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

updated

Tags: stretch, injury, movement, prevention, exercise, self-treatment, treatment, muscle, pain problems

Two articles on PainSci cite Behm 2016: (1) Stretching for Flexibility(2) 5 Main Reasons Athletes Stretch… All Flawed

PainSci notes on Behm 2016:

This wide-ranging review concluded that “studies indicate a 54% risk reduction in acute muscle injuries associated with stretching,” which is at odds even with previous reviews by some of the same key authors. For instance, while McHugh et al were optimistic in 2010, they based their optimism on speculation and characterized the evidence as limited, which was just six years prior, with almost no relevant new evidence in the interim. Such unjustified optimism undermines my confidence in the paper significantly.

The authors recommend: “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.”

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

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.

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