Everything You

Wanted to Know
About Stretching*
(*BUT WERE AFRAID TO ASK)

Stretching

Clinical relevance

Tests: Functional vs.

Dysfunctional

Return to normal

Measurement

Tools

Additional Variables

Reprinted from Weppler & Magnusson, 2010

Stretching

Viscoelastic Deformation

Plastic Deformation

Sarcogenesis

Neuromuscular Facilitation

Sensory Responses

Length-Tension Curves

Reprinted from Weppler & Magnusson, 2010

Viscoelastic Deformation

Viscoelasticity

Elasticity

Viscosity

Viscoelastic stress relaxation

The decline in resistance to stretch is expressed as a percentage of

initial resistance. 5

Viscoelastic
Deformation

Reprinted from
Magnusson SP. Passive
properties of human
skeletal muscle during
stretch maneuvers. 1998
via Weppler &
Magnusson, 2010 5

Viscoelastic Deformation

Reprinted from Magnusson SP, Aagaard P, Nielson JJ., 2000

Plastic Deformation
Muscle

Plastic (permanent) deformation

Length tension slope doesnt

support theory in normal
environments

Conflicting results with one

intense stretch regiment

Connective Tissue

May be possible

Stress-strain curve

Origin of evidence

Two studies

Imprecise language

facilitate viscous flow within

the connective tissue.

Plastic Deformation

Reprinted from Butler DI, Grood

ES, Noyes FR. Biomechanics of
ligaments and tendons. 1978,
via Threlkeld JA, 1992 4

Sarcogenesis

Animal studies

number of sarcomeres can be changed by prolonged immobilization

in extreme positions. 5

Adaptation to functional lengths

Would have to be shift to the right in L/T curve.

Plantar flexor study

Human testing

Neuromuscular Facilitation

Neurophysiological explanation suggests the limiting factor

during stretching to be muscular resistance secondary to reflex
activity. 3

Previous studies show contrary

Contract-relax stretch

Reprinted from Magnusson SP, Simonsen EB,

Aagaard P, Sorensen H, Kjaer M. 1996 3

Neuromuscular Facilitation

Reprinted from Magnusson SP, Simonsen

EB, Aagaard P, Sorensen H, Kjaer M,
1996 3

Sensory Theory

Drawing conclusions from previous studies

Psychological

Tests based upon subject-determined end point

Limitations of study

Ben & Harvey 2010 hamstring study

Standardized and non-standardized torque

Changes in extensibility are reflected by changes in joint angle with

the application of a standardized torque. 1

Sensory Theory

Standardized torque of 18 Nm (13.3 ft-lbs)

applied

Non-standardized 11 point pain scale

Intervention

Unmeasured stretch to tolerance

no difference in the change scores of

passive hip flexion angle with the application of
standardized stretch torque. 1

Difference with non-standardized torque

no change in pain intensity scores

Reprinted from Ben M, Harvey

LA. 2010 1

Sensory Theory

Reprinted from Ben M, Harvey LA. 2010

Conclusions, Conflictions,
Continuation

Terminology

Variable acquisition

Sensation vs. torque vs. angle

Active vs. passive

Clinical Relevance

References

Ben M, Harvey LA. Regular stretch does not increase muscle extensibility: a
randomized controlled trial. Scand J of Med & Sci Sports, 2010; 20: 136-144

Magnusson SP, Aagaard P, Nielson JJ. Passive energy return after repeated
stretches of the hamstring muscle-tendon unit. Med Sci Sports Exerc, 2000;
32: 1160-1164

Magnusson SP, Simonsen EB, Aagaard P, Sorensen H, Kjaer M. A mechanism

for altered flexibility in human skeletal muscle. Journal of Physiology., 1996;
497.1: 291-298

Threlkeld JA. The Effects of Manual Therapy on Connective Tissue. Physical

Therapy, 1992; 72: 893-902

Weppler CH, Magnusson SP. Increasing muscle extensibility: a matter of

increasing length or modifying sensation? Physical Therapy, 2010; 90: 438449

Special thanks to
Matthew Pugliese