Is stretching useful?

05.Stretch.NationalMall.WDC.10apr06Today we have a guest post from author Alex Hutchinson.  Alex writes a monthly column in Runner’s World (they also host his excellent Sweat Science blog) and is a Senior Editor at Canadian Running magazine.  You can find more on Alex at the bottom of this post.

As Alex mentions below, he recently published a fantastic book which has a rather large section on the health benefits of stretching (or lack thereof).  As a longtime skeptic of stretching myself, I was very excited when he agreed to summarize the research evidence in a guest post.  Enjoy the post!

I guess I should start by stating my bias: I don’t like stretching. For over a decade, I stretched every day, usually twice a day – but I never enjoyed it. I still try to be as impartial as possible in analyzing the evidence for and against stretching, but I figure you have the right to know that I’m a stretching skeptic!

So what is this evidence I refer to? Over the past decade or so, there has been a complete change in how coaches and exercise scientists view stretching. It’s the biggest change in elite training that I’m aware of during that time, and these days it’s the biggest gap between elite athletes and the average person at the gym. I devote an entire chapter to the topic in my recent science-of-exercise book, Which Comes First, Cardio or Weights?, and I’m going to draw on that to present a few highlights of the recent research.

1. Does stretching help you avoid injury during exercise?

This is very difficult to “prove” one way or the other, because every person and every injury is unique. Still, a 2004 systematic review that analyzed 361 studies concluded that “stretching was not significantly associated with a reduction in total injuries.” Other reviews have reached similar conclusions. The early studies that suggested stretching would help always included stretching as part of a warm-up; it now appears that a warm-up (e.g. five minutes of gentle jogging) is important but stretching isn’t.

2. Does stretching help you avoid soreness after exercise?

No. A 2011 Cochrane review of 12 randomized studies with more than 2,000 subjects in total concluded that “muscle stretching, whether conducted before, after, or before and after exercise, does not produce clinically important reductions in delayed-onset muscle soreness.” This is not a surprise: post-exercise soreness is thought to result from microscopic damage to muscle fibres; you can’t “undamage” the muscles by stretching them.

3. Does stretching make you faster, stronger, or more powerful?

Quite the opposite, actually. A number of studies have found that stretching your muscles leaves them weaker and less powerful for somewhere between 30 minutes and two hours. You can’t jump as high and you can’t sprint as fast, possibly because you’ve disrupted the nerve signals from the brain to the muscle (after being stretched against their will, the muscle fibres basically put the brain on “mute”). And if you go for a longer run or bicycle ride, you’ll run slower at the same effort.

This doesn’t just apply to stretching immediately before a run, incidentally. Several studies have looked at correlations between “sit-and-reach” flexibility and running economy (which is like a car’s fuel economy, a measure of how much energy it takes to travel at a given speed). The consistent finding is that the more flexible you are, the less efficient you are as a runner. One theory is that, since your legs act like coiled springs while running, returning 40-50% of the energy you need for each stride, stretching gives you “floppy” springs that can’t store energy as well.

4. But what if I like stretching?

Then stretch away! None of this evidence really offers a compelling reason not to stretch, unless you’re an elite athlete worried about the milliseconds that could make the difference between glory and disgrace. Stretching will make you more flexible (which is pretty nice if, say, you every have to sit cross-legged on the floor), and it will also offer a little bit of strengthening. And for many people, it just makes them feel good.

And there are certain situations where stretching really is important. If you’re a ballerina or a hockey goaltender, extending your maximal range of motion is part of your job – stretching is not optional. But if you’re a runner, the injuries you should be worried about aren’t going to result from trying to do the splits.

5. So how should I prevent injuries?

The first and most important thing is a gradual warm-up. Whether it’s jogging, biking, skipping, skating, or whatever, take at least five minutes to get your heart pumping and your muscles warm. This will do precisely what we used to assume stretching would do: make your muscles softer, looser, and more flexible, simply because of the temperature increase.

That may be enough. But for vigorous activities, you may then want to do some “dynamic stretching.” Unlike traditional static stretching (which is what I’ve been talking about above), dynamic stretching involves movement, and focuses on taking the muscles you plan to use through their usual range of motion and a bit beyond (but not to their maximum range of motion). This article has three simple examples that I use before running a hard workout.

Ultimately, as I said above, the current body of evidence doesn’t make a convincing case that nobody should stretch. So if you enjoy stretching, by all means carry on. But as far as I can see, there’s no compelling reason than anyone should stretch if they don’t want to. And even better, for those of you who could never be bothered to stretch in the first place, you can stop feeling guilty about it.

Alex Hutchinson

About the author: A former quantum physics researcher and national-team distance runner, Alex Hutchinson blogs about the science of training and fitness, and writes the monthly Fast Lane training column in Runner’s World. His latest book is Which Comes First, Cardio or Weights?  You can follow him on Twitter and Facebook.

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23 Responses to Is stretching useful?

  1. John H says:

    On the other hand, the detrimental effect of static stretching on maximal strength seems limited to very long duration (>60s) stretching.

    http://www.ncbi.nlm.nih.gov/pubmed/21659901

    The joint and tendon issues that having tight muscles cause are not imaginary either. If you can get away without stretching, more power to you.

    J

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    • Travis says:

      Thanks for that link, John.

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    • Thanks for the link, John. A couple of quick comments:

      (1) This review only looks at muscular strength and power, so it doesn’t say anything about the findings related to activities like running and cycling. The main study that found a performance decrease in endurance running after static stretching used stretches held for 30 seconds.

      (2) I have a hard time understanding how they come to such firm conclusions about the lack of effect of shorter (30-45 seconds) stretches on strength and power. For example, according to their own summary, the 8 studies looking at strength after 30-45s stretch found a pooled average decrease in strength of 4.2 +/- 2.7 %. I agree that, for most people, a decrease in strength of a few percent during their workout doesn’t matter. But it seems pretty clear that those decreases do exist.

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  2. Neal W. says:

    Using strength training as your stretching is the best form of flexibility training. For example, if you want to increase hamstring flexibility, one really great exercise is the stiff legged deadlift as opposed to a passive standing pike stretch. You want to build lots of strength through the range of motion, which is what the stiff legged deadlift will do and the passive pike stretch will not.

    In the future, studies should look at how flexibility training according to these guidelines differs from traditional passive-static flexibility training on outcomes in injury prevention and performance.

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    • Josh Duke says:

      hmmm.
      Not sure about this.
      What about all the NFL players having pectoral muscle tears from the bench press? Certainly one would think they were properly warming up and building the weight up gradually set by set?

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  3. Devin says:

    Do you know if there have been any studies done on the long term impact of stretching? The studies cited above seem to only address the short term effects of stretching on injuries and performance. Ie. “If I stretch before this workout, how will it affect my chance of injury and performance in this workout?”

    It seems to me the more relevant question is
    “If I stretch before every workout, how will it affect my long term chance of injury and my long term performance?”

    It’s not obvious to me that the answer to the second question will be the same as the answer to the first, and it’s the second one that is more relevant to anyone in sports. The gains in flexibility over time could offset the slight increased risk of injury due to stretching immediately before working out. Which may in turn imply that stretching reduces the risk of injury, but shouldn’t be done 2 hours (or so) before a hard workout. Similar questions arise for performance, does the increase in flexibility offset the temporary loss in performance? Does stretching before or after (or completely separate from) weight lifting have any long term impact on strength and muscle mass gains? Given that growth is due to microscopic muscle damage, it’s plausible that stretching immediately after lifting enhances this damage, therefore increasing muscle gain.

    Note: I haven’t read the studies cited above in detail, I’m just going by the summary given here.

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    • Travis says:

      All good questions, and as far as I know they are without any clear answers at the moment (more knowledgeable folks please feel free to jump in). I went to a session at ACSM a couple weeks ago examining the evidence for and against stretching, and the real take-home message for me is that the evidence isn’t great either way. Right now the evidence suggests to me that it’s not very useful for injury prevention or performance benefits, but there haven’t been many high quality studies looking at stretching, so it’s hard to be certain.

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      • Devin says:

        That’s been my impression of all the studies I’ve read (or read about) on the subject, with the caveat that they all have attempted to address the first question in my previous post, rather than the second.

        If you ever come across something addressing the long term effects of regular stretching, I hope you’ll make a post about it. I don’t often come across papers on the subject, unless they’re covered on one of the blogs I read.

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        • Thanks for the comments, Devin. Just to clarify, the injury studies I’m referring to weren’t “one-shot deals” where they looked at injury risk during a single workout following (or not following) stretching. They typically followed subjects for somewhere between a few months and a year to observe cumulative injury risk — so they were, to some degree, addressing your second question.

          Still, the evidence is very weak either way: it’s certainly doesn’t “prove” that stretching can’t help reduce injury risk. But for me, the question is: shouldn’t the burden of proof be to show that a time-consuming intervention actually has a benefit, rather than to prove that it doesn’t?

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          • Josh Duke says:

            Well it seems to me, that if you actually do have some tightness in your muscles, and then you warm-up and stretch.. and you can feel your muscles loosen and increase in range of motion, that this (naturally) is going to help.

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  4. David says:

    The “This article” link is broken.

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    • Travis Saunders, MSc, CEP says:

      Thanks David. It looks like it’s been taken down from the Globe website, but I’ve updated the link to the Google cache of the article.

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      • Ugh – sorry about that, guys. The Globe just relaunched their website, and seem to have (temporarily?) removed most of my past articles. Unfortunately, the cached version of the article doesn’t have the illustration of the stretches I was hoping to show. My apologies.

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  5. Jason Amsden says:

    For some really good information about stretching – or as Kelly Starret would rather call it “mobilization” see http://www.mobilitywod.com

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  6. Ironically enough, I was recently prescribed stretches by two practitioners separately — my doctor and my dentist — for specific ailments, and they really seem to have helped.

    I had minor but annoying neck and shoulder pains which my doctor said were typical of office workers spending many hours hunched at a screen. Some rather unusual cervical spine and shoulder stretches were given to me on a Xeroxed sheet. I started practicing them in the mornings before going to work and they made a huge, huge difference.

    I also had this feeling like my jaw was coming unhinged and it was really painful to either chew with it unhinged, or else even more painful to pop it back in again. Instead of dealing with that all the time, my dentist prescribed me some simple jaw and shoulder stretches. Those really, really helped reduce the incidence of the problem, but I think using a prescribed grind-guard at night (my dentist hates the non-prescription softer ones) seems to have really eliminated the problem.

    My 2-cents. Maybe stretches don’t help your athletic performance much, but from my recent experience they really seem to help rehabilitate or work-around certain damages, in the form of aches and pains. I recall being very relieved that my doctor was not trying to prescribe me some new dang painkiller pill or unnatural high-tech solution for what were ultimately very, very simple problems. Now, if only there were some kind of stretch to tighten up the neck tissue and prevent sleep apnea… (the CPAP machine, for example, is exactly what I think of as an “unnatural high-tech solution to a simple problem”)

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  7. Michelle says:

    I think this is a great article and it’s good to question the validity of what we have just blindly accepted for so long. This is how I see it;

    In its most basic form, stretching is a natural and instinctive activity; it is performed by humansand many animals. Stretching often occurs instinctively after waking from sleep, after long periods of inactivity, or after exiting confined spaces and areas. When I hear the arguments on whether to stretch or not to stretch, I feel like it’s trying to prove whether we really need to drink water or whether we really need to exercise. It’s a natural, instinctive activity and I can only speak from personal experience the benefits I see with stretching.

    There are many factors and reasons for reduced joint ROM only one of which is muscular tightness. Muscle “tightness” results from an increase in tension from active or passive mechanisms. Passively, muscles can become shortened through postural adaptation, disuse or scarring; actively, muscles can become shorter due to spasm or contraction. Regardless of the cause, tightness limits range of motion, preventing you from getting that reach for the ball, kick on the field, triangle in BJJ or other movement requirement in sporting or daily life, can lead to injury in a compensatory area and may create muscle imbalances where other areas are forced to do the work in a preferably functioning state.

    It is important to keep in mind that not all stretching is created equal, and yes I do believe there is a load of BS out there. I also am not a fan on any sole form of Yoga, although I do adopt parts from different styles and use those that I find most effective. Some forms of Yoga are extreme and many practices do not focus on individual differences or acknowledge all body areas. For example, in many Yogic practices, hamstring stretching is generally favoured over quadriceps stretching, the pecs are usually not thoroughly addressed, suboccipitals, forearms and key neck muscles are usually not addressed, and the list can go on. A student may also be in the class who already has an anterior pelvic tilt and hamstrings that are already too loose, meaning to stretch further will do nothing more than further destabilise their pelvis. Similarly there are many students attending Yoga classes who are hypermobile (women are more susceptible) and strength work would really be preferable. Hormonal changes within the female monthly cycle (not to mention pregnancy) also influence joint laxity and care should be taken to prevent joint destabilisation and aggravation. I have taken parts of Yoga that work for me, parts of what I experienced as a dancer growing up, parts of what I have learnt with exercise physiology and also what I have learnt with physical therapy to include not only stretching of the muscle, but stretching of the fascia and neural structures as well.. where appropriate!

    I have read the research too and agree that stretching won’t positively affect DOMS (how could it as I agree with your point!), it can inhibit strength, strength endurance and power performance as it has a sedating effect on the nervous system.

    My take home message is basically that
    1. Stretching may not affect muscle soreness but I personally believe it helps with the recovery process, just the same way that massage and contast baths are recommended for sports recovery as they alter blood flow to the muscles and help remove accumulated waste products.

    2. I believe it is important for maintaining muscle length, even if it does not actually lengthen muscles. I also believe it is important for muscle and joint health.

    3. I believe stretching is warranted for those sports that require a certain level of flexibility and joint ROM to prevent injury.

    4. I believe the benefits of stretching may actually be due to the idea of ‘moving energy around the body’ (it sounds alternative I know) in a similar way that accupuncture (if you believe in it) can heal.. since muscle fascial lines have been shown to parallel ody meridians.

    5. I believe any static stretching prior to exercise should include those muscles that are already tight and inhibited, such as commonly seen with pec minor as an example, since its normal level of chronic tension can otherwise reduce the performance of its antagonist via reciprocal inhibition, or can alter muscle recruitment in surrounding muscles.

    When I stretch, I generally stretch a couple of chronically tight muscles pre-workout, sometimes more statically sometimes more dynamically, and keep my main stretching sessions separate from my workouts.

    Good ideas to consider are; the use of static stretches immediately before bed to calm the nervous system and promote a more restful sleep; use dynamic stretches pre-workout ; allow your strength training to improve your flexiblility by performing movements full-range (within individual ability) and as a general rule of thumb, stretch those muscles that are found to be short and stiff rather than going yoga full macho.

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    • Travis Saunders, MSc, CEP says:

      Thanks for the detailed comment, Michelle!

      Just a couple points that I found interesting (I’m a skeptic about acupuncture and meridians, so I’m just going to leave those aside :))

      tightness limits range of motion, preventing you from getting that reach for the ball, kick on the field, triangle in BJJ or other movement requirement in sporting or daily life,

      I agree to a point, but just wanted to point out that this is *very* sport dependent. As Alex mentioned in the post, the required range of motion for a ballerina is very different from the range of motion required from me as a distance runner/recreational road hockey player. If a person’s flexibility is such that they cannot perform their favourite types of exercise or activities of daily living, then stretching (or anything else that increases flexibility) will definitely help. But short of hyperextending my knee, a bit more hamstring flexibility is not going to help me get the ball before my competitor.

      I personally believe it helps with the recovery process, just the same way that massage and contast baths are recommended for sports recovery as they alter blood flow to the muscles and help remove accumulated waste products.

      Interestingly, the evidence on these factors is surprisingly weak as well (it seems like common sense that they should help, but that common sense seems to be wrong). We actually had a guest post by a researcher in this area a few years ago (http://www.obesitypanacea.com/2009/07/massage-post-exercise-aiding-or.html). Speaking from experience, contrast baths and/or massages certainly make me feel better after a hard workout, but there’s not much evidence that they actually speed recovery (that’s not to say that it’s 100% certain that they don’t help recovery, just that there’s not much evidence so far to support it, and the mechanisms we always pointed to don’t seem to be the ones at play).

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    • Josh Duke says:

      You know really, again.. from MY experience.. stretching simply makes me feel better because it appears to undo “knots” and sore spots within my muscles.. I know “common sense” isn’t reason enough to say it works. However.. I do know that when, say, I’ve been training for a marathon, and I’ve gotten in a 20 miler.. my calves and quadriceps are stiff and sore. After a cold bath, and a bite to eat, I return to a warm bath and begin to massage and stretch out a bit. Then, out of the bath, while still warmed up, I do 5 minutes or so of stretching. It always helps.. or atleast makes me feel better.

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  8. Pingback: Is stretching useful? « Dr. Brian Grady’s blog

  9. Josh Duke says:

    I want to avoid making an argument from experience.. however..

    I’ve been a distance runner for 13 years and have logged a load of miles. I’ve also had my share of injuries.

    The question is this.. and I’ll give two examples:

    If I had stretched more, might I have avoided that groin pull during that very hard 10k with the steep downills?

    If I had stretched more when I noticed my calf was feeling “stiff” for about a week, would I have not avoided tearing a calf muscle?

    The point here is this.
    Stretching for me, works as an injury preventer and upon returning from injury. You don’t have to be a ballet dancer for stretching to be very useful.

    Now, before EVERY run, I soak, massage and stretch my calves and hamstrings in hot water for about 10 minutes.

    As a result, my range of motion is improving, and I know that my calves can handle the hills and hard runs.

    I tore my calf in October, didn’t run again till December, and haven’t had any problems since, after beginning my stretching routine.

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  10. Pingback: Surprising Exercise Science: What’s The Use Of Stretching? - Better Health

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