Stretching and injury prevention - An obscure relationship

Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
Sports Medicine (Impact Factor: 5.04). 02/2004; 34(7):443-9.
Source: PubMed


It is generally accepted that increasing the flexibility of a muscle-tendon unit promotes better performances and decreases the number of injuries. Stretching exercises are regularly included in warm-up and cooling-down exercises; however, contradictory findings have been reported in the literature. Several authors have suggested that stretching has a beneficial effect on injury prevention. In contrast, clinical evidence suggesting that stretching before exercise does not prevent injuries has also been reported. Apparently, no scientifically based prescription for stretching exercises exists and no conclusive statements can be made about the relationship of stretching and athletic injuries. Stretching recommendations are clouded by misconceptions and conflicting research reports. We believe that part of these contradictions can be explained by considering the type of sports activity in which an individual is participating. Sports involving bouncing and jumping activities with a high intensity of stretch-shortening cycles (SSCs) [e.g. soccer and football] require a muscle-tendon unit that is compliant enough to store and release the high amount of elastic energy that benefits performance in such sports. If the participants of these sports have an insufficient compliant muscle-tendon unit, the demands in energy absorption and release may rapidly exceed the capacity of the muscle-tendon unit. This may lead to an increased risk for injury of this structure. Consequently, the rationale for injury prevention in these sports is to increase the compliance of the muscle-tendon unit. Recent studies have shown that stretching programmes can significantly influence the viscosity of the tendon and make it significantly more compliant, and when a sport demands SSCs of high intensity, stretching may be important for injury prevention. This conjecture is in agreement with the available scientific clinical evidence from these types of sports activities. In contrast, when the type of sports activity contains low-intensity, or limited SSCs (e.g. jogging, cycling and swimming) there is no need for a very compliant muscle-tendon unit since most of its power generation is a consequence of active (contractile) muscle work that needs to be directly transferred (by the tendon) to the articular system to generate motion. Therefore, stretching (and thus making the tendon more compliant) may not be advantageous. This conjecture is supported by the literature, where strong evidence exists that stretching has no beneficial effect on injury prevention in these sports. If this point of view is used when examining research findings concerning stretching and injuries, the reasons for the contrasting findings in the literature are in many instances resolved.

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    • "It is generally accepted that increasing the flexibility of the ankle joint promotes better performance and decreases the number of injuries [25] [26] [27] [28] ; however, contradictory findings were reported in the literature [29] [30] [31] . The dissociated activation in the ankle muscles is critical for the control of the co-activated muscle pattern by the RAI. "

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    • "Recent advances in sports medicine and rehabilitation indicate that flexibility is important for overall health and physical condition (Monteiro et al. 2008; Yuktasir and Kaya 2009). Stretching is widely recommended to increase joint mobility (Daneshmandi et al. 2010), eliminate contractures (Grabara et al. 2010; Harvey et al. 2002), increase athletic performance, prevent or reduce muscle injury (Bonvicine et al. 2005; Casáis Martínez 2008; Grabara et al. 2010; McHugh and Cosgrave 2010; Witvrouw et al. 2004) as well as its treatment (Malliaropoulos et al. 2004; Spernoga 2000). "
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    ABSTRACT: The purpose of this study was to examine the influence of sex on the acute effect of static-passive one-session stretching on V sit-and-reach scores in university students. A sample of 76 college students aged 19–30 years were divided into a women group (n = 36) and men group (n = 40). During one session the students performed stretching exercises for the major body muscles using the static-passive technique. Hamstring and lower back muscles extensibility was estimated by the V-sit-and-reach test at the beginning and at the end of the stretching session. The results of the two-way ANOVA with the Bonferroni adjustment showed that females and males did not show a different response to the one-session stretching intervention (p > 0.05). However, both the women and men increased statistically their scores after performing the stretching session (p < 0.001). In conclusion, no differences have been found in the trainability of flexibility by sex. However, there are differences of flexibility by the sex of students, being the females, who obtained the highest marks in the V-sit-and-reach. All this knowledge could help coaches to design more effectives stretching programs.
    Full-text · Article · Jun 2014
    • "Whether pre-exercise stretching induces changes in the eccentric strength of hamstrings, such as peak force occurring at a joint angle corresponding to a shorter muscle length that is not optimal and/or causes a reduction of energy absorption capacity of the muscle-tendon unit (area under length-tension relationship) remains to be quantified. If these changes do occur it may predispose the athlete to be more prone to hamstring strains (Brockett, Morgan, & Proske, 2004; Witvrouw et al., 2004). Additionally, it is unclear if stretching impairs unilateral H/Q ratios and increases the risk of hamstring strains. "
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    ABSTRACT: The purpose of this study was to investigate the acute effect of an active lower limb stretching routine with a sports-related training load on the hamstring eccentric length-tension relationship. 49 recreational sportsmen completed three assessment sessions, an initial familiarization session and two experimental sessions (control and stretching in random order). Immediately after the interventions (stretching or control), eccentric isokinetic peak torque, maximum force angle and total work were measured in prone position. If the alteration of the eccentric length-tension relationship could be used as a primary risk factor of hamstring muscle strains, the findings of the present study tentatively suggest that static stretching would not be able to alter the relative risk of hamstring muscles.
    No preview · Article · Mar 2014 · Revista Internacional de Medicina y Ciencias de la Actividad Fisica y del Deporte
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