Immediate effects of quantified hamstring stretching: hold-relax proprioceptive neuromuscular facilitation versus static stretching
PainSci commentary on Puentedura 2011: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
It’s common for stretching enthusiasts to dismiss my concern that stretching is not all that useful with the concession that, of course, static stretching is quite pointless, but fancier methods (their methods) are “obviously” clinically useful. By far the most common example of allegedly superior stretching is the broad category of “proprioceptive neuromuscular facilitation,” and more specifically the hold relax method. Supposedly this approach works better than mere pulling on muscle. However, this test of the immediate effects HR-PNF versus static stretch on hamstrings was a bust: they both increased flexibility equally well (for whatever that’s worth). “No significant differences were found when comparing the effectiveness of HR-PNF and SS techniques. Both stretching methods resulted in significant immediate increases in hamstring length.”
~ Paul Ingraham
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.
PURPOSE: To compare the immediate effects of a hold-relax proprioceptive neuromuscular facilitation stretching (HR-PNF) versus static stretch (SS) on hamstring flexibility in healthy, asymptomatic subjects.
SUBJECTS: Thirty subjects (13 female; mean age 25.7 ± 3.0, range 22-37) without excessive hamstring muscle flexibility were randomly assigned to one of two stretch groups: HR-PNF or SS.
METHODS: The left leg was treated as a control and did not receive any intervention. The right leg was measured for ROM pre- and post-stretch interventions, with subjects receiving randomly assigned interventions one week apart. Data were analyzed with a 3 (intervention: HR-PNF, SS, control) × 2 (time: pre and post) factorial ANOVA with repeated measures and appropriate post-hoc analyses.
RESULTS: A significant interaction was observed between intervention and time for hamstring extensibility, F(2,58) = 25.229, p < .0005. Main effect of intervention for the tested leg was not significant, p = .782 indicating that there was no difference between the two stretch conditions. However, main effect for time was significant (p < .0005), suggesting that hamstring extensibility (for both stretching conditions) after intervention was greater than before.
CONCLUSION: No significant differences were found when comparing the effectiveness of HR-PNF and SS techniques. Both stretching methods resulted in significant immediate increases in hamstring length.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.