Is Stretching a Huge Waste of Time!?


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Why stretch!?

Most people you talk to will tell you that stretching is good for you, especially in regards to warming up before sports, exercise or some other physical activity. Common forms of stretching include static stretching (where the joint is held in a position for a period of time), dynamic stretching (where the joint is moved through its range), and PNF stretching (stretching > contracting > stretching again). This article will focus more on static stretching. While static stretching can be beneficial, what is the research telling us about its utility?

It's confusing! 

Do our muscles actually get longer after we stretch? Well, some studies show no change in the length of the musculotendinous unit after long-term stretching (3, 5, 7, 11, 14, 21, 22). These researchers conclude that the increases in length are explained by the individual's increased ability to tolerate the painful stretch sensation. However, some studies do show (albeit small and transient) physical increases in the length of the tissue (4, 6, 8, 12, 15, 16, 18). 

This is a bit confusing, right?

A reasonable conclusion would be to say stretching probably increases both one’s tolerance to the discomfort of the stretch sensation and increases the length of the musculotendinous unit by a small amount.

"So if you enjoy stretching, then by all means continue to do it as part of your exercise routine..."

What stretching probably doesn't do 

  • Reduce injury rates
    • Contrary to popular opinion, stretching doesn’t seem very effective for reducing the chance of getting injured with sports or activity (17, 19).
  • Increase injury rates
  • Meaningfully alter running economy
  • Reduce delayed onset muscle soreness (DOMS) after working out
  • Create loose, floppy tendons/muscles!
  • Align collagen fibres post-injury/surgery
  • Fix posture (9)
  • Break up scar tissue/fascia/adhesions post-injury/surgery
  • Permanently lengthen muscles
  • Cure injury


However, does this mean we should stop stretching altogether? No, not necessarily!

What stretching probably does do 

  • Slightly reduce (~1-5%) your power, strength, balance and/or speed if held >60s and performed immediately before activity (1, 2, 10)
    • Although some researchers think this doesn’t translate to a sporting context (17) and some have actually shown increases in these measures (Kokkonen, 2007)
  • Increase your ability to tolerate the discomfort of stretching
    • Helpful for athletes who need to routinely manoeuvre their limbs into end of range positions (gymnasts, martial artists, etc.)
  • Cause fascicle growth! (6)
  • Give a positive psychological response
  • Get some people moving again 
  • Alter the perception of the stretched area
    • Stretching can be used to "toy with the nervous system" and reduce the intensity of the pain of an injured area 


So if you enjoy stretching, then by all means continue to do it as part of your exercise routine, but perhaps don’t spend excessive amounts of time stretching at the expense of strengthening exercises. Strengthening exercises are important for preparing the body for sport and activity, and have actually been shown to be more effective than stretching for reducing your chances of injury (13).

I think this quote from David Behm is a helpful summary:

Generally, a warm-up to minimise impairments and enhance performance should be composed of a submaximal intensity aerobic activity followed by large amplitude dynamic stretching and then completed with sport-specific dynamic activities. Sports that necessitate a high degree of static flexibility should use short duration static stretches with lower intensity stretches in a trained population to minimise the possibilities of impairments.” –David Behm


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References:
1. Baxter, C., McNaughton, L., Sparks, A., Norton, L., & Bentley, D. (2017). Impact of stretching on the performance and injury risk of long-distance runners,  Research in Sports Medicine, 1, 78-90.
2. Behm, D. G., & Chaouachi, A. (2011). A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol, 111(11), 2633-2651. doi: 10.1007/s00421-011-1879-2
3. Ben, M., & Harvey, L. A. (2010). Regular stretch does not increase muscle extensibility: a randomized controlled trial. Scand J Med Sci Sports, 20(1), 136-144. doi: 10.1111/j.1600-0838.2009.00926.x
4. Blazevich, A. J., Cannavan, D., Waugh, C. M., Miller, S. C., Thorlund, J. B., Aagaard, P., & Kay, A. D. (2014). Range of motion, neuromechanical, and architectural adaptations to plantar flexor stretch training in humans. J Appl Physiol (1985), 117(5), 452-462. doi: 10.1152/japplphysiol.00204.2014
5. Folpp, H., Deall, S., Harvey, L. A., & Gwinn, T. (2006). Can apparent increases in muscle extensibility with regular stretch be explained by changes in tolerance to stretch? Aust J Physiother, 52(1), 45-50.
6. Freitas, S. R., & Mil-Homens, P. (2015). Effect of 8-week high-intensity stretching training on biceps femoris architecture. J Strength Cond Res, 29(6), 1737-1740. doi: 10.1519/jsc.0000000000000800
7. Gajdosik, R. L., Vander Linden, D. W., McNair, P. J., Williams, A. K., & Riggin, T. J. (2005). Effects of an eight-week stretching program on the passive-elastic properties and function of the calf muscles of older women. Clin Biomech (Bristol, Avon), 20(9), 973-983. doi: 10.1016/j.clinbiomech.2005.05.011
8. Guissard, N., & Duchateau, J. (2004). Effect of static stretch training on neural and mechanical properties of the human plantar-flexor muscles. Muscle Nerve, 29(2), 248-255. doi: 10.1002/mus.10549
9. Hrysomallis, C., & Goodman, C. (2001). A review of resistance exercise and posture realignment. J Strength Cond Res, 15(3), 385-390.
10. Kay, A. D., & Blazevich, A. J. (2012). Effect of acute static stretch on maximal muscle performance: a systematic review. Med Sci Sports Exerc, 44(1), 154-164. doi: 10.1249/MSS.0b013e318225cb27
11. Konrad, A., & Tilp, M. (2014). Effects of ballistic stretching training on the properties of human muscle and tendon structures (Vol. 117).
12. Kubo, K., Kanehisa, H., & Fukunaga, T. (2002). Effect of stretching training on the viscoelastic properties of human tendon structures in vivo. J Appl Physiol (1985), 92(2), 595-601. doi: 10.1152/japplphysiol.00658.2001
13. Lauersen, J., Bertelsen, D., & Andersen. (2013).  The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials, BMJ, 48, 11.
14. Magnusson, S. P. (1998). Passive properties of human skeletal muscle during stretch maneuvers. A review. Scand J Med Sci Sports, 8(2), 65-77.
15. Mahieu, N. N., McNair, P., De Muynck, M., Stevens, V., Blanckaert, I., Smits, N., & Witvrouw, E. (2007). Effect of static and ballistic stretching on the muscle-tendon tissue properties. Med Sci Sports Exerc, 39(3), 494-501. doi: 10.1249/01.mss.0000247004.40212.f7
16. Marshall, P. W., & Siegler, J. C. (2014). Lower hamstring extensibility in men compared to women is explained by differences in stretch tolerance. BMC Musculoskeletal Disorders15, 223. http://doi.org/10.1186/1471-2474-15-223
17. McHugh, M., & Cosgrave, C. (2010).  To stretch or not to stretch: the role of stretching in injury prevention and performance. Scand J Med Sci Sports, 2, 169-181.
18. Nakamura, M., Ikezoe, T., Takeno, Y., & Ichihashi, N. (2012). Effects of a 4-week static stretch training program on passive stiffness of human gastrocnemius muscle-tendon unit in vivo. Eur J Appl Physiol, 112(7), 2749-2755. doi: 10.1007/s00421-011-2250-3
19. Shrier, I. (1999). Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clin J Sport Med, 9(4), 221-227.
20. Weppler, C. H., & Magnusson, S. P. (2010). Increasing muscle extensibility: a matter of increasing length or modifying sensation? Phys Ther, 90(3), 438-449. doi: 10.2522/ptj.20090012
21. Witvrouw, E., Mahieu, N., Danneels, L., & McNair, P. (2004). Stretching and injury prevention: an obscure relationship. Sports Med, 34(7), 443-449.


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