Injured athletes often ask “What stretch should I do to fix my problem?”  New studies and current literature reviews suggest that stretching is not as effective as most people believe it to be when it comes to injury prevention.  Athletes and patients do benefit from stretching, but when should you stretch and how? 

A report issued by the CDC in 2000 concluded “there is not sufficient evidence to endorse or discontinue pre-run or post-run stretching to prevent injury among competitive or recreational athletes.”  This conclusion is based on work by Ian Shrier, M.D. 1999 in a paper titled “Stretching Before Exercise Does Not Reduce the Risk of Local Muscle Injury”.  The CDC also introduced this notion due to the fact that young athletes need to spend more time doing aerobic exercise to reduce the obesity risk, rather than spend so much time stretching.  Despite all this questioning of the value of stretching there are times appropriate to stretch and there are health benefits from stretching.  This is why people fell better when doing Yoga, Pilates and Tai Chi. Athletes and patients do get pain relief from stretching due to what is thought to be an analgesic effect.

It is important to know the demands of different stretching techniques on muscles when making recommendations to patients and athletes.  An individualized approach that accounts for variation and differences between healthy and injured tissues is the most effective and safe way to design the correct type of exercise program. 

There are three common types of stretching utilized by therapists and trainers:

1. Static Stretching which involves stretching a muscle as far as one can tolerate it and holding for a given length of time. 

2. Active Stretching involves moving a joint through its full range of motion to stretch muscles, tendons and ligaments.

3. Contract-Relax Stretching includes resistance at the end of a stretch when a muscle is lengthened.

These types of stretching can all be beneficial to improve range-of-motion and perhaps athletic performance when done correctly.  It is important to note individual variations in flexibility do exist.  As we get older we loose flexibility at a steady rate beyond age 50.  Genetics also accounts for an individual’s flexibility throughout his or her life. When an individual is genetically tight or extremely loose this will dictate the type of stretching needed, if any   New evidence suggests that stretching before exercise does not prevent overuse or acute injuries.  This does not mean that stretching exercise should be shelved completely.  *Generally a 10 – 15 aerobic minute warm-up, followed by stretching can be effective to improve flexibility when playing a sport.  If you are very tight, static or contract-relax stretching may be most effective, but if you are loose or “double jointed” active stretching is better in order to avoid overstretching.  When you have hyper-mobile joints due to the natural laxity of ligaments, muscles and joints it is better to stabilize your joints by concentrating on strength and stability rather than stretching. 

Active stretching along with Physical Therapy modalities such as the latest technology, the Cold Laser, may be safe soon after injury since active stretching does not further stress healing tissue.  Static stretching of an injured muscle, tendon, or ligament will over stress the collagen that is lying down to repair the injured tissue.  In more severe cases of injury such as a partially ruptured tendon or ligament no stretching until some healing at 4 to 6 weeks may be indicated.  Static or contract relax stretching is best on non-injured individuals who have reduced range-of-motion due to muscle tightness.  These stretches should be held for about 30 seconds and repeated 5 repetitions after a sufficient warm-up* or after playing sports.  

Stretching is part of an active and healthy lifestyle, but should be done properly.  At John Ward Physical Therapy in Charlestown, RI we can help you with all your exercise needs, including stretching correctly.  We offer Personal Training, Pilates, Yoga and Tai Chi as well as the 830Laser (“a remarkable new device that speeds healing of damaged soft tissues”).  Click here to visit our website JohnWardPT.com or call us at (401)364-0100 to find out more about our services.  Stretching is one way to help you stay active.  Remember “Motion Is Lotion”.