Stretching Part 3: Take-Home Points and Conclusion From Work-Fit Total Therapy Centre in Oakville
The controversy over what stretching technique to use, how long one should use the technique, and how frequent should the technique be used is very evident given the information that I have provided in this three part series. The lack of clear cut answers can generally be attributed to lack of quality research available to answer some of the above questions. However, the following major points can be made as a review of the material alluded to in this three part series:
1. the increase in ROM experienced with any stretching protocol is likely due to an increase in tolerance to the discomfort associated with the stretch rather than an actual increase in extensibility of the muscle tissue itself;
2. regular stretching will result in an increase in performance markers such as isometric force production and velocity of contraction but will have no effect on the efficiency/ease of movement
3. acute/pre-exercise stretching does not have a positive effect on performance markers but is associated with an improved running economy/efficiency. Therefore, acute stretching prior to leisure running may be of benefit but is not recommended in advance of performance dependent sporting activities;
4. it appears that a single 30-second stretching bout once a day may be the most effective practice and that periods greater than 30 seconds are no more effective; this however is dependent on the individual who is performing the stretching and serves as a general recommendation. Therefore, adjust the duration of stretching accordingly.
5. in terms of modalities such as ice or heat applied prior to stretch, it does not matter as both appear to improve the outcome of a stretch not by affecting tissue temperature but by adding to the analgesic effect of the stretch;
6. if the main objective of stretching is to prevent injury, then the recommendation would be to eliminate the stretching and increase the warm-up; therefore, it would be a better idea to spend time performing a thorough warm-up, and not so much time stretching prior to activity. However, as mentioned above, it is dependent on the activity that is being performed and the goals of that activity.
7. Finally, due to poor quality research, a recommendation on the optimal stretching technique that would allow for the most efficient increase in ROM is difficult to develop. The focus should be on duration, frequency, and individuality of the stretching protocol rather than a blanket recommendation.
In closing, it is hoped that this three part series has provided some enlightenment on a topic that many trainers/therapists recommend often based on traditional strength and conditioning practices rather than evidenced-based practice. With an increase in research dedicated to the seemingly simple topic of stretching, we will soon have clear cut answers to some of the remaining questions that I have outlined above. For now, if someone asks you about stretching in terms of incorporating it into a general exercise regiment, the one thing you can say with certain is that “it depends.”
If you have any questions or comments on this topic or any other topic related to neuromusculoskeletal health, please feel free to contact me at firstname.lastname@example.org or visit www.workfitphysiotherapy.ca
Hollie, F., Simon, D., Harvey, L. A., and Gwinn, T. (2006). Can apparent increases in muscle extensibility with regular stretch be explained by changes in tolerance to stretch? Australian Journal of Physiotherapy 52: 45-50.
Magnusson, S. P., Simonsen, E. B., Aagaard, P., Sorensen, H., and Michael Kjaer, M. (1996). A mechanism for altered flexibility in human skeletal muscle. Journal of Physiology 497(1): 291-298.
Shrier, I. (2004). Does Stretching Improve Performance? A Systematic and Critical Review of the Literature. Clinical Journal of Sports Medicine 14: 267–273.