Literature review

Literature review: Stretching and Athletic Performance



Literature review: Stretching and Athletic Performance

Introduction

Stretching before participation in athletic activities is standard practice for all levels of sports, competitive or recreational. Athletes, coaches, trainers, physiotherapists, and physicians recommend stretching in an effort to both prevent injury and enhance performance; numerous journal articles and textbooks are devoted to the topic, providing a variety of approaches directed to different parts of the body and for specific sporting activities . As more people participate in sports and other recreational activities through social changes (e.g., Title IX) and increased recognition that physical activity is part of a healthy lifestyle, injury prevention becomes more important( McNair Stanley 2006 pp.313-317). However, some investigators have questioned the routine practice of stretching and contend that there is little evidence that stretching pre- or postparticipation prevents injury and that it might affect performance negatively. In particular, a recent systematic review concluded that the best available evidence indicates that stretching before or after exercise does not prevent muscle soreness or injury and that there is insufficient evidence to assess effect on performance. We developed a logic model to illustrate the relations among stretching, flexibility, performance, and injury (Fig. 1). Flexibility is an intrinsic property of the body tissues that determines the range of motion achievable without injury at a joint or group of joints . There are several methods of stretching to increase flexibility including passive, static, isometric, ballistic, and proprioceptive neuromuscular facilitation (PNF) (Table 1). Although static stretching is the easiest and most frequently used stretching method, each approach has advocates(Malliaropoulos Papalexandris Papalada et al. 2004 pp.756-759). Both passive and PNF techniques require a second person with specific skills, and there is some concern that PNF techniques might increase the risk of injury because of the resulting increase in stretch tolerance (i.e., the ability to increase the range of stretching without pain). Concerns about connective tissue trauma have caused the practice of ballistic stretching to fall from favor .

Flexibility is dependent on the viscoelasticity of muscle, ligaments, and other connective tissue. Flexibility is assessed with tools such as goniometers to measure joint angles, fleximeters to measure the degree of bending, and arthrometers to measure joints. These tools are generally used to measure static flexibility (i.e., the measured range of motion about a joint or series of joints in an immobile subject), and the relationship of these measures to dynamic flexibility (i.e., the measure of resistance to active motion about a joint or series of joints) is not clear(Witvrouw Mahieu Danneels et al. 2004 pp.443-449 . Although some persons are described as loose-jointed, a general body measure of flexibility has not been demonstrated, and there is little agreement on the definition and limits of normal flexibility . The improvement in short-term flexibility that results from stretching has been documented. As with stretching, little evidence exists that documents a relation between increased flexibility and reduced incidence of injury. Indeed, injury may be related to too much or too little flexibility or, in some instances, increasing flexibility may actually increase the rate of injury . The lack of flexibility does not account for many muscle injuries that occur within a normal range of motion . However, an imbalance in flexibility in individual athletes might predispose to injury . Although stretching before activity might improve performance for some sports that require an increased ...