To Stretch or Not to Stretch -- That Is Still the Question

Laird Harrison

Disclosures

February 26, 2016

In This Article

Does Static Stretching Work?

Generations of Americans have spent hours trying to touch their toes. And many athletes and trainers believe in the power of the pregame stretch to ward off injury or improve performance.[1,2] But does it work?

The answer to that question has proved devilishly difficult to answer. In recent years, several studies have challenged the traditional approach to stretching. They have shown that static stretching—in which an athlete holds muscles in an elongated position for an extended period—can cause temporary muscle weakness.[3]

So some experts now advise against static stretching before sports. As an alternative, many recommend dynamic stretching, in which the athlete moves a joint rapidly through its range of motion.[4]

Now a new review of the literature on stretching has sparked a counterrevolution of a sort, with the authors arguing that static stretching has a place in athletic warm-up routines after all.[3] "The term we used is cost-benefit analysis," says lead author David G. Behm, PhD, a professor in the School of Human Kinetics and Recreation at Memorial University of Newfoundland in St. John's, Newfoundland, Canada. "It's more important for me not to have an injury than not to have a decrease in performance."

Mainstream publications including Outside,[5]Men's Journal,[6]Cosmopolitan,[7] and the New York Times[8] have reported on the news. But at least one expert critic of static stretching, Ian Shrier, MD, PhD, past president of the Canadian Academy of Sports Medicine and an associate professor at McGill University in Montreal, Canada, hasn't budged from his position.

"Since the early 1980s, stretching has been promoted as a method to prevent injury and improve athletic performance," Dr Shrier wrote in the journal The Physician and Sportsmedicine.[9] "Although research suggests that this may be true for regular stretching performed every day, an isolated act of stretching immediately before exercise likely has no effect on injury prevention and actually impairs performance in strength and power sports."

This back-and-forth is enough to give even the most flexible healthcare practitioner a case of whiplash. The question has relevance not only for athletes but for the general population, as range of motion is important to activities of daily living and declines with age.[4]

A Multitude of Variables

At first glance, settling the question of stretching's proper role in sports seems fairly simple. You randomly assign some athletes to stretch and other athletes not to stretch. Then you record who jumps highest or runs fastest, and who gets injured and who doesn't, during sporting events or athletic workouts.

The problem is that there are so many different types of stretching. In addition to static stretching and dynamic stretching, some people practice proprioceptive neuromuscular facilitation (PNF), which combines static stretching with isometric contractions in a cyclical pattern. Typically this type of stretching requires the assistance of a partner.[3] An example is a hamstring stretch in which one partner lies on the floor on his back, leg lifted, with the other partner gently pushing against the leg until a slight discomfort is felt in the hamstring muscle.

Then there are variables, such as which joints the individual is stretching, how far, how often, and for how long. It also may matter what else the individual is doing to warm up, how flexible the individual is before stretching, the amount of time between stretching and participating in sports, and which activity the individual is preparing to undertake after stretching.[4]

The question gets more complicated when you try to figure out what's happening inside the body that is being stretched. The condition of tendons, ligaments, cartilage, synovial fluid, and nerves, as well as muscles, all factor into an individual's flexibility.[4]

In the new review, an international group of researchers scrutinized all the studies they could find that were published in English since 1989. The studies looked at static stretching, dynamic stretching, and PNF as they pertain to performance, range of motion, and injury prevention.[3]

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