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Press Release Stretching Before a Run Does Not Prevent Injury
However, runners who typically stretch should continue, or risk injury
Quote:
Stretching before a run neither prevents nor causes injury, according to a study presented today at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
More than 70 million people worldwide run recreationally or competitively, and recently there has been controversy regarding whether runners should stretch before running, or not at all. This study included 2,729 runners who run 10 or more miles per week. Of these runners, 1,366 were randomized to a stretch group, and 1,363 were randomized to a non-stretch group before running. Runners in the stretch group stretched their quadriceps, hamstrings, and gastrocnemius/soleus muscle groups. The entire routine took 3 to 5 minutes and was performed immediately before running.
The study found that stretching before running neither prevents nor causes injury. In fact, the most significant risk factors for injury included the following:
* history of chronic injury or injury in the past four months;
* higher body mass index (BMI); and
* switching pre-run stretching routines (runners who normally stretch stopping and those who did stretch starting to stretch before running).
“But, the more mileage run or the heavier and older the runner was, the more likely he or she was likely to get injured,”
“As a runner myself, I thought stretching before a run would help to prevent injury,” said Daniel Pereles, MD, study author and orthopaedic surgeon from Montgomery Orthopedics outside Washington, DC. “However, we found that the risk for injury was the same for men and women, whether or not they were high or low mileage runners, and across all age groups. But, the more mileage run or the heavier and older the runner was, the more likely he or she was likely to get injured, and previous injury within four months predisposed to even further injury,” he added.
Runners who typically stretch as part of their pre-run routine and were randomized not to stretch during the study period were far more likely to have an injury. “Although all runners switching routines were more likely to experience an injury than those who did not switch, the group that stopped stretching had more reported injuries, implying that an immediate shift in a regimen may be more important than the regimen itself,” he added.
The most common injuries sustained were groin pulls, foot/ankle injuries, and knee injuries. There was no significant difference in injury rates between the runners who stretched and the runners who didn’t for any specific injury location or diagnosis.
Re: Stretching Before a Run Does Not Prevent Injury
This issue was somewhat discussed on another thread a short while ago. As mentioned then, there are various forms of stretching & thus research will probably be more productive on the benefits (or not) on the two main stretching types... of which in my view will be the more common static type (i.e. stretch & hold) & the dynamic type (i.e. extended ROM movements). I also feel that there is probably a more conducive time & place for each i.e. the dynamic variety during warm-up & the static variety during cool-down/during the day. This is where I feel the research should in part focus on... i.e. the "when" for the particular type of stretch.
I presume the above research would have had a stretch criteria where the stretch group subjects were instructed on what to do (how to do the stretches) & I presume it would have been of the more common static variety; however, there is no mention of the nature of the stretches tested (at least from the above citation). There are also many potential variables as well which could also interfere with the nature of the results.
I do feel stretching is a valid & beneficial activity for everybody... whether it be sports people or sedentary types (however, sedentary types would be less likely to be proactive with health maintenance). The reason stretches is likely beneficial for us humans is due to our common inactive lifestyle. A lot of people are spending hours a day sitting, working at a desk/at computers (unconducive body posture for hours on end). This does have a tendency to help shorten muscle groups i.e. hip flexors, thus affecting back leg extension in running. Hence it probably wise to stretch these affected muscle groups at some point as they will be needed for the more dynamic activity of sport where the muscles/tendons & joints are required to go through its paces for efficient movement to take place for more demanding activity.
I personally believe the static type stretch wouldn't be conducive just prior to sport as it could affect muscle integrity, strength & the efficiency factor of 'limb stiffness'. On the other hand I feel the dynamic variety would be more conducive prior to sport as it is more activity specific (i.e. in ROM & speed/velocity) thus tuning the muscle groups for more demanding ROM & loads. I believe the Kenyon runners tend to warm-up this way.
Anyhow, more research is definitely needed so we can provide our patients more informed tips on how to look after themselves whilst training.
Re: Stretching Before a Run Does Not Prevent Injury
Funny when I read this I came to the conclusion that people who change their warm up habits get injured at a greater rate. Which is not that surprising
Re: Stretching Before a Run Does Not Prevent Injury
Quote:
Originally Posted by BEN-HUR
I do feel stretching is a valid & beneficial activity for everybody...
I do not think that anyone is disputing that. What this research and other research is showing is that stretching as part of the warm up routine does not prevent injury. That does not mean that you should not stretch for a whole lot of other reasons.
I have had some interesting discussions with several running coaches about this and they were aware of the previous research that showed that pre-exercise stretching did not prevent injury; they interpreted that research as saying that you should not strectch (which is NOT what the research showed), so they just dissmissed the research as nonsense....funny how they interpreted it that way.
__________________ Craig Payne
__________________________________________________ ___________________________________ Follow me on Twitter | Run Junkie God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
Re: Stretching Before a Run Does Not Prevent Injury
The other thing to consider is what type of "running" is the individual proceeding with...
jogging
intervals
hills
aerobic / anaerobic
sprints
VO2max
etc.
To what intensity of running in what time-frame, may or may not influence the benefits of pre-event stretching?
Does an individual need to selectively focus on stretching specific physiological complexes (soft tissue groups) dependant upon history of injury?
To Running Coaches - More info required before satisfying the call to either abandon or stock up on pre-stretching for running athletes.
Re: Stretching Before a Run Does Not Prevent Injury
For those of you who still think that stretching causes muscle damage, you may want to read this paper just published in latest Medicine and Science in Sports and Exercise.
Quote:
Med Sci Sports Exerc. 2011 Mar;43(3):491-500.
Effects of flexibility training on eccentric exercise-induced muscle damage.Chen CH, Nosaka K, Chen HL, Lin MJ, Tseng KW, Chen TC.
1.Department of Physical Education, National Chiayi University, Chiayi County, TAIWAN;
2.School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei City, TAIWAN;
3.School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Western Australia, AUSTRALIA;
4.Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei City, TAIWAN; and 5Department of Physical Education and Health, Taipei Physical Education College, Taipei City, TAIWAN.
Abstract
PURPOSE: : This study investigated whether flexibility training would attenuate muscle damage induced by maximal eccentric exercise.
METHODS: : Thirty untrained young men were allocated to static stretching (SS), proprioceptive neuromuscular facilitation (PNF), or control group (n = 10 per group). The SS consisted of 30 sets of a 30-s standard SS with a 30-s rest between sets, and the PNF included 5 sets of the 30-s standard SS followed by 3 sets of three "contract-relax-agonist-contract" procedures. These were performed three times a week for 8 wk, and all subjects performed six sets of 10 maximal isokinetic (30°·s) lengthening contractions of the knee flexors after the 8-wk training or 8 wk after the baseline measures (control). Changes in indirect markers of muscle damage before and for 5 d after the eccentric exercise were compared among the groups.
RESULTS: : The range of motion (ROM) of the hip joint increased by 25°, and the optimum angle of the knee flexors shifted (P < 0.05) to a longer muscle length by 10° after training, without significant differences between SS and PNF. No significant changes in these variables were evident for the control group. Compared with the control group, the SS and PNF groups showed significantly (P < 0.05) smaller decreases and faster recovery of knee flexor muscle strength and smaller changes in optimum angle, ROM, muscle soreness, and plasma creatine kinase activity and myoglobin concentration without significant differences between the groups. The preeccentric exercise ROM or optimum angle was significantly (P < 0.05) correlated with the changes in the muscle damage markers.
CONCLUSIONS: : These results suggest that both SS and PNF training are effective in attenuating eccentric exercise-induced muscle damage and that flexible muscles are less susceptible to the damage.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Re: Stretching Before a Run Does Not Prevent Injury
Effect of Neuromuscular Warm-up on Injuries in Female Soccer and Basketball Athletes in Urban Public High Schools
Cynthia R. LaBella, MD; Michael R. Huxford, MEd, ATC; Joe Grissom, MPP; Kwang-Youn Kim, PhD; Jie Peng, MS; Katherine Kaufer Christoffel, MD, MPH Arch Pediatr Adolesc Med. 2011;165(11):1033-1040.
Quote:
Objective To determine the effectiveness of coach-led neuromuscular warm-up on reducing lower extremity (LE) injuries in female athletes in a mixed-ethnicity, predominantly low-income, urban population.
Design Cluster randomized controlled trial.
Setting Chicago public high schools.
Participants Of 258 coaches invited to participate, 95 (36.8%) enrolled (1558 athletes). Ninety coaches and 1492 athletes completed the study.
Interventions We randomized schools to intervention and control groups. We trained intervention coaches to implement a 20-minute neuromuscular warm-up. Control coaches used their usual warm-up.
Main Outcome Measures Coach compliance was tracked by self-report and direct observation. Coaches reported weekly athlete exposures (AEs) and LE injuries causing a missed practice or game. Research assistants interviewed injured athletes. Injury rates were compared between the control and intervention groups using {chi}2 and Fisher exact tests. Significance was set at P < .05. Poisson regression analysis adjusted for clustering and covariates in an athlete subset reporting personal information (n = 855; 57.3%).
Results There were 28 023 intervention AEs and 22 925 control AEs. Intervention coaches used prescribed warm-up in 1425 of 1773 practices (80.4%). Intervention athletes had lower rates per 1000 AEs of gradual-onset LE injuries (0.43 vs 1.22, P < .01), acute-onset noncontact LE injuries (0.71 vs 1.61, P < .01), noncontact ankle sprains (0.25 vs 0.74, P = .01), and LE injuries treated surgically (0 vs 0.17, P = .04). Regression analysis showed significant incidence rate ratios for acute-onset noncontact LE injuries (0.33; 95% CI, 0.17-0.61), noncontact ankle sprains (0.38; 95% CI, 0.15-0.98), noncontact knee sprains (0.30; 95% CI, 0.10-0.86), and noncontact anterior cruciate ligament injuries (0.20; 95% CI, 0.04-0.95).
Conclusion Coach-led neuromuscular warm-up reduces noncontact LE injuries in female high school soccer and basketball athletes from a mixed-ethnicity, predominantly low-income, urban population.
Stretching Before a Run Does Not Prevent Injury
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