Flexibility and Injury

I've been busy recently with work and that meant I had forgotten to post a link to this excellent piece by Colin Gordon of Edinburgh Deep Tissue Massage on Flexibility and injury:

When we talk about the need for improved flexibility in injury prevention we are not talking about the need to develop the range of movement demonstrated by a gymnast merely that we have the normal range of movement for our joints....

If we are to tackle flexibility issues fully with we need to think beyond simply stretching, in any form, as to why we lack ROM within a joint but that whilst stretching will not prevent injury, there is no evidence that it does, there is no reason not to utilise various stretching type techniques to help regain our normal range of motion.

Go and read the whole thing

Hip Flexor Stretch

Someone (the nano workout crew) has been watching Kelly S 

The original

Stretching again

Another study that says dynamic stretches rather than static stretches are appropriate for use before exercise.

Relative static stretch-induced impairments and dynamic stretch-induced enhancements are similar in young and middle-aged men.

More on stretching

My posts on the stretching research often prompt some reaction.   Mike Robertson has a really helpful post which pulls together a lot of the research on stretching:  Q&A: Is Static Stretching Good?
It is not a simple as don't stretch, the issue is when and why:

This is perhaps the most important question – not only is it important that we choose the right type of stretch, but we also need to perform the right stretch at the right time.

For example, I love dynamic stretching – but doing it before bed isn’t a great idea. Who wants to be fired up and neurally primed right before bed?

Don’t answer that

Or imagine an elite athlete getting ready to hit the field – do they want to static stretch (and calm their nervous system and relax their muscles) right before they go out and sprint, run or cut explosively?

Here’s a general framework of when you should use each type of stretch:

• Use static stretches immediately before bed. This will not only help you relax but calm the nervous system and promotes better sleep.  One exception could be to use static stretching before lifting sessions if the primary focus of your session/training block is improving mobility, or if you need to increase extensibility in a specific muscle group (i.e. the hip flexors).
• Use dynamic stretches pre-workout, or as part of a mobility circuit throughout the day.
• Use EQI’s immediately post-workout, and only on muscle groups or areas that have been found to be short or too stiff in relation to adjacent segments.

oh no, not stretching again......

Sorry to return to this subject, especially with the pumped up and  over-hyped video, but I think this guy makes good points on the impact of stretching before exercise.  Once you get past the music at the start, it is pretty solid stuff too.




 
As we have said before, static stretching pre-exercise tends to lead to a poorer performance (the Sock Doc has said this in a great article)

More on stretching...for Bozos?

I obviously wouldn't go that far seeing as I keep posting videos of Kelly Starret, but I do think that the arguments for indiscriminate stretching are limited.  For some of us at some times to address particular issues i think there is an argument for stretching. 

Anyway, Zero Drop has posted this list of

10 Reasons Why Runners Should Not Stretch

• Stretching is exercise for the muscles like sea water is hydration for the body. When you're desperate for relief, it feels so right but only makes things worse.
• All athletes, especially runners, are so passionate about stretching. They defend it like their political association, religion, or family. I think many of them may have pictures of their kids in their wallets doing all types of cool stretches that they show their coworkers every day at the water cooler.
• Runners will follow any trend they think will make them run faster. Whether it's a new supplement, pair of socks, pair or shoes, custom orthotics, or stretching. They're the first in line for the Kool-Aid.
• Stretching is a conditioned behaviour, not one we are innately born with. I see my kids run, jump, climb, throw things, and carry objects of all sizes. They move well, and efficiently. I've never seen them stretch. Their developing nervous systems know better.
• The day I see my dog holding a stretch is the day I'll start stretching too.
• Flexibility is a reflection of overall health and fitness. Stretching does absolutely nothing for health or fitness. It's not exercise. It's not a warm-up or a cool-down. And it definitely doesn't substitute for restful sleep or a wholesome diet.
• Yoga is not stretching. Stretching is not yoga. Enough of that claim.
• Make sure you stretch if you want to weaken muscles, promote injuries, decrease performance, delay tissue healing, and have absolutely way too much free time.
• Stretching reduces injuries and improves endurance performance just like certain shoes will make you run or jump faster. Neither claim is true.
• I enjoy watching runners stretch. They must stretch because they think they will run faster. I bet they believe in Sasquatch too.

Sock Doc's full article STOP STRETCHING is definitely worth reading

Stretching may increase your flexibility, but you will most likely be weaker and the results are often short-lived. Saying that stretching reduces injuries or improves endurance performance, (the two main reasons given for stretching), is like saying certain shoes will make you run or jump faster. Many continue to make both these claims, yet neither has ever been proven, and many still buy the shoes and stretch with them on. Stretching is not exercise and not a warm-up before a run or any activity. Aerobic activity is the best warm-up as it increases flexibility in a safe way while improving oxygen utilization, lung capacity, and fat burning.
So balance your muscles and your entire body by balancing your life with proper exercise, diet, and other lifestyle factors. Stop drinking that Kool-Aid propaganda and just say “No!” to stretching!

Stretching doesn't do jack squat for reducing muscle soreness.

Bret Contreras repeats what we've said here before:

Stretching and DOMS
DOMS (delayed-onset muscle soreness) typically arises within a day of exercise and peaks in intensity at around 48 hours. Many strength & conditioning practitioners believe that stretching before or after exercise will reduce soreness.

Henschke and Lin (2011) reviewed the research on this topic and concluded that stretching does not affect muscle soreness. Twelve total studies were included with a combined 2,377 participants. Pooled estimates showed that pre- and post-exercise stretching reduced soreness on average by one point on a 100-point scale one day following exercise, increase soreness on average by one point on a 100-point scale two days following exercise, and had no effect on soreness by day three.

Findings were consistent across settings (lab vs. field studies), types of stretching, intensity of stretching, populations (athletic, untrained, men, women) and study quality, so the conclusions are not likely to change with future research. To reiterate, stretching doesn't affect muscle soreness.

Hip Flexor Stretch

Although I have previously pointed to studies which question the general value of stretching  particularly in terms of impact on sports performance, injury and muscle soreness.  Stretching before exercise has been especially challenged.

However, stretching to restore deficits caused by poor posture or the environment - like too much sitting - is still something that I do and recommend.  Here is Tom Furman on a simple stretch series for the hipflexors.  Tom says "Stretching, and eliminating hip flexor tightness can improve posture and reduce back ache."

Stretching...

My latest article in TGO is on Stretching.  I've put some of the research that I reference here.  One of the most respected outdoor writers in the UK  -  Chris Townsend - liked my piece.  He wrote on his blog:

I must admit though that the piece that gave me most pleasure in this issue is a short Hill Skills one on the latest research into stretching by Chris Highcock. Why should a piece on the boring activity of stretching delight me so much? Because it says that it's pointless and may even "make you slower, weaker and less efficient". Yippee! I've thought that for years, based on nothing more than personal experience and an intense dislike of the activity. Now I have academic research to back me up. Many years ago when I regularly did long hill runs and mountain marathons I tried stretching because all these super-fit runners I saw at the start of events were doing it and saying it was essential if I wanted to avoid injury. The only result was that I ached more the day after running and stretching than after the days when I didn't stretch at all so I soon abandoned it despite dire warnings as to the results. I can now not stretch and feel that this is a positive approach. That makes me happy.

That was satisfying to read.

Stretching is pants

Bill is always recommending that I look at Paul Ingrahm's material.  I don't know why but I've only just now checked him out.  Thanks Bill

Here is Paul on stretching and the ITB band, both things that I've mentioned here recently!

Check out his site:  Save Yourself

Dynamic Flexibility

It is interesting to watch how the elite warm up.  It is something I've been reading about for a while - static stretches for warm up are not helpful.  Rather they can harm performance.  Instead dynamic moves are best.






via recover your stride

That is not to say that there is no roel for static stretches of course, just not necesarily for warm up.

Stretching.....here we go again

I've had stuff here before that questions the value of static stretching.  Here is more:

Effects of Dynamic Warm-up on Lower Body Explosiveness Among Collegiate Baseball Players.

It is the same again.....static stretching makes subsequent performance worse, while dynamic stretches improve it.

A good commentary here from Mike Reinold. 

Still Stretching?

Sweat Science points out something that I've featured on this blog a fair bit in the past:  “Stretching before or after exercise does not reduce delayed-onset muscle soreness.”  He is commenting on a recent review article in the British Journal of Sports Medicine 

While I agree with all that I do think there is some benefit for stretching certain muscles.  I am pretty convinced by the argument of Janda re Tonic and Phasic muscles, that there are certain muscles that tend to tighten up and others that tend to be weaker, especially as we age.  I think Rif once described this in terms of the foetal postion.  As we age we tend to return to a foetal position, gravity is pulling us back into a ball.  The muscles on the fron of the body contract - biceps, pecs, psoas, calves, hamstrings (ok those last two are not on the front) - while those on the back, the postural muscles that hold you up[ against gravity - the glutes, abs, rhomboids - get weaker. 

You need to stretch out the muscles that tend to tightness and strengthen those that tend to weakness....or at least that is what Dan John would argue.....

Stretching....another review

I've had stuff here before about stretching usually saying that it is a waste of time.

I spotted a new review - well the abstract anyway.  It agrees that static stretching can negatively impact performance but concludes:

The detrimental effects of static stretch are mainly limited to longer durations (≥60 s) which may not be typically used during pre-exercise routines in clinical, healthy or athletic populations. Shorter durations of stretch (<60 s) can be performed in a pre-exercise routine without compromising maximal muscle performance.

Effect of Acute Static Stretch on Maximal Muscle Performance: A Systematic Review.

Why Stretching is not a good warm up

Phil Maffetone has a good piece up on the dangers of stretching, and why it’s not the best way to warm up.


UPDATE  Stretching vs. Non-Stretching

Confusion arises when a study shows that ranges of motion or flexibility improve with stretching. This has been shown by some studies. However, increased range of motion at what cost? These studies don’t address this important question. One problem caused by stretching is that muscles become too loose—weaker—allowing the associated joint to move in a wider range of motion. This increased range of motion/flexibility puts more stress on the joint, which is no longer supported properly by the muscle, increasing the risk of injury.

Damaging a muscle through any means, including stretching, will obviously have an adverse affect on an athlete’s gait. The loss of smooth efficient movement puts stress on virtually all other structures—ligaments, tendons, joints and bones, in addition to many muscles. The body tries to compensate for this irregular movement, and in doing so uses up more energy, taking away from ones performance. A recent study by Jacob Wilson and colleagues from Florida State University showed how stretching can result in poor running economy, increasing energy consumption during an endurance event, and decreasing performance.

Loosen your neck and run faster

My pal Colin from Edinburgh Deep Tissue Massage sent me an interesting link to a post from Carson Boddicker:

Hamstrings, Suboccipitals, and Running Speed

in it Carson points out that releasing the suboccipitals - muscles at the top of your neck, base of your skull - increases hip mobility more that addressing the hamstrings directly.

Colin has posted about it too on his blog and all this ties in with the ideas of Tom Myers  on Anatomy trains that I have posted about before  -  all your muscles are connected.

This diagram shows how the hamstrings link to the skull in Myers' analysis.

Really useful stuff.

Looks like Carson Boddicker is another one to follow!

Stretching....just makes you better at putting up with stretching

So, stretching doesn't stretch the muscle....it just makes you more tolerant of stretching?

Six weeks of sustained 30-min daily stretch does not increase the extensibility of the hamstring muscle of healthy individuals. It does, however, improve stretch tolerance leading to increased joint range of motion without any actual improvements in muscle extensibility.

Regular stretch does not increase muscle extensibility

Bridges to activate the glute medius

Shoulder Stretch

Stretching...guess what

Guess what.....another study says that before and after physical activity does not appreciably reduce all-injury risk. (but it might make you less sore) Of course I've pointed similar studies out before.


A pragmatic randomised trial of stretching before and after physical activity to prevent injury and soreness.


OBJECTIVE: To determine the effects of stretching before and after physical activity on risks of injury and soreness in a community population.
DESIGN: Internet-based pragmatic randomised trial conducted between January 2008 and January 2009.
SETTING: International.
PARTICIPANTS: 2,377 adults who regularly participated in physical activity.
INTERVENTIONS: Participants in the stretch group were asked to perform 30-second static stretches of 7 lower limb and trunk muscle groups before and after physical activity for 12 weeks. Participants in the control group were asked not to stretch. Main outcome measurements: Participants provided weekly on-line reports of outcomes over 12 weeks. Primary outcomes were any injury to the lower limb or back, and bothersome soreness of the legs, buttocks or back. Injury to muscles, ligaments and tendons was a secondary outcome.
RESULTS: Stretching did not produce clinically important or statistically significant reductions in all-injury risk (HR = 0.97, 95% CI 0.84 to 1.13), but did reduce the risk of experiencing bothersome soreness (mean risk of bothersome soreness in a week was 24.6% in the stretch group and 32.3% in the control group; OR = 0.69, 95% CI 0.59 to 0.82). Stretching reduced the risk of injuries to muscles, ligaments and tendons (incidence rate of 0.66 injuries per person-year in the stretch group and 0.88 injuries per person-year in the control group; HR = 0.75, 95% CI 0.59 to 0.96).
CONCLUSION: Stretching before and after physical activity does not appreciably reduce all-injury risk, but probably (that is not a very scientific word!) reduces the risk of some injuries, and does reduce the risk of bothersome soreness.