scientists, physiotherapists and coaches. Flexibility is an intrinsic property of tissues that determines the achievable range of motion without injury at a joint or a group of joints [1]. In discussing the oxygen carrying capacity of blood, RBC count, hemoglobin and hematocrit are essential elements that contribute to decrease or increase in the oxygen carrying capacity of blood to the tissues and carbon dioxide desorption [2,3]. ...
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Purpose: The aim of the study was to investigate the effect of stretching before intense exercise on hematologic parameters and cell injury. Subjects: The subjects of the present study were 12 adolescent members of the Kurdistan Province futsal team (age: 14.83 ± 0.38 years, height: 173.92 ± 5.90 cm, weight: 63.50 ± 7.94 kg, peak power: 459.42 ± 95.94 watts). The RAST test was used to estimate the anaerobic power and to create the training load. Indexes of blood including white and red blood cells, hemoglobin, hematocrit, platelet and the levels of CK and LDH enzyme activities were measured. Results: The results of the pre and the post tests showed that among hematological parameters and cell damage indexes, the red blood cell and hemoglobin in both groups and the level of LDH in the training group were not significantly changed (p>0.05). Other parameters in the pre-test and post-test measures were statistically changed (p<0.05). Conclusion: Based on the results of the present study, it seems that stretching before intense training decreases the cell damage and side effects of exercise training on the hematological factors.
... They also very the time and intensity of the warm-up (Atkinson et al. 2005, Burkett et al. 2005, Fradkin et al. 2006. Most warm-up procedures use stretching exercises at the end of it to increase the range of motion and prevent injury (Gremion 2005, 2006a, Little et al. 2006, Zakas et al. 2006). An active warm-up is based on physiological adaptive processes of skeletal muscles, cardiovascular and respiratory systems. ...
... Despite the seemingly obvious benefit of "priming" the cardio-respiratory and neuromuscular systems before vigorous exercise, the effect of prior exercise on the metabolic and gas exchange response to exercise and its potential impact on performance, has until recently received only modest empirical attention. While increased muscle temperature may improve physical performance in tasks requiring the generation of maximal muscle power, evidence that prolonged exercise performance is similarly improved by warm-up exercise is limited (Evans et al. 2002, Fletcher et al. 2004, Gremion 2005. Scientists have considered the effect of previous exercise on a range of physiological responses to exercise, including those of oxygen uptake (VO2), glycogenolysis and blood lactate concentration, heart rate, acidbase balance and blood gases (Bouno et al. 1982, Robergs et al. 1990, Robergs et al. 1991. ...
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The main objective of the paper was to evaluate the influence of warm up and the rest interval separating it from exercise on maximal anaerobic power and acid-base balance (ABB). The research material included 12 students of physical education with an average age, maximal oxygen uptake, body height and mass The students performed 3 exercise trials. During trial I a 30s Wingate test wits preceded by a 15 min warm-up performed on a ergocycle with the intensity set at 50% VO(2)max and the pedaling frequency equal to 60 rev./min. The rest interval between the end of warm-up and the onset of exercise equaled 5 min. During the second trial the same warm-up procedure was conducted yet the rest interval between the cessation of warm-up and exercise equaled 15 min. On the third occasion the 30 s Wingate test was performed without a warm-up. During the Wingate test the following variables were registered: total external work (W-TOT), maximal power (P-max), average power (P-AV), time of reaching P-max (TrPmax) the index of power decrement (Pdi%). Additionally the following acid-base variables were evaluated in the blood: LA, HCO3, BE and pH. \ The results of ANOVA did not show a significant effect of the 15 min warm-up on all the considered anaerobic power indices: W-TOT P-max, P-AV, TrPmax, while statistically significant effects of the warm-up were obtained in post exercise plasma LA concentration and other acid-base balance variables (p<0,001, F=13,06), HCO3 (p<0,001, F= 14,61), pH (p<0,01, F= 11, 49), BE (p < 0, 00 1, F= 14,9 7)...
... Like other physical features, flexi bility may be trained at submaximal intensity (stretch ing), performed within the normal range of motion and slightly forcing for 4 to 6 seconds, or at the maximal intensity (flexibilizing), performed with discomfort on the pain threshold for at least 10 to 15 seconds. In flexi bility training, ballistic, proprioceptive neuromuscular facilitation (PNF), and static methods are traditionally used, with the latter having greater applicability [2]. ...
... Flexibility training has been used by athletes to pre vent lesions and enhance athletic performance [2][3][4]. Nevertheless, its use in isolation as preparation for exer cise is unlikely to prevent lesions and may even hamper performance in sports involving strength and power [5]. ...
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Purpose. To verify whether there are changes in the performance levels of the explosive force when the same muscle group previously underwent different intensities of flexibility training (stretch & flex). Basic procedures. The tests were performed with 25 females on three consecutive days and were preceded by a 10-minute warm-up period. First, each participant performed a maximum vertical jump on a contact platform. The jump was repeated after 10 minutes, and the first day was considered the control (C). On the second day, a routine of stretching exercises (S) was included, and on the third day, the same routine, but intensified with a maximum static stretching exercises (flexibilizing - F), was used. Main findings. The height reached in the control jump decreased by 0.17%, showing no influence on the performance when the jump happened on the same day, with a time-interval of only 10 minutes (p = 0.903). On the day of the stretching routine, there was a reduction of 3.6% (p = 0.001), and on the third day with flexibilizing, there was a 6.8% reduction (p = 0.001). A comparison of the groups showed no significant differences between them. Conclusions. The jumps after the two stretching routines were significantly lower. Submaximal or maximal (flexibilizing) stretching exercises reduced the explosive force of vertical jumps, although the differences between the training intensities were not significant.
... Like other physical features, flexi bility may be trained at submaximal intensity (stretch ing), performed within the normal range of motion and slightly forcing for 4 to 6 seconds, or at the maximal intensity (flexibilizing), performed with discomfort on the pain threshold for at least 10 to 15 seconds. In flexi bility training, ballistic, proprioceptive neuromuscular facilitation (PNF), and static methods are traditionally used, with the latter having greater applicability [2]. ...
... Flexibility training has been used by athletes to pre vent lesions and enhance athletic performance [2][3][4]. Nevertheless, its use in isolation as preparation for exer cise is unlikely to prevent lesions and may even hamper performance in sports involving strength and power [5]. ...
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Effects of Different Intensities of Flexibility Training on Explosive Force Purpose. To verify whether there are changes in the performance levels of the explosive force when the same muscle group previously underwent different intensities of flexibility training (stretch & flex). Basic procedures. The tests were performed with 25 females on three consecutive days and were preceded by a 10-minute warm-up period. First, each participant performed a maximum vertical jump on a contact platform. The jump was repeated after 10 minutes, and the first day was considered the control (C). On the second day, a routine of stretching exercises (S) was included, and on the third day, the same routine, but intensified with a maximum static stretching exercises (flexibilizing - F), was used. Main findings. The height reached in the control jump decreased by 0.17%, showing no influence on the performance when the jump happened on the same day, with a time-interval of only 10 minutes (p = 0.903). On the day of the stretching routine, there was a reduction of 3.6% (p = 0.001), and on the third day with flexibilizing, there was a 6.8% reduction (p = 0.001). A comparison of the groups showed no significant differences between them. Conclusions. The jumps after the two stretching routines were significantly lower. Submaximal or maximal (flexibilizing) stretching exercises reduced the explosive force of vertical jumps, although the differences between the training intensities were not significant.
... Stretching exercises are an essential component of the cool-down phase. 1 Stretching during the recovery process is effective in increasing blood circulation in tense muscles and preventing delayed muscle soreness. 2 There are various types of stretching in the literature, and static stretching is the most widely used stretching type. 3 There are also differences in the literature regarding the frequency and duration of stretching. ...
... Flexibility, the range motion achievable at a joint or group of joints without getting injured (Gremion, 2005), is considered an important aspect of sports performance, however, its role in each sport varies depending on the nature and demands involved (Rey et al., 2016). It is postulated that high flexibility level has a significant effect on performance, however, studies exploring the relationship of flexibility with sports performance are limited and have heterogeneous results. ...
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This study aimed to assess the effect of high and low levels of flexibility on key performance indicators of volleyball performance. Eighty-four volleyball players (n=84; mean±SD; decimal age: 16.57±1.51; height (cm): 176.23±8.77; body mass (kg): 66.14±11.79) were selected for the study. The design of the study was cross-sectional and to measure selected variables i.e. agility, lower body muscular power, and acceleration speed; 6×10 m shuttle run, countermovement jump (with arm swing) test and 20 m sprint test (standing start) were used. To measure the flexibility level of the players, sit and reach test was used. Shapiro-Wilk normality test was conducted to check the distribution of data and the Levine test was applied to check homogeneity of the variance in data. Participants were divided into two groups i.e. High Flexibility Group (HFG) and Low Flexibility Group (LFG) using k-means cluster analysis and independent t-test was applied to find the differences between HFG and LFG. The level of significance was set at p < 0.05. Results showed statistically significant difference between HFG and LFG in agility, acceleration speed and lower body muscular power and, based on the results, it was concluded coaches should include flexibility training in the regular training programme. The results obtained supported the rationale that baseline flexibility may influence the performance of volleyball players. Article visualizations: </p
... in the present investigation, GMr and SS stretching techniques were equally effective in improving the range of motion and muscular flexibility, in line with previous studies, 16,25,26 but this improvement was short-lasting in comparison to WBV. ...
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Background: The current study aimed to investigate and compare the influences of global postural rieducation techniques (GPR), stretching exercises on a whole-body vibration platform (WBV), and static stretching exercises on hamstrings flexibility in elite soccer players. Methods: 24 professional soccer players were randomly assigned to either global postural re-education (N.=8), stretching on whole-body vibration group (N.=8) or static stretching (N.=8), during the first 4 weeks of the precompetitive season. Assessment of hamstring muscle flexibility was performed using a straight leg raise test. All participants were assessed three times: at baseline, at the end of the study protocol and 14 days after the end of the study protocol. Results: The short-term increase in hamstring muscle flexibility was observed in all 3 groups, without significant differences among groups. However, after 14 days from the end of the interventions only the WBV group maintained the flexibility level achieved just at the end of the protocol with no significant changes in both legs whereas a significant decrease in the SLRT in GPR and SS groups, in right and left legs (GPR, P=0.002; P=0.015; SS, P=0.0001; P=0.0001), was observed. Conclusions: These results would suggest that GPR, static stretching on whole-body vibration and static stretching techniques all improve hamstring muscle flexibility, but only stretching on WBV maintains the effect over time in professional soccer players.
... Conclusions: The results suggest less influence of flexibility on the trampoline in relation to other gymnastics sports, with some requirements proper to the specialty. KEYWORDS: Trampoline, Gymnastics, Range of motion, Flexibility, Male category, Female category.Reid, Burnham, Saboe y Kushner, 1987; Lysens et al 1989; Gore, 2000; Gremion, 2005; McNeal y Sands, 2006; Sands, McNeal, Stone, Russell.y Jemni, 2006; Kinser, Ramsey, O'Bryant, Ayres, Sands y Stone, 2008; Sands, McNeal, Stone, Kimmel, Haff, y Jemni 2008;). ...
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Introduction: Cross-sectional, comparative and correlational study of flexibility in Spanish trampolinists. Method: Sample of 60 national elite trampolinists, divided into 4 groups based on competitive categories: U-15 male (n = 23, 11.95 ± 1.79 years) and female (n = 9, 11.44 ± 1.23 years); Absolute male (n = 18, 20.72 ± 4.66 years) and female (n = 10, 16.1 ± 2.02 years. ROM was assessed by measuring angles and then analyzing them by digital photography for active and passive flexion and extension of trunk, shoulder, hip and abduction. Comparisons were made with each group and correlations between ROM and the points scored in exercises. Results: Both groups show higher female than male ROMs while ROMs of trunk and shoulders have higher correlations with the scores. Conclusions: The results suggest a lesser influence of flexibility in trampoline in relation to other gymnastic sports and requirements proper to the specialty.
... According to Gremion G (2005), static stretching has become a popularly and safely used for muscle recovery method in competitive sport and prevention muscular injury. It is contribute to reduce pain perception, edema, muscle spasm (i.e. from pain-muscle spasm cycle), and also increase muscle elongation after induced muscle damage from eccentric exercise (Dain & Declan, 2006;Torres, Appell & Duart, 2007;Covert et al., 2007) . ...
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Delayed onset of muscle soreness is the unaccustomed activity, which may last for several days post-exercise due to impaired muscle performances. Stretching and cold-water immersion are an ordinary way to reduce muscle soreness. This study aimed to investigate effects of these treatments on functional signs of muscle soreness after plyometric training. Forty-five subjects, aged from 18 to 25 years, were randomized into three groups; stretching, cold-water immersion, and combine group. Participants performed the plyometric training. Treatments were given for 20 minutes. Soreness sensation, range of motion, quadriceps strength and vertical jump performance were measured at before exercise, after exercise, after intervention, 24, 48, 72, and 96 hour. All variables showed a significant time effect indicating the presence of muscle damage. Furthermore, they showed significant different between groups on vertical jump height, decreasing for combined intervention at 24 h, a lesser on range of motion in combine group compared with the stretching groups at 48 and 72 hours. These results suggest that either cold-water immersion or stretching can maintain impaired performance following the exercise in term of flexibility and vertical jump performance, whereas the combine one is not seem to be a practical strategy to alleviate functional signs of muscle soreness. Therefore, stretching or cold-water immersion alone is a common way to application for athletic recovery performance compared to the combine these techniques. © 2015, Editura Universitatea din Pitesti. All rights reserved.
... From the findings, 88% of coaches believed that PES increases a player's performance. Evidence in the literature tends to point towards a decrease in strength, and thus in performance, following an acute bout of stretching [17,18]. Some authors found that a bout of static stretching decreased maximal voluntary force for up to two hours [19,20]. ...
... From the findings, 88% of coaches believed that PES increases a player's performance. Evidence in the literature tends to point towards a decrease in strength, and thus in performance, following an acute bout of stretching [17,18]. Some authors found that a bout of static stretching decreased maximal voluntary force for up to two hours [19,20]. ...
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Context and Objective: Hamstring strain is a common injury in football and it causes a sig-nificant amount of time lost from competition and training. Since poor flexibility is thought to predispose to muscle strain, stretching is rou-tinely recommended during warm-up routines by coaches to prevent injuries. However, avail-able evidence suggests that pre-exercise stretch-ing (PES), especially static stretching, has no benefit on injury rates and may even reduce per-formance in explosive type activities. We de-signed this study to assess the attitudes, beliefs and practices of football coaches regarding stretching in the prevention of hamstring strains. Design: A cross-sectional survey. Setting: Mau-ritius Football Association (MFA). Participants: 26 football coaches registered with the MFA. Intervention: Questionnaires were distributed to football coaches of the MFA via sports officers. Questionnaires were then collected two weeks after distribution. Main Outcome Measures: At-titudes, beliefs and practices of football coaches regarding stretching in the prevention of ham-string strains. Results: MFA coaches held gen-erally positive attitudes and beliefs towards stretching. 88% of coaches felt that PES is bene-ficial and 93% believed that PES prevents ham-string strains. The majority of coaches recom-mended stretching after warming up (81%) and after the training session (93%). 76% of coaches also advised stretching outside the training sessions. 96% of coaches used static stretching to stretch the hamstrings. The hamstrings were stretched on average for 4 times at each training session and the mean duration of a static stretch was 12 seconds. Conclusions: Nearly all coaches believed that PES prevents hamstring strains al-though evidence is limited. Some of the coaches' beliefs and practices were not in line with cur-rent recommendations. Coaches reported that their stretching practices would be most likely influenced by scientific research. Thus there is an urgent need to devise awareness and training programmes in this area.
... Em relação à performance e ao alongamento, estudos que envolveram programas de alongamento e verificaram seus efeitos crônicos constataram que o alongamento realizado antes da prática esportiva ou do exercício trouxe ganhos para a flexibilidade e performance muscular em longo prazo (8)(9)(10). ...
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INTRODUÇÃO: A crioterapia é indicada para diminuir o desconforto durante as sessões de alongamento e proporcionar melhores resultados no ganho de extensibilidade. OBJETIVO: O objetivo do estudo foi verificar o ganho de extensibilidade dos músculos isquiotibiais, comparando o alongamento estático com o alongamento estático associado à crioterapia. MATERIAIS E MÉTODOS: Participaram 20 indivíduos, com idade entre 18 e 25 anos, divididos igualmente em dois grupos, os quais realizaram alongamento e alongamento associado à crioterapia. Foram utilizadas bolsas de gelo, na região posterior da coxa, durante 15 minutos. Em seguida, foi realizada a aplicação do alongamento estático de isquiotibiais, em duas séries, de 30 segundos cada. RESULTADOS: Foram encontradas diferenças significativas na extensibilidade dos músculos isquiotibiais em ambos os grupos, porém não houve diferenças significativas na extensibilidade dos músculos isquiotibiais quando comparado o alongamento estático com o alongamento estático associado à crioterapia. CONCLUSÃO: Houve aumento imediato da extensibilidade dos músculos isquiotibiais. Porém, o uso de crioterapia não se mostrou eficaz para o ganho de extensibilidade.
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Physical activity is extremely important in maintaining good health. Activity is not possible without a certain amount of flexibility. This report discusses issues related to flexibility fitness. Flexibility is a property of the musculoskeletal system that determines the range of motion achievable without injury to the joints. Static flexibility tests measure the limits of the achievable motion, but these limits are subjective. Dynamic flexibility tests are more objective and measure the stiffness of a passively stretched muscle group. However, there are no recommended field tests available at this time. Normal ranges of static flexibility are well-documented for most joints. Major deviations from the norm may be associated with a higher incidence of muscular injury. While there is theoretical association between flexibility and several musculoskeletal problems, there are few prospective studies showing significant associations. Currently, there is little scientific evidence upon which to base individual prescriptions for static flexibility development beyond the maintenance of normal levels. Any recommendation for stretching to improve flexibility should be based on a valid assessment of flexibility using sound testing procedures. Recommendations for stretching procedures based on recent reviews of the viscoelastic response of muscle to stretching are presented. (Contains 85 references.) (SM)
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The present study sought to investigate the effects of preexercise stretching on delayed onset muscle soreness (DOMS), i.e. soreness, tenderness and loss of muscle force, that usually occurs after strenuous or unaccustomed eccentric exercise. Ten female volunteers performed 10 sets of 10 maximal isokinetic eccentric contractions for knee flexion with both legs after a 5-min ergometer cycling warm-up. Prior to the exercise for one leg, randomly chosen, 4 x 20 s of static stretching for the hamstring muscle group was implemented. Rated soreness, tenderness on algometer pressure and loss of maximal eccentric contractile force was evaluated preexercise and 24, 48 and 96 h postexercise. The exercise bout produced severe DOMS, with parameters peaking and troughing at 48 h postexercise. However, no significant differences were found, regarding any of the parameters, when comparing stretched and nonstretched legs. The present study thus suggests that preexercise static stretching has no preventive effect on the muscular soreness, tenderness and force loss that follows heavy eccentric exercise.
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The purpose of this study was to examine the effect of muscle stretching on delayed-onset muscle soreness (DOMS). Two experiments were conducted, with 10 healthy, sedentary subjects in each. In the first, subjects performed the stretches before the DOMS-producing exercise; in the second, subjects performed the stretches after exercise. Each subject performed 10 1-min stretches of the hamstring muscles of one leg. The other leg acted as the control. The DOMS-producing exercise was three sets of 20 maximal concentric and eccentric contractions of the hamstrings performed on both legs. The subjects rated the pain they experienced in each leg every 12 h for the next 72 h on a visual analog scale (VAS). In the second experiment, pain threshold of the hamstrings and height of straight leg raise (SLR) were also measured at 0 and 48 h. In both experiments, analysts of variance revealed a significant (p < 0.05) difference in the VAS over time, but not between legs. Results were the same for the pain threshold and SLR measurements in the second experiment. It is concluded that a stretching protocol, performed before or after eccentric exercise, does not reduce DOMS. (C) Lippincott-Raven Publishers.
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Under the conditions of this study, postexercise static stretching did not alleviate exercise-induced DMS either acutely or chronically. These results do not prove that stretching is never effective in alleviating DMS. However, they indicate that stretching does not always reduce soreness. We believe that claims about the efficacy of stretching should be qualified. Additional research is needed to clearly define the conditions under which DMS is reduced by stretching including the details of effective stretching protocols, and to determine the mechanisms by which stretching may affect DMS. Finally, even if stretching has limited effects of DMS, it still is important and achieving and maintaining flexibility and appropriate lengths of muscle-tendon units.
Article
This article addresses the medical, scientific, and practical aspects of stretching. Sections include information on the physiology of flexibility and stretching, stretching versus warm-up, and the clinical evaluation of flexibility. Detailed instructions for numerous stretching exercises for the major muscle groups are provided. Techniques for proper stretching are included.
Article
It has been suggested in the lay literature that static stretching and/or warm-up will prevent the occurrence of Delayed-Onset Muscle Soreness (DOMS). The primary purpose of this study was to determine the effects of static stretching and/or warm-up on the level of pain associated with DOMS. Sixty-two healthy male and female volunteers were randomly assigned to four groups: (a) subjects who statically stretched the quadriceps muscle group before a step, (b) subjects who only performed a stepping warm-up, (c) subjects who both stretched and performed a stepping warm-up prior to a step test, and (d) subjects who only performed a step test. The step test (Asmussen, 1956) required subjects to do concentric work with their right leg and eccentric work with their left leg to voluntary exhaustion. Subjects rated their muscle soreness on a ratio scale from zero to six at 24-hour intervals for 5 days following the step test. A 4x2x2 ANOVA with repeated measures on legs and Duncan's New Multiple Range post-hoc test found no difference in peak muscle soreness among the groups doing the step test or for gender (p greater than .05). There was the expected significant difference in peak muscle soreness between eccentrically and concentrically worked legs, with the eccentrically worked leg experiencing greater muscle soreness. We concluded that static stretching and/or warm-up does not prevent DOMS resulting from exhaustive exercise.
Article
Musculotendinous injuries are responsible for a significant proportion of injuries incurred by athletes. Many of these injuries are preventable. Importantly, musculotendinous injuries have a high incidence of recurrence. Thus, muscle injury prevention is advocated by coaches and trainers. Yet, most of the recommendations for muscle injury prevention are attempted by athletes and taught by coaches without supporting scientific evidence. This paper reviews the mechanics of muscular injury, associated and predisposing factors, and methods of prevention with a review of the supporting research and rationale for these methods with an emphasis on warm-up, stretching and strengthening. Muscles that are capable of producing a greater force, a faster contraction speed and subjected to a greater stretch are more likely to become injured. Many factors have been associated with muscular injury. From current research, some conclusions and recommendations for muscle injury prevention can be made. Overall and muscular conditioning and nutrition are important. Proper training and balanced strengthening are key factors in prevention of musculotendinous injuries as well. Warm-up and stretching are essential to preventing muscle injuries by increasing the elasticity of muscles and smoothing muscular contractions. Improper or excessive stretching and warming up can, however, predispose to muscle injury. Much research is still needed in this important aspect of sports medicine.
Article
The duration of the effect of contract-relax stretching on range of motion (ROM) in the lower extremities was measured on eight male volunteers. The stretching procedure was performed as one isometric contraction, followed by relaxation and then a passive extension of the muscle being stretched. The treated muscle groups were the adductors, hamstrings, rectus femoris, iliopsoas, gastrocnemius, and soleus. The total stretching time was 15min. Six ROMs were tested 0, 30, 60, and 90min after the stretching procedure. There was a significant increase in hip abduction (+17% +/- 3), knee flexion (+4% +/- 1), hip flexion (+4% +/- 2), ankle dorsiflexion with knee flexed (+18% +/- 7), and ankle dorsiflexion with knee straight (+16% +/- 5). The increase remained for 90min for all ROMs except for ankle dorsiflexion with the knee straight.
Article
This study involved comparison of three techniques for increasing range of motion. Fast stretch (ballistic), slow stretch, and IA-CA, a modified version of proprioceptive neuromuscular facilitation (PNF) were compared using 24 normal male Ss. Controlling for serial order effects, 6 groups of 4 Ss each were administered the treatments, and the differences between pre- and post-exercise measures were observed. Multiple regression analysis indicated the superiority of the IA-CA approach.
Article
To study the efficacy of an injury prevention program in a randomized trial, 12 teams (180 players) in a male senior soccer division were followed up for 6 months. The 12 teams were allocated at random to two groups of six teams, one being given a prophylactic program and the other serving as control. The program was based on previous studies of injury mechanisms. It comprised (1) correction of training, (2) provision of optimum equipment; (3) prophylactic ankle taping; (4) controlled rehabilitation; (5) exclusion of players with grave knee instability; (6) information about the impor tance of disciplined play and the increased risk of injury at training camps; and (7) correction and supervision by doctor(s) and physiotherapist(s). The injuries in the test teams were 75% fewer than in the controls. The most common types of soccer injuries, sprains and strains to ankles and knees, were all significantly reduced. It is concluded that the pro posed prophylactic program, including close supervi sion and correction by doctors and physiotherapists, significantly reduces soccer injuries.
Article
The effects of general warming up, massage, and stretching on ranges of motion (ROM) and strength of quadriceps and hamstring muscles were measured in eight male volunteers. Thigh muscle strength was not influenced by the experimental procedures. Stretching resulted in a significantly increased range of hip flexion/extension, hip abduction, knee flexion, and ankle dorsiflexion; the effect was significantly greater than that obtained by massage and warming up separately or combined. Only ankle dorsiflexion was influenced by massage or warming up, whereas stretching affected all muscle groups tested. Stretching was, therefore, superior to the other methods tested for increasing flexibility in the lower extremity.
Article
63 college women served as subjects in this 7-wk. study examining the effects of static, dynamic, and proprioceptive neuromuscular facilitating stretching techniques on the flexibility of the hamstring-gastrocnemius muscles. Subjects were assigned to one of the 3 treatment groups and received treatment 3 days a week. A pretest, a midtest (after 11 treatment days), and a posttest (after 21 treatment days) were administered. Analysis of group and test effects was accomplished by using a 3 X 3 factorial design with the group factor nested and the test factor crossed. Post hoc analysis indicated that all scores significantly improved from pretest to posttest. The findings indicated all 3 methods of flexibility training produced significant improvements when pretest and posttest mean scores were compared.
Article
Active hip flexion is considered to be important for many physical activities. Six popular mobility exercises were compared in this study to see if active flexibility exercises would give superior results in improving daily or more permanent gain of active hip flexion. Out of 119 women university students completing the study, all but the control group took part in five one-minute bouts of mobility work three days a week for three weeks. A day of testing before and after the nine exercise days comprised the 11 sessions of the four-week experiment. Significant gains of 15 or more degrees were accomplished by all methods including the control group, as measured by the Leighton Flexometer. A two factor design with repeated measures determined that active and passive stretching methods were not significantly different in their contribution to active range improvement. Proprioceptive neuromuscular facilitation techniques were not superior to more conventional stretching methods. Rigorous mobilization on the five test days along with physical education activity may explain the significant progress of the control group. Daily gains in active mobility were minimal, particularly with active stretching exercises. Standardization of time for flexibility exercise regimens apparently equalizes the results, and thus, given equal opportunity, all mobility work has parallel merit in promoting active range of hip flexion.
Article
Musculotendinous strains are among the most prevalent injuries for which health care professionals provide treatment and rehabilitation interventions. Flexibility has been identified as one of the primary etiologic factors associated with musculotendinous strains, but limited research exists on the effect of a preventive stretching program on musculotendinous strains. Therefore, the purpose of our study was to compare the number of musculotendinous strains for the hamstrings, quadriceps, hip adductors, and gastrocnemius-soleus muscle groups before and after the incorporation of a static stretching program for each muscle group. We analyzed the incidence of musculotendinous strains among the players of a Division III collegiate football team between 1994 and 1995. All variables were consistent between the 2 seasons except for the incorporation of a lower extremity stretching program in 1995. One hundred and ninety-five Division III college football players. We calculated the number of musculotendinous strains that required a minimum absence of 1 day from practices or games in 1994 and 1995. A x(2) analysis revealed a significant reduction in the number of lower extremity musculotendinous strains in 1995 as opposed to 1994. Our statistical analysis indicates an association between the incorporation of a static stretching program and a decreased incidence of musculotendinous strains in Division III college football players.