An article talking about this very thing was released on the Wall Street Journal online this week and it perked my interest. If you want to read it click here. I was hoping that someone was finally able to find some hard evidence into this tough question. Unfortunately, like most things medical reported by the media, it only raises the question and fails to bring forward good answers.
The article is a quick read and has some advice to it. Dr Jay Hartel of the University of Virginia is quoted and some of his information can be helpful. His comments can be summed up this way: stretch if it feels good, and keep it feeling good.
Theories abound on this subject, none of which have been proven. It would make sense that if you get your body moving a little better before taking on physical exertion that you will move better. We see examples of this in everyday life; stretching just after waking, your cat reaches our her paws, guys shrug their shoulders before a bar fight in the movies. We can all think of examples when we have done similar. There is also the theory of “warming-up”, which stretching typically is part of. This too seems to fit in with preparing our bodies to move. At our simplest level we are made of very basic parts that fall prey to all kinds of physical laws such as thermodynamics, etc. Are we not mostly water mixed with sugars, proteins and fats? Maybe a few minerals thrown in. We are a complex syrup! Think of syrup straight from the refrigerator. Flows slowly right? What happens as it gets warmer? There are also theories about static or dynamic stretching. Basically do we get to one position and hold it or do we dynamically move into various positions progressing further into the amount of motion we will need for our task? If there was time, I could keep listing more and more theories. In part, I wanted to illustrated how complex this question can be and why there is still no definitive answer.
There is research being done on this question. A quick search of this subject on Google Scholar will show you that. But upon closer inspection you will find the research goes in many different ways. There are many limitations to scientific studies as they work hard to eliminate any possible errors or guess work. They are limited to one specific question on one type of person with one experimental outcome. Then you need to try this experiment hundreds and hundreds of times. It takes time and money. We are at the point were we have hints of a few possible findings, but nothing factual: pre-participation stretching may help reduce the risk of injury in certain types of activities, dynamic warm-ups have shown some benefit as well, working on range of motion prior to doing something that requires lots of mobility maybe helpful, too much static stretching may reduce overall strength when performed before an activity, stretching after a workout might reduce incidence of muscle soreness. The list can go on.
So here is the take of a clinical professional, me! Based on the current evidence and what I have seen after several years in the clinic and with my own workouts, stretching has its place. So does warming-up. However, these are not the same thing and need to be dealt with separately. Unfortunately, the answer is also, “it depends.” We are all so individual in our bodies, how we move and what we do to be active that I think there may never be one correct answer. I just don’t think it would make sense that similar stretches would have the same effect on injury reduction for a marathon runner and a figure skater; or a football player and a construction worker.
In our quest to answer such a general question we eliminate the individual from the equation. Think of shopping for a really good fitting pair of jeans at a large chain retailer. Most often this is a difficult task for many, easy for several, and perfect for few! These jeans are made based on averages, not individuals.
So now to the real question, injury prevention. It is very important that we take a close look at what you are doing and what you are trying to achieve. Lets say you just showed up 15 minutes early to your weekly basketball game with friends and it is 5:45AM, in Buffalo (NY) in February! Chances are you have moved very little for the past 8 hours and are likely very cold. It is also likely that you don’t feel very fluid or ready to move at that moment. It maybe completely mental, but getting your body moving to similar movements you will use in your game should be advantageous. However, does this mean just reaching for your toes and the ceiling a few times then jumping right into things? In my opinion, no. How about the question of a easy weekend run? Maybe you have been up for 4-5 hours, already been working around the house a little and not looking to break any speed records. You grab your shoes, lace up and just start jogging at an easy pace then build up. I really see little wrong with using the jogging as your warm-up. It needs to be looked at individually!
Personally, I like to prepare my body for whatever task I am going to do, do it, then follow-up with stretches that continue to push into functional ranges of mobility that I feel I need to work on; based on limitations I felt during the activity. So for each activity; weight lifting, running, cycling, golf, my pre and post routines will look different. This is where having a knowledgeable physical therapist can benefit you greatly.
We are movement specialists. As a physical therapist I break down what you are doing into more basic kinematic movements and then match those with specific exercise and stretches to help you reach your goals. It is also my job to be familiar with current scientific evidence and apply that to you the individual as it seems prudent. Just because there is an article on the Wall Street Journal don’t assume it applies to you. My goal for this blog post was to get you thinking. Think about your personal activity, injuries in the past and present and how they may be related. Does how your stretch or warm-up relate to what you do? Does it mimic what you do? Does it give you a mental edge? Does it make you feel better or ready to get in the game? If you cannot answer these questions or need help answering them. That is a sign you need me (or any other qualified physical therapist in your area).
As always, I look forward to your comments or questions. Thanks.