Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review

Abstract Objective: To determine the effects of stretching before and after exercising on muscle soreness after exercise, risk of injury, and athletic performance. Method: Systematic review. Data sources: Randomised or quasi-randomised studies identified by searching Medline, Embase, CINAHL, SPORTDiscus, and PEDro, and by recursive checking of bibliographies. Main outcome measures: Muscle soreness, incidence of injury, athletic performance. Results: Five studies, all of moderate quality, reported sufficient data on the effects of stretching on muscle soreness to be included in the analysis. Outcomes seemed homogeneous. Stretching produced small and statistically non-significant reductions in muscle soreness. The pooled estimate of reduction in muscle soreness 24 hours after exercising was only 0.9 mm on a 100 mm scale (95% confidence interval −2.6 mm to 4.4 mm). Data from two studies on army recruits in military training show that muscle stretching before exercising does not produce useful reductions in injury risk (pooled hazard ratio 0.95, 0.78 to 1.16). Conclusions: Stretching before or after exercising does not confer protection from muscle soreness. Stretching before exercising does not seem to confer a practically useful reduction in the risk of injury, but the generality of this finding needs testing. Insufficient research has been done with which to determine the effects of stretching on sporting performance.

[1]  B. Arroll Review: stretching before or after exercise does not prevent muscle soreness or reduce risk of injury , 2003 .

[2]  P. Lee,et al.  Publication bias in meta-analysis: its causes and consequences. , 2000, Journal of clinical epidemiology.

[3]  R D Herbert,et al.  A randomized trial of preexercise stretching for prevention of lower-limb injury. , 2000, Medicine and science in sports and exercise.

[4]  I. Shrier,et al.  Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. , 1999, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[5]  R. Souhami,et al.  Mitomycin, ifosfamide, and cisplatin in unresectable non-small-cell lung cancer: effects on survival and quality of life. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  G. Sundelin,et al.  The effects of preexercise stretching on muscular soreness, tenderness and force loss following heavy eccentric exercise , 1999, Scandinavian journal of medicine & science in sports.

[7]  D. E. Hartig,et al.  Increasing Hamstring Flexibility Decreases Lower Extremity Overuse Injuries in Military Basic Trainees , 1999, The American journal of sports medicine.

[8]  H. Vet,et al.  The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. , 1998, Journal of clinical epidemiology.

[9]  M. McHugh,et al.  Flexibility and Its Effects on Sports Injury and Performance , 1997, Sports medicine.

[10]  J. Kelly,et al.  Various treatment techniques on signs and symptoms of delayed onset muscle soreness. , 1996, Journal of athletic training.

[11]  Les M Irwig,et al.  An evidence based approach to individualising treatment , 1995, BMJ.

[12]  O. Brodin,et al.  Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials , 1995 .

[13]  M. Clarke,et al.  Identifying relevant studies for systematic reviews , 1995, BMJ.

[14]  K. Dickersin,et al.  Systematic Reviews: Identifying relevant studies for systematic reviews , 1994 .

[15]  J. Wessel,et al.  Effect of Stretching on the Intensity of Delayed‐Onset Muscle Soreness , 1994 .

[16]  D. Machin,et al.  A Medical Research Council (MRC) randomised trial of palliative radiotherapy with two fractions or a single fraction in patients with inoperable non-small-cell lung cancer (NSCLC) and poor performance status. Medical Research Council Lung Cancer Working Party. , 1992, British Journal of Cancer.

[17]  J. de Haes,et al.  Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom Checklist. , 1990, British Journal of Cancer.

[18]  J A Nicholas,et al.  The influence of flexibility on the economy of walking and jogging , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[19]  F Mosteller,et al.  Some Statistical Methods for Combining Experimental Results , 1990, International Journal of Technology Assessment in Health Care.

[20]  E. Howley,et al.  The effects of static stretching and warm-up on prevention of delayed-onset muscle soreness. , 1989, Research quarterly for exercise and sport.

[21]  M. Safran,et al.  Warm-Up and Muscular Injury Prevention An Update , 1989, Sports medicine.

[22]  A. Zigmond,et al.  The Hospital Anxiety and Depression Scale , 1983, Acta psychiatrica Scandinavica.

[23]  G. McGlynn,et al.  Effect of electromyographic feedback and static stretching on artificially induced muscle soreness. , 1979, American journal of physical medicine.

[24]  H. D. Vries Electromyographic Observations of the Effects of Static Stretching upon Muscular Distress , 1961 .

[25]  H. Devries,et al.  Prevention of Muscular Distress after Exercise , 1961 .

[26]  R. Herbert How to estimate treatment effects from reports of clinical trials. II: Dichotomous outcomes. , 2000, The Australian journal of physiotherapy.

[27]  T. Worrell,et al.  Effects of a static stretching program on the incidence of lower extremity musculotendinous strains. , 1999, Journal of athletic training.

[28]  Cross Km,et al.  Effects of a static stretching program on the incidence of lower extremity musculotendinous strains. , 1999 .

[29]  Robert D. Herbert,et al.  Effects of ankle dorsiflexion range and pre-exercise calf muscle stretching on injury risk in Army recruits. , 1998, The Australian journal of physiotherapy.

[30]  H. Dickhuth,et al.  Effects of contract-relax stretching training on muscle performance in athletes , 1997, European Journal of Applied Physiology and Occupational Physiology.

[31]  D. Girling,et al.  Randomized trial of palliative two-fraction versus more intensive 13-fraction radiotherapy for patients with inoperable non-small cell lung cancer and good performance status. Medical Research Council Lung Cancer Working Party. , 1996, Clinical oncology (Royal College of Radiologists (Great Britain)).

[32]  G. Grégoire,et al.  Selecting the language of the publications included in a meta-analysis: is there a Tower of Babel bias? , 1995, Journal of clinical epidemiology.

[33]  C A Smith,et al.  The warm-up procedure: to stretch or not to stretch. A brief review. , 1994, The Journal of orthopaedic and sports physical therapy.

[34]  G A Wood,et al.  Stretch shorten cycle performance enhancement through flexibility training. , 1992, Medicine and science in sports and exercise.

[35]  J A Schwane,et al.  Does Postexercise Static Stretching Alleviate Delayed Muscle Soreness? , 1989, The Physician and sportsmedicine.

[36]  A. Donner,et al.  Analysis of data arising from a stratified design with the cluster as unit of randomization. , 1987, Statistics in medicine.

[37]  R. D. Hunter,et al.  WHO Handbook for Reporting Results of Cancer Treatment , 1980 .