One of the most frequent questions I get asked is in regard to the correct stretching protocol when warming up for sports or at the gym. What type is best? When should they be done and for what duration?
Types of Stretches
As with many questions regarding the human body, the answer is dependent upon numerous variables and giving a generic stretch protocol is difficult. As physiotherapists we use many different types of stretches including static, dynamic, ballistic, proprioceptive neuromuscular (PNF)and many more. They are generally used to help the body achieve the necessary movement and mobility needed for the task it is trying to perform. Not only do they often form an integral part of a patient’s treatment, but they are also vital in reducing future injury risk.
As a result of the flourishing fitness, health and wellbeing industries there is ongoing research into all different types of stretches which is giving us an ever increasing knowledge base into this area. As a result advice on the correct stretching protocol is continually being updated.
When deciding what to prescribe for a patient it is important to know what type of activity they are undertaking. For example you would not do the same stretches before you take your first golf swing as you would if you were trying to increase your knee mobility after surgery. On top of this the age of the person doing the stretch needs to be taking into account, as the properties of the structures we are stretching will change with age and therefore will respond differently.
These are only a few of the long list of variables that would need to be addressed when giving advice on stretches and it gives an indication how trying to have a generic ‘one size fits all’ stretch is probably inappropriate.
One of the most common stretches that are used through gyms and in sport is the static stretch. This involves holding a muscle in an elongated position for a sustained period. Recently these stretches have had some bad publicity with research showing that when undertaken before activity they can lead to reduced muscle strength and can hinder physical performance.
However the negative effects of these stretches are generally only observed when the stretches have been done in isolationand not part of a general warm up routine or when they have been held for over 60 seconds. When shorter duration stretches are undertaken as part of a pre-exercise routine evidence shows no compromise to muscle performance. There is also evidence that shows when, even in isolation, static stretches that are held for under 60 secondshave no negative effects, with one study finding that they actually increased leg extension power. However I think warm up routines are vital in preparing yourself for all levels of activity, whether it is for a morning of gardening or for a grand final and therefore I rarely recommend static stretches in isolation
I do not think there is enough evidence to advise people to stop doing static stretches but when they are used they should be held for less than 60 seconds and should be incorporated in a warm up routine rather than in isolation. Having said that I also do not think they are vital and if you have been someone who has never stretched before activity there is no overwhelming evidence that suggests you should start although I would recommend to do some form of warm up.
This advice is, however, dependent on injury. If you have an injury, either an old one or a new one, certain warm ups or stretches may be inappropriate. Therefore if you are in a position where you are looking for stretches to bring into your warm up routine because of an injury, or if you are returning to sport after an injury, then I would strongly advise to have a full assessment from a physiotherapist and get a diagnosis and a specific set of exercises or stretches.