Optimizing Stretching for Injury
Abstract & Commentary
Synopsis: Static stretching has a positive short-term effect on muscle length that is lost when stopped.
Source: Willy RW, et al. Effect of cessation and resumption of static hamstring stretching on joint range of motion. Journal of Orthopedic and Sports Physical Therapy. 2001;31(3): 138-143.
The purpose of this study was to address 2 basic questions regarding the "best" way to perform static stretching. Specifically, does static stretching have an effect at all on muscle length (as measured by range of motion)? If so, does that positive effect last over a specific period of time? Eighteen college-age subjects (mean age, 21 years; 12 males, 6 females) volunteered for the study. Selection criteria included short hamstrings (defined as a knee angle of less than 160° with the hip at 90° while the patient is supine). Both right and left lower extremities were included in the study. The study lasted 16 weeks and variables controlled for during that time included lower extremity stretching and other exercise during the course of the study. The first 6-week period was the initial stretching period, followed by a 4-week cessation period that was in turn followed by a resumption of a stretching period for 6 weeks. Flexibility measurements were performed at the end of each period. These measures were performed with the patient supine as previously described. Hip and knee positions were verified with goniometry. Stretching was performed for 30 sec ´ 2 with 30 sec of rest in between. Results indicated that during the first stretching period, there was a significant (P < .05) increase in knee range of motion (143 ± 11.1° to 152 ± 9.4°). However, this range was not maintained during the cessation period. The third resumption of stretching resulted in an increase in range of motion similar to the initial stretch period.
Comment by Clayton F. Holmes EdD, PT, ATC
Stretching is one of the most common interventions used in sports and sports medicine. While this intervention has long been thought to be effective in prevention of an initial injury and as part of the treatment of sports injuries, relatively little consistency exists with regard to application of stretching. Characteristics that are often varied include: when (pre- and/or postexercise or treatment); how much (repetitions and sets); how long to hold a stretch (5 seconds, 30 seconds, etc); how often (daily, etc) and type (static, ballistic, etc). In addition, questions exist with regard to how long a positive effect lasts. The results of this study indicate that any positive effect of static stretching appears to be relatively short-term in nature. The implications with regard to exercise prescription are clear. Anyone prescribing stretching as a preventive measure or after an injury should realize that the stretching should become a habit of the athlete—one that continues throughout the athlete’s career and, hopefully, beyond. It is critical to note that this study does not report that the stretching had no effect. In fact, the opposite is true. The stretching regimen did have a positive effect on knee range of motion after each stretching period. This finding is consistent with previous literature.1 It should also be noted that Willy and colleagues used a protocol that has been previously described in the literature. For example, 30 seconds does seem to be the optimal time with which to hold a static stretch.2 In addition, it should be noted that previous literature has reported that length gains can be maintained by stretching as little as once a week.3
References
1. Bandy WD, Irion JM. The effect of time on static stretch on the flexibility of the hamstring muscles. Physical Therapy. 1994;74:845-852.
2. Bandy WD, et al. The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Physical Therapy. 1997;77:1090-1096.
3. Wallin D, et al. Improvement of muscle flexibility. A comparison between two techniques. Am J Sports Med. 1985;13:263-268.
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