We’ve been long told the importance and benefits of stretching for pain and function, but is this justified?
A key component of injury management that gets overlooked frequently is the importance of strengthening and improving range of motion through stretches.
However, stretching has its place in rehabilitative exercise programs as well!
Let’s take a look at the differences in both these movements and how this can improve function in patients:
Strengthening, also known as strength training, is when an exercise is performed against resistance at relatively high intensities bringing on a muscle strengthening response.
Typical parameters for a strength training program are 3-4 sets of 8-12 repetitions while working at around 80% of your maximal effort.
Strengthening can involve the use of your own body weight, weights, or a resistance band.
Stretching, in the traditional sense, refers to static stretching.
This is when a muscle is taken to its maximal lengthened position and held for a period of time in order to bring on a permanent increase in muscle length over time.
The typical time held for the desired effect is approximately 30-60 seconds.
When addressing chronic pain or injury, performing a gentle stretch can be beneficial.
While stretching has its place in providing relief, previous studies and evidence suggest that strengthening is the best option for injury rehabilitation and reducing the likelihood of future injuries.
The strongest evidence supporting strengthening over stretching comes from a systematic review and meta-analysis of 26,600 individuals.
This review came to the conclusion that strength training alone was able to reduce the likelihood of acute injuries and overuse injuries in sports by 33% and 50%, respectively.
Conversely, stretching alone was not found to be effective in reducing the likelihood of future sporting injuries.
Common conditions such as chronic low back pain, chronic neck pain, neck-related headaches, plantar fascia pain, hip osteoarthritis, and hamstring injuries have also all been shown to have greater benefits from strength training than stretching.
On top of its injury-reducing properties, strength training can also improve athletic performance as well for runners, sprinters, and other high-intensity athletes.
In the context of rehabilitation, strengthening is generally my go-to over stretching as it can provide both the benefits of strengthening and stretching if performed appropriately.
This response is brought on when the eccentric muscle contraction is focused on during the exercise, which is when a muscle lengthens while contracting.
Eccentric muscle contraction is emphasized by focusing on the slow lowering of the weight or slow return from the end position to the starting position.
By implementing this, the muscle and the tendon are lengthened and strengthened simultaneously.
While this can bring on some delayed onset muscle soreness, it’s an effective and efficient way to reap the benefits of strengthening and stretching.
(Check out our article about whether or not to ice acute injuries and muscle soreness!)
Stretching has its role in injury management, and it can be useful for improving flexibility over time and providing temporary pain relief.
It can also allow individuals to incorporate more movement throughout the day easily in between daily tasks.
In order to properly rehabilitate from an injury, reduce the risk of future injuries, and participate in sports or vigorous exercise, stretching alone will not suffice.
Stretching as a part of a comprehensive training program can be a great addition to your routine, but strengthening can provide a way to prevent future injury and enhance performance.
To learn more about strength training and injury rehabilitation, book an appointment with one of our Physiotherapists through the link below!
https://atlasphysio.janeapp.com/
Fiataraone Singh, M., Heckett, D., Schoenfeld, B., Vincent, H.K., & Wescott, W. (2019) ACSM Guidelines for Strength Training. https://www.acsm.org/blog-detail/acsm-certified-blog/2019/07/31/acsm-guidelines-for-strength-training-featured-download
Lauersen, J. B., Bertelsen, D. M., & Andersen, L. B. (2014). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British journal of sports medicine, 48(11), 871–877. https://doi.org/10.1136/bjsports-2013-092538
Kristensen, J., & Franklyn-Miller, A. (2012). Resistance training in musculoskeletal rehabilitation: a systematic review. British journal of sports medicine, 46(10), 719–726. https://doi.org/10.1136/bjsm.2010.079376
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Rathleff, M. S., Mølgaard, C. M., Fredberg, U., Kaalund, S., Andersen, K. B., Jensen, T. T., Aaskov, S., & Olesen, J. L. (2015). High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scandinavian journal of medicine & science in sports, 25(3), e292–e300. https://doi.org/10.1111/sms.12313
Brosseau, L., Wells, G. A., Pugh, A. G., Smith, C. A., Rahman, P., Àlvarez Gallardo, I. C., Toupin-April, K., Loew, L., De Angelis, G., Cavallo, S., Taki, J., Marcotte, R., Fransen, M., Hernandez-Molina, G., Kenny, G. P., Regnaux, J. P., Lefevre-Colau, M. M., Brooks, S., Laferriere, L., McLean, L., … Longchamp, G. (2016). Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis. Clinical rehabilitation, 30(10), 935–946. https://doi.org/10.1177/0269215515606198
Van der Horst, N., Smits, D. W., Petersen, J., Goedhart, E. A., & Backx, F. J. (2015). The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. The American journal of sports medicine, 43(6), 1316–1323. https://doi.org/10.1177/0363546515574057
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Bolger, R., Lyons, M., Harrison, A. J., & Kenny, I. C. (2015). Sprinting performance and resistance-based training interventions: a systematic review. The Journal of Strength & Conditioning Research, 29(4), 1146-1156.
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