A Synopsis on Stretching

by  Leonard Marks, MD

 I just read an synopsis of an article from the Clinical journal of Sports Medicine involving stretching. The author, I. Shrier ,did a major review of the literature and went through 138 articles involving stretching and sports. Of those 138, only 12 had control groups (one group with stretching and one without). In summary there is scant evidence that stretching reduces the risk of local muscle injury.

The author then went back to the basic science literature to determine if there were any underlying support for the hypothesis that stretching prevents local injury. The review also provided evidence that stretching would not prevent local injury. Some of the data found demonstrated that stretching can mask muscular pain in athletes; in many sports we do not exceed the maximum muscle length; and even mild stretching has been demonstrated to produce some damage at the cellular level.

My own feeling is that most youth are so flexible that stretching is not necessary. Warm-up to me is of utmost important. I do not pretend to understand the concept of “working out the kinks,’ but I find it necessary for all activities early in the morning. Unfortunately, as we age, early in the morning becomes progressively later.

In general I question the concept of exercise when the body is sore. A sore body is telling us something. Rather than do everything we can to work through the soreness, perhaps we should take the day off.

For my athletes I recommend light running (always with a ball) progressing to a gentle, minimally competetive game situation designed to “get the body working” (and, as per above, I admit that I do not understand on a cellular level what this is). As for actual stretching, I have that to the athlete. What works for some will not work for others.

The only exception is the athlete who has lost full range of motion of a joint. In this case my upbringing/training/prejudices come through and forces me to have that athlete stretch out, hoping that in the future evidence will support my bias.