Stretching Before Playing. What’s the Verdict?
Today we’re going to talk about stretching before playing. We’ll go through some research and hopefully give you a general idea of what is the right recommendation to make to your patients.
But first, here’s that bumper music
OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.
Now that we are locked in and rocking, I want to ask you to go to chiropracticforward.com and sign up for our newsletter. It’s just an email. We don’t sell it, we won’t use it any more than once per week when a new episode comes out, and it’s the best way for lots of you to get a reminder when episodes go live.
Did you know that I literally get more emails from myself than I get from anyone else? It’s true. As soon as I think of something that needs to get done, I send myself an email. Muy pronto. If I don’t, it’ll be gone in the ether. Like a wisp of smoke. It’s there and then swoosh….it’s gone. Lol. That may be just a consequence of aging but it’s been that way for some time now. We just learn how to deal with those things and develop the coping mechanisms that allow life to continue as unimpeded as possible.
Back to school, yes, we have the knuckleheads back in school and, while they were unhappy, I was all smiles inside. I love being on a schedule and school offers that regimented, timetable type of deal. That’s what I operate best under. When the kids are here, there, and everywhere, I just lose my mind a little honestly so, for my colleagues that have kids…..hell yeah.
We made it through Summer.
We are honored to have you listening. Now, here we go with some vital information that we think can build confidence and improve your practice which will improve your life overall.
You have high-stepped right into Episode #37
I mentioned some time ago that I really enjoy some of the private groups on Facebook. Specifically, I enjoy the Forward Thinking Chiropractic Alliance and the Evidence-based Chiropractic Facebook groups. I would be crazy to fail to mention our OWN private Facebook group which is called oddly enough the Chiropractic Forward Facebook group.
You can learn so much stuff you weren’t even expecting to find out or didn’t even know you didn’t know. That’s the best kind of learning I think.
Stretching Before Playing
On that note. In one of those groups, there was a discussion not too long ago on stretching before playing or participating in an athletic event. When I was an athlete from elementary age all the way through college, we stretched. We stretched a lot.
In playing football in college, I couldn’t tell you whether stretching before playing made any difference in game time performance because there was never an opportunity to NOT stretch.
However, I actually won state here in Texas in the discus and competed at state in the shot put when I was in high school and I can tell you from personal experience and from knowing my body very well back then…..I always felt weaker when I stretched before an event.
Luckily, we were allowed to kind of do our own thing in track and field when it came to warm-ups and I started avoiding stretching purely based on the way it made me feel weaker. Stretching before playing in my particular case was a no-go.
I found I got a lot more use out of visualization and relaxing my mind. On that note, I had a college coach recommend a book to me that made all of the difference to me in regards to performance. It was called Peak Performance and authored by Charles A. Garfield.
It is a phenomenal book. Mostly because it didn’t offer general ideas on visualization and relaxation. It gave you specific, easy to use exercises that allowed you to get it and use it immediately. I can’t recommend it highly enough if you can still find it. I’m old now so my copy may one of the few left. But, I did leave a link in the show notes that takes you to a copy at Barnes and Noble if interested.
Now, was my idea that stretching before playing made me weaker before a throwing event crazy or not? Let’s dive and see what the research has to say on it.
Since there are several papers to run over and our time is limited here, I will not be going very deeply into each paper. We will get the general ideas, I will cite them in the show notes for Episode 37 at chiropracticforward.com and, if you want to learn more, you can find the papers linked there or in our private Chiropractic Forward Facebook group.
OK, let’s see what we have here. Let’s start with one called “Current concepts in muscle stretching for exercise and rehabilitation” by PT and PhD Phil Page. It was published in the International Journal of Sports Physical Therapy in February of 2012.
Why They Did It
The purpose of this clinical commentary is to discuss the current concepts of stretching before playing and summarize the evidence related to stretching as used in both exercise and rehabilitation.
There are three muscle stretching techniques frequently described in the literature: Static, Dynamic, and Pre-Contraction stretches.
Static stretching before playing is the probably the type of stretching we all commonly think of. It’s where you hold a specific position and tension or stretch the muscle or the muscle group. We hold it for 10 or so seconds and usually do that for 3 sets. Traditionally anyway.
Next is Dynamic stretching before playing, which is characterized by either active or ballistic dynamic stretching. Active dynamic stretching involves moving a limb through its full range of motion to the end range and repeating it several times while Ballistic dynamic stretch involves rapid, alternating movements or “bouncing” at the end-range of the motion. Ballistic dynamic stretching is no longer recommended due to an increased risk of injury.
The last of the three is Pre-contraction stretching before playing. This involves a contraction of the muscle being stretched or a contraction of its antagonist muscle before stretching. According to Dr. Page’s paper, the most common type of pre-contraction stretching is proprioceptive neuromuscular facilitation (PNF) stretching.
There are several different types of PNF stretching including “contract-relax” (C-R), “hold relax” (H-R), and “contract-relax agonist contract” (CRAC); these are generally performed by having the patient or client contract the muscle being used during the technique at 75 to 100% of maximal contraction, holding for 10 seconds, and then relaxing.
This paper is all about any and all stretching before playing depending on the person and activity so there’s no real specificity in the recommendations but you can derive some generalizations here.
For warm-up for sports and exercise purposes, Dr. Page says that static stretching is most beneficial for athletes requiring flexibility for their sports like gymnastics, dance, etc. He says that dynamic stretch may be better for athletes that will be running or jumping like basketball players or sprinters. However, he states that stretching has not been shown to reduce the incidence of overall injuries.
For warm-up for sports and exercise purposes, Dr. Page says that static stretching is most beneficial for athletes requiring flexibility for their sports like gymnastics, dance, etc.
Dynamic stretch may be better for athletes that will be running or jumping like basketball players or sprinters. However, he states that stretching has not been shown to reduce the incidence of overall injuries.
Next, here’s one called “Effects of dynamic and static stretching on vertical jump performance and electromyographic activity” by PA Hough et. al. published in Journal of Strength Conditioning Research in 2009.
This was a randomized controlled trial. This one is actually older than the last one but I wanted to cover the last one prior to this one so that you’d know the differences in the types of stretching before playing. So…..on with the show here.
Why They Did It
The purpose of this study was to assess the effects of static stretching and dynamic stretching on vertical jump performance and electromyographic activity of the vastus medialis.
What They Found
- There was significantly greater EMG amplitude in the dynamic stretched individuals that the static stretch folks.
- The vertical jump was statistically greater in the dynamic stretch group than the static stretch as well.
- Static stretch actually has a negative influence on the vertical jump while dynamic has a positive impact.
“This investigation provides some physiological basis for the inclusion of DS and exclusion of SS in preparation for activities requiring jumping performance.”
This investigation provides some physiological basis for the inclusion of Dynamic Stretch and exclusion of Static Stretch in preparation for activities requiring jumping performance.
Let’s keep it moving. Here’s one called “Effects of running, static stretching and practice jumps on explosive force production and jumping performance” by W.B. Young et. al. published in Journal of Sports Medicine and Physical Fitness in 2003.
Why They Did It
The purpose of the study was to compare the effects of running, static stretching of the leg extensors and practice jumps on explosive force production and jumping performance.
What They Found
The results of this particular study showed that sub-maximum running and practice jumps had a positive effect whereas static stretching before playing had a negative influence on explosive force and jumping performance. It was suggested that an alternative for static stretching should be considered in warm-ups prior to power activities.
Sub-maximum running and practice jumps had a positive effect whereas static stretching had a negative influence on explosive force and jumping performance
That definitely confirms my personal experience back in track and field in high school. All we really knew back then was the static stretch.
Right on into the next paper by JC Gergley called “Latent effect of passive static stretching on driver clubbed speed, distance, accuracy, and consistent ball contact in young male competitive golfers” published in Journal of Strength and Conditioning Research in 2010.
Why They Did It
This investigation was conducted to determine the effect of 2 different warm-up treatments over time on driver clubhead speed, distance, accuracy, and consistent ball contact in young male competitive golfers.
What They Found
The authors concluded, “The results of this inquiry strongly suggest that a total-body passive static stretching routine should be avoided before practice or competition in favor of a gradual active dynamic warmup with the clubs. Athletes with poor mechanics because of lack of flexibility should perform these exercises after a conditioning session, practice, or competition.”
We continue with “The acute effects of static stretching compared to dynamic stretching with and without an active warm-up on anaerobic performance” authored by Bradley Kendall and published in International Journal of Exercise Science in 2017.
Why They Did It
“The Wingate Anaerobic Test (WAnT) has been used in many studies to determine anaerobic performance. However, there has been poor reporting of warm-up protocols and limited consistency between warm-up methods that have been used.
With the WAnT being such a commonly-used test, consistency in warm-up methods is essential in order to compare results across studies. Therefore, this study was designed to compare how static stretching, dynamic stretching, and an active warm-up affect WAnT performance.”
It was hypothesized that the dynamic stretching would lead to greater peak power than the static stretching protocol. However, results of post hoc analyses failed to detect a significant difference. For the other measured variables, no significant differences were found.
However, the Bonferroni adjustment is quite stringent and may have failed to detect a significance due to the small sample size in this study. When comparing dynamic stretching to static stretching, Cohen’s effect size suggested that dynamic stretching may have a small to moderate effect on performance.
The comparison between static and dynamic stretching before playing approached significance and had a small to moderate effect, supporting studies that have concluded dynamic stretching before playing to be more beneficial than static stretching prior to anaerobic performance output.”
And here we arrive at our last article called “Injury prevention and management among athletic populations: to stretch or not stretch?” by Kieran O’Sullivan and Sean McAulliffe of Ireland and Gregory Lehman of Canada. This article appeared in Aspetar Sports Medicine Journal in 2014.
Since this article is long, we won’t get too detailed here. We will hit the high spots and link it in the show notes for episode #37 at ChiropracticForward.com and hopefully, you can read it in depth
Why They Wrote It
The authors wanted to discuss whether there is evidence that static stretch is worth including in athlete management.
I found it interesting to see a quote at the beginning of this article that said, “There is consistent evidence that SS increases flexibility in the short-term, although the gains in flexibility decrease relatively quickly, such that they are lost within 30 minutes.”
There is consistent evidence that SS increases flexibility in the short-term, although the gains in flexibility decrease relatively quickly, such that they are lost within 30 minutes.
They summarized static stretch as follows:
- SS increases flexibility in both the short- and long-term
- Flexibility is also increased by strength training, especially eccentric training.
- Interestingly, strength training appears to increase both tendon stiffness and overall MTU stiffness, while simultaneously increasing ROM
- Neither SS nor strength training appears to consistently decrease the stiffness of the joints.
- none of the reviews showed a beneficial effect of SS on performance
- Maximal strength appears to be more commonly negatively affected by SS than explosive muscular performance or power
- Sustained SS does not appear to enhance running or walking efficiency even when ROM is increased. Results are equivocal with SS and endurance performance. In contrast, strength training consistently improves endurance performance
- Acute SS for greater than 45 seconds should be avoided immediately before participation in activities where strength or power are important
- Shorter durations of SS are also hard to justify immediately before participation in activities where strength or power are important
- In endurance activities, acute SS is hard to justify immediately before participation as performance may be reduced
- SS is far less effective than strength training in enhancing strength and power and it’s unclear whether adding SS might reduce the strength gains achieved, so why do it?
- There is not sufficient evidence to endorse or discontinue routine stretching before or after exercise to prevent injury among competitive or recreational athletes
- In terms of injury prevention, it appears SS has very little to offer and should not be used.
- Alternatively, a meta- analysis showed that strength training reduced incidence of sports injuries to less than one third
They summarized the article by saying, “the only area in which SS might seem to offer a specific advantage is in the area of increasing flexibility. There may be times when the most important goal is enhancing flexibility (e.g. ballet) and in these isolated circumstances SS may be justifiable.
However, there remains a lack of evidence that gains are superior to those of a strength training programme. Even if strength training is eventually confirmed as being inferior to SS at increasing flexibility, the fact that strength training improves performance, pain, disability, injury and return to sports rates mean strength training must be a mainstay of athletic development and training, in contrast to SS.”
Even if strength training is eventually confirmed as being inferior to SS at increasing flexibility, the fact that strength training improves performance, pain, disability, injury and return to sports rates mean strength training must be a mainstay of athletic development and training, in contrast to static stretch.
What a fascinating article. We only touched on a few of the larger ideas in the article but it’s FULL of information and learning. If sports and stretching are a part of your focus, the article is a must. Everything they talk about is cited properly so you can really dive in face first if you want.
Great stuff folks.
I’m going to say that my notion in high school, in my mind, has been confirmed. I just felt weaker if I performed static stretch for more than just a few seconds. Like the stretching just took the wind out of my sails.
I’ve learned a ton through putting this podcast and I hope you have too! Hell, that’s what we’re here for right?
Go forward this week with more confidence in your recommendations for stretching before athletic activity. If we didn’t hit enough here for you, dive into the show notes and the citations at chiropracticforward.com Episode #37 and do some of your own homework. You’ll be better for it. I promise.
I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is a mechanical pain and responds better to mechanical treatment instead of chemical treatments.
The literature is clear: research and experience show that, in 80%-90% of headaches, neck, and back pain, patients get good to excellent results when compared to usual medical care and it’s safe, less expensive, and decreases chances of surgery and disability.
It’s done conservatively and non-surgically with little time requirement or hassle for the patient. If done preventatively going forward, we can likely keep it that way while raising overall health! At the end of the day, patients have the right to the best treatment that does the least harm and THAT’S Chiropractic, folks.
Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.
Being the #1 Chiropractic podcast in the world would be pretty darn cool.
We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
??Social Media Links
??Player FM Link
Enjoy other episodes of our Chiropractic Forward Podcast!
1. Page P, CURRENT CONCEPTS IN MUSCLE STRETCHING FOR EXERCISE AND REHABILITATION. Int J Sports Phys Ther, 2012. 7(1): p. 109-119.
2. Hough PA, Effects of dynamic and static stretching on vertical jump performance and electromyographic activity. J Strength Cond Res, 2009. 23(2): p. 507-12.
3. Young WB, Effects of running, static stretching and practice jumps on explosive force production and jumping performance. J Sports Med Phys Fitness, 2003. 43: p. 21-7.
4. Gergley JC, Latent effect of passive static stretching on driver clubhead speed, distance, accuracy, and consistent ball contact in young male competitive golfers. J Strength Cond Res, 2010. 24(12): p. 3326-33.
5. Kendall B, The Acute Effects of Static Stretching Compared to Dynamic Stretching with and without an Active Warm up on Anaerobic Performance. Int J Exerc Sci, 2017. 10(1): p. 53-61.
6. O’Sullivan K, Injury prevention and management among athletic populations: To stretch or not stretch. Aspetar Sports Medicne Journal, 2014. 3(3): p. 624-628.