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Sager and Grenier, Int J Phys Med Rehabil 2014, 2:4

Medicine & Rehabilitation

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ISSN: 2329-9096 DOI: 10.4172/2329-9096.1000208

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Research Article Open Access

Comparison of Yoga Versus Static Stretching for Increasing Hip and Shoulder
Range of Motion
Melayna Sager and Sylvain Grenier*
Human Kinetics, Laurentian University, Sudbury Ontario, Canada
*Corresponding author: Sylvain Grenier, Human Kinetics, Laurentian University, Sudbury Ontario, Canada, Tel: 705-675-1151, Ext: 1095; E-mail:
sgrenier@laurentian.ca
Received date: 20 April 2014; Accepted date: 17 June 2014; Published date: 20 June 2014
Copyright: © 2014 Sager M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background/Purpose: Currently the most common method to increase flexibility is through static stretching,
however yoga is rising in popularity. The purpose of the study was to compare yoga and static stretching to
determine which is most effective for improving hip and shoulder range of motion.

Methods: Subjects participated in one of three groups, yoga, stretching and control. Range of motion was
assessed on entry and 1 month later. An analysis of variance was conducted for comparison between each group. A
p value of 0.05 was used to determine if the data is significantly different.

Results: Compared to the control group, those who participated in the one-month class, both yoga and static
stretching showed significant improvements in range of motion. The yoga group showed a greater range of motion
improvement that the static stretching group with a mean difference of 1.08902 degrees (p<0.001, 95% confidence
interval, η2=0.224).

Conclusions: Yoga is shown to have a greater effect on range of motion at the shoulder and hip than static
stretching in a healthy population. With further positive results, yoga may prove to have an important therapeutic role
with joint restrictions.

Keywords: Yoga; Static stretching; Range of motion; Flexibility tissues and limitations in joint flexibility [4,7]. Stretching is a popular
method used in order to promote improvements in mobility and range
Abbreviations: of motion [4,8]. With regular stretching muscle tension is reduced,
movements become easier helping to improve coordination. Range of
ROM: Range of Motion; ANOVA: Analysis of Variance motion is improved, flexibility is maintained or improved, and the
likelihood of strain injuries is decreased [6,9]. In general stretching
Introduction helps to create a general feeling of well-being [6,9].

With increasing age people will often lose range of motion
diminishing their ability to do activities of daily living [1,2]. To
maintain flexibility the most common method is through static
stretching, however yoga is becoming increasingly more popular [3]
with the added benefits of deep breathing and relaxation. This study
explores the value of yoga in comparison to static stretching when
related to increasing range of motion in the hip and shoulder joints.
It is important to have an understanding of the difference between
range of motion and flexibility, to properly decipher the issues. Range
of motion has been defined as the obtainable movement at any specific
joint [1,4,5]. Flexibility on the other hand refers to the muscles
surrounding the joint and is defined as the mobility of the muscles and
the length to which they extend [4]. Range of motion within a joint is
dependent on the bony structure of the joint, the surrounding
connective tissues, as well as the length of the muscles spanning the
particular joint [1,4,5]. Therefore if a muscle is lacking in flexibility it
may cause a reduced range of motion [1,4,6].
Throughout activities of daily living, repetitive stress or overuse
injuries are very common and are in part caused by restrictions in soft
Yoga uses asanas (static postures) to help improve muscular
strength and flexibility.
Specifically, hatha yoga combines a focus on asanas, pranayamas
(breath control) and chanda (meditation), throughout the class to
quiet the mind and to increase concentration [3,10–13]. Graves,
Krepcho and Mayo, did a study in which they determined that of 3000
patients treated with yoga for various chronic health problems, 98% of
those surveyed proclaimed it to be useful in preventing and managing
the effects of their chronic health problems [11,12]. Looking
specifically at flexibility it was shown to increase range of motion,
which is most likely attributed to the asanas [10,14].
In general, more research needs to be done on yoga as it is an ever-
growing method of treatment for increasing flexibility, which in turn is
thought to help increase range of motion [1,4]. Using goniometry as
an accepted method for evaluating range of motion, the effects of yoga
and static stretching on flexibility will be compared for hip and
shoulder range of motion. To date no comparison studies have been
conducted on these types of treatments. Based on previous research it
is hypothesized that though both will have a positive effect when it
comes to increasing flexibility, yoga will be better suited to increase

Int J Phys Med Rehabil Volume 2 • Issue 4 • 1000208

ISSN:2329-9096 JPMR, an open access journal
Citation: Sager M, Grenier S (2014) Comparison of Yoga Versus Static Stretching for Increasing Hip and Shoulder Range of Motion. Int J Phys
Med Rehabil 2: 208. doi:10.4172/2329-9096.1000208
range of motion do to its focus on asanas (static postures), pranayamas
(breath control), and chanda (meditation). The aim of the study is to
compare yoga and static stretching to determine which is most
effective for improving hip and shoulder range of motion.
Methods
First, contact was made with multiple YMCA yoga instructors in
order to find a certified instructor who would be willing to teach a
yoga class two nights a week with a focus on hips and shoulders. Two
yoga instructors, certified yearly by the YMCA, volunteered each to
teach one night a week for an hour. The next step was to book the
facility. The multipurpose room was booked at the YMCA four nights
a week for an hour each night.
Participants
Once ethics approval was obtained, flyers were put up throughout
the YMCA advertising for participants who would be interested in
volunteering to be participants in this study. Through e-mail further
contact was made with participants in order to provide them with
further details. A total of 44 subjects, (control group: n=21, yoga
group: n=11, and static stretching group: n=12), gave their full consent
and participated in data collection. Subjects were between the ages of
18- 65 years old with no recent musculoskeletal injuries.
Following pre-testing, each subject participated in 1 of 3 groups.
The first group participated as a control in the study and did not do
any stretching for 4 weeks in between pre- test and post-test measures
[15]. The second group participated in 4 weeks of hatha yoga and the
third group participated in 4 weeks of static stretching.
Participants in the hatha yoga group attended one-hour classes two
nights a week for the duration of 4 weeks [16]. The classes took place
Tuesday nights from 6:30 to 7:30pm and Thursday nights form 7:30 to
8:30pm. Attendance was taken at each class [17]. See APPENDIX I, for
a breakdown of the yoga class provided.
Finally the participants in the static stretching group also attended
classes two nights a week for four weeks. These classes took place
Monday and Wednesday nights from 7:30pm to 8:30pm. Attendance
was taken at each class [17]. See APPENDIX II for a breakdown of the
stretching classes provided to the participants.
Once the 4 weeks were completed all participants attended post-
testing sessions two days following their last class. The same
procedures were followed as that of the pre-test measures.
Equipment
Range of motion at the hip and shoulder was measured using a
goniometer. The goniometer1 was made of metal, had two arms and a
180-degree protractor in the center on each side. The protractor was
marked off in one-degree increments and the arms of the goniometer
were 12 inches long. The instrument was validated using known angles
of 0, 45, 90, 135, and 180 degrees [18].
Measurement Procedure
Prior to any data collection participants were required to complete a
PAR-Q questionnaire, a general lifestyle questionnaire, and a consent
form. If they met all the required criteria they volunteered to take part
1 The goniometer was manufactured by J SKLAR MFG CO. Long Island City, NY.
Int J Phys Med Rehabil
ISSN:2329-9096 JPMR, an open access journal
Page 2 of 6
in one of the three groups and were asked to attend an initial
measurement session two days prior to class participation. No warm
up was performed at the testing sessions [15].
Standard goniometer measurements were made for shoulder
flexion, extension, abduction, adduction, horizontal abduction and
horizontal adduction on both the left and right side. The same
examiner made two goniometer measurements for each motion
[4,19-21]. The terminal position of range of motion was determined
when the participant felt tension [19]. The examiner did have prior
knowledge about subject participation in each of the three groups.
When measuring shoulder flexion the subject was supine with
knees and hips bent and back flat on the floor. The arm was at their
side with the palm of the hand facing in and thumb pointing up
[1,4,22]. The axis of rotation was placed just bellow the acromion
process on the lateral head of the humerus. The stationary arm was in
line with the greater trochanter and along the mid-axillary line of the
trunk. The moving arm was placed along the lateral midline of the
humerus and in line with the lateral epicondyle [1,23]. Shoulder
extension followed the same goniometer placement as that of shoulder
flexion however the patient was in a prone position [1,4,22].
For shoulder adduction and shoulder abduction the same protocol
was used. The subject was placed in a supine position with their knees
and hips bent and back flat on the floor. Their arm at their side with
the palm facing up [1,22]. The axis of the goniometer was placed and
the anterior portion of the acromion process through the center of the
humerus head. The stationary arm was placed at the lateral and
anterior surface of the chest, running parallel to the midline of the
sternum. The moving arm was placed along the anterior surface of the
arm and runs parallel to the midline of the humerus and in line with
the medial epicondyle [1,23].
Like adduction and abduction, measuring the range of motion
during horizontal shoulder adduction and abduction the protocol
remains the same for both the anterior and posterior movements. The
subject was positioned in an upright kneeling position their elbow at a
90 degree angle and their arm was be raised out to the side until level
with the shoulder [22]. The axis of the goniometer was then placed on
the superior portion of the acromion. The stationary arm was along
the midline of the shoulder leading towards the neck and the moving
arm was placed along the midline of the humerus in line with the
lateral epicondyle [23].
Standard goniometer measurements were then performed on the
hip, which included hip flexion, extension, adduction and abduction
on both sides of the body. Once again the same examiner made two
goniometer measurements for each motion [4,19-21] and the terminal
position of range of motion was determined when the participant felt
tension [19].
During hip flexion and extension the axis of the goniometer was
placed slightly anterior and superior to the greater trochanter. The
stationary arm was placed parallel to the long axis of the trunk and the
moving arm was placed along the midline of the femur on the lateral
side [1,23]. The subject was in a supine position during hip flexion and
in a prone position during hip extension [1,22].
For hip adduction and hip abduction the subjects were lying in a
supine position [1,22]. The axis of rotation was placed at the hip joint
in line with the greater trochanter. The stationary arm was placed
Volume 2 • Issue 4 • 1000208
Citation: Sager M, Grenier S (2014) Comparison of Yoga Versus Static Stretching for Increasing Hip and Shoulder Range of Motion. Int J Phys
Med Rehabil 2: 208. doi:10.4172/2329-9096.1000208
bellow and parallel to level of the anterior supra iliac spine and the
moving arm was placed in line with the midline of the patella on the
anterior surface of the thigh [1,23].
Data Analysis
All statistical analysis was conducted in SPSS v21 [19]. Means and
standard deviations for pretest and post-test measures were calculated
as well as for the gain scores (the mean differences between pretest and
posttest measures). A post-hoc Tukey test was used to compare
between between yoga participants, static stretching participants and
the control group, in a one- way analysis of variance (ANOVA).
Independent variables included the joint, the side of the body and the
motion and the dependent variable was range of motion. The changes
Figure 1: Average overall change in range of motion (ROM) for the yoga group, the static stretching group and the control group.
The results were later broken down by joint and compared between
the three groups. For the hip yoga was shown to have a significant
increase in hip ROM compared to both the control (p<0.001, 95%
confidence interval, η2=0.280) and static stretching groups (p=0.003,
95% confidence interval, η2=0.280), with a mean difference of
1.4232995 degrees greater than that of static stretching. Results also
showed that overall both static stretching and yoga showed the change
in ROM to be significantly greater than that of the control group for
Int J Phys Med Rehabil
ISSN:2329-9096 JPMR, an open access journal
Page 3 of 6
between the pre-test and post-test values were used to examine the
affects of the three groups on hip and shoulder range of motion
(ROM). A p value of 0.05 was used to determine if the data is
significantly different.
Results
Overall both yoga and static stretching showed a significant
improvement in ROM in comparison to the control group (p<0.001,
95% confidence interval, η2=0.224). Yoga showed the greatest
improvement in ROM with a mean difference of 1.08902 degrees
(p<0.001, 95% confidence interval, η2=0.224) in relation to static
stretching. The above results are summarized in Figure 1.
the shoulder (p<0.001, 95% confidence interval, η2=0.195), however
neither yoga nor static stretching were significantly different from
each other (p=0.07, 95% confidence interval, η2=0.195).
Finally results for the joints were further broken down into the
individual motions. Of the six shoulder motions analyzed, two were
found to be significant between the two treatment groups. Yoga had a
significant increase in shoulder abduction (p<0.001, 95% confidence
interval, η2=0.376) while static stretching had a significant increase of
Volume 2 • Issue 4 • 1000208
Citation: Sager M, Grenier S (2014) Comparison of Yoga Versus Static Stretching for Increasing Hip and Shoulder Range of Motion. Int J Phys
Med Rehabil 2: 208. doi:10.4172/2329-9096.1000208

Page 4 of 6

horizontal adduction (p=0.016, 95% confidence interval, η2=0.199). range of motion as compared to a control group. Further results
See Table 1 for a summary of the mean difference and significance for indicate that overall there was a significant difference between the two
the six shoulder motions. treatment groups (yoga and static stretching). Participants in the yoga
group had an overall mean increase in ROM greater than that of the
Movement other participants. These findings are in agreement with the original
Flexion Yoga 1.45265 Yoga 4.80087* Static Stretching
hypothesis.
degrees > than 3.34821* degrees Yoga uses asanas (static postures) to help improved muscular
degrees > than
Control > than Control
Static Stretching strength and flexibility. Specifically, hatha yoga combines a focus on
asanas, pranayamas (breath control) and chanda (meditation),
Extension Yoga 0.35606 Yoga 7.37987 * Static Stretching
degrees > than 7.02381* degrees throughout the class to quiet the mind and to increase concentration
degrees > than
Static Stretching
Control > than Control [3,10-13]. Further benefits include relaxation, deep breathing,
monitored stretching and increased body awareness [3,10,17] As a
Adduction Yoga 1.43561 Yoga 4.34632* Static Stretching result, the combined factors are a leading reason for the increased
degrees > than
degrees > than 2.91071* degrees range of motion when compared to static stretching.
Control > than Control
Static Stretching
There have been many studies over the years that focus on range of
Abduction Yoga 5.07955* Yoga 8.34740* Static Stretching motion and flexibility. A number of these articles have used the same
degrees > than degrees > than 3.26786* degrees definition as that provided above which is that range of motion is the
Static Stretching Control > than Control
obtainable movement at any specific joint [1,4,5], while flexibility
Horizontal Yoga 2.83144* Yoga 2.80844* Static Stretching refers to the muscles surrounding the joint and is defined as the
Adduction degrees < than degrees > than 5.63988* degrees mobility of the muscles and the length to which they extend [4]. Other
Static Stretching Control > than Control articles have used the two terms interchangeably or defined the terms
Horizontal Yoga 0.29545 Yoga 2.38312* Static Stretching
in a different manner all together. This becomes an issue when
Abduction degrees > than 2.67857* degrees comparing studies, therefore a universal definition of both flexibility
degrees < than
Static Stretching
Control > than Control and range of motion needs to be determined.

*The mean difference is significant at the 0.05 level

Another issue that presents itself and that has remained
controversial over the years is whether or not flexibility is a benefit or
detriment to health. Several articles have found that flexibility and
Table 1: Mean difference and significance determined for the shoulder increased ROM have little to no effect at preventing sport injuries
joint. [24-26] however in opposition, many articles termed flexibility and
increased ROM to be a leading treatment in rehabilitation and for
Upon completion of the hip analysis only one motion was found to
maintenance of overall health [6-8,27,28]. In general of the various
show any increased improvement in ROM with respect to a
studies that have been performed, there have been mixed findings,
comparison between treatment groups. Hip adduction had a positive
varying in quality, suggesting a need for further investigation in this
mean increase for yoga (p=0.023, 95% confidence interval, η2=0.252).
area of research.
The mean differences and the significance of the hip motions are
summarized in Table 2. Though there is still debate about joint flexibility in athletes,
increasing ROM and flexibility is an important component with
Movement people suffering from various musculoskeletal
Flexion Yoga 1.60038 Yoga 7.44264* Static Stretching injuries. Properly designed therapeutic exercise programs will put
degrees > than 5.84226* degrees emphasis on regaining range of motion first [4]. The significant
degrees > than
Control > than Control
Static Stretching increase in ROM from yoga participants proves that even a 4- week
program twice a week would be beneficial for those suffering from
Extension Yoga 1.09280 Yoga 5.16126* Static Stretching
degrees > than 4.06845* degrees restricted ROM and decreased flexibility.
degrees > than
Control > than Control
Static Stretching Most recent claims in the media have been that yoga is actually the
cause of multiple repetitive strain injuries mainly related to the hip
Adduction Yoga 2.14394* Yoga 5.28680* Static Stretching
degrees > than degrees > than 3.14286* degrees
when performed repeatedly over a long period of time [29]. To date no
Static Stretching Control > than Control definitive research has been done on this topic. Proper care needs to be
taken in order to ensure that postures are adjusted to evenly distribute
Abduction Yoga 0.85606* Yoga 5.09416* Static Stretching that body weight throughout the joint and muscles to reduce the risk
degrees > than degrees > than 4.23810* degrees
Static Stretching Control > than Control of injury [10]. Once again the opportunity presents itself for future
research that is needed in this area.
*The mean difference is significant at the 0.05 level
Breathing is also a very important component of yoga. An
environment that is created to emphasized quiet, relaxation and trust
Table 2: Mean difference and significance determined for the hip joint. has been found to be associated with dramatic increases in flexibility
and athletic performance [30]. As a result of the focus on breath
Discussion control, yoga has been shown to have increasing value when it comes
to therapy and rehabilitation [31]. There is a need for yoga to become
The results of this study confirm, in agreement with our hypothesis,
that both yoga and static stretching interventions significantly increase

Int J Phys Med Rehabil Volume 2 • Issue 4 • 1000208

ISSN:2329-9096 JPMR, an open access journal
Citation: Sager M, Grenier S (2014) Comparison of Yoga Versus Static Stretching for Increasing Hip and Shoulder Range of Motion. Int J Phys
Med Rehabil 2: 208. doi:10.4172/2329-9096.1000208

Page 5 of 6

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Acknowledgements
I would like to thank my supervisor Sylvain Grenier for his help in
making this research possible. With his support, encouragement and
advice, he inspired me to continue research in this field and to
concentrate my research on rehabilitation.
I also offer my gratitude to my certified yoga instructors, Shirle
Landriault, and Laurissa Laframboise, who volunteered their time and
expertise to this project.
As well I would like to thank Laurentian University who supplied
me the tools and support necessary to complete the research.
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ISSN:2329-9096 JPMR, an open access journal
Citation: Sager M, Grenier S (2014) Comparison of Yoga Versus Static Stretching for Increasing Hip and Shoulder Range of Motion. Int J Phys
Med Rehabil 2: 208. doi:10.4172/2329-9096.1000208
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