Does Stretching Help Prevent Injury?

Hamstring Stretch
Should You Stretch Your Muscles?

Does stretching before you exercise help prevent an injury? This will be a lifelong question many chiropractors are going to be asked by their sport active patients. I believe most people would assume that stretching before exercise is a must do thing in order to prevent a sport injury and that stretching is a type of “warm-up” routine before exercising.

A friend sent me a stretching news article talking about this exact question about should we stretch before exercise in order to prevent injury. My friend did this because he knew that I had done my literature review thesis in my 4th year at the AECC. I titled that paper “The benefits and risks and stretching“. I was interested in looking at research studies, available in 2003, looking at this question on should we stretch for health performance and sports injury prevention. I think you’ll be surprised what is being found nowadays when it comes to stretching and injury prevention.

Should I Stretch to Prevent a Sports Injury? Probably Not

As I mentioned earlier I think if you ask most people if muscle stretching before exercise is necessary to prevent an injury they would say “Yes, of course, isn’t that just common sense?” I must admit here I had always thought the same way. Over my sporting years having athletic coaches in rowing, hockey, track and field athletics, cricket all telling me that I must stretch before and after sport. That is why, back in 2003, I wanted to look deeper into this question.

Types of Stretching Techniques

The first thing to remember is that there are different types of stretching techniques that you can do.

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The most common ways to stretch are:

  1. Static stretching,
  2. Ballistic stretching,
  3. PNF stretching,
  4. Dynamic stretching.

Static Stretching

A static stretch is one where you reach and hold the muscle stretch.

A common example of a static stretch would be a standing hamstring stretch that runners do where they lean forward to touch their toes. The picture at the top shows a man doing the sit and reach hamstring stretch on the floor.

The aim of a static stretch is to try hold and relax any tight muscles. In the following video from sportsinjuryclinic.net you can see a woman perform various static stretches on her hamstring muscles in the sit and reach position. She is doing the very fast just to show different positions to stretch in. Ideally a static stretch is held for at least 30 seconds up to 60 seconds from my research.

Ballistic Stretching

It is not common to see athletes performing ballistic stretching anymore. However, a ballistic stretch is where you might bounce, usually quite fast, repeatedly into the stretch. The idea is to push your muscle reflex limits quickly.

For example standing and leaning forward bouncing down to try touch your toes whilst standing. In the following video from personal trainer Jeff Bonsall, you’ll see examples of ballistic stretching for the hamstring, tennis, and karate kicks. In my research this stretch technique was the least beneficial and created the highest risk for a sports injury.

PNF Stretching

PNF stands for proprioceptive neuromuscular facilitation. This way of stretching is when you would contract the muscle you want to stretch first then try stretch it out after the contraction a.k.a contract-relax technique.

An example would be to first tighten your hamstring muscle then after do a static stretch move after. In the following video Doctor of Physical Therapy, Kelly Starrett from mobilitywod.com explains the basics of what is PNF stretching to a class of crossfit athletes. Kelly uses an example of PNF stretching a muscle in his hand.

Dynamic Stretching

A dynamic stretch is where you would move the muscle in question through its natural range of motion in order to feel a stretch in the muscle fibres.

An example would be a golfer who gently and repeatedly swings a golf club in the swing plane in order to feel their back and arm muscles stretch through the correct golf swing. In the following video Mike Pedersen from performbettergolf.com  shows how he warms up his golf muscles before hitting the ball from the first tee box. This is a great example of a sports specific dynamic stretch.

So Which Stretching Technique Is Better?

No stretch technique has been shown to significantly better than another when it comes to injury prevention. The best way to stretch depends on what you can physically able to do and what your goal you are trying to achieve.

For example, if you just want more muscle flexibility for greater range of motion and you can only stretch by yourself, then maybe static stretching is better for you. If you want to stretch before a sport event to “feel loose” and your on your own then I would recommend dynamic stretching as better option. If you have someone who can help you stretch your muscles then proprioceptive neuromuscular facilitation stretches are a good option.

So Does Stretching Before Exercise Prevent Injury?

In 2003/2004 when I did my research reading I didn’t find that any particular type of stretching before exercise made a massive difference in reducing your risk of getting sports injury.

It looks like from the latest news article that it hasn’t changed since really.

What Muscle Stretching Can Do For You

However I do believe there are some benefits to muscle stretching.

Some points about what stretching CAN DO for you are:

  • Increase flexibility,
  • Maintain a good joint range of motion,
  • Stimulate nerves and help in rehabilitation,
  • Make you feel good.

Some points about what stretching DOES NOT DO for you are:

  1. Helps heat up the muscle for a warm-up. Especially static stretching doesn’t attract lots of blood,
  2. Improve your risk of preventing injury in running,
  3. Fix back pain. A combination of strength, stretch and balance exercises are better for you than stretching alone,

These are my main points about muscle stretching. There are other benefits to stretching not mentioned. But why are you stretching then, what are you trying to do?

How Long Do You Need to Stretch?

The amount of time you need to hold a stretch to increase flexibility is about 30 sec. To really increase your flexibility in the muscle you would need to stretch the muscle daily a few times in a day.

To become flexible and supple like a gymnast it takes training. Just like we use weight training to get stronger muscles you need to train the muscle fibres with regular stretching of the muscle units to allow them to lengthen.

Which Muscle Do I Need to Stretch?

It depends again on your activity. The muscle a swimmer uses will mainly be the shoulder area, a footballer their leg muscles, a golfer will be their back and arm muscles etc… So which muscles you should stretch depends again on your activity.

I would say also look at which one is tighter than the other. Asymmetry in muscles between one side of your body and the other could be causing you a problem. I see this in hip rotation with the right hip harder to turn in compared to the right in most right handed people. This is because right-handed people use the right hip more for their power so would be naturally tighter/stronger.

So Should You Stretch At All?

I’d say YES you should stretch. Flexibility is one of the foundations for health. Jack Lalanne explained the basics of health best in his videos.

For us to be ‘healthy’ we need to be able to do certain movements in a to live our lives. If you couldn’t stretch your shoulder properly when reaching you might find it harder to dress, clean or feed yourself. If you hips are inflexible it is harder to get up from sitting or run. That is why you need to know how to perform a correct hip hinge exercise.

So again you don’t have to be gymnastic flexible to be healthy, you have to be just flexible enough to be able to move to your daily needs in life.

As mentioned in the latest stretching research study people who were used to stretching and who were told to stop ended up hurting themselves more. So if you are used to stretching before exercise and aren’t hurting yourself lots in sport then probably best to just carry on as normal.

Image Credit: Some rights reserved by Tobyotter

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About Gary Kirwan

Chiropractor who likes helping people get better using movement as medicine as I know that the body has a fantastic ability to heal itself. Keen interest in trapped nerve pain as I know too many people live in pain in this world.

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