Stretching: The Truth

I Examine The Importance Of Stretching Pre And Post Workout To Prevent Injury

For this week's CBS Doc Dot Com segment, I thought I'd cover something completely non-controversial: what can weekend warriors learn from elite athletes? But I'm starting to believe that in this era of evidence-based medicine, nothing may be truly knowable. I went to the studios of the world famous Ballet Hispanico in New York City and spoke to athletic trainer Megan Richardson. She took me through the motions, emphasizing the importance of warming up and stretching in preventing injury. It sounded good and it felt good. But proving in the medical literature that it's effective is another thing. An online search quickly produced multiple conflicting reports and advice: stretching definitely works, stretching definitely doesn't work; stretching only works if you do it my way. Click here for a sampling:

PubMed:Warm-up And Stretching

PubMed: Stretching Perspectives

BioMed Central: The Effects Of Stretching

My friend and CBS colleague, Richard Schlesinger, offered his solution. "I get around it by neither stretching nor exercising." Had I listened to Richard, my blog would have ended right here. But I figured I needed at least one more paragraph so I contacted a true expert on the subject, Ian Shrier MD, PhD, a specialist in sports medicine and Associate Professor at McGill University. He has a PhD in physiology and is Past-President of the Canadian Academy of Sport Medicine. He's not a huge fan of stretching right before exercise. "First, the stretching, whether with or without warmup, does not improve performance. It makes you run slower, jump not as high, and makes you weaker." And "stretching definitely can hurt people if you overstretch; people do it all the time if they force the stretch." He added, "I don't think it hurts you in general if you do it properly but it doesn't prevent injury." He's more supportive of stretching at other times, including after exercise, saying, "Regular stretching at other times is beneficial. It makes you stronger, jump higher, etc, and there are three studies suggesting it reduces injuries as well, although the results were only significant in one." He adds that "stretching is analgesic; it allows you to put your muscle through a wider range of motion without feeling tension. And that may be why ballerinas say that stretching helps them." Dr. Shrier spells out his take on the subject in detail in a chapter called "Does stretching help prevent injuries?"

For me, Dr. Shrier's most interesting advice, especially for weekend warriors, was about the importance of warming up. He explained that muscles need energy to function properly. Energy is mainly produced inside of cells in structures called mitochondria. When you are resting, your mitochondria power down. During exercise, it takes awhile for the cell to rev up the enzymes needed for breaking down fat and carbohydrates for fuel and for using oxygen to make energy from that fuel. If you start running at full speed without warming up, your body will produce lactic acid. Lactic acid can impair muscle function for awhile, preventing you from sprinting efficiently at the end of the race. So Dr. Shrier suggests gradually warming up. He estimated it takes about 3 to 5 minutes to efficiently go from one level of exercise to the next -- for example, going from rest to a ten minute mile or going from a ten minute mile to a seven minute mile. If you go for a jog, "you walk, then jog slowly, and then pick up it up. Elite marathoners might go for a fifteen to twenty minute jog before they run a marathon. That allows them to run faster at the beginning of the race. They run the second half of the marathon faster than the first."

In summary -- and I suspect that I am the first person today to tell you this -- don't outpace your mitochondria.

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Comments

[tash1228]

I always felt like stretching before workouts does nothing for me, whereas stretching after helps. It's great to get a professional opinion on whether it's neccessary to stretch before excercising because I don't do it. On the other hand it's comforting to know that I'm doing the right thing by warming up before workouts. Thanks.

[LordMoon]

It's been my experience that stretching, should never be considered a warm up. Opening up the joints, before a workout, can feel good if you have problems, but ironically makes joints and muscles more vulnerable to injuiry. Because joints and muscles that are too open, don't provide enough structural support for intense work outs.

Stretching is best after a work out, after the muscles have cooled down a little, and are starting to stiffin a little. Because, you don't get as much benefit, without resistance from the opposing muscle groups - when muscles are too hot they don't resist as much, then again there is also a risk of over stretching, when muscles are tired.

As you age, your muscles lose elasticity, so stretching can be a great way to restore proper muscle tone and shape, for healing, and repair.

[GEM-592]

The question of stretching before or after goes way back, with successful proponents on both sides. One thing weekend warriors should know about elite athletes is that they often conclude that what has worked for them must be the correct way for everybody. Also, exercise science is filled with a good amount of uncertain opinion and inconclusive rationale - even the author admits that "nothing may be truly knowable," then he goes on to offer an opinion against stretching before exercise in favor of warming up.

For most of us, regular moderate exercise should be the goal. To this end, your primary method should be to listen to your body in order to avoid injury while maximizing your benefit and enjoyment. Don't be afraid to try different techniques or schedules to avoid boredom and find out how your body responds. Take a grain of salt with the advice of elite athletes who tend to want to step in to tell you you're doing it wrong, listen and learn but remember that in some areas there are no hard and fast answers.

[RadicalRepublican]

Stretching works. For me anyway. When I stretch before and after a workout the pain and stiffness in by lower back dimishes. My hamstrings and gluts otherwise tighten and create unbearable pressure on by back.

[lsbartz]

When I go to the gym, I warm up on the rowing machine for five minutes before I touch any iron.

[Conk]

Correct. You should warm up your body first, then stretch. Never stretch cold.

[Rule Of Law]

In the gym we warm up by doing multiple light reps of whatever exercise we will be doing. Stretching has been found to loosen the girdle of muscles and ligaments that locate your joints before any strenuous exercise making you more prone to accident. Stretching after a heavy workout is a great way to ease the lactic acid out of the muscle which prevents some of the post workout soreness the next day.

[RumiSouth]

The advice to stretch AFTER exercise is spot-on. I've found that a brief stretch before exercise helps me get limbered for the warm-up; a good, long stretch after exercise leaves me less sore and feeling stronger for the rest of the day.

[PocketWatch]

If you watch boxing, you see fighters that come into the ring already sweated up. There is a reason for that. If they come in "dry," they rarely do well in the first few rounds. Makes total sense.