The Relation Between Stretching Typology and Stretching Duration: The Effects on Range of Motion

Abstract

Different stretching strategies and protocols are widely used to improve flexibility or maintain health, acting on the muscle tendon-unit, in order to improve the range of motion (ROM) of the joints. This review aims to evaluate the current body of literature in order to understand the relation between stretching typology and ROM, and secondly to evaluate if a relation exists between stretching volume (either as a single training session, weekly training and weekly frequency) and ROM, after long-term stretching. Twenty-three articles were considered eligible and included in the quantitative synthesis. All stretching typologies showed ROM improvements over a long-term period, however the static protocols showed significant gains (p<0.05) when compared to the ballistic or PNF protocols. Time spent stretching per week seems fundamental to elicit range of movement improvements when stretches are applied for at least or more than 5 min, whereas the time spent stretching within a single session does not seem to have significant effects for ROM gains. Weekly frequency is positively associated to ROM. Evaluated data indicates that performing stretching at least 5 days a week for at least 5 min per week using static stretching may be beneficial to promote ROM improvements.

Key words

flexibility - range of motion - stretch - long term - ballistic stretching - passive stretching - PNF - static stretching - active stretching

• References

• 1 Apostolopoulos N, Metsios GS, Flouris AD, Koutedakis Y, Wyon MA. The relevance of stretch intensity and position-a systematic review. Front Psychol 2015; 6: 1128
• 2 Ayala F, de Baranda Andujar PS. Effect of 3 different active stretch durations on hip flexion range of motion. J Strength Cond Res 2010; 24: 430-436
• 3 Ayala F, Sainz de Baranda P, De Ste Croix M, Santonja F. Comparison of active stretching technique in males with normal and limited hamstring flexibility. Phys Ther Sport 2013; 14: 98-104
• 4 Bandy WD, Irion JM, Briggler M. The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Phys Ther 1997; 77: 1090-1096
• 5 Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab 2015; 41: 1-11
• 6 Blazevich AJ, Cannavan D, Waugh CM, Miller SC, Thorlund JB, Aagaard P, Kay AD. Range of motion, neuromechanical, and architectural adaptations to plantar flexor stretch training in humans. J Appl Physiol (1985) 2014; 117: 452-462
• 7 Blazevich AJ, Kay AD, Waugh C, Fath F, Miller S, Cannavan D. Plantarflexor stretch training increases reciprocal inhibition measured during voluntary dorsiflexion. J Neurophysiol 2012; 107: 250-256
• 8 Cipriani DJ, Terry ME, Haines MA, Tabibnia AP, Lyssanova O. Effect of stretch frequency and sex on the rate of gain and rate of loss in muscle flexibility during a hamstring-stretching program: a randomized single-blind longitudinal study. J Strength Cond Res 2012; 26: 2119-2129
• 9 Coledam D, Aires de Arruda G, Ramos de Oliveira A. Chronic effect of static stretching performed during warm-up on flexibility in children. Rev Bras Cineantropom Desempenho Hum 2012; 14: 9
• 10 Dantas E, Daoud R, Trott A, Nodari R, Conceição M. Flexibility: components, proprioceptive mechanisms and methods. In Biomedical Human Kinetics 2011; 39:
• 11 Davis DS, Ashby PE, McCale KL, McQuain JA, Wine JM. The effectiveness of 3 stretching techniques on hamstring flexibility using consistent stretching parameters. J Strength Cond Res 2005; 19: 27-32
• 12 Feland JB, Hawks M, Hopkins JT, Hunter I, Johnson AW, Eggett DL. Whole body vibration as an adjunct to static stretching. Int J Sports Med 2010; 31: 584-589
• 13 Feland JB, Myrer JW, Schulthies SS, Fellingham GW, Measom GW. The effect of duration of stretching of the hamstring muscle group for increasing range of motion in people aged 65 years or older. Phys Ther 2001; 81: 1110-1117
• 14 Gleim GW, McHugh MP. Flexibility and its effects on sports injury and performance. Sports Med 1997; 24: 289-299
• 15 Gomes AR, Cornachione A, Salvini TF, Mattiello-Sverzut AC. Morphological effects of two protocols of passive stretch over the immobilized rat soleus muscle. J Anat 2007; 210: 328-335
• 16 Guissard N, Duchateau J. Neural aspects of muscle stretching. Exerc Sport Sci Rev 2006; 34: 154-158
• 17 Guissard N, Duchateau J, Hainaut K. Mechanisms of decreased motoneurone excitation during passive muscle stretching. Exp Brain Res 2001; 137: 163-169
• 18 Halder K, Chatterjee A, Pal R, Tomer OS, Saha M. Age related differences of selected Hatha yoga practices on anthropometric characteristics, muscular strength and flexibility of healthy individuals. Int J Yoga 2015; 8: 37-46
• 19 Harriss DJ, Macsween A, Atkinson G. Standards for Ethics in Sport and Exercise Science Research: 2018 Update. Int J Sports Med 2017; 38: 1126-1131
• 20 Harvey LA, Byak AJ, Ostrovskaya M, Glinsky J, Katte L, Herbert RD. Randomised trial of the effects of four weeks of daily stretch on extensibility of hamstring muscles in people with spinal cord injuries. Aust J Physiother 2003; 49: 176-181
• 21 Johnson AW, Mitchell UH, Meek K, Feland JB. Hamstring flexibility increases the same with 3 or 9 repetitions of stretching held for a total time of 90 s. Phys Ther Sport 2014; 15: 101-105
• 22 Kokkonen J, Nelson AG, Eldredge C, Winchester JB. Chronic static stretching improves exercise performance. Med Sci Sports Exerc 2007; 39: 1825-1831
• 23 Konrad A, Tilp M. Effects of ballistic stretching training on the properties of human muscle and tendon structures. J Appl Physiol (1985) 2014; 117: 29-35
• 24 Konrad A, Tilp M. Increased range of motion after static stretching is not due to changes in muscle and tendon structures. Clin Biomech (Bristol, Avon) 2014; 29: 636-642
• 25 Kubo K, Kanehisa H, Fukunaga T. Effect of stretching training on the viscoelastic properties of human tendon structures in vivo. J Appl Physiol (1985) 2002; 92: 595-601
• 26 Lopez-Bedoya J, Vernetta-Santana M, Robles-Fuentes A, Ariza-Vargas L. Effect of three types of flexibility training on active and passive hip range of motion. J Sports Med Phys Fitness 2013; 53: 304-311
• 27 Magnusson SP. Passive properties of human skeletal muscle during stretch maneuvers. A review. Scand J Med Sci Sports 1998; 8: 65-77
• 28 Magnusson SP, Simonsen EB, Aagaard P, Sorensen H, Kjaer M. A mechanism for altered flexibility in human skeletal muscle. J Physiol 1996; 497 Pt 1 291-298
• 29 Mahieu NN, Cools A, De Wilde B, Boon M, Witvrouw E. Effect of proprioceptive neuromuscular facilitation stretching on the plantar flexor muscle-tendon tissue properties. Scand J Med Sci Sports 2009; 19: 553-560
• 30 Mahieu NN, McNair P, De Muynck M, Stevens V, Blanckaert I, Smits N, Witvrouw E. Effect of static and ballistic stretching on the muscle-tendon tissue properties. Med Sci Sports Exerc 2007; 39: 494-501
• 31 Marshall PW, Cashman A, Cheema BS. A randomized controlled trial for the effect of passive stretching on measures of hamstring extensibility, passive stiffness, strength, and stretch tolerance. J Sci Med Sport 2011; 14: 535-540
• 32 McHugh MP, Cosgrave CH. To stretch or not to stretch: the role of stretching in injury prevention and performance. Scand J Med Sci Sports 2010; 20: 169-181
• 33 Moher D, Liberati A, Tetzlaff J, Altman DG, The PG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med 2009; 6: e1000097
• 34 Nakamura M, Ikezoe T, Takeno Y, Ichihashi N. Effects of a 4-week static stretch training program on passive stiffness of human gastrocnemius muscle-tendon unit in vivo. Eur J Appl Physiol 2012; 112: 2749-2755
• 35 Nakamura M, Ikezoe T, Tokugawa T, Ichihashi N. Acute effects of stretching on passive properties of human gastrocnemius muscle-tendon unit: Analysis of differences between hold-relax and static stretching. J Sport Rehabil 2015; 24: 286-292
• 36 O'Sullivan K, McAuliffe S, Deburca N. The effects of eccentric training on lower limb flexibility: a systematic review. Br J Sports Med 2012; 46: 838-845
• 37 Peng W, Babiloni C, Mao Y, Hu Y. Subjective pain perception mediated by alpha rhythms. Biol Psychol 2015; 109: 141-150
• 38 Sainz de Baranda P, Ayala F. Chronic flexibility improvement after 12 week of stretching program utilizing the ACSM recommendations: hamstring flexibility. Int J Sports Med 2010; 31: 389-396
• 39 Shadmehr A, Hadian MR, Naiemi SS, Jalaie S. Hamstring flexibility in young women following passive stretch and muscle energy technique. J Back Musculoskelet Rehabil 2009; 22: 143-148
• 40 Stathokostas L, Little RMD, Vandervoort AA, Paterson DH. Flexibility training and functional ability in older adults: A systematic review. J Aging Res 2012; 2012: 306818
• 41 Weppler CH, Magnusson SP. Increasing muscle extensibility: a matter of increasing length or modifying sensation?. Phys Ther 2010; 90: 438-449
• 42 Wyon M, Felton L, Galloway S. A comparison of two stretching modalities on lower-limb range of motion measurements in recreational dancers. J Strength Cond Res 2009; 23: 2144-2148
• 43 Yuktasir B, Kaya F. Investigation into the long-term effects of static and PNF stretching exercises on range of motion and jump performance. J Bodyw Mov Ther 2009; 13: 11-21
• 44 Zakas A, Galazoulas C, Grammatikopoulou MG, Vergou A. Effects of stretching exercise during strength training in prepubertal, pubertal and adolescent boys. J Bodyw Mov Ther 2002; 6: 170-176
• 45 Zollner AM, Abilez OJ, Bol M, Kuhl E. Stretching skeletal muscle: chronic muscle lengthening through sarcomerogenesis. PLoS One 2012; 7: e45661