Does Stretching Improve Performance Or Help Prevent Exercise Related Injury?

Me and a gymnast at the old National Stadium

Alright folks, I have a controversial topic to discuss. Trainers, coaches and of course physios have for the longest time asked both elite athletes and patients to stretch be it for rehabilitation or in pursuit of improved performance.

Do physios, coaches and trainers advise and patients/athletes practice it out of habit, outdated beliefs or current best practice?

In this day and age, we want everything to be evidence based. But are there any evidence based benefits of stretching? Does stretching help prevent exercise related injury?

The  articles discussed by Shrier (2004) and Weldon and Hill (2003) are both systematic reviews. (A systematic review is a computer aided search for ALL randomized & controlled clinical trials, meaning it's top of the pile in terms of quality).

Well, with regards to improving performance, here's the evidence. In Shrier's review paper, only one article suggested running economy (running more efficiently) was improved. Four articles studied running speed or sprinting, with one study being beneficial, one detrimental while two was inconclusive.

The paper concluded that stretching does not help to improve maximum strength or how high you can jump. There is some evidence however, to suggest that regular stretching performed outside of the pre exercise period (and not stretching before exercise) improves strength, jump height and sprinting. 

In fact, a few studies actually show that stretching before exercise has actually shown to increase your chance of sustaining an injury. Especially so if you are an endurance athlete with reduced flexibility.

The evidence also suggests that stretching immediately prior to exercise is detrimental to activities that require isolated force or power. There is also insufficient evidence to show that it helps with running economy (running more efficiently).

Well, here you go, not quite what you expected right? I know what our patients are gonna ask us. What do we do? Do we still stretch or not? Here's my opinion based on my work and observations with our athletes and patients. 

1. Minimize pre exercise static stretching since it hinders power and maximum strength.

2. Do your pre game or exercise warmup with movements that simulate your sport.

3. Stretch after exercise or at a time not related to exercise since regular stretching helps.

Please email me if you want the articles.

References

Shrier, I. (2004). Does Stretching Improve Performance? A Systematic and Critical Review of the Literature. Clinical Journal of Sports Medicine. 14(5) p 267-273.

Wendon, SM and Hill, RH. (2003). The Efficacy of Stretching for Prevention of Exercise-related injury: A Systematic Review of the literature. Manual Therapy. 8(3) p 141-150