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Does Typical Stretching Work?

Typical stretching does not work!

Saul Yudelowitz BSc (Hons)

Below are extracts from many differs journals which pertain to stretching. What the reader needs to understand is that overall there is considerable disagreement with regard to stretching. While these extracts show that stretching has no or little effect there are also articles that show the opposite. Clearly more research is needed so that we can advise and treat our patients from a basis of consensus. There appears to be a great amount of disagreement between what constitutes a stretch and an eccentric contraction.
 
 
Extracts from different journals:
 
 

The role of stretching in injury prevention has also been examined in systematic reviews, but no significant benefit has been reported. (5; 6)
 
5 Herbert RD, Gabriel M. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. BMJ 2002;325:468–72.
6 Thacker SB, Gilchrist J, Stroup DF, et al. The impact of stretching on sports injury risk: a systematic review of the literature. Med Sci Sports Exerc 2004;36:371–8.
 
 
 
Extremes of flexibility have been associated with injury (19; 20) and one specific area of attention is the impact of suboptimal flexibility on hamstring injury. The role of stretching in enhancing flexibility and reducing injury remains contentious. (21; 22)
 
19.Jones BH, Cowan DN, Tomlinson JP, et al. Epidemiology of injuries associated with physical training among young men in the army. Med Sci Sports Exerc 1993;25:197–203.
20 Taimela S, Kujala UM, Osterman K. Intrinsic risk factors and athletic injuries. Sports Med 1990;9:205–15.
21 Shrier I. Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clin J Sports Med 1999;9:221–7.
22 Shrier I. Stretching before exercise: evidence based approach. Br J Sports Med 2000;34:324–5.
 
 
 
Our previous study showed no change in maximum ankle dorsiflexion after stretching in subjects with limited gastrocnemius extensibility.
 
Johanson MA, Wooden M, Catlin PA, et al. Plantarflexor stretching effects on static and dynamic ankle dorsiflexion. Phys Ther Sport. 2006;7:93–100.
 
 
 
Halbertsma and Goeken (5) concluded that neither a 10-minute stretch (8) nor a 4-week daily home stretching program made short hamstrings any longer or less stiff, but only altered the stretch tolerance.
 
 
5. Halbertsma J, Goeken L. Stretching exercises: effect on passive extensibility and stiffness in short hamstrings of healthy subjects. Arch Phys Med Rehabil. 1994;75:976-981.
8. Halbertsma J, van Bolhuis A, Goeken L. Sport stretching: effect on passive muscle stiffness of short hamstrings. Ach Phy Med Rehabil. 1996;77:688-692.
 
 
 
The authors of these studies concluded that stretch perception is a major factor in explaining why some stretching techniques yield greater gains in ROM than others.
 
Ulrike H. Mitchell, J. William Myrer, J. Ty Hopkins, et al. Acute Stretch Perception Alteration Contributes to the Success of the PNF “Contract-Relax” Stretch. Journal of Sport Rehabilitation, 2007, 16, 85-92 © 2007 Human Kinetics, Inc.
 
 
Youdas et al (21) and Grady and Saxena (22) also examined a wider range of stretch durations and reported further contradictory results. These researchers stretched the gastrocnemius muscle using a range of 30- to 300-second stretch durations but achieved no significant effect in improv­ing ankle active ROM.
 
21. Grady JF, Saxena A. Effects of stretching the gastrocnemius muscle. J Foot Surg. 1991;30(5):465-469.
22. Norkin CC, White DJ. Measurement of Joint Motion: A Guide to Goniometry. 3rd ed. Philadelphia, Pa: FA Davis Co; 2003.
 
 
 
These findings suggest that passive stretching does increase ROM temporarily. This we would attribute to creep, that is, the tendency of a viscoelastic material (musculotendinous unit) to deform as a load (body weight) is applied over time (3 minutes).

Panjabi MM, White AA. Biomechanics in the Musculoskeletal System. New York, NY: Churchill Livingstone; 2001.

 
 
The results of this study indicate that a 3-minute passive stretch of the ankle over 3 days produces linear increases in ROM over the course of each day’s 3-minute stretch. It did not, however, produce a sustained increase in ROM among apparently healthy individuals. Therefore, we cannot recommend a stretching regimen such as we employed if the goal is to increase ROM.

Pratt K, Bohannon R. Effects of a 3-minute standing stretch on ankle-dorsiflexion range of motion. J Sport Rehabil. 2003;12:162-173. © 2003 Human Kinetics Publishers, Inc.

 
 
 
Taken together, these results indicate that stretching changes the viscoelastic properties of muscle–tendon units. However, since in these studies the compliance of the whole muscle-tendon unit is measured (by measuring the passive resistive torque associated with the range of motion changes), from these findings it cannot be concluded whether stretching influences the stretch tolerance, and the compliance of the muscle, the compliance of the tendon, or both.

E Witvrouw, N Mahieu, P Roosen, P McNair. The role of stretching in tendon injuries. Br J Sports Med 2007;41:224–226. doi: 10.1136/bjsm.2006.034165

 
 
This is particularly so with the hamstrings where I have now seen five de novo hamstring origin tears that occurred purely whilst doing stretching exercises.

Malcolm Read, MRCGP. Over stretched. BrBr J Sports Med 1989 23: 257-258

 
 
These findings indicated that performing 15 min static or contract-relax stretching had detrimental effects on the torque production capacity of plantar flexor muscles and should be precluded before competition. Mechanisms explaining this alteration seemed to be stretch modality dependent.

NicolasBabaultab, Blah Y.L.Kouassib, KevinDesbrosses. Acute effects of 15 min static or contract-relax stretching modalities on plantar flexors neuromuscular properties. Journal of Science and Medicine in Sport. Volume 13, Issue 2, Pages 247-252 (March 2010)

 
 
Stretching had no influence on kicking ROM or foot speed, possibly because of the complexity of the kicking skill.

W Young, P Clothier, L Otago, L Bruce, D Liddell. Acute effects of static stretching on hip flexor and quadriceps flexibility, range of motion and foot speed in kicking a football. Journal of Science and Medicine in Sport March 2004 Vol. 7, Issue 1, 23-31

 
 
One session of static stretching does not influence the course of the passive muscle stiffness curve. The increased ROM, ie, the extensibility of the hamstrings, results from an increase in the stretch tolerance.

Jan P.K. Halbertsma, Annette I. van Bolhuis, Ludwig N.H. Göeken. Sport stretching: Effect on passive muscle stiffness of short hamstrings. Archives of Physical Medicine and Rehabilitation
July 1996 Vol. 77, Issue 7, 688-692

 
 
This study suggests that static stretching may have no effect on active stiffness of the ankle plantar-flexors and that these findings may have value in the design of stretching programs and in aetiological studies pertaining to flexibility.

D.Glenn Hunter, Vince Coveney, Jonathon Spriggs. Investigation into the effect of static stretching on the active stiffness and damping characteristics of the ankle joint plantar flexors. Physical Therapy in Sport. February 2001 Vol. 2, Issue 1, 15-22

 
 
The acute effect of repeated passive stretching of short hamstring muscles is negligible. With an instrumental straight-leg raising test, the relevant muscle variables can be examined noninvasively.

Jan P.K. Halbertsma, Ingrid Mulder, Ludwig N.H. Göeken, Willem H. Eisma. Archives of Physical Medicine and Rehabilitation. April 1999 Vol. 80, Issue 4, Pages 407-414

 
 
These results suggest that static stretching does not affect maximal eccentric isokinetic torque or power production, nor does it change muscle activation.

Joel T. Cramer, Terry J. Housh, Glen O. Johnson, Travis W. Beck, Jared W. Coburn, Joseph P. Weir. An Acute Bout of Static Stretching Does Not Affect Maximal Eccentric Isokinetic Peak Torque, the Joint Angle at Peak Torque, Mean Power, Electromyography, or Mechanomyography. J Orthop Sports Phys Ther. 2007;37(3):130-139

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