Does stretching really help?

 

Stretching is a controversial topic within the physical therapy world. Until the 2000s, static stretching was a staple of every athlete’s warm up and warm down prior to exercise and athletic performance. Since the 2000s more and more research has come out evaluating its effectiveness on flexibility, pain, recovery and injury prevention. The results have been interesting to say the least.

What are the proposed mechanisms of stretching?

The basic unit of a muscle is a sarcomere. At rest, these sarcomeres have a lot of overlap but as we stretch this overlap lessens, allowing the muscle to lengthen. Other mechanisms at play are structures known as the muscle spindle and golgi tendon organ, which activate and inhibit muscle recruitment in relation to stress and tension.

So back to the question does stretching help?

There is a mass of research on this topic and a conclusion is hard to nail down. Dividing the question into 3 sections seems to give the most clarity:

  1. Flexibility: Stretching has been shown to be effective in increasing joint range of motion (ROM), some forms of stretching have been found to be more effective than others. The improved flexibility has been found to come from increased stretch tolerance rather than an actual increase in muscle length.
  2. Pain reduction and rehabilitation: According to a Cochranes systematic review from 2011, there is no benefit of stretching at reducing muscle soreness after exercise. However, as a therapeutic tool to decrease pain in orthopedic patients, stretching does have a positive effect in increasing ROM and reducing pain.
  3. Injury prevention: Static stretching (holding a position for an extended period) has been proven to be a helpful tool to increase flexibility. On the other hand, it decreases muscle strength and may have a negative effect on performance when done before exercise. A warm-up and dynamic stretching (stretching the muscle through the motion) is advocated before exercise, though evidence is inconclusive.

 

My take

In my experience, static stretching as a therapeutic tool is effective in reducing pain and this is backed by research. The most common protocol advocated is a 30 second hold repeated 3-4 times. In terms of flexibility, experience and research show that static and PNF stretching are effective. To improve flexibility longer time frames are needed (60 seconds plus). As a tool for injury prevention (although the research is inconclusive), it makes sense that dynamic stretching prepares the muscle for the required sport. Belief is another important factor and has an impact on outcome, therefore if stretching has been a staple of your routine for many years I would continue.

Ryan

 

References

 

  1. P. IJSPT 2012
  2. cochranes systematic review 2011 “stretching to prevent or reduce soreness after exercising”
  3. Robert Y.W APTA 2009
  4. A. JSP 2015
  5. O’Sullivan .K. BMC 2009
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