Stretching the Truth – What the new evidence tells us about stretching by Rachel Fairweather

Stretching the Truth – What the new evidence tells us about stretching by Rachel Fairweather

Stretching the Truth – What the new evidence tells us about stretching

Stretching – it’s good for you- isn’t it? Surely it’s common wisdom that stretching makes you feel better, increases flexibility, prevents injury before sports challenges, improves athletic performance, reduces muscle soreness after exercise and alleviates the pain of a bad back (that is if you actually DID the exercises your physio had prescribed). Runners and cycling magazines promote the value of stretching for “leaner,thinner bodies”, Google harangues us with ads for stretching-friendly lycra clothing, and yoga has never been more popular.  Stretching has become a whole industry in itself with ever- fancier names applied to the latest stretching methods. Indeed it can be dizzying to try and keep up with the current state of the art stretchy technique. Stretching is “dynamic, baliistic, proprio- neuro- facilitated, active isolated, passive, contracty- relaxy and above all finger lickin’ good!”

Yet an explosion of academic interest into stretching over the past decade has suggested that maybe stretching isn’t the absolute panacea for all ills that it has been built up to be. The truth is much more complex than the simple dichotomy of “stretching is good for you” or “stretching is useless and a waste of time”.  So lets break down the magic from the myth, hyperbole from hard fact, as we look at the academic evidence and expose the real truth about stretching.

Common Wisdom about stretching

If you are at all interested in bodywork, complementary therapies or the health and fitness industry you will probably subscribe to one or more of the following beliefs about stretching.

  • Stretching helps you be more flexible – it permanently lengthens short and tight muscles
  • You should stretch before you work out as it helps prevent injury
  • If you stretch before and after exercise it helps prevent and reduce muscle soreness (known in the trade as DOMS – delayed onset muscle soreness)
  • Stretching before an event helps improve performance in sport
  • Stretching makes you feel good
  • Stretching is helpful for musculo-skeletal pain such as a bad back

What the evidence says

Lets take each of these beliefs one by one and see what the research evidence has come up with.

Stretching helps you be more flexible

Well yes it does – numerous research studies have shown that regular stretching does indeed make us more flexible. If we regularly stretch our hamstrings we should be able to reach further (Decoster 2005) Depending on your starting place this may mean you are now able to do up your shoelaces while standing, get further into that pesky forward bend in yoga or win that circus job you have been after.

However what is fascinating is that the reason we can stretch further is probably nothing to do with elongating the muscles permanently. A thorough systematic review of academic studies on the subject (Weppler 2010) proposes that any change in muscle (or connective tissue) length is transient and in fact the only reason we can go further on repeated exposure to stretching is due to an alteration of sensation only. In other words our brains just get used to stretching a little further each time – our resting muscle length remains exactly the same. Bad news for health and fitness magazines promising a “longer leaner body” through stretching!

You should stretch before and after you work out as it prevents injury

Mixed news on this one. There is conflicting evidence as to whether stretching can prevent injury and the somewhat unsatisfying conclusion when reviewing all of the evidence is that stretching “might prevent some injuries in some sports at least some of the time”

There are several authors who have looked at all the research studies out there – for example a systematic review of the literature by Thacker et al (2004) concluded that “Stretching was not significantly associated with a reduction in total injuries”. This is not particularly helpful for the athlete wondering if they should stretch or not before exercising –the authors’ summary of the study ends with the politician’s “we can neither confirm or deny” type advice that:

 “There is not sufficient evidence to endorse or discontinue routine stretching before or after exercise to prevent injury among competitive or recreational athletes.”

Another systematic review (Hart 2005) was less circumspect, concluding baldly “Limited evidence showed stretching had no effect in reducing injuries.”

However it seems that perhaps stretching may help to reduce injury for some sports but not others (Witvrouw et al 2004).  Stretching seems to reduce injuries in sports that involve bouncing and jumping activities with a high intensity of stretch-shortening cycles (SSCs) (e.g. soccer and football]. However when the type of sports activity contains low-intensity, or limited SSCs (eg: jogging, cycling and swimming) stretching may not be helpful in preventing injury. This is seen in the literature, where strong evidence exists that stretching has no beneficial effect on injury prevention in these sports.

Other authors (Woods 2007) suggest that it has been difficult to interpret all the available research due to the number of different stretching techniques used and felt instead  “that certain techniques and protocols have shown a positive outcome on deterring injuries.” They recommend that a warm-up and stretching protocol should be implemented prior to physical activity. The routine should allow the stretching protocol to occur within the 15 minutes immediately prior to the activity in order to receive the most benefit.

Small et al 2008 concluded that although static stretching does not reduce overall injury rates, there is preliminary evidence that static stretching may reduce musculotendinous injuries.

It also seems that stretching as a regular routine rather than just before you exercise is more likely to reduce injury – so going to that regular yoga class may be more likely to reduce your possibility of injury than the short stretching procedure before sports. (Shrier 2007)

Stretching helps prevent and reduce muscle soreness (DOMS)

The research is pretty unequivocal on this one – it doesn’t, or at best only a little bit. A large review of all the relevant studies (Herbert 2011) concluded that:

“The evidence from randomised studies suggests that muscle stretching, whether conducted before, after, or before and after exercise, does not produce clinically important reductions in delayed-onset muscle soreness in healthy adults.”

There was one large study showing that stretching before and after exercise reduced peak soreness over a one week period but this was only by, on average, four points on a 100-point scale. Hardly something to write home about.

Stretching before an event helps improve performance in sport

There is a bit of a shock-horror headline about this one as research over the past decade has suggested that not only does stretching have less impact than previously thought on performance but in some cases actually has a negative impact. That’s right – depending on the sporting event, pre-event stretching may actually cause you to do worse.

This finding specifically applies to sports that require isolated force or power (such as jumping) –in these cases stretching prior to an event can cause diminished performance. This is true whether the stretching technique used is static, ballistic or PNF. So elite basketball players would jump less high if they stretched immediately before playing. Maybe this was the problem in the 1990s movie “White men can’t jump” –perhaps the white guys were sticking too strongly to their pre- event stretching routine!

On the other hand, regular stretching at other times (not immediately before an event) actually improves the results for many sporting activities including enhancing running speed. (Shrier 2004). In other words regular stretching after exercise or at a time unrelated to exercise is more beneficial than your pre-exercise stretching “warm up” routine.

So if you want to improve general sporting performance, get to that regular stretching or yoga class!

Stretching makes you feel good

This is an easy one to prove or disprove as it is firmly based on the scientific foundation of your own personal laboratory. Does stretching make you feel good? Great – do more of it! Do you hate it? Then find another way to exercise or increase flexibility if you need to.

The potential psychological benefits of stretching seem to have been largely overlooked in the research studies as lets face it, academics are usually in pursuit of more “science-y” things to prove. Yet anecdotal evidence suggests that humans love to stretch – it helps us feel more balanced, less tired and is a good form of stress relief. Stretching is the basis of spiritual practices such as yoga – the poses (asanas) help prepare the body for the contemplation of meditation afterwards. Eastern massage practices such as Thai massage and shiatsu incorporate stretching as an integral part of the art. The purposes of these stretches is not to increase flexibility but to promote balance and harmony in the meridians and energy of the body.

One of the few studies conducted on stretching and mood was in a Spanish workplace that implemented a short programme of stretching exercises (Montero-Marín 2013). Findings showed that the programme was effective for reducing levels of anxiety, bodily pain and exhaustion, and for raising levels of vitality, mental health, general health and flexibility. This type of intervention could be seen as a low-cost strategy for improving the well-being of workers.

There are also many studies testifying to the positive effects of the ultimate stretching practice – yoga- on anxiety, depression and well being. There has been growing evidence of therapeutic benefits of yoga for anxiety, depression, dysthymia, obsessive compulsive disorder, alcohol dependency syndrome and to improve cognitive symptoms of schizophrenia. (Panesar 2011)

Stretching is good for musculo-skeletal pain such as a bad back

Good news for stretching here. Many studies have demonstrated the positive effects of yoga on pain (Posadzki 2011). It seems that these effects may also be true for conventional stretching – one study showed that both yoga and stretching classes were more effective than a self care booklet in improving function and reducing symptoms due to chronic low back pain with these benefits lasting several months

So is stretching good for me or not?!

As always the answer is – it depends. A summary of the research evidence suggests that:

  • If you want to prevent injury and improve your sporting performance then regular stretching or yoga is more effective than just stretching before exercise
  • If you do a competitive sport that involves isolated force or power it may be wise to avoid stretching immediately before an important event (although you should still do other warm up exercises)
  • Stretching and yoga is good if you have chronic pain such as a bad back
  • Stretching helps you feel good!

Happy stretching!

References

Hart, L., 2005. Effect of stretching on sport injury risk: a review. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine, 15(2), p.113.

Herbert, R.D., de Noronha, M. & Kamper, S.J., 2011. Stretching to prevent or reduce muscle soreness after exercise. The Cochrane database of systematic reviews, (7), p.CD004577

Montero-Marín, J. et al., 2013. [Effectiveness of a stretching program on anxiety levels of workers in a logistic platform: a randomized controlled study]. Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria, 45(7), pp.376–83.

Panesar, N. & Valachova, I., 2011. Yoga and mental health. Australian and New Zealand Journal of Psychiatry, 45, pp.A64–A65.

Posadzki, P. et al., 2011. Is yoga effective for pain? A systematic review of randomized clinical trials. Complementary therapies in medicine, 19(5), pp.281–7.

Sherman, K.J. et al., 2011. A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain. Archives of internal medicine, 171(22), pp.2019–26.

Shrier, I., 2007. Does stretching help prevent injuries ? Evidence Based Sports Medicine, pp.97–116.

Small, K., Mc Naughton, L. & Matthews, M., 2008. A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Research in sports medicine (Print), 16(3), pp.213–31

Thacker, S.B. et al., 2004. The impact of stretching on sports injury risk: a systematic review of the literature. Medicine and science in sports and exercise, 36(3), pp.371–8.

Witvrouw, E. et al., 2004. Stretching and injury prevention: an obscure relationship. Sports medicine (Auckland, N.Z.), 34, pp.443–449.

About Rachel Fairweather and the Jing Institute

Rachel Fairweather is co-founder and director of The Jing Institute of Advanced Massage Training – an organisation dedicated to excellence in all aspects of postgraduate massage training. We are dedicated to helping massage therapists have the lifestyle and business you deserve. Based in Based In Brighton, London, Wigan, Kendal and Edinburgh, we offer courses around the country including London and Edinburgh. Our courses include longer qualifications in advanced massage including our revolutionary BTEC Level 6 (degree level) in Advanced Clinical and Sports massage and 1-2 day CPD courses in Marketing, Hot Stone Fusion, trigger point, myofascial release, stretching, pregnancy, on site, living anatomy and many others.

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