Stretching – Are You Doing it Right? An Evidence-based Approach on the Latest Research and Information on Stretching.
Before exercise, after exercise, in a morning, on your days off, even a yoga class – stretching has always been a part of exercise and it’s a great way to help prepare us for activity, reduce tightness and ease stiffness in joints – at least that’s what we think it does.
Stretching can be a bit of a chore and often we feel compelled to do it as it appears to be deep rooted in the culture of exercise and even life. As new evidence emerges its showing some very different viewpoints in regard to stretching and it could change the way in which you view stretching and its uses.
This blog is going to review some of the latest findings in research to show what stretching is and isn’t doing and shattering some long-held beliefs. The way we look at stretching is changing – get to know the facts and decide how you will use stretching going forward.
What is stretching and its different types
Stretching can be defined as:
“a form of physical exercise in which a specific muscle or tendon (or muscle group) is deliberately flexed or stretched in order to improve the muscle's felt elasticity and achieve comfortable muscle tone.” (Weearpong et al 2004)
Within stretching there are different techniques known as static and dynamic:
Static stretching is as the name suggests – a still hold of the limb at its furthest range to facilitate a stretch. A passive static stretch can also be performed if another person holds the limb for you and takes the limb further for you to create a greater stretch.
Dynamic stretching is a movement-based stretch aimed at increasing blood flow throughout the body while also loosening up the muscle fibres. Standard dynamic stretches are typically performed prior to exercise to help warm-ups – movements include lunges, walking calf raises and movement-based hamstring stretching.
Stretching in society and current beliefs:
- We wake in the morning feeling a little bit tight and stiff (unless you’re lucky enough to be young) and one of the best ways to get us feeling better and a bit looser is to have a stretch! This for many people is part of their daily routines and can often help us feel a bit looser at the start of the day. Remaining still all night can develop soreness and tightness in certain areas.
- Pre exercise stretching - now we’ve all done it or maybe we haven’t but if you’ve been involved in exercise, the culture and routine is to perform some stretches to warm-up.
- Post exercise stretching - stretching that is done with the belief to help reduce soreness developing in the days following activity.
- Stretching based exercise - yoga!
- Improving flexibility - if you feel that you are lacking flexibility, sometimes stretching may seem like a good option to increase your movement. It’s important to realise why you would be stretching and is your flexibility actually limiting you from doing what you need? Or do you compare your flexibility amount to someone else’s. If your body is working and functioning well, flexibility may not be that important.
- Physiotherapy / Rehabilitation - a common factor in most rehab plans given out by therapists. Some stretching is needed at certain times of recovery which help to control pain levels. Personally, some stretching is needed but only in early stages of recovery to help manage pain, but strength-based rehab stands up in the evidence better for recovery from injury.
The hard, stiff stretching facts about anatomy
Now if one of the reasons you are stretching is to improve your flexibility or range of motion in a certain body area then you may want to keep reading. The body is stiff and tight in certain areas – because it needs to be! Places like the thoracic spine and lumbar spine are designed to be robust in nature to help protect the vital organs and structures inside that keep you functioning and alive. The body is an intelligently designed for a reason.
Having an unhealthy target of improving your flexibility to match that of your yoga instructor or someone you’ve seen on Instagram just isn’t attainable or healthy for that matter.
Some great examples of muscles that can’t be stretched properly are:
Glute max – when pulling your knee up you would need to take it further than your stomach – which is impossible.
Quadriceps – unable to gain a proper stretch due to the knee hitting its end range of movement. When you do a quad stretch it only stretches around 15% max of the muscle length the rest is barely stretched.
IT Band – first off, it’s not a muscle, secondly, it’s a band of fascia which has a tensile strength similar to that of steel…good luck.
There are many more examples of muscles and tendons in the body that are either impossible to stretch or that are barely stretched but common beliefs remain regarding stretching body parts, especially for rehab reasons.
Remember, it may feel like a stretch and it may be a small one but is it actually ‘stretching & lengthening’ your muscle – in short, no, it’s biomechanically impossible.
The research – how this changes your perception of stretching for different aims:
- You may have heard people say that it is important to stretch after you work out to help reduce your post exercise soreness which you suffer in the following days. A study done in 2002 on this subject by Herbert & Gabriel (1) have shown that stretching post workout has no significant effect on your soreness levels or reducing your injury risk. Discomfort post exercise is usually caused from the intensity of the activity and how capable your body is at dealing with it – stretching does not affect this.
- Stretching does not show benefit in soldiers for their lower limbs and even increased risk of injury in some participants (2) during a large-scale study in 2000. Some of the study even showed that it increased injury risk!
- Stretching for warm-ups is pointless (3) This paper in 2011, looked at 4500 studies before narrowing it down to about 100 to look at in more detail. They found “overwhelming evidence” of “no significant effect,” and that is certainly no surprise to me who has been looking at evidence on this topic for a while.
- Stretching in football has always been common place – times have changed but for the most part it remains a common factor in the hobbyist or grassroots scene as a warm up prior to football. Multiple research papers (4, 5, and 6) show there is no benefit on performance or reducing injury risk. FIFA have implemented all of the recent evidence to produce a warm-up and injury prevention program for youth football – which includes no stretching at all and is based upon muscle activation and joint mobility – this prepares the body for what it is ready to do. Stretching can switch the muscle off and make it underprepared for exercise.
- Stretching and weightlifting has also been a popular topic in gyms. In a 2016 study (9) of female athletes stretching during squat sessions – it did not improve squat performance and a 2014 study (10) on university students (men and women) that showed stretching before and during weight lifting exercise had a significant impact on strength and performance of each of their lifts – sometimes up to 28% loss of strength performance!
- Now if you run, it is more than likely that you typically perform a few pre run stretches which are short in nature and consist of calves, hamstrings and quads. Research (7) on runners and pre run stretching did not show any benefits for performance whatsoever based upon the evidence.
- Now if you have been diagnosed with ITB syndrome or runners knee involving the IT band – you may have been advised to stretch the IT band or foam roller it. Pointless. Ingraham in 2017 writing for Pain Science (8) following a comprehensive review of evidence states IT Band stretching does not work, it is a popular idea, but it’s very hard to do it right, and it’s probably not worth it he concludes. See earlier regarding the nature of the IT band and how it is impossible to stretch.
- Cool downs – a comprehensive review of the literature in 2018 (11) which reviewed active cool down methods including; stretching, foam roller, a reduced exercise intensity, water based activity, and passive cool downs which means doing nothing after exercise, had no impact on a variety of markers. The research shows that no significant effect on recovery, performance, stiffness, soreness, muscle damage, cardiovascular markers and injury risk. This study included a large evidence base and it concludes that cool downs aren’t very effective after exercise.
Mobility Exercise Examples
Hip Mobility In and Out
Leg Swing Side
Muscle Activation Examples
Single Leg RDL
Squat with Band
Clam with Band
Hip Abduction with Band
Drawing the Sword with Band
Bilateral Abduction with Band
Upright Row with Band
Bench Row with Band
Put simply, there are better things that could benefit you more than stretching. Stretching is great when implemented in the acute stage of injury to help minimise the pain, after this we should then follow a specific strength rehab plan for long term recovery. A good warmup does not need to focus on stretching as the evidence proves ‘stretching for warm-ups is pointless’. A good warm up should consist of a good mobility and muscle activation movements. Cool down stretches aren’t very effective after exercise and there is no significant effect on recovery, performance, stiffness, soreness, muscle damage, cardiovascular markers and injury risk. Therefore, we advise that your cool down gradually brings your heart rate down, allowing time to recover and help blood to return to the heart without any blood pooling.
During weight training in the gym avoid any static stretching before or during exercise as this will have a negative effect on your performance. Always remember to include mobility and muscle activation movements as part of your warm up.
Strength training, mobility work and sports massage is a good combination to help aid recovery.
All of our exercise prescription photos and videos in this blog came from our clinical software Rehab My Patient.
- (Herbert RD, Gabriel M. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. BMJ. 2002 Aug;325(7362):468. PainSci #57209.
- Pope RP, Herbert RD, Kirwan JD, et al. A randomized trial of preexercise stretching for prevention of lower-limb injury. Medicine Science in Sports Exercise. 2000 Feb;32(2):271–7. PubMed #10694106.
- Kay AD, Blazevich AJ. Effect of Acute Static Stretch on Maximal Muscle Performance: A Systematic Review. Med Sci Sports Exerc. 2011 Jun 8. PubMed #21659901.
- Hart L. Effect of stretching on sport injury risk: a review. Clin J Sport Med. 2005 Mar;15(2):113–113. PubMed #15782063.
- Soligard T, Myklebust G, Steffen K, et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ. 2008;337:a2469. PubMed #19066253. PainSci #56160.
- Soligard T, Nilstad A, Steffen K, et al. Compliance with a comprehensive warm-up programme to prevent injuries in youth football. Br J Sports Med. 2010 Sep;44(11):787–93. PubMed #20551159. PainSci #54998.
- Pereles D, Roth A, Thompson DJ. A Large, Randomized, Prospective Study of the Impact of a Pre-Run Stretch on the Risk of Injury in Teenage and Older Runners. USATF.org. 2011 Jun 15. PainSci #55243.
- Pain Science - IT Band stretching does not work 2017 – Pain Science.com
- Heisey CF, Kingsley JD. Effects of Static Stretching on Squat Performance in Division I Female Athletes. Int J Exerc Sci. 2016;9(3):359–367. Published 2016 Oct 1.
- Acute muscle stretching inhibits muscle strength endurance performance AG Nelson, J Kokkonen, DA Arnall - The Journal of Strength & Conditioning 2005 - academia.edu
- Van Hooren, B., Peake, J.M. Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports Med 48, 1575–1595 (2018). https://doi.org/10.1007/s40279-018-0916-2