Does Stretching Help? Answer: Yes, and No

Last week I wrote about increased risk for knee injuries, with poor form on squats and lunges, and unaccustomed plyometrics. The fact is that increasing strength is a critical component of injury risk reduction, it’s just that you have to do it correctly. This week, let’s look at another controversial topic. Does stretching help?

Between increasing strength, improving balance, and increasing flexibility -- is one better than another? It turns out that the most effective way to reduce injury risk is through increased strength, followed by improved balance.

Surprisingly, stretching to improve flexibility has not been shown to reduce injury risk. It doesn’t seem to be harmful so do it if you enjoy it or if you feel it improves your sport and fitness performance.

Can Stretching Prevent Injuries?

The most surprising finding from several published scientific studies is that stretching does not reduce injury risk. This seems to be true for dynamic stretching and static stretching.

In a large systematic review and meta-analysis, Lauersen and colleagues found that strength training reduced acute injury risk across multiple injury types by about 70% and overuse injuries by about 50%. Balance (proprioception) exercises were also very effective, reducing injury risk by about 35%. Stretching and flexibility had no effect.

More recently, Knapik and colleagues studied the effect of calf stretching on injury rates in high school basketball players. They found that the stretching programs improved ankle flexibility but had no effect on injury rates compared to a group not on any stretching program.

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For guidelines and best practices for WHEN AND IF your local authorities have deemed it safe to return to the play, check out U.S. Soccer's PLAY ON home page HERE.

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Is Stretching Helpful In Other Ways?

There’s no doubt that many types of stretching programs can be effective ways to improve joint motion and flexibility. From a functional standpoint I feel that’s a very good thing. Some sports require substantial ranges of motion to function well, such as dance and gymnastics. In throwing sports we know that an internal rotation deficit in the shoulder is a risk for upper extremity injury, and increasing internal rotation improves throwing mechanics. A golfer would do well to maximize trunk rotation.

There’s good evidence that post-activity flexibility exercises combined with massage, foam roller, or other tissue mobilization techniques reduces soreness and speeds recovery.

Additionally, most people just feel better being more flexible compared to being stiff. Yoga, combining flexibility with mindfulness and stability is an activity millions of people enjoy.

There are plenty of reasons we should use stretching and flexibility exercises as part of our regular fitness practice, but surprisingly we shouldn’t expect them to reduce injury rates.

Key Points:
In large published scientific studies, stretching has not reduced injury rates in sport and fitness activities.
Stretching is effective in other ways, such as improving joint range of motion, overall flexibility, and improving post-activity recovery.

(Dr. Dev K. Mishra, a Clinical Assistant Professor of orthopedic surgery at Stanford University and Medical Director of Apeiron Life, is the creator of the online injury management course and the Good to Go injury assessment App for coaches, managers, parents and players. Mishra writes about injury recognition and management at blog, where this article originally appeared.)

3 comments about "Does Stretching Help? Answer: Yes, and No".
  1. Bob Ashpole, August 8, 2020 at 10:33 p.m.

    In my view, stretching is part of strength training. If stretching is studied in isolation, it is not realistic. I can't conceive of strength training without stretching. So I suspect that when they studied strength exercises, stretching was involved too. 

    Full range of motion is an important aspect of strength exercises. Stretching helps maintain the full range of motion. 

    From reading the article, I wonder if the "injury" was knee injuries or just injury generally. About 10 years ago, FIFA announced that the FIFA 11+ did not significantly reduce knee injuries, but did reduce injuries generally. So I am wondering if those FIFA 11+ studies have been determined flawed.

  2. frank schoon, August 11, 2020 at 9:48 a.m.

    We have gone way beyond what I would call preparing one's body to play. The problem is bigger than just stretches and I refer to the 'mindless', 'group-think', 'follow the herd or sheep' mentality that seems to be a hallmark identity of coaching. For example, remember when 'stretches' was the 'thing' in soccer back in the 80's. I remember in the 80's when Michel Platini playing for Juventus  came to DC. Everyone watched the Italian players come out on the field carrying a rubber mat, then proceeded to do for about 20min all kinds of stretches. I know the coaches in the stands watching this display were getting orgasms, taking abundance of notes like they to do at the yearly coaching conventions ,thinking we have to do this for our teams for it looks so professional.... Everyone got caught up and followed the 'stretching' trend until it petered out for some reason or another and things went back to normal, which to me was abnormal in itself to start out with....

    Here is another example of coaches herd mentality, remember the 'cool down' run after the game. Every Tom ,Dick and Harry who thought of himself as a great coach did this 'cool-down' run. It looked so professional but sooner or later that little trend petered out as well.....What happened???

    I remembered the 'Johan Neeskens' effect in soccer. All coaches after watching Rinus Michels' Ajax and the Dutch team of WC'74 wanted to play like Holland and all wanted to have a 'Johan Neeskens' type of righthalf. All these coaches went overboard trying to copy Rinus Michels training techniques, which in fact were totally misinterpreted resulting in soccer today having less individualism and more physical play, which runs counter to the hallmark of 'Total Soccer'. This is what happens when coaches copy other coaches and trends. Coaches are NOT creative they just COPY what others do, who in turn COPY others...that's the extend of the creativeness in coaching...

    There are many examples but here's one more of how the mindless herd of coaches copy the trends.  Today's trend is to have rightfooted leftwing and a leftfooted rightwing. Coaches ,today don't even think twice but automatically have the wingers play in reverse positions. This really runs counter to anything that is logical way of playing. But coaches don't question, their herd mentality is 'that's what everyone else does'... UNTIL THIS TREND HAS RUN IT'S COURSE.

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  3. frank schoon, August 11, 2020 at 10:23 a.m.

    When stretches were in vogue years ago as aforementioned, I not being a stretch fan thought maybe there is something to it.  The result was I had more pulled muscles that I ever did. I thought maybe it's just me, but there was an interview back in the 90's with Louis van Gaal who is of my generation likewise tried it which resulted in having quite a few pulled muscles...

    Everyone is different, everyone has different muscles sets, for example they found out that Maradona's muscles take more time to recover after an action. Then why does for everyone to do the same muscle stretch exercises, which is NOT RIGHT. 10minutes before games English players would lay in a hot tub of water before coming out on the field and never had muscle pulls.

    I"m so against what I see today is this 3-ring circus of warmup routines before the game. All the players are herded in a group and go through the same routines...WHICH IS CRAZY.  I grew up in an environment where INDIVIDUALISM was stressed. In those days , players would come out on the field, do their own thing, pass a ball around, shoot at goal a couple of times, a couple quick sprints,  a few dribbles, 'check out the chicks' in the stands, maybe a stretch or throw your legs around, whatever, but my mind was conditioned to be ready to play. But today in the warmup the coach throws out some pennies and prepares for a small sided game, which is ok for defenders but not for me. I want to be left alone, allow my mind to feel creative, wander into what I want to do. Players are different, especially ones, who tend be more individualistic, and don't want to be caught up in all this group crap.....

    I think coaches need to let players 'be' and not get caught up in all the latest trends especially dealing with warmups. When I give an a lesson in shooting, I would pass the ball back and forth with the student for a few minutes, beginning with 5meters apart then extending the distance each time. This is the best and most natural way to stretch the muscles for shooting and do this a couple of minutes. The warmup/ stretch routines have become overemphasized for what is really needed...

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