A pragmatic randomised trial of stretching before and after physical activity to prevent injury and soreness

Objective To determine the effects of stretching before and after physical activity on risks of injury and soreness in a community population. Design Internet-based pragmatic randomised trial conducted between January 2008 and January 2009. Setting International. Participants A total of 2377 adults who regularly participated in physical activity. Interventions Participants in the stretch group were asked to perform 30 s static stretches of seven lower limb and trunk muscle groups before and after physical activity for 12 weeks. Participants in the control group were asked not to stretch. Main outcome measurements Participants provided weekly on-line reports of outcomes over 12 weeks. Primary outcomes were any injury to the lower limb or back, and bothersome soreness of the legs, buttocks or back. Injury to muscles, ligaments and tendons was a secondary outcome. Results Stretching did not produce clinically important or statistically significant reductions in all-injury risk (HR=0.97, 95% CI 0.84 to 1.13), but did reduce the risk of experiencing bothersome soreness (mean risk of bothersome soreness in a week was 24.6% in the stretch group and 32.3% in the control group; OR=0.69, 95% CI 0.59 to 0.82). Stretching reduced the risk of injuries to muscles, ligaments and tendons (incidence rate of 0.66 injuries per person-year in the stretch group and 0.88 injuries per person-year in the control group; HR=0.75, 95% CI 0.59 to 0.96). Conclusion Stretching before and after physical activity does not appreciably reduce all-injury risk but probably reduces the risk of some injuries, and does reduce the risk of bothersome soreness. Trial registration anzctr.org.au 12608000044325.

[1]  S. Kamper,et al.  Stretching to prevent or reduce muscle soreness after exercise. , 2011, The Cochrane database of systematic reviews.

[2]  Martyn J. Matthews,et al.  A Systematic Review into the Efficacy of Static Stretching as Part of a Warm-Up for the Prevention of Exercise-Related Injury , 2008, Research in sports medicine.

[3]  Andrew D. Oxman,et al.  A Televised, Web-Based Randomised Trial of an Herbal Remedy (Valerian) for Insomnia , 2007, PLoS ONE.

[4]  R. Bahr,et al.  Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries , 2006, British Journal of Sports Medicine.

[5]  S. Cummings,et al.  An Internet-Based Randomized, Placebo-Controlled Trial of Kava and Valerian for Anxiety and Insomnia , 2005, Medicine.

[6]  G. Guyatt,et al.  Grading quality of evidence and strength of recommendations , 2004, BMJ : British Medical Journal.

[7]  Julie Gilchrist,et al.  The impact of stretching on sports injury risk: a systematic review of the literature. , 2004, Medicine and science in sports and exercise.

[8]  W. Schill Applied Longitudinal Data Analysis for Epidemiology: A Practical Guide. , 2004 .

[9]  S. Weldon,et al.  The efficacy of stretching for prevention of exercise-related injury: a systematic review of the literature. , 2003, Manual therapy.

[10]  J. Twisk,et al.  Applied Longitudinal Data Analysis for Epidemiology: A Practical Guide , 2003 .

[11]  R. Herbert,et al.  Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review , 2002, BMJ : British Medical Journal.

[12]  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.

[13]  J. Wittes,et al.  Analysis and interpretation of treatment effects in subgroups of patients in randomized clinical trials. , 1991, JAMA.

[14]  C. Bulpitt,et al.  Clinical Trials—Issues and Approaches , 1984 .

[15]  T. Louis,et al.  Clinical trials : issues and approaches , 1984 .

[16]  S. Piantadosi Clinical Trials : A Methodologic Perspective , 2005 .

[17]  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.