Stretching – is it always beneficial?

stretching

Stretching has long been proposed as aiding injury prevention, and there’s a widely-held belief that stretching improves flexibility. However, evidence now shows that this is not always true.

“It is important to note, that, at this time, there is no empirical evidence to support the notion that pre-exercise stretching reduces the risk of injury in any population or activity, and that the only evidence we currently have suggested it does not”. ~ R P Pope

In 2003, a systematic review of the literature looking at the efficacy of stretching for injury prevention found no literature in 20 years that conclusively supported stretching for injury prevention. (3)>

Time and time again we see high-profile athletes with recurrent hamstring strains. These athletes are often given a program of stretching and strengthening and told to ensure they stretch prior to training/competing only to re-injure the same muscle as soon as it is tested. It is also common to see patients with tight muscles being told to stretch, only to find them coming back with increased pain and stiffness.

 

So what should we do to improve flexibility?

Muscle activity is dictated by neural input, as without a nerve supply there is no muscle function (1). Primary muscle injury is also rare – there will always be some involvement of neural innervation disruption. No matter how “strong” a muscle is, the quickest way to compromise its function is via the nerve supply.

 

Pilates has been shown to improve flexibility without stretching.

Physiotherapists who use clinical Pilates as a treatment method have the training to understand what directional preference an injury/condition has, and how the associated nerve supply will react. Therefore, Pilates can be used to effectively increase flexibility, without increasing the risk of injury, and without the need for stretching. In fact, Clinical Pilates will often give the client a 50% improvement in Straight Leg Raise (SLR) or fingers to the floor. These results, achieved without incorporating hamstring stretches, are now being studied and have been shown to be statistically significant. (4)

The application of Pilates and the effect that it has on neuro-dynamics can also result in increased stability to a joint. The various exercise positions used in Pilates results in increased neural input to the support muscles of a joint, meaning that muscles fire faster and stabilise the joint, thus preventing injury. We are now seeing many of the large football clubs in the UK, and AFL clubs in Australia, implementing Pilates in their strength and conditioning programs, which is resulting in fewer injuries to players and improved performance. (5)

 

Our physiotherapists have developed 3 online Pilates programs that will increase flexibility and stability, and decrease pain. These are only a few of the positive outcomes occurring from this evidence-based treatment method.

 

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1 Nyland J, Brosky T, Currier D, Nitz A and Caborn D Review of the afferent neural system of the knee and its contribution to motor learning. Journal of Orthopaedic & Sports Physical Therapy, 1994 Jan; 19(1):2-11

2 Pope RP, Herbert RD, Kirwan JD, Graham BJ A Randomised trial of pre-exercise stretching for prevention of lower limb injury. Official Journal of the American College of Sports Medicine, 2000 Feb;32(2): 271-7

3 Weldon SM, Hill RH The efficacy of stretching for prevention of exercise-related injury: a systematic review of the literature. Man Ther 2003 Aug;8(3):141-50 Tull

<4 Tulloch E, Phillips C, Sole G, Carman A, Abbott JH DMA Clinical Pilates Directional-Bias Assessment: Reliability and Predictive Validity. Journal of Orthopaedic & Sports Physical Therapy, 2012 Aug;42(8):676-87

5 Wajswelner H, Metcalf B, Bennell K Clinical Pilates versus general exercise for chronic low back pain: randomized trial.  Med Sci Sports Exerc 2012 Jul;44(7):1197-205

 

 

 

 

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