Stretching – Tackling the biggest myth in sport!

by | Aug 20, 2021 | Exercise, Sports Injuries

Should I be stretching before the big game?

Although stretching has long been promoted as an injury prevention method, recent systematic reviews conclude that there is no evidence to support its efficacy.

The Types of Stretching

Static stretching:

  • Static stretching involves moving the muscle or joint into an elongated position and holding the position for an extended period.

  • Historically, this type of stretching has been used to prepare the muscle for exercise.

Dynamic stretching:

  • Dynamic or ballistic stretching is when the muscles and joints are taken through their range of motion during movement. This type of practice is more specific to preparation for exercise and sports in particular

  • During the rehabilitation process care should be taken to not ‘bounce’ the muscle that is recovering from injury

  • Dynamic stretches have been shown to significantly increase tendon flexibility and elasticity and have been promoted for end-stage rehabilitation for tendon injuries

  • However, ballistic stretching involves eccentric contractions during the stretch phase, which may results in soreness or injury and therefore care should be taken when incorporating such stretches

Static stretching does NOT improve muscle length

  • Static stretching changes the muscle-tendon functions (range of motion and maximum voluntary contraction), which are related to mechanical changes of the muscle but not the actual tendon structure

  • In a 2019 study there was a decrease in muscle-tendon stiffness after static stretching observed immediately, but not 5 or 10min after stretching

Static stretching does NOT prevent injury

  • Warm-ups are typically composed of a submaximal aerobic activity, stretching and a sport-specific activity

  • The stretching portion traditionally incorporated static stretching

  • However, there are numerous of studies demonstrating static stretching induced performance impairments

  • A number of researches have concluded that stretching has no effect on injury prevention (Gleim and McHugh 1997; Herbert and Gabriel 2002; Small et al. 2008).

  • Sustained static stretching can impair subsequent performance;

  • Maximal voluntary contraction

  • Isometric force and isokinetic torque

  • Training-related strength measures such as one repetition maximum lifts

  • Power-related performance measured such as vertical jump (jump height)

  • Sprints running economy (reaction, movement time and balance)

  • Agility

  • The acute negative effects of stretching seem to be associated with stretches at a duration of 60 seconds, while stretches of shorter duration may have less significant deficits

  • The most powerful injury prevention tool available is strength training, at increasing loads over a 6-8 week period.

What is safe stretching? When Should I be stretching?

  • It is important to differentiate between pre-exercise stretching (where stretching does not appear to prevent injury) and regular stretching outside periods of exercise (where there is some clinical and basic science evidence suggesting stretching may prevent injury)

  • Additionally, stretching does not seem to reduce the effects of DOMS (Delayed onset of Muscle Soreness)

  • Dynamic stretching which involves controlled movement through the active range of motion should be the choice pre-exercise.

The effect of stretching after exercise

  • Athletes often stretch after exercise in an attempt to improve range of motion and reduce the perception of musculotendinous stiffness. While it is a regular component of post-exercise regimens, there is limited evidence of the effect of stretching on various aspects of recovery

  • Lund et al. suggested that stretching following bouts of eccentric exercise may delay recovery. In a study investigating the effect of static stretching on DOMS following eccentric quadriceps of seven untrained females, they reported that recovery of strength was impaired in the group who stretched their quadriceps for three repetitions of 30 seconds each day after exercise caused further mechanical disruption and exacerbated muscle damage

  • In contrast, Torres et al. reported no effect of daily stretching on maximum voluntary contraction of the quadriceps following eccentric exercise in healthy untrained men .

Key messages

  1. Perform dynamic stretching before exercise.
  2. You can perform static stretches after exercise or at any other time to give you temporary relief of stiffness or pain.

References

Barbosa, G., Trajano, G., Dantas, G., Silva, B., & Vieira, W. (2019). Chronic Effects of Static and Dynamic Stretching on Hamstrings Eccentric Strength and Functional Performance. Journal Of Strength And Conditioning Research, 1. doi: 10.1519/jsc.0000000000003080

Bertolaccini, A., da Silva, A., Teixeira, E., Schoenfeld, B., & de Salles Painelli, V. (2019). Does the Expectancy on the Static Stretching Effect Interfere With Strength-Endurance Performance?. Journal Of Strength And Conditioning Research, 1. doi: 10.1519/jsc.0000000000003168

Brukner, P., Khan, K., Clarsen, B., Cook, J., Cools, A., & Crossley, K. et al. (2017). Brukner & Khan’s clinical sports medicine. North Ryde, N.S.W.: McGraw-Hill Education (Australia).

Konrad, A., Reiner, M., Thaller, S., & Tilp, M. (2019). The time course of muscle-tendon properties and function responses of a five-minute static stretching exercise. European Journal Of Sport Science, 1-9. doi: 10.1080/17461391.2019.1580319

Smith, J., Washell, B., Aini, M., Brown, S., & Hall, M. (2019). Effects of Static Stretching and Foam Rolling on Ankle Dorsiflexion Range of Motion. Medicine & Science In Sports & Exercise, 1. doi: 10.1249/mss.0000000000001964

Su, H., Chang, N., Wu, W., Guo, L., & Chu, I. (2017). Acute Effects of Foam Rolling, Static Stretching, and Dynamic Stretching During Warm-ups on Muscular Flexibility and Strength in Young Adults. Journal Of Sport Rehabilitation, 26(6), 469-477. doi: 10.1123/jsr.2016-0102

Williams, M., Harveson, L., Melton, J., Delobel, A., & Puentedura, E. (2013). The Acute Effects of Upper Extremity Stretching on Throwing Velocity in Baseball Throwers. Journal Of Sports Medicine, 2013, 1-7. doi: 10.1155/2013/481490

 

Ankle dorsiflexion knee to wall measure for squat

How to Treat and Manage Stiff Ankles

If your ankle mobility isn’t up to par, the next steps depend on the source of the restriction. Generally, if the limitation is felt at the front of the ankle, it may be due to joint-related issues.

  • Banded Ankle Mobilizations: This technique involves using a resistance band tied to a stable surface while performing ankle flexing exercises on a step. Check out this quick helpful video for guidance.

Conversely, if the tightness is located in the back of your ankle around the Achilles tendon region, consider:

  • Contract/Relax Stretches: A simple exercise like the bent-knee calf raise can effectively relieve restrictions in this region.

Lastly, for an immediate solution, consider using a wedge or support under your heels during a squat. Two papers from The Journal of Strength and Conditioning Research have shown that wedges can enhance squat depth without negatively impacting biomechanics. While some may see this as a “cheat,” the science supports it. If you struggle to achieve that 12 cm in the knee-to-wall test and find it challenging to squat low, use that wedge!

Hip Range of Motion

How Much Flexibility Do I Need and How Do I Test It?

For effective squatting, studies have determined that achieving 125 degrees of hip flexion is necessary—this is 35 degrees beyond a right angle. To test your hip mobility, you can use an inclinometer available on your iPhone. Simply follow these steps:

  1. Lie down on your back with your legs extended.
  2. Place the inclinometer length-ways on your thigh,
  3. Gently lift your knee towards your chest to measure the maximum angle, without moving the opposite leg.

     

    measuring hip flexion

    How to Treat and Manage Stiff Hips

    The hip joint is mostly passive during a squat, so if you’re experiencing limitations, it’s most likely due to an issue with the hip joint itself. There is up to 20% of the population that may be limited by the shape of their hip joint and the way it developed during childhood and adolescence. If that is the case, it makes if very difficult to improve the range of motion. Things like acetabular retroversion or a lower femoral head/neck offset ratio cannot be changed.

    For the rest of the population, here are some effective strategies for improving hip mobility:

    • Banded Hip Mobilisations: These exercises can help increase the range of motion in your hips by stretching and mobilizing the joint. Look for a demonstration in this video.
    • Inner Range Hip Flexor Strengthening: Strengthening your hip flexors can counteract tightness and enhance your ability to squat lower.
    • Like with ankle mobility, adding a heel wedge can help. By elevating your heels, you may experience a reduction in trunk forward bend, minimizing the hip flexion required and facilitating a more comfortable squat position.

    Conclusion

    Mastering a deep squat requires more than just strength; it hinges on sufficient ankle and hip range of motion. The studies from 2015 and 2022 have made it clear: flexibility in these joints is paramount for optimal performance.

    By regularly assessing your mobility and implementing these targeted exercises and techniques, you can improve your squat depth, enhance your overall strength training, and reduce the risk of injury. Remember, every body is unique, so listen to yours and adjust your approach accordingly. Happy squatting!