Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review

Abstract

Abstract:Recently, there has been a shift from static stretching (SS) or proprioceptive neuromuscular facilitation (PNF) stretching within a warm-up to a greater emphasis on dynamic stretching (DS). The objective of this review was to compare the effects of SS, DS, and PNF on performance, range of motion (ROM), and injury prevention. The data indicated that SS-(-3.7%), DS-(+1.3%), and PNF-(-4.4%) induced performance changes were small to moderate with testing performed immediately after stretching, possibly because of reduced muscle activation after SS and PNF. A dose-response relationship illustrated greater performance deficits with ≥60 s (-4.6%) than with <60 s (-1.1%) SS per muscle group. Conversely, SS demonstrated a moderate (2.2%) performance benefit at longer muscle lengths. Testing was performed on average 3-5 min after stretching, and most studies did not include poststretching dynamic activities; when these activities were included, no clear performance effect was observed. DS produced small-to-moderate performance improvements when completed within minutes of physical activity. SS and PNF stretching had no clear effect on all-cause or overuse injuries; no data are available for DS. All forms of training induced ROM improvements, typically lasting <30 min. Changes may result from acute reductions in muscle and tendon stiffness or from neural adaptations causing an improved stretch tolerance. Considering the small-to-moderate changes immediately after stretching and the study limitations, stretching within a warm-up that includes additional poststretching dynamic activity is recommended for reducing muscle injuries and increasing joint ROM with inconsequential effects on subsequent athletic performance.Key words: static stretch, dynamic stretch, proprioceptive neuromuscular facilitation, ballistic stretch, flexibility, warm-up.Résumé : Depuis peu, on utilise plutôt l'étirement dynamique (« DS ») que l'étirement statique (« SS ») ou la facilitation neuromusculaire proprioceptive (« PNF ») au sein d'une séance d'échauffement. Cette analyse documentaire se propose de comparer les effets de SS, DS et PNF sur la performance, l'amplitude de mouvement (« ROM ») et la prévention de blessures. D'après les données, on observe des modifications de performance faibles à modérées quand l'évaluation est réalisée immédi-atement après la séance d'étirement : SS (-3,7 %), DS (+1,3 %) et PNF (-4,4 %), et ce, possiblement à cause de la diminution de l'activation musculaire consécutive à SS et PNF. La relation dose-réponse révèle une plus grande baisse de performance quand la séance de SS par groupe musculaire ≥60 s (-4,6 %) vs. <60 s (-1,1 %). Par contre, SS suscite un gain modéré de performance (2,2 %) quand le muscle est plus allongé. L'évaluation est réalisée en moyenne 3-5 minutes post-étirement. La plupart des études n'incluent pas des activités dynamiques post-étirement; avec l'inclusion de ces activités, on n'observe pas de modification nette de la performance. DS suscite des gains de performance faibles à modérés...

Does Stretching Have Long-Term Effects on Muscle Performance? A Clinical Commentary

“…Stretching is a strategy commonly employed in both training and rehabilitation programs [2] and it is used often in warm-up routines [6]. Nevertheless, a considerable amount of evidence in the last decade has shown that stretching prior to activity may impair performance [7][8][9]. Hence, elongating a muscle prior to tasks that require maximal performance has been discouraged.…”

Chronic Pain and Exercise: Studies on pain intensity, biochemistry, adherence and attitudes

“…In paper 1, improvements in both the STRENGT and STRETCH group were found. In addition, stretching improves range of motion due to increased flexibility in muscles and tendons, as well as neural adaptations leading to an improved stretch tolerance [150]. Hence, even if stretching earlier has been interpreted to not be beneficial for chronic pain conditions [39], there is interesting to speculate about possible physiological effects as results of stretching exercise in painful muscles.…”

“…Increased muscle tension in chronically painful muscles has in fact been reported earlier [228,229], and muscle tension might enhance the nociceptive activity and thus, in a sensitized nervous system lead to increased pain perception. If stretching diminish the nociceptive activity [150,151] by reducing the muscle tension, stretching could consequently possibly lead to decreased pain perception.…”

“…Flexibility of a muscle is related to its tension, which can be divided in active tension (innervation of motor neuron and reflexive activation), and passive tension (viscoelasticity and fascia) [148][149][150]. Consequently, the acute effects of stretch can be described in terms of viscoelastic and neural effects [150,151].…”

“…Viscoelastic effects are shown as a decrease in resistance to passive tension of the muscle. The neural effects is related to an inhibition of contractile activity in the muscles, which leads to an acute stretch-induced strength loss [148,150,151].…”