When we think about stretching we first need to understand the desired outcome. Is it the feeling of the stretch, is it the elongation of the muscle, is it an increase in performance or is it the increase in flexibility? Once we understand what is it that we want we can better understand why to stretch. If all we want is the feeling of a stretch then go ahead and do the stretches that we were all taught in gym class. For the other three options it is a bit more complicated. Is the muscle truly short or is it a joint problem? Why is it short? What benefit will be had by stretching it? If indeed the muscle is short, will stretching be the best option? Will stretching help this person?
With all the discussion of whether or not to stretch I have developed a slight aversion to the word stretching. In the health and fitness industries we have seen over the years various articles stating that stretching is bad for you. In the layman's world we have a very ingrained thought process that stretching is great for you. So which is it?
Looking at what we often did in gym class before we played dodgeball and the like, this probably fell into the bad category. The type of stretching we were taught in gym class falls into the description of static stretching. Static stretching has been shown to decrease power output in various sporting activities. A 2009 study showed that static stretching decreased vertical jump height in male subjects. A 2007 study looked at static stretching alone or in combination with dynamic warm ups relative to 50 meter sprint performance. This study found that static stretching alone or in combination decreases sprint performance. In May of 2009 there was a study published that looked at the effects of static stretching on several components of the game of golf. Here is what they found: Signiﬁcant (p , 0.05) decreases in clubhead speed (24.19%), distance (25.62%), accuracy (231.04%), and consistent ball contact (216.34%) were observed.
So if stretching doesn't help us improve performance, then why do we do it? To prevent injury of course! Well maybe not.
In 2004, Stephen Thacker, MD of the CDC authored a study called "The Impact of Stretching on Sports Injury Risk: A Systematic Review of the Literature," which found that stretching doesn't prevent injuries and in fact another study done by the US military found that it may increase injury rates!
With the findings in the above mentioned studies, how can stretching be good for you? Well stretching has been shown to increase flexibility. Tightness is often a problem we see with aging and a sedentary lifestyle. It also depends on the sport as there may be flexibility goals that need to be reached in order to perform at the desired level. Gymnasts need to do the splits. Golfers need to be able to get all the way back in the back swing. In every day life we need to be able to look over our shoulder when driving. We need to be able to squat down to pick things up.
So is there a better way to "stretch"? Yes, it is called a dynamic warm up. In all of the above mentioned studies the researchers also looked at the dynamic warm up and in each of them benefits were found.
Dynamic warm ups can be a variety of different things depending on your activity of choice. For a marathoner it could be doing that first mile or so at a much slower pace. For a soccer player it could be performing slow cutting drills and ball strikes before going all out. Dynamic active stretching can also be done by taking a joint/muscle through a range of motion, pausing briefly at end range and then repeating 8 times. Think about it more as mobilizing the body part than stretching the muscle. Often during a dynamic stretch you will not feel a "stretch", rather you will just notice yourself being able to move farther in a direction.
Bottom line: We need to have the flexibility that we need - how we get there depends on what we're looking to do. If it is a joint issue we need to mobilize the joint. If it is truly a shorten muscle we to elongated that muscle slowly (usually a static stretch over 10 mins). But more often it is a combination of joint and muscle tightness, not muscle shortness. The best option in these cases is to perform mobility exercises and identify if there is limitations because of weaknesses.
To be honest I rarely give classic stretches out to my patients. Instead I will prescribe mobility exercises or strengthening exercises to restore proper joint biomechanics and load distributions. I am amazed how often these tight or short muscles just disappear.