Over the years, we have heard so many recommendations regarding the advantages of stretching our muscles and warming-up before exercising. Most of the advice is offered by friends, personal trainers, athletes, and health care professionals—and most is well-intentioned. However, we also know that it could be conflicting and based on misinformation and misconceptions.
Stretching and range-of-motion movements of at least one or two minutes is usually what many of us might need; although it is also true that some may need more time to do it. Local heat or cold compresses applied to muscles also have been recommended—either one works, but only while stretching.
There are many stretching techniques and not all of them would benefit everyone. Recommendations by health care professionals should be offered only after a complete physical exam and medical history: individualized advice is a must, because we are all at different stages on our life and our physical condition may not allow for certain techniques, which, if improperly applied, might lead to injuries.
Stretching has been a part of fitness and exercise programs for many years and although it could be beneficial, there is no scientific evidence that it avoids or decreases the risk of injuries, improves athletic and sports performance and also may relieve or decrease muscle soreness or pain.
Recent studies found that sustained stretching over time, as opposed to occasional stretching, would not decrease injuries, even doing it just immediately before exercising.
Regarding pain and stiffness, the increase in stretching tolerance might be more beneficial while reducing their occurrence. Although the range of motion may increase, stiffness may still be present.
Although we still do not know the cause, stretching increases the threshold for pain; frequent stretching increases muscle mass and this, in turn, may increase the tolerance for pain, particularly when holding time is as long as one minute, depending on individual situations. Sudden, bouncing stretching does not yield similar benefits and it is risky.
Stretching daily increases range of motion and tolerance for pain, if it is done for at least thirty seconds—or longer, depending on the muscle groups—has proven beneficial in the long-term—approximately two to three months.
As a general recommendation, stretching for thirty to sixty seconds should be a part of a good group fitness program; however, as we noted before, all programs must be tailored to individual needs and physical condition, limitations, injuries, etc. The benefits are also different depending on muscle groups: sometimes it is enough to stretch three or four times, for only fifteen seconds. Sometimes, similar results are achieved only when stretching for about forty-five to sixty seconds. Stretching should be done until less muscular tension is noted without causing pain.
Of course stretching after having sustained injuries would require a different approach: longer stretches to achieve similar changes in the range of motion.
Range of motion can also be increased by warming or icing during stretching, but this approach will not prevent injuries. Active warm-ups without stretching will not increase range of motion.
Most of us believe that warm-up activities alone would take care of muscle stiffness and increase range of motion and it is true—up to a point, for only small muscle groups. Stretching is what makes the difference; this is probably the reason why it has been recommended for a long time to warm up before stretching… However, neither would prevent injuries. For the “weekend” athlete who wants to prevent injuries while performance is not the main goal, increasing warm-ups with light activity and not stretching would be of benefit.
What is the safest way to stretch? Which method is better? These and many other questions remain unanswered, because not enough studies have been done. Common sense indicates that we should find the method that allows us to achieve the best range of motion. We should adjust time and frequency while making progress; we should always keep in mind that pain is the natural warning before a muscle or tendon injury occurs.
By Annie M. Williams, MD