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.

Download full-text


Available from: Malachy McHugh, Dec 16, 2014
    • "(Page, 2012) Numerous articles have been published on the effectiveness of stretching programs, especially pertaining to the length of the hamstrings muscles. (Page, 2012) Although most studies examining the effect of stretching on hamstring muscles reported an increased range of motion, (Decoster, Cleland, Altieri, and Russell, 2005) the literature is controversial with regard to the effects of hamstring stretch on maximal muscle performance (Page, 2012; Kay and Blazevich, 2012) and the prevention of musculoskeletal injuries, (Goldman and Jones, 2011; McHugh and Cosgrave, 2010; Pope, Herbert, Kirwan, and Graham, 2000) and suggests its inefficiency to reduce delayed onset muscle soreness (DOMS). (Herbert, De Noronha, Kamper, 2011) With regard to the way stretching techniques should be performed: ballistic (i.e. "

    No preview · Article · Jan 2016 · Physiotherapy Theory and Practice
  • Source
    • "Thus, dose-dependent effects cannot be examined suitably in this context. Nonetheless, 3 studies (Brandenburg 2006; Sekir et al. 2010; Costa et al. 2013) reported significant reductions in a total of 8 eccentric strength measures, whereas 6 studies (Ayala et al. 2014; Cramer et al. 2006, 2007; Gohir et al. 2012; McHugh and Nesse 2008; Winke et al. 2010) reported no change in 15 eccentric measures (≥60 s, –4.2%); these small-tomoderate changes are similar to those observed when isometric and concentric testing were completed (Supplementary Table S4 1 ). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Recently, there has been a shift from static stretching (SS) or proprioceptive neuromuscular facilitation (PNF) stretching within a warm-up to a greater emphasis on dynamic stretching (DS). The objective of this review was to compare the effects of SS, DS, and PNF on performance, range of motion (ROM), and injury prevention. The data indicated that SS- (-3.7%), DS- (+1.3%), and PNF- (-4.4%) induced performance changes were small to moderate with testing performed immediately after stretching, possibly because of reduced muscle activation after SS and PNF. A dose-response relationship illustrated greater performance deficits with ≥60 s (-4.6%) than with <60 s (-1.1%) SS per muscle group. Conversely, SS demonstrated a moderate (2.2%) performance benefit at longer muscle lengths. Testing was performed on average 3-5 min after stretching, and most studies did not include poststretching dynamic activities; when these activities were included, no clear performance effect was observed. DS produced small-to-moderate performance improvements when completed within minutes of physical activity. SS and PNF stretching had no clear effect on all-cause or overuse injuries; no data are available for DS. All forms of training induced ROM improvements, typically lasting <30 min. Changes may result from acute reductions in muscle and tendon stiffness or from neural adaptations causing an improved stretch tolerance. Considering the small-to-moderate changes immediately after stretching and the study limitations, stretching within a warm-up that includes additional poststretching dynamic activity is recommended for reducing muscle injuries and increasing joint ROM with inconsequential effects on subsequent athletic performance.
    Full-text · Article · Dec 2015 · Applied Physiology Nutrition and Metabolism
    • "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]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective was to evaluate the efficacy of gymnastic training (GYM) and dynamic mobilization exercises (DMEs) on stride length (SL) and epaxial muscle size in therapy horses. Nine cross-bred hippotherapy horses that performed three, 25-minute therapeutic riding sessions per week throughout the study period were randomly assigned to three experimental groups: a control group in which the horses were sedentary with no additional physical activity; a group that performed DMEs; and a group that performed both DMEs and additional GYM including pelvic tilting, backing, turning in small circles, and walking over a raised rail to strengthen the abdominal and pelvic stabilizer muscles. The exercises were performed 3days per week for 3months, with evaluations at the start and end of the study. Stride quality was assessed by measuring SL and tracking distance (TD). Epaxial muscle size was monitored by ultrasonographic measurement of m. longissimus dorsi (LD) thickness and m. multifidi (MM) cross-sectional area. Paired t tests were used to compare within groups across time, and between groups were detected using analysis of variance with Tukey post hoc test. When walking at 1.3m/s, SL and TD at walk increased significantly (P < .05) in horses subjected to GYM. Thickness of LD did not change in any group, but cross-sectional area of MM increased significantly by 3.55cm2 (DME) and 3.78cm2 (GYM). It was concluded that GYM training improved stride quality and DME-stimulated MM hypertrophy which has been shown to improve intervertebral joint stability in other species.
    No preview · Article · Aug 2015 · Journal of Equine Veterinary Science
Show more