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If something feels tight, should I stretch it? Well, that all depends…

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A reputable sports media outlet recently contacted me via twitter to see if I would be willing to contribute to an article focusing on seven stretches that everyone should perform before they go running.

When I first saw this request, I was excited! I always love an opportunity to write and share my knowledge and passion with other runners. However, after the initial excitement, I came to the realization that I could not write such a broad, generalizable article because it goes against what my education and clinical experience has taught me. Frankly, in my opinion, the article “seven stretches that all runners should do” would advocate bad advice. With this in mind, I replied and thanked them for the opportunity to write and explained that I could definitely provide them with 4 global “stretches” that I like but that fundamentally, I do not believe that all runners should perform a standard stretching program. Of course, this was not exactly what they wanted to hear and they thanked me and said they would keep me in mind for future opportunities.

What I Know About Stretching:

The research performed in the area of stretching gives a lot of grey answers. Some articles say stretching is good and necessary for injury prevention, whereas other research shows that it can decrease power output and alter the optimal length-tension ratio of the muscle unit, thus making it detrimental.

As a high school and college athlete, I stretched sporadically. Honestly, when I reflect back to when I would stretch, I really only did it when I was injured, had the extra time, and was doing everything and anything I could do to “get better.” But as soon as I was healthy again, my stretching routine was back to being minimal. I did a lot of ancillary work, strength work, core work and dynamic stretching through drills and circuit training. Static stretching itself is not that important, unless a muscle group is TRULY short.

Every muscle has its optimal length-tension ratio and our lifestyles can disrupt “normal” to accommodate our passions and hobbies. This is why gymnasts, dancers and divers are able to perform movements and hold positions that would cause my leg to pop off. Their muscles have adapted through years of training in order to perform the motions that they need in order to be successful in their sport. A gymnast needs significantly more hamstring length than a runner, but that does not mean that the runner’s hamstrings are short and need to be stretched.

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In high-level athletes, muscles have adapted optimally to function at that athletes’ highest level. Stated briefly, this means that some muscles have actually shortened functionally. For example, cyclists and speed skaters have functionally short hip flexors, as both of those sports are performed in a sustained flexion type posture. Now, think about this: Is it a good idea to stretch those functionally shortened muscles? Doing so will basically negate their functional adaptations for that specific activity.

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Normal hamstring length is considered to be an angle of 80 degrees between the table and the straight leg raised from a horizontal position (Kendall, 2005, p. 348). Clinically, I rarely see individuals that have passive hamstring tension before 80 degrees (Will Nation, you take the cake here! I think you get about 50 degrees!) So, if my athletes have a straight leg raise of 80 degrees, I do not need them to spend time performing static hamstring stretches. I want them performing other exercises, but I don’t think that stretching a muscle group that is not actually short is going to help them. The same goes for hip flexors, hip external rotators (or piriformis as the running community dubs this group of muscles), quads, calves and please don’t even get me started on the IT band (that needs to be an entire blog article in itself!!).

Disclaimer: These are a lot of my opinions, so lets do a quick review of what the literature out there has to say about stretching. There is moderate to strong evidence that routine static stretching does not reduce overall injury rates (Small et al., 2008). There is preliminary evidence, however, that static stretching may reduce musculotendinous injuries (Small et al., 2008). Zakaria (2015) looked at using stretching as a method for injury prevention in high school soccer players and found no difference between dynamic stretching and dynamic and static stretching in the prevention of lower-extremity, core, and back injuries. Overall, the study showed that static stretching did not provide any added benefit to dynamic stretching in the prevention of injury in this population before exercise.

Research by Sekir et al. (2015) disproved the loss of power theory by showing that there is no decrease in power output in the functional hamstring to quadriceps ration following a static stretching routine. This result supports the idea that athletes can confidently perform static stretching during their warm-up routines and not worry that they are negatively affecting the functional strength of their muscles. A study by Clark and colleagues (2014) showed that while dynamic stretching is beneficial in decreasing presynaptic inhibition, it did not lead to the hypothesized increase in power output. From these two studies, it would appear that stretching has no positive or negative effect on power output and no protective value in preventing injuries.

With this in mind, what do I clinically recommend to “warm up” before a workout? I recommend jogging at a comfortable pace, gradually increasing that pace for 10-15 minutes and then performing drills and strides. Then you can stretch the muscles that are measurably short in your specific case. Keep in mind that this differs from runner to runner! When you do stretch, stretch gently. Make sure the muscle is completely relaxed and don’t bounce when you stretch.

To find out which muscles are measurable short in your case, and how you should stretch it, contact your expert physical therapists at Mondo Sports Therapy. We are happy to help out.

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References

  1. Clark L, O’Leary C, Hong J & Lockard M (2014). The acute effects of stretching on presynaptic inhibition and peak power. The Journal of Sports Medicine and Physical Fitness. 54(5):605-10.
  2. Evjenth O & Hamberg J (1980). Muscle stretching in manual therapy, a clinical manual. Alfta Rehab.
  3. Kendall F. (2005). Muscles, Testing and Function 5th edition, pg 384
  4. Sahrmann, S. (2002). Diagnosis and Treatment of Movement Impairment Syndromes. Mosby Elsevier.
  5.  Sekir U, Arabaci R & Akova B (2015). Acute effects of static stretching on peak and end-range hamstring-to-quadriceps functional ratios. World Journal of Orthopaedics 18;6(9):719-26
  6. Small K, McNaughton L & Matthews M. (2008) A Systematic review into the efficacy of static stretching as part of a warm-up for prevention of exercise-related injury. Research in Sports Medicine 16(3):213-31.
  7. Zakaria A, Kiningham R & Sen A (2015). Effects of Static and Dynamic Stretching on Injury Prevention in High School Soccer Athletes: A Randomized Trial. Journal of Sports Rehabilitation 24(3):229-35.

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