A systematic review on the effect of stretching in sports injury prevention

  • Assuman Nuhu
  • José M. Frantz

Abstract

Introduction:

Although stretching increases soft tissue flexibility and joint range of motion , numerous studies demonstrated contradictory findings as to its effect in injury prevention. Aim: The purpose of this systematic review is to assess the effectiveness of stretching on the prevention of injuries.

Methodology :

An electronic search using MEDLINE, SCIENCE DIRECT, COCHRANE , EBSCOHOST, SPORTDiscus and CINAHL databases, checking the references. Randomised control trials (RCTs) and cohort studies investigating stretching as an injury  prevention measure published in the last decade were selected rn this review. Methodological quality was assessed  using the Critical Appraisal Skills Programme (CASP) tool.

Results :

Two RCTs and two prospective cohort studies all of high quality were included in this analysis. One cohort study found that stretching reduced the incidence of exercise related injuries. Two RCTs and one cohort study found that stretching did not produce practical reduction on the occurrence of injuries.

Conclusion:

Stretching exercises does not give a practical useful reduction in the risk of injuries. Not enough recent research has been done to draw definitive conclusion on the effect of stretching in injury prevention. Well designed studies are needed to shed light as to the effect of stretching in exercise-related injury risk reduction

References

Amason. A., Anderse n. T.E.,Holme. 1., Engebretsen.L., & Bahr.

R.,(2008) . Prevention of hamstring strains in elite soccer: an intervention study. Scandinavian Journal of Medicine & Science in Sport,18, 40-48 .

Arnheim, D.D., & Prentice WE. (1993). Principles of athletic training. (ath Ed.). Mosby-Year book, St. Louis, Missouri. pp.246-267.

Bandy. W.O. & Irion. J.M., (1994). The effect of time on static stretch on the flexibility of the hamstring muscles. Physical Therapy, 74,845-852

Brukner. P., & Khan. K.. (1993). Clinical sports medicine.

Sydney, Australia: McGraw-Hill. pp: 372-391.

Cabbie B. J , Brunell. K.L, Finch. F.C, Wajswelner. H. & Orchard .J.W. , (2006). Predictors of hamstring injury in the elite level of Australian football. Scandinavian Journal of Sports MedicinE, 16, 7-13.

Clyde. L.A., (2006). The basis for e.yi.dence-based... practice: evaluating the research evidence. New Library World, 107, 180-192.

Critical Appraisal Skills Programme (CASP). (2006). Critical Appraisal Skills Programme. Retrieved from

www.phru.nhs.uk on 03/05/2008 at 12:28.

---:;---:-::--::-

Cross. K.M., & Worrell. T.W., (1999). Effects of a static stretching program on the incidence of lower extremity musculotendinous strains. Journal of Athletic Training, 34, 11- 14.

DePina. G.M., Webright.. W.G., & Arnold..B.L.,-{2000}..-Duration of stretching protocol. Journal of Athletic Training, 35, 56-59.

Dickersin. K., Scherer. R., & Lefebvre. C., (1994). Identifying relevant studies for systematic reviews. British Medical Journal , 309, 1286-1291.

Etnyre. B.R. & Abraham L.D. (1986). Gains in range of ankle dorsiflexion using three popular stretching techniques. American Journal of Physical Medicine, 65, 189-196.

Hagglund. M., Walden. M. & Ekstrand. J., (2004). Injury

incidence and distribution in elite football: a prospective study of the Danish and the Swedish top divisions. Scandinavian Journal of Medicine and Science in Sport, 15, 21-28.

Harting. D.E. & Henderson. J.M., (1999). Increasing hamstring flexibility decreases lower extremity overuse injuries in military basic trainees. American Journal of Sport Medicine, 27, 173-176.

Harvey. L., Herbert. R. & Crosbie. J., (2002). Does stretching

induce lasting increases in joint ROM? A systematic review.

Physiotherapy Research International, 7. 1-13.

Herbert. R.D. & Gabriel. M., (2002). Effect of stretching before and after exercising on muscle soreness and risk for injury: A systematic review. British Medical Journal, 325, 468-470.

Lee.Y.S.& Laffrey. S.C.. (2006). Predictors of physical activity in older adults with borderline hypertension. University of Texas at Austin. Nursing Research, 55, 110-120.

Leininger. R.E, Knox. C.L & Comstock R.D. (2007).

Epidemiology of 1.6 million pediatric soccer-related injuries presenting to US emergency departments from 1990 to 2003. (Clinical report), 35, 288-294.

Lucas. R.C & Koslow. R (1984). Comparative study of static,

dynamic, and proprioceptive neuromuscular facilitation stretching techniques on flexibility. Perceptual and Motor Skills, 58, 615-618

Magnusson P, Simonsen E, Aagaard H, Sorensen H & Kjer M.

(1996). A mechanism of altered flexibility in human skeletal muscle. Journal of Physiology, 497, 291-298.

Moiler. M., Ekstrand. J., Oberg. B. & Gillquist. J., (1985).

Duration of stretching effect on range of motion in lower extremities . Archives of Physical Medicine and Rehabilitation, 66,171-173.

Mulvihill. C., Rivers. K & Aggleton. P., (2000)':-A qualitative S1trdy investing the views of primary-age children and parents on physical activity. Health Education Journal, 59, 166-179.

Osternig. L.R, Robertson. R.N. Troxel. R.K & Hansen. P. (1990). Differential responses to proprioceptive neuromuscular facilitation (PNF) stretch techniques . Medicine & Science in Sports & Exercise, 22, 106-111.

Thacker. S.B, Gilchrist. J., Stroup. D.F & Kimsey D.C.J.R (2004). The impact of stretching on sports injury risk: A systemat ic review of the literature. Medicine & Science in

Sports & Exercise, 36, 371-378. ----- ••-

Pope. R.P., Herbert. R.D & Kirwan. J.D ., (1998) . Effects of ankle dorsiflexion range and pre-exercise calf muscle stretching on injury risk in army recruits. Australian Journal of Physiotherapy, 44, 165-177.

Pope. R.P., Herbert. R.D., Kirwan. J.D., Graham. B.J., (2000).A randomized trial of pre-exercise stretching for prevention of lower-limb injury. Medicine & Science in Sport & Exercise, 32, 271-277.

Roberts. J.M & Wilson. J., (1999). Effect of stretching duration on the active and passive range of motion in the lower extremity. British Journal of Sports Medicine, 33, 259-263.

Shrier. I. & Gossal. K.. (2000). Myths and truths of stretching.

Individualized recommendations for healthy muscles. The

Physician and Sports Medicine, 28, 1-11.

Walter. J., Figoni. S.F., Andres. F.F. & Brown. E., (1996). Training intensity and duration in flexibility. Clinical Kinesiology, 50, 40-45.

Weldon. S.M & Hill. R.H., (2003). The efficacy of stretching for prevention of exercise-related injury: a systematic review of the literature. Manual Therapy, 8, 141-150.

Yeung. E.W & Yeung. S.S. (2001). Intervention for preventing

soft-tissue injuries in runners. Cochrane Database of Systematic Reviews, 3, DC 001256.

Zebas. C.J & Rivera. M.S . (1985). Retention of flexibility in selected joints after cessation of stretching exe rcise programme. In C.O. Dotson, & J.H. Humphrey (Eds.). Exercise physiology : current selected research (pp: 181- 191). New York :AMS Press, Inc.

Section
Articles