‘SHOULD I STRETCH BEFORE EXERCISE? WHAT ABOUT AFTER? DID I GET INJURED BECAUSE I DIDN’T STRETCH ENOUGH? HOW MUCH SHOULD I STRETCH AND HOW OFTEN?’

These are common questions health professionals get asked and a simple Google search can provide lots of different answers, but what does research say is the correct answer? We’ve often been told by health professionals, coaches and gym instructors that ‘we need to stretch’ more, but why?

The aim of this blog is to unpack some common questions and to see how research answers them:

1. Will stretching help my pain? I recommend reading our blog post ‘What is pain?’ before continuing if this is an important question to you.
2. Will stretching prevent injury?
3. Do I need to stretch? What benefits will it provide me?

In this blog, we’re going to be focusing on static stretching (the kind you often do at the end of a fitness class), where you hold part of your body in a stretched position for a given period of time. Static stretching has historically been prescribed to ‘increase flexibility’.

Will stretching help my pain?

If you’ve read our blog post ‘What is pain?’ you will hopefully have learnt that pain is complex and that there are many factors that contribute to it. As there are so many accumulative reasons why someone may experience pain, to reduce the solution down to just ‘you need to stretch this area more’ is insufficient. Our bodies are so much more than pulleys and levers, they’re highly complex organisms capable of adapting to their environment. This is a good thing. It means we don’t always need to rely on external aids to heal us – we can do it ourselves.

There is some research that stretching can have beneficial effects on pain such as ‘non-specific’ neck pain (Ylinen, Kautiainen, Wirén & Häkkinen, 2007) and back pain (Khalil et al., 1992). However, there is also a clearly stated lack of research supporting commonly believed ‘benefits’ of stretching such as that stretching your hamstrings can help with lower back pain (Hori, Hasegawa, Takasaki, 2019).

Pain and preference to stretching is so individual that perhaps it’s not the stretching itself that is important, but finding enjoyable movement through the body. This movement can sometimes be achieved in stretching if you enjoy it and can tolerate how it feels, but it could also be achieved by doing other enjoyable activities such as going for a walk with your family or playing in the backyard with your kids.  

Will stretching prevent injury?

‘You need to stretch before/after exercising or else you’ll get injured’ – something I was continuously told throughout my adolescence in a variety of sports.

For advice so often given, I was surprised to find the literature did not show significant evidence to support it. In 2004, a systematic review found that there was not enough evidence to endorse or stop stretching either before or after exercise (Thacker, Gilchrist, Stroup & Kimsey, 2004). For competitive and recreational athletes, stretching before exercise was not found to reduce risk of muscle injury (Shrier, 1999).

So basically, the review of literature is not saying to stop or start stretching, but rather that it’s probably not as important as we once thought. In fact, more current research is now suggesting it should be prescribed on an individual basis, rather than broadly given to many (Lewis, 2014).

To dig even deeper, there is strong evidence that other factors such as poor cardiovascular and muscle endurance are risk factors for injuries (Nuzzo, 2019). So, if you’re time poor or want to train as efficiently as you can, these might be the areas you would preferentially focus on to reduce risk of injury.

Do I need to stretch? What benefits will it provide me?

As ‘do I need to stretch?’ is often asked because of the reasons above, you will see that it is not a necessary component in living a pain and injury-free life. However, if it feels good and you enjoy doing it, this is an adequate reason to continue.

Some benefits to static stretching may include increased range of motion (Behm & Chaouachi, 2011). However, this is potentially because of increased tolerance to discomfort of stretching rather than actual changes to tissues (Muanjai, 2017).

Perhaps the greatest benefit of stretching is that for some it can be a stress reliever. After a stressful day of work, it can feel nice to unplug from the computer, slowdown and spend some time moving areas that you haven’t had the chance to move throughout the day. Finding movement that feels good can sometimes be difficult, so if you have found that stretching works for you and feels good - this alone is a fantastic reason to continue.

The science tells us that if you enjoy stretching and find benefit in it - then go for it. There’s no harm in continuing to stretch and it can be enjoyable taking the time to relax and enjoy moving your body. However, claims that stretching one part of your body prevents pain in another, reduces risk of injury, or stops you hurting after exercising is well…a stretch, given that the research doesn’t explicitly say so. If you find stretching boring, tiresome and a bit of a chore – then spend your time moving in a way you enjoy instead.

NEED HELP WITH PAIN OR INJURY? GET IN TOUCH TO SEE HOW WE CAN HELP

REFERENCES:

Behm, D. G., & Chaouachi, A. (2011). A review of the acute effects of static and dynamic stretching on performance. European journal of applied physiology, 111(11), 2633–2651. https://doi.org/10.1007/s00421-011-1879-2

Hori, M., Hasegawa, H., & Takasaki, H. (2019). Comparisons of hamstring flexibility between individuals with and without low back pain: systematic review with meta-analysis. Physiotherapy theory and practice, 1–24. Advance online publication. https://doi.org/10.1080/09593985.2019.1639868

Khalil, T. M., Asfour, S. S., Martinez, L. M., Waly, S. M., Rosomoff, R. S., & Rosomoff, H. L. (1992). Stretching in the rehabilitation of low-back pain patients. Spine, 17(3), 311–317. https://doi.org/10.1097/00007632-199203000-00012

Lewis J. (2014). A systematic literature review of the relationship between stretching and athletic injury prevention. Orthopedic nursing, 33(6), 312–322. https://doi.org/10.1097/NOR.0000000000000097

Muanjai, P., Jones, D. A., Mickevicius, M., Satkunskiene, D., Snieckus, A., Skurvydas, A., & Kamandulis, S. (2017). The acute benefits and risks of passive stretching to the point of pain. European journal of applied physiology, 117(6), 1217–1226. https://doi.org/10.1007/s00421-017-3608-y

Nuzzo, J. (2019). The Case for Retiring Flexibility as a Major Component of Physical Fitness. Sports Medicine, 50(5), 853-870. doi: 10.1007/s40279-019-01248-w

Shrier I. (1999). Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 9(4), 221–227. https://doi.org/10.1097/00042752-199910000-00007

Thacker, S. B., Gilchrist, J., Stroup, D. F., & Kimsey, C. D., Jr (2004). The impact of stretching on sports injury risk: a systematic review of the literature. Medicine and science in sports and exercise, 36(3), 371–378. https://doi.org/10.1249/01.mss.0000117134.83018.f7

Ylinen, J., Kautiainen, H., Wirén, K., & Häkkinen, A. (2007). Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial. Journal of rehabilitation medicine, 39(2), 126–132. https://doi.org/10.2340/16501977-0015

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