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To stretch or not to stretch that is the question!

Adam Meakins / September 23, 2012

But what is the answer?

There has been a hell of a lot of debate about stretching and its eects and role in injury prevention recently, with many
debates and discussions on it. Thing such as should we stretch before or after exercise? What's the best way to stretch?
And how long should we stretch for?
All these questions seem to have multiple answers with confusing and conflicting claims and counterclaims, leaving most of us none the
wiser. This uncertainty has also created a few heated disagreements between physios, coaches and sports scientists as we all think we
have the best answer.
So this is my quick, simple review of a few of these questions on stretching based on the current research, as well as my own personal
experience, views and opinions?

What type of stretching is best?

Firstly, I am only going to look at two forms of stretching, static and dynamic. These are the type that most of us do regularly and know
well, and don't need any assistance from anyone else. The other types of stretching such as PNF, hold/relax are usually more suited for
the physios treatment room.
What is static stretching?
This is the type of stretch where you elongate a muscle and hold it there for a period of time, such as the hamstring stretch you often
see being done by leaning forward keeping the leg straight! (I hate this stretch for hamstrings but thats for another blog) or the common
calf stretch by placing the foot behind you

What is dynamic stretching?

This type of stretching uses movement and momentum of the limb or trunk to move the muscle from one end of range to the other end
of range, its best performed slow and controlled, not vigorous or bouncy, thats sometimes known as ballisitic stretching. An example of
dynamic stretching for thr hamstrings is when you see a runner swinging the leg forwards and backwards

Which type of stretching is better?

Well it depends on what the goal is and what you want to achieve? Each type of stretch has pro's and cons, and both are thought to be
suited for two different purposes.
In a nutshell it's now believed by most that static stretching should not be used just prior to exercise or sports as it can effect your
performance. Instead dynamic stretching is thought to be better for pre exercise activity. But static stretching is still considered to be
better than dynamic stretching for improving range of movement and maintaining flexibility in general.

But is this true?

Well research has indeed found that static stretching can reduce strength, power and performance (essential for most sports). A recent
meta analysis (review of all the research on a subject) by Simic et al (2012) looked at 104 studies on the subject of pre exercise static
stretching and concluded

the usage of static stretching as the sole activity during warm-up routine should generally be avoided

However, the key word in that conclusion is 'SOLE' and this seems to have been conveniently overlooked by all the anti static
stretching protestors out there.
Yes the review found a reduction in strength, power, and explosive performance in those who statically stretched before exercise. But
the effects were small (although statistically significant) being between 5.4% 1.9%. So unless your are a high level professional athlete

you are unlikely to notice these reductions. Its also worth noting that these negative effects are in fact negligible if the stretch was kept
under 45 seconds (which most stretches are) and the negative effects where only short lived, with things returning to normal after just a
5-10 minute period after the stretching. It also goes on to conclude that short static stretching is actually recommended for activities
that involve slower eccentric contractions, or sports that require greater ranges of movement such as gymnastics, marital arts etc.
Finally it's also worth remembering that ALL these studies measured tests of performance, not acutal sporting performance, making any
true identificarion if negative effect questionable.
Now what about the benefits of dynamic stretching before sports? Well again another systematic review done by Behm et al (2011)
stated

Dynamic stretching has been shown to either have no effect or may augment subsequent performance, especially if the
duration of the dynamic stretching is prolonged

Again the key word here is MAY, again overlooked by the anti static stretching pedants who insist dynamic stretching is the ONLY way
to prepare for exercise or sport
Finally this study by Behm concluded

Generally, a warm-up to minimize 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 minimize the possibilities of impairments

I interpret this very sensible conclusion as saying a combination of both static and dynamic stretching for most sports seems to be the
answer, with the emphasis on the type of sport being the guiding factor as to which type of stretching should be done. Not that one
type of stretch over the other is best.

So what about stretching to reduce risk of injury?

The evidence for both dynamic and static stretches to reduce the incidence of injury is 'inconclusive' (just as most things are in the injury
prevention research world) a study by McHugh et al (2010) on the role of stretching and injury prevention concluded

With respect to the effect of pre-participation stretching on injury prevention a limited number of studies of varying quality
have shown mixed results

Basically meaning we don't know?

But again common sense clearly has to be used, and preparing your body for the sport or exercise its about to face can only be a good
thing.
Each sport is different, so each warm up will be different, with different emphasis on amount of things and intensity to stretch or not to
stretch. This will be on an individual to individual basis.
There is no one magic warm up routine. There is no one type of stretching better than the other!
However, when it comes to stretching and warming up it seems the research is advising us to spend time doing predominately dynamic
stretching and low intensity aerobic activity similar to the sport or exercise, but, if your sport requires large amplitude movements then
include some short duration static stretches as well.

Do we even need to stretch or warm up at all?

This may seem a controversial, and even a crazy and potentially risky suggestion, but I know many, many people that throw on their
trainers and run, me included. I never stretch before my runs, and only do a few calf stretches after for about 30 secs once in a while
after runs.
I also know of loads of weekend footballers, rugby players etc whose idea of a warm up is a pee behind the goal posts before kick off,
and they don't seem to suffer any more lack of performance or injuries when compared to those that go through a comprehensive
warm up routine.

Ok so the weekend warriors and myself can not really be classed as high level athletes, but it does raise some intriguing doubts over the
effects of warm up.

So why do we bother?
Well, its usually out of habit, routine or because of ingrained myths and fears installed in us that the body is fragile and needs coaxing
into action.
This notion is flawed, in my opinion, the human body is inherently reslient and has a remarkable capacity for adaptation to activity.
However, with all that being said I'm not going to suddenly start recommending that everybody stops doing any form of warm up before
sport, maybe that's my own ingrained beleifs, or just an adverse risk to legal suits from all of you stop warming up and getting injured!
So I do recommend some warm up before sport.

How long should you warm up for?

This is a question I get asked a lot, and unfortunately the research here is also inconclusive, as usual. However, after working in a variety
of sports I tend to use a set of broad rules of how long a warm up should last dependant of the activity.
For,example, I usually recommend to spend either 25% or 50% of your total planned activity time warming up, based on whether your
activity or sport is high or low intensity in nature.
For example, if a low intensity jog for 30 minutes is planned, I suggest a warm up lasting for 25% of the time, so about 7 minutes.
However, if you have a 30 minute high intensity, multiple direction session planned, I recommend you increase the warm up time to
about 50%, so approximately 15 minutes in total.
Now I know this may seem like a long time, but Imthink its worth it, and I do cap the maximum time for any warm up to about 15-20
minutes, as even the longest sporting events such as marathons don't need anymore than that!
Now although I have said earlier that I don't stretch or warm up before my usual (very) low intensity runs, I do practice what I preach if I
am going to an activity that involves high (ish) intensity such as when I play the odd game of rugby now and then, or do a sprint interval
training session.
What routine you do varies highly dependant on what you have planned, for example if it's sprint intervals in a straight line then it will be
progressive running drills and plyometrics in a single plane of direction with lots of dynamic hamstring and hip flexor movements. If
however its a game of rugby, it will incorporate more multidirectional drills as well as warming up other areas such as the shoulders and
the neck, not just the legs.

Summary
Static stretching does have a role to play, and it can be included in to a warm up program without any significant fears of
negative side eects as often being reported
But, it is probably best to do predominantly dynamic stretching before most exercise and perhaps leave most of the static
stretching for between your exercise sessions and/or in the physio room. However, if you have always stretched this way
in the past and have had no problems and feel it helps you then please, please continue, also if you routinely don't do any
warm up or stretching before exercise and want to continue this way then I think that's perfectly ok too.
Finally, if you want to find the best warm up routine I'm afraid to say that there is no one size fits all program or technique
that works better than any other. Its pretty much down to trial and error to see what feels right for you, it's no more
scientific than that, no matter what some fussy physio, silly sports scientist or cantankerous coach tells you, do what feels
right for you.
As always thanks for reading and enjoy your sport!
Adam

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12 thoughts on To stretch or not to stretch that is the question!

James

September 23, 2012 at 7:17 pm

Hey Adam,
This is some good information. There seemed to be a backlash against stretching over the last few years. Ive seen
several sources saying we should stop static stretching entirely which I think is an over reaction to what the research
has actually shown.
Reply

The Sports Physio

September 23, 2012 at 7:45 pm

Hi James
Thanks for your comment, yes I totally agree the negative press on static stretching has gone a bit too far, it
defiantly has a role to play and a place in maintaining muscle length, but it shouldnt be used prior to
exercise thats all
Think the message has been misinterpreted
Regards
Adam
Reply

tatamihealth

September 24, 2012 at 9:30 am

Im quite surprised that in all this debate still no one talks about the need to use static stretching to reduce tone in
those muscles that are contributing to dysfunctional patterns of movement to improve mechanics and therefore reduce
injury rates.
Its only ever thought that to stretch a muscle is to try and prevent that particular muscle from injury. It goes to show
that academics are often very out of touch with what highly experienced physios and trainers are actually trying to
achieve with static stretches.
Take a piriformis stretch for example.reducing tone with a stretch greatly improves the function of the glutes, there
better lower limb mechanic and reduced chance of injury. It doesnt get much simpler when you understand the

functional anatomy involved!

Off my soap box now..
Reply

Josh Stone, MA, ATC, NASM-CPT, CES, PES, FNS

November 3, 2012 at 8:49 pm

First and foremost, as a fellow sports medicine blogger I am excited to have discovered your blog. Great
stuff.
I agree with most of the material in this particular post; however I see no reason to avoid static stretching
prior to exercise. Acute variables for static stretching call for held stretch for 20-30 seconds. In the cited
meta-analysis there is no loss of strength or performance measures when performing a stretch for 20-30
seconds. As you stated the functional measures of decline increase when stretching for periods longer than
45 seconds.
Static stretching for 20-30 seconds has yields no functional loss. In addition and as you stated above, static
stretching is prudent to the correction of human movement dysfunction and relaxation of hypertonic
muscles. Individuals with human movement dysfunction should absolutely perform static stretching prior to
exercise IMO.
Also, I think those individuals that do present with dysfunctional movement should take caution or even
avoid dynamic stretching. Multiplanar flexibility for these individuals may actually cause more ha than good.
Nonetheless, awesome blog, awesome blog site and I am glad to have found you. I may even re-blog some
of yours material.
Cheers
Reply

The Sports Physio

November 3, 2012 at 8:58 pm

Hi Josh
Thanks for your comments, and your very valuable insights into this stretching issue
I agree with what you say and think static stretching has had some bad press lately and the
reductions in performance when found are small and possibly only relevant for elite athletics.
Interesting point on dynamic stretching and risks would be good to follow this up
It would be great to get some blog swapping and cooperation going with your site and I look
forward to reading more of your articles
Cheers
Adam
Reply

Andy DuBois

March 21, 2013 at 5:41 am

Is there any evidence that static stretching does what it is claimed to do?
maintain or improve active ROM or relaxing hypertonic muscles?
Whilst static stretching may not be as bad for you as some make out it that doesnt mean its worth doing .
The explanation that static stretching helps improve or maintain active ROM has no scientific basis or research to back

it up. So if it doesnt improve active ROM then why do we do it?

Reply

The Sports Physio

March 21, 2013 at 8:18 am

Hi Andy
Thanks for your comments, i can confidently say there is reams and reams of evidence on static stretching
improving muscle length and ROM, sure, some of it is of dubious quality but it pretty well accepted that
static stretching increases musculotendionous lengths
The issues with static stretching are what are the mechanisms behind this? Does it reduce athletic
performance? And what are the guidelines/parameters to get most effective stretch? These need more
research and clarification?
I advise you to go to PubMed or PedRo to do an online search on static stretching and you can look at the
heaps of evidence for yourself
Cheers
Adam
Reply

Andy DuBois

March 21, 2013 at 8:29 am

Thanks for the reply Adam. I am aware there is a lot of research to show that static stretching
increases muscle flexibility but very little measuring dynamic flexibility a quick search on
hamstring flexibility for example shows that the way of measuring the flexibility is with the subject
prone this has little relevance to the flexibility required under speed and load in a sprint for
example. What I would like to know is is the any evidence that static stretching improves active
range of movement in daily activities running walking, or any other dynamic movement. I have
seen research that it doesnt but havent seen any that supports it.
Reply

sydney

July 18, 2013 at 3:28 pm

Very well said. It is really important to know how to manage, prevent and deal with stretch.
adhesive capsulitis treatment
Reply

Sjoerd den Dekker

October 20, 2013 at 10:41 am

Good information and very nice to read!

But why dont you make a different approach per type of sport? This is not to be critically, but just a question to
understand your way of thinking.
Keep up the good work!
Reply

The Sports Physio

October 20, 2013 at 1:19 pm

Hi and thanks for your comments, I agree totally and thought that was what I said in my blog that each warm
up each stretch should be targeted to the individual and to the task planned
Thanks
Adam
Reply

Ehsan Padash

December 12, 2013 at 8:03 pm

tnx
Reply

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