Overview

Even though a strong cultural bias has formed against the use of static stretching, the stretching intervention is still an effective technique for increasing range of motion as well as creating position-specific range of motion, assisting with rehabilitation or corrective exercise programs, contributing to injury prevention protocol, and enhancing performance, which includes advancing skill development and specific training effects such as hypertrophy.

This article will outline the various ways that static stretching can be incorporated into rehab, prehab and training.

Introduction

Over the last 25 years in exercise and training, there has been a massive shift away from static stretching to dynamic stretching, especially in regard to pre-activity warm-ups and movement preparation routines (movement prep), as a variety of studies indicated that the technique of static stretching would impair performance, particularly in various expressions of strength, power, speed, reaction time, balance and coordination. (Judge, 2020)

Consequently, a strong cultural bias grew against using static stretching in a warm-up routine before physical activity that was indicated by a survey of 195 American Soccer coaches, in which 134 coaches refused to use static stretching as part of their warm-up routines before training and competition. (Judge, 2020)

Additionally, this cultural bias also spilled over into mainstream culture as numerous media outlets, including reputable publications such as the New York Times and Scientific American, published articles or videos warning the general public to avoid static stretching before activity. 

Here is the link to the NY Times article and the link for the Scientific American article.

Research Supporting the Use of Static Stretching

In contradiction to this cultural bias, much research on static stretching (SS) indicates that the technique can be purposeful and effective in the following ways:

• SS increases strength (+2.2%) when muscles are lengthened. (Behm et al., 2015)
• SS are more effective at creating position-specific Range of Motion than Dynamic Stretches. (Samson et al., 2012; Paige et al., 2012; Murphy et al., 2010)
• SS can help foster a positive mindset for performance. (Lima et al., 2019; Chaabene et al., 2019)
• SS can help reduce the risk of injury, especially in novice and/or untrained individuals that are participating in power or speed activities. (Behm, 2015; Behm, 2016; Thomas et al., 2018; Chaabene 2019)
• SS are used in a variety of rehabilitation and corrective exercise programs. (Trajano et al., 2014; Kim et al., 2019; Madadi-Shah et al., 2019; Jafari et al., 2019)
• Numerous studies demonstrate that Short-Duration Static Stretching (SD-SS) would not significantly impair performance when incorporated into a Full Warm-Up Routine. (Behm et al., 2015; Kay and Blazevich, 2012; Samson et al., 2012; Reid et al., 2018; Lima, 2019; Chaabene, 2019)
• SD-SS can be incorporated into training sessions to assist in increasing muscle hypertrophy (Trinade et al., 2020; Evangelista et al., 2019)

Defining Static Stretching

Static stretching is the process of holding a “controlled continuous movement to end range -of-motion (ROM) of a single joint or multiple joints by either actively contracting the agonist muscles (i.e. active stretch) or by using external forces such as gravity, partner, stretching aids (i.e. passive static stretch with bands)” and “in the end position, the individual holds the muscles in a lengthening position for a certain time.” (Chaabene, 2019)

Purpose

Maintaining or increasing Range of Motion is a common objective in rehab, prehab and training programs, especially when a reduction in flexibility has been reported to decrease at an average rate of 10% per 10 years, beginning at the age of 20, all of which can significantly affect an individual’s ability to perform daily life activities, let alone participate in sports or other physical activities. (Thomas et al., 2018)

This decline in flexibility can be attributed to a combination of aging and lifestyle, as the modern lifestyle is filled with many sedentary behaviors and labor-saving devices that decrease an individual’s level of physical activity and increase the total amount of repetitive movements, such as looking down at a phone. Both aging and lifestyle help to create changes in the biomechanical properties of an individual’s muscles, tendons and connective tissues that feature a reduction in strength as well as limited range of motion. (McCrum et al., 2018)

Fortunately, muscles, tendons and connective tissues maintain their mechanosensitivity throughout aging, which allows for a possible restoration of both strength and range of motion. (McCrum, 2018)

Static stretching, along with other types of stretching protocol, are designed to increase range of motion through restoration of tissue extensibility in order to create the required amount of flexibility for a given sport or activity, as well as a preventative measure around individual’s ability to perform daily life activities and maintain or improve their quality of life. (Thomas, 2018)

Additionally, static stretching has been reported to be more effective at restoring Range of Motion (20.9% increase over 4 weeks) compared to other types of stretching, including ballistic (11.65% increase) and proprioceptive neuromuscular facilitation (PNF) stretching (15% increase). However, there are conflicting findings regarding the comparison of stretch types, for which more research is recommended. (Thomas, 2018)

Uses for Static Stretching

Static stretching is recommended to be used in a variety of protocols, including rehab, prehab and training. This stretching technique has demonstrated its effectiveness at increasing range of motion, as well as for creating position-specific range of motion. Additionally, static stretching has assisted the effectiveness of various injury prevention protocols.

Rehab-Prehab Spectrum

Much of the scientific literature defines prehabilitation as a process of preparing an individual to successfully endure the traumatic stress associated with planned surgery. Yet, prehab is also commonly referred to as an exercise intervention that focuses on restoring and/or optimizing an individual’s movement quality, which is the primary objective of a rehabilitation program. Therefore, this review proposes that rehab and prehab exist on a continuum, in which the objective is to improve the functionality in an individual’s movement.

Injury is the threshold that separates rehab from prehab and also offers a distinct barrier to scope of practice. Only qualified medical professionals can legally diagnose and treat an injury. However, the absence of injury does not disqualify the importance of an exercise intervention that aims to improve movement qualities, which is the objective for corrective exercise programs, injury prevention protocols and performance enhancement strategies, including movement prep or a full warm-up routine. 

Training 

While rehab and prehab focus on movement quality, training can be categorized as any activity or program that aims to develop specific biomotor skills and physiological capacity, including strength, power, and endurance. (Bompa, 1999)

Of course, training can certainly contain prehab protocols within the program as many coaches and trainers can attest to the importance of optimizing biomechanical function and movement quality to maximize both results and longevity within a program. 

Additionally, many training programs are constructed on concrete timelines, such as competition schedules for athletic programs, wherein delivering specific strength qualities are integral to performance. At the same time, many programs are limited in time allotted to the training, which can lead to elements of the program, such as prehab exercises like static stretching, being cut out due to time constraints.

Fitness vs Training

Fitness has grown into a common pursuit for billions of people as well as a multi-billion-dollar industry. Fitness activities range from convention exercise routines to exotic events shoaded in flashing lights and blaring music. Additionally, people pursue fitness for various reasons as well, from health-related goals or social interaction to social status and aesthetics.

Even though both fitness and training are arranged into individual episodes called ‘workouts,’ the overall structure of these exercise modalities differ in organization and intent. Training programs are a planned sequence of workouts that aim to provide progressive stimulus to drive adaptations in a specific direction. (Bompa, 1999) 

Fitness can be planned and organized around specific intends as well, such as body composition or weight loss. The workouts can even be complimentary, such as pairing cycling with yoga and weightlifting. However, the workouts in fitness are not organized to deliver sequential stimuli that lead to progressive adaptations. Although, many people will surely experience adaptations from fitness as they may lose weight, build muscle, and improve flexibility. 

The main difference is training is specific and intentional around adaptations and fitness is much more variable in intent and application. Regardless of exercise modality, static stretching is still an effective technique that can be used in rehab, prehab, training and/or fitness.

Static Stretching in Rehab and Corrective Exercise Programs

While rehabilitation requires a medical diagnosis, both rehab and corrective exercise programs are exercise interventions designed to address observed dysfunctions or compensatory patterns that have, are, or can cause injury, pain, or discomfort. The goal of these programs are the restoration of biomechanical function and the optimization of movement quality, for which static stretching can certainly play an integral role.

In rehabilitation, static stretching is regularly used to increase muscle length and joint Range of Motion as well as an intervention to help restore optimal arrangement of collagen fibers in healing tissues, which is typically associated with contractures, scarring and other deformities. (Paige et al., 2012)

Corrective exercises programs address changes in postural alignment as well as compensatory strategies in an individual’s biomechanics and/or motor behavior that can lead to abnormal morphological and neurological adaptations, which can restrict range of motion and create muscle imbalances or strength imbalance around specific joints. Malalignments in posture and compensatory strategies in movement can lead to repetitive strain and stress on muscles and connective tissues that may evolve into discomfort, pain or injury. (Kim et al., 2019, Nussabaumer et al., 2010)

Rehab and corrective exercise programs typically consist of a combination of flexibility training and strength training that aim to restore optimal alignment and biomechanics while limiting or eliminating physiological deformities and neurological compensations, which makes it difficult to isolate the effectiveness of static stretching as an intervention within these programs. Nonetheless, Static Stretching is integrated into numerous rehab and corrective exercise programs, including the Janda Approach and the Corrective Exercise Continuum from the National Academy of Sports Medicine.   (Paige, 2012; Kim, 2019; Rubini et al., 2007)

Early Phase Focus on Static Stretching

Some rehab and corrective exercise programs utilize static stretching in the early stages of the program to increase range of motion and then phase out the stretching technique in favor of activation, integration and strength training techniques that would enable the body to improve neuromuscular coordination and strength throughout the new range of motion. (Kim, 2019; Paige, 2012; Jafari et al., 2020)

Continued Use of Static Stretching

Conversely, some rehab, corrective exercise and training programs utilize static stretching throughout the entire program, such as the Janda Approach, while others incorporate static stretching and strength training together by utilizing the stretching technique to promote inhibition of the antagonist muscles before or in between strength training sets. (Trajano et al., 2014)

Janda Approach

Based on Vladamir Janda’s theories of muscle imbalance, the Janda Approach was created by Phil Page, a discipline of Janda, and utilizing static stretching in combination with isometric strength training to form an exercise intervention that addresses musculoskeletal pain and optimizes alignment. (Janda et al., 1983; Janda et al., 1987; Paige, 2012; Kim 2020)

The effectiveness of the Janda approach was examined in a recent study wherein participants practiced a series of 14 different static stretches for 15s each before performing 5 specific isometric strength exercises at 100% maximal voluntary contraction (MVC) for 3s for 3 rounds, 3x times per week for 6 weeks, after which range of motion was significantly improved and discomfort and pain were self-reported as decreased after the intervention.  (Kim, 2020)

NASM Corrective Exercise Continuum

In another recent study, Jafari et al. examined the effectiveness of the NASM Corrective Exercise Continuum as measured by the Functional Movement Screen (FMS) in a population of firefighters, all of whom had an FMS score of ≤14, which indicates an elevated risk for injury. (Jafari, 2020)

The NASM Corrective Exercise Continuum consists of the following four stages: inhibition, lengthening, activating andintegration. Static stretching is used by many in the lengthening stage of this method, including in this study, as it helps restore optimal alignment and range of motion to movement patterns and postural strategies. (Jafari, 2020)

The lengthening stage, as well as the inhibition stage that focuses on various soft tissue therapy techniques including foam rolling and trigger point interventions, gradually decreased in each session over the course of the program as the participants progressively strengthened weakened muscle groups and learned to integrate body segments more effectively. (Jafari, 2020)

The end result was a significant improvement in FMS scores. The firefighters in the study had an FMS score of 10.6 at the start of the corrective exercise intervention, which consisted of an hour-long session 3x per week for 8 weeks. At the end of the intervention, the participants had an average FMS score of 17.6, which equates to a 69% improvement. (Jafari, 2020)

Improved Gait and Decreased Low Back Pain

Low back pain (LBP) usually first occurs for individuals between the ages of 20-40 with a high prevalence of LBP developing in the age range of 30-60 years old, which contributes to most older adults, 84%, suffering from LBP. (Forouzanfar et al., 2015; Bird and Payne, 1999; Kamper et al., 2016)

Madadi-Shad et al. used a corrective exercise program to improve gait efficiency and decrease LBP in older adults that were between the ages of 65-75 years old, had a navicular drop of at least 10mm and reported LBP. (Madadi-Shad et al., 2019)

The corrective exercise program utilized a static stretching protocol of 4 repetitions of 30s for each movement during the first two weeks of the program before initiating a strength training program that utilized resistance band training for 42 sessions. (Madadi-Shad, 2019)

At the end of the study, participants significantly increased their walking speed and Total Time to Peak (TTP), which demonstrates improved force absorption while walking, and reported a deduction in LBP. An improvement in gait efficiency is the predictive cause for the results as well as a reduction in the risk of future injury from overuse and/or falls. (Madadi-Shad, 2019)

Further research is needed to understand best practices for corrective exercise programs, including examining exercise prescription and exercise selection as many failures or shortcomings in rehabilitation and corrective exercise interventions may be a result of inappropriate programming. (Wallden, 2015)

Injury Prevention

Sometimes referred to as injury mitigation, injury prevention is “any effort to prevent or reduce the severity of bodily injuries caused by intrinsic factors (vs. extrinsic factors such as contact force, environment, etc.) before they occur.” (Jarafir, 2020)

Injury prevention exists a little further down from rehab and corrective exercises on the rehab-prehab spectrum as these interventions share the same process of identifying risks and treating dysfunctions or compensation patterns in order to promote biomechanical functionality and movement quality.  

Cook et al. explains the importance of optimizing functionality and movement quality as a form of injury prevention because “it is necessary to first learn the proper fundamental movements and then improve the physical fitness since strengthening the body with improper movements increases the risk of injury.” (Jarafir, 2020; Cook et al., 2014)

Static stretching is utilized within injury prevention strategies, especially during a full warm-up, to restore range of motion as well as to improve the compliance of the musculotendinous unit (MTU), which is recommended for recreational athletes, aging individuals and novice or untrained individuals that participate in speed and power activities. 

Increasing MTU compliance helps these populations to limit the stiffness in muscles, tendons and connective tissues, which can limit the elasticity and force absorption of these tissues and increase the risk of injury in sports, training or other physical activities.  (Garrett Jr., 1990; Wood, Bishop and Jones, 2007; Behm, 2015; McCrum, 2018; Thomas, 2018)

Unfortunately, the occurrence of an injury is both complex and unique to the individual as well as to the situation. However, in a review that covered 125 different studies on static stretching, Behm et al. concluded that the inclusion of static stretching within a full warm-up reduced the risk of acute muscle injuries by 54%, which provides broad support for injury prevention strategies. (Behm, 2015)

More research is recommended to understand how to differentiate and implement effective injury prevention strategies for specific populations and circumstances. 

High School Football

Bixler and Jones conducted a study that incorporated a stretching protocol into the halftime routine for high school football teams, from which there was a significant reduction in soft tissue injuries, i.e. strains or sprains, in the ensuing third quarter of each game. (Wood, Bishop and Jones, 2007; Bixler and Jones, 1992)

Australian Rules Football

As previously mentioned, Verrall et al. combined static stretching with specific drills to significantly reduce the number of hamstring injuries in Australian Rules Football. In addition to encouraging the players to stretch their hamstrings intermittently throughout training and practice, the study required each player to stretch their hamstrings in a fatigue state at the end of training and practice. The players continued this stretching program, as well as their weight training program, for two years and significantly decreased the number of hamstring strains per 1,000 hours of playing time. The authors suggest that performing static stretching at the end of training while in a fatigued state helped to increase tissue resiliency as well as range of motion. (Wood, Bishop and Jones, 2007; Verral et al., 2005)

Long Term Programs

Pope et al. also reported the benefits of a long-term stretching program on injuries. In this study, Pope et al. reported that habitual or long-term stretching would create a larger ‘non-injury zone’ (NIZ) within an individual’s movement patterns and positions. (Wood, Bishop and Jones, 200;, Pope et al., 1998)

Additionally, the study concluded that individuals with poor flexibility were 2.5 times more likely to be injured than individuals with average flexibility and 8 times more likely to be injured than individuals with high flexibility, all of which makes habitual stretching a worthy intervention in regard to injury prevention. (Pope, 1998)

Conflicting Findings

In spite of this evidence that supports the use of static stretching within an injury prevention protocol, there are studies, including Pope et al., that reveal conflicting findings and highlight the need for more research regarding effective injury-prevention strategies. (Wood, Bishop and Jones, 2007, Pope et al., 2000)

Performance Enhancement

As previously mentioned, performance enhancement exists on the Rehab-Prehab Spectrum and could be defined as the organization of interventions that focus on improving the biomechanical function and movement quality associated within a sport, training or physical activity, including daily life activities, for which Vincent et al. provides a template that involves a biomechanical needs analysis of the activity. (Vincent et al., 2019)

In their narrative review, Vincent et al. provide a detailed map of the mechanical stresses that act on the lacrosse player’s body while executing a typical overhead throwing motion, especially during the crank back phase of the throw. This map demonstrates where all of the torque vectors exist in this action, from which it would be possible to estimate which muscle groups and muscle chains may restrict the velocity of the throw due to limitations in range of motion. (Vincent, 2019)

Vincent et al. also discusses the importance of shoulder internal rotation, elbow extension and wrist flexion within the overhead throw, for which performing intermittent short-duration static stretches throughout training or competition as encouraged in Verrell et al., may both help reduce the risk of injury while also ensuring adequate Range of Motion for the throw. (Verrell, 2005; Vincent, 2019)

This study also expresses the importance of separating the shoulders from the pelvis during the arm cocking phase, similar to the wind up of an overhand serve in tennis. This movement task requires an adequate range of motion through the Anterior Oblique Sling (AOS), which consists of the hip adductor (groin), oblique, abdominal and pectoral muscles. Performing short-duration static stretching for the AOS intermittedly throughout practice or competition can ensure that the player maintains enough range of motion to effectively perform the movement task of the crank back phase while training or competing.  (Vincent, 2019)

More research is recommended to further develop effective interventions and routines to enhance performance based on a biomechanical analysis of the intended activity.

Vincent et al. also discusses the importance of shoulder internal rotation, elbow extension and wrist flexion within the overhead throw, for which performing intermittent short-duration static stretches throughout training or competition as encouraged in Verrell et al., may both help reduce the risk of injury while also ensuring adequate Range of Motion for the throw. (Verrell, 2005; Vincent, 2019)

This study also expresses the importance of separating the shoulders from the pelvis during the arm cocking phase, similar to the wind up of an overhand serve in tennis. This movement task requires an adequate range of motion through the Anterior Oblique Sling (AOS), which consists of the hip adductor (groin), oblique, abdominal and pectoral muscles. Performing short-duration static stretching for the AOS intermittedly throughout practice or competition can ensure that the player maintains enough range of motion to effectively perform the movement task of the crank back phase while training or competing.  (Vincent, 2019)

More research is recommended to further develop effective interventions and routines to enhance performance based on a biomechanical analysis of the intended activity.

Warm-Up or Movement Prep

The warm-up, also referred to as movement prep by many, is one of the most widely utilized performance enhancement protocols. The Warm-up aims to prepare the individual for the movement demands of the intended physical activity and usually precedes the competition event, practice, or training session. 

Short-Duration Static Stretching Recommended in Warm-up

As mentioned at the beginning of this review, there is a strong cultural bias against using static stretching in a warm-up routine as it has been linked to impairments in strength and performance. (Chaabene et al., 2019)

However, many studies, including several reviews, have consistently reported that short-duration static stretching (less than 60 seconds) did not negatively affect strength or performance when incorporated into a full warm-up. Furthermore, short-duration static stretching is recommended to be included in a full warm-up as it helps increase overall range of motion, effectively creates position-specific range of motion and reduces the risk of injuries, especially for novice or untrained individuals participating in power or speed activities. (Woods, 2007; Chaouchi et al., 2010; Gelen et al., 2010; Behm and Chaouachi, 2011; Kay and Blazevich, 2012; Behm, 2015; Behm, 2016; Reid et al., 2018; Chaabene, 2019)

Parameters of a Full Warm-Up

According to Wood, Bishop and Jones, the purpose of a full warm-up is to improve muscle dynamics, including contraction velocity and force, and prepare the individual for the movement demands, which includes range of motion and neurological coordination, of the targeted activity, training session or event while also reducing the risk for injury. (Wood, Bishop and Jones, 2007)

Step One: Aerobic Activity

Low intensity aerobic activity is recommended at the start of a full warm-up in order to help reduce muscle viscosity, increase muscle temperature and deliver more nutrients to working muscles, all of which will contribute to more Range of Motion in ensuring stretching techniques. (Woods, Bishop and Jones, 2007; Behm, 2015) 

The intensity of this aerobic activity should be low to moderate in order to preserve high-energy phosphate availability for the main workout or activity, for which the recommended intensity would be 40-60% of VO2 Max that equates to light or mild sweating and increased rate of respiration. (Wood, Bishop and Jones 2007)

Step Two: Short-Duration Static Stretching

In a review of 55 studies, Chaabene et al. concluded that the inclusion of short-duration static stretching (SD-SS) was recommended for untrained and recreational athletes due to the techniques positive effect on increasing range of motion and reducing musculotendinous unit (MTU) injuries, i.e. sprains and strains. (Chaabene, 2019)

Many other studies also recommended limiting the duration of each static stretch to less than 60s with some studies capping duration at 45s, in order to diminish the possibilities of any impairment to strength and performance. 

The American College of Sports Medicine recommends performing 2-4 rounds of static stretching for 15-30s each within a Full Warm-Up. (Paige, 2012)

Positive Mindset

Additionally, Lima et al. reported that “there was a positive psychological effect as the individuals felt more confident of achieving high performance in the ensuing sports-related tests,” which supports the claim that static stretching helps to cultivate a mindset for performance. (Lima, 2019)

Step Three: Dynamic Stretching

Several studies have found that performing dynamic stretching after short-duration static stretching would not lead to significant impairments in strength or performance. (Chaouchi et al., 2010; Gelen et al., 2010; Behm and Chaouachi, 2011; Behm, 2015)

Technique Defined

Dynamic stretching consists of controlled movement through a joint’s range of motion in a repeated manner that creates a cyclical loading and unloading of the muscles that raises muscle temperature, decreases tissue viscosity and increases extensibility, all of which contributes to improved muscle compliance. (Fletcher et al., 2010; Behm, 2015)

Coordination and Energy

Dynamic stretching will also increase both nerve conduction velocity and central drive, which assist neuromuscular coordination. Additionally, dynamic stretching will induce enzymatic reactions in the muscles that increase cellular metabolism and help provide energy that will be required in the upcoming training session or competition. (Guissard and Duchateau, 2006; Trajano et al., 2013; Behm, 2015)

Vary Speeds in Dynamic Stretching

Combining slow and fast reps of dynamic stretching led to a significant improvement (4.9%) in vertical jump performance as well as increased concentric and eccentric torque (15% and 7%) in the hamstrings and quadriceps. (Hough et al., 2009; Yamaguchi et al., 2007; Behm 2015)

Step Four: Skill-Specific Activities

The last component of a full warm-up is reserved for skill-specific activities that aims to prepare the individual for the specific tasks of the upcoming training session or competition, all of which vary from sport to sport and activity to activity. 

Warm-Up’s Objective: Range of Motion

Short-duration static stretching (≤60s) is recommended within a full warm-up or movement prep phase due to its effectiveness to increase range of motion and create position-specific range of motion, such as the wrist position in a front rack.

In one of the first studies that examined the effectiveness of static stretching within a full warm-up, de Weijer et al. observed a noticeable increase in the range of motion of knee extension (10.3º) as compared to performing static stretching without a full warm-up (7.7º), which supports the premise of combining low-intensity aerobic activities with static stretching. (de Weijer ,2003)

Murphy et al. also demonstrated that performing static stretching after an aerobic activity would lead to a greater range of motion as well as assist in creating position-specific range of motion. Additionally, Murphy et al. proposes that incorporating static stretching into a full warm-up leads to more proficiency in positions-specific range of motion as compared to dynamic stretching. (Murphy 2012)

Static Stretching vs Dynamic Stretching

As mentioned at the beginning of this review, there is a strong cultural bias in favor of using dynamic stretching over static stretching within a full warm-up. While this bias is based on the risk of performance impairments, several studies have examined the effectiveness of each technique in regard to improving range of motion, for which there have been conflicting results.

A collection of studies concluded that static stretching was more effective for increasing Range of Motion than dynamic stretching. (Bandy and Irion, 1994; Power, 2004; Beedle and Mann, 2007; O’Sullivan, 2009; Covert, 2010)

While other studies reported that dynamic stretching was as effective as static stretching in regard to range of motion. (Amiri-Khorasani, 2011; Perrier, 2011; Samukawa, 2011)

Yet many other studies, including Morrin et al., demonstrated that combining static stretching with dynamic stretching would increase range of motion the most, as well as improving balance and preserving performance and strength. (Chaouchi et al., 2010; Gelen et al., 2010; Behm and Chaouachi ,2011; Kay and Blazevich, 2012; Morrin et al, 2013)

Position-Specific Range of Motion

Many sports and activities have specific position demands, such as the ability to perform the front splits in gymnasts or the middle splits to block a shot in hockey. These position demands are typically referred to as position-specific flexibility or position-specific range of motion.

More importantly, position-specific range of motion differs from general range of motion, which can be a summation of various segmental measurements, such as hamstring length in knee extension, that many studies use within their research.

Additionally, position-specific range of motion is integral to many different sports, including gymnastics, figure skating, and martial arts, and can impact the performance of individual performances, such as a goalie in hockey or a punter in American Football. (Samson 2012, Murphy et al. 2010)

Static Stretching effective for Position-Specific Range of Motion

Static stretching was reported to increase range of motion more effectively than dynamic stretching, especially in regard to position-specific range of motion. (Samson, 2012; Covert et al., 2010; O’Sullivan et al., 2009)

However, more research is needed in this area as other studies have reported that dynamic stretching was as effective as static stretching in regard to position-specific range of motion. (Samson, 2012; Beedle and Mann, 2007; Herman and Smith, 2008)

Stronger Longer, Weaker Shorter

Akin to position-specific range of motion, there are possible strength demands of specific positions that static stretching can both improve or reduce. 

In a review of 125 studies, Behm et al. concludes that static stretching leads to improvements in strength (+2.2%) when the muscle is in lengthened positions but experienced a strength loss when held in shorter positions. (Behm et al., 2015)

According to Behm et al, a rock climber may be interested in utilizing static stretching more often due to the strength it may provide on lengthened muscles and extended joints, while an arm wrestler would most likely abstain from static stretching before competition.

Long-Duration Static Stretching in Prehab

Many individuals have a goal of increasing either overall and/or specific range of motion that long-duration static stretching (>60s) can impact, but this technique is not recommended to be used during the movement prep phase.

Alternatively, long-duration static stretching (LD-SS) can be an effective technique to incorporate in an individual’s prehab program that focuses on increasing range of motion and used intermittently throughout the day or week, but not prior to a training session or competition due to its negative effect on strength and performance. (Behm, 2016; Lima, 2019; Behm et al. 2021)

Recap: Movement Prep

Short-duration static stretching (≤60s) is recommended to be part of a full warm-up, which is commonly referred to as the movement prep phase of a training session or sport. The use of static stretching will help increase range of motion and more importantly, create position-specific range of motion, while also helping to provide a mindset for performance and combine with dynamic stretching to increase muscle activation and improve neuromuscular coordination. 

Cool Down & Recovery

As previously mentioned, this review examines the technique of static stretching to investigate the efficacy of the strong cultural bias against it, in regard to using the technique before training or competition. At the same time, this review was able to investigate the cultural belief that static stretching is a technique that can help the body recover from exercise.

According to a meta-analysis of static stretching during cool downs, Afonson et al. reports that this technique will not help the body recover from exercise, nor will static stretching help prevent Delayed On-set Muscle Soreness (DOMS). (Afonson et al., 2021)

The meta-analysis pointed to many interesting findings including how light aerobic cycling was more effective than proprioceptive neuromuscular facilitation (PNF) stretching to restore muscle strength, i.e. maximal voluntary contraction (MVC), after exercise, which can be beneficial to individuals involved in bouts of competition such as in wrestling tournaments and track meets. (Mika et al., 2007)

The meta-analysis also reported many examples wherein passive recovery, i.e. rest, was just as effective in achieving recovery for the body based on MVC, EMG of muscle activation, and peak torque, as well as creatine kinase and lactate kinetics levels. (Robey et al., 2009; Ce et al., 2003)

“Overall, our data does not support nor contradict the utilization of post-exercise stretching… stretching does not seem to enhance recovery in relation to passive recovery (i.e. rest)… for now, recommendations on whether post-exercise stretching should be applied for the purpose of recovery are misleading, as the (insufficient) data that is available does not support those claims.” (Afonson, 2021)

Further research is recommended to examine if any mode of stretching can affect recovery.

In regards to the prevention of DOMS, which is one of the main reasons that individuals will stretch after exercise, static stretching has not been found to be an effective technique to use. (Robey et al., 2009; Ce et al., 2003; Wessel and Wan, 1994; Cheung et al., 2003; Xie et al., 2018; Herbert and Gabriel, 2002; Henschke and Lin, 2011; Herbert et al., 2011)

This review asserts that the use of static stretching in the cool down can still be recommended if the individual has a goal of increasing joint range of motion, which can be accomplished through continual exposure to stretching over time that would help to improve the individual’s stretch tolerance.

The cool down can provide additional time that the individual’s motor behavior processes can begin to ‘trust’ a larger range of motion. Additionally, the main workout will surely have increased the muscle’s temperature and decreased its viscosity, all of which makes the body more receptive to static stretching.

Muscle Hypertrophy 

As previously mentioned, one of the purposes of this review is to clarify some cultural misunderstandings in regard to static stretching, one of which is that static stretching by itself can induce muscle hypertrophy.

Due to the findings of a few select studies, many researchers have turned to examine the effects of stretch training on muscle architecture, in order to determine if muscles could experience sarcomerogenesis and hypertrophy from stretching alone.

Unfortunately, the review was only able to find studies that document changes in muscle architecture from static stretching in animals, except for one study, wherein Freitas et al. demonstrated an increase in fascicle length after high intensity static stretching performed for 450s per bout, 3x per week for 8 weeks. (Goldspink et al., 1977; Langevin et al., 2005; Langevin et al., 2013; Freitas et al., 2015)

Several other studies also investigated the effects of static stretching on muscle architecture in humans, but none have demonstrated either sarcomerogenesis and hypertrophy without the use of load. (Nunes et al., 2020; Sato, 2020; Yahata et al., 2020)

Interset Stretching & Strength Training Leads to Hypertrophy

Trindade et al. were able to demonstrate how static stretching combined with strength training helped to increase hamstring muscle thickness, i.e. hypertrophy, in a group of experienced weight lifters. This study complements the findings from Evangelista et al. that demonstrated how interset static stretching for 30s in between strength training of 4 sets of 8-12 reps 2x per week for 8 weeks would increase muscle thickness. (Evangelista et al., 2019; Trindade et al., 2020)

Interset Stretching & Corrective Exercise Programs

It’s important to note that the cumulative duration of the interset stretching documented by Evangelista et al. surpasses the recommended amount of cumulative duration for pre-activity stretching training, which increases the risk for muscle performance impairments through inhibition of the stretched muscles. (Behm et al., 2016; Evangelista et al., 2019; Behm et al., 2021)

However, the consequence of inhibition of muscle performance through interset stretching may be a valuable tool for a corrective exercise program that aims to inhibit overactive muscles that create a muscle imbalance or strength imbalance around a given joint or within a specific movement pattern. (Paige, 2012; Janda et al., 1983; Janda et al., 1986; Jafari et al. 2020)

More research is needed to truly understand how stretch training and strength training can be complementary towards specific goals, including corrective exercise, muscle hypertrophy and performance.

How to Stretch:

Exercise Prescription

This review proposes that understanding the dose-relationship, i.e. how long and how much, of static stretching will lead to effective use of the technique through appropriate exercise prescription, which may also help to shift the cultural bias surrounding this exercise intervention.

Stretch Frequency: More Often is Better.

Freitas et al. proposed that stretch frequency was an important parameter to address for static stretching, which several studies have reported that a higher weekly frequency leads to greater increases in range of motion and Thomas et al. proposed 5 days per week as an optimal frequency. (Freitas, 2017; Thomas, 2018; Lima, 2019)

Stretch Intensity: Personal Preference

There are conflicting findings regarding stretch intensity, which refers to the perception of the sensation involved in the stretch. While Murphy et al. proposes that intensity levels need to reach 80% of discomfort in order for the greatest amount of Range of Motion to be achieved, other Lima et al. report that low intensity static stretching has been shown to be as effective at high intensity static stretching. At the same time, Freitas et al. propose that stretch frequency is more influential than stretch intensity in regard to Range of Motion, which suggests that individual personal preference towards intensity would be an appropriate approach to the intervention. (Murphy, 2010; Lima, 2019)

Stretch Duration: Short Before Performance

The amount of time that a single repetition of a stretch is held is referred to as stretch duration, which is an important monitor to track in regard to performance metrics.

Short-Duration Static Stretching: <60 Seconds

According to consistent findings in the literature, short-duration static stretches (SD-SS), which are stretches held for less than 60s per repetition, do not create significant impairments in performance, especially when incorporated into a full warm-up and combined with either dynamic stretching and/or a skill-specific warm-up. (Behm, 2015; Lima, 2019; Chaabene, 2019)

Long-Duration Static Stretching ≥60 Seconds

On the other hand, long-duration static stretching (LD-SS), stretches held for 60 seconds or more, has consistently shown to cause impairments in performance and are not recommended to be used before physical activity. However, LD-SS is effective for increasing an individual’s stretch tolerance and range of motion. (Weppler, 2010; Behm, 2015; Behm, 2021)

Stretch Volume: More Volume Leads to More Adaptations

The cumulative duration of stretching over the course of a session or a week is referred to as stretch volume. 

Several studies have indicated that session stretch volume can lead to impairments in performance, for which Murphy et al. recommends limiting session stretch volume to ≤90s per session in order to avoid strength-induced impairments. (Young et al. 2006; Murphy, 2010; Behm, 2011)

In regard to weekly stretch volume, Thomas et al. concluded that a minimum of 5 minutes per muscle group over the course of 4 weeks was required to increase range of motion (Thomas, 2018). However, Davis et al. offer conflicting findings that suggest stretching 3x per week for a total of 90s in weekly stretch volume led to significant improvement in range of motion after 4 weeks of stretching (Davis et al., 2005). However, both studies indicate that 4 weeks in length of the stretch program was integral to the effectiveness of the intervention.

Conclusion

Even though there has been a cultural bias in the past two decades against the use of static stretching, the technique has been proven to be useful in rehab, prehab and training programs. The enclosed review acknowledges the parameters of static stretching (position, mode, intensity, duration and frequency) as well as their effect on both Range of Motion and performance.  Understanding the parameters of static stretching will allow for effective use of the technique in any type of exercise intervention or program. Alternatively, following the guidelines mentioned above, will increase the effectiveness of static stretching in rehab, prehab or training.