SPORTS MEDICINE STRETCHING beyond normal range

n Exercises that ensure that all relevant joints and muscles are taken through the largest range of movement that will be required during the sport

n Sport-specific drills at high intensity - skill rehearsal. Athletes must appreciate the difference between

exercises used in a dynamic warm-up, when muscles and joints work within their current range, and ballistic stretching exercises.

Some athletes falsely believe that if stretching is inappropriate in the warm-up it is of no value at all. It is important that we stress that athletes using dynamic warm-up still require mobility/flexibility work in their general conditioning programmes.

Obviously it is important that the timing of the warm-up has been well thought out. There is no benefit in increasing cardiovascular output, enhancing blood flow to joints and muscles, making demands of neuromuscular pathways and mentally preparing for practice or play if the athlete then has to wait before commencing training or competition.

References

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3. Herbert RD and Gabriel M. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. British Medical Journal 2002;325,468-470

4. Shrier, I. Does Stretching Improve Performance?: A Systematic and Critical Review of the Literature. Clinical Journal of Sport Medicine 2004;14(5):267-273

5. Balyi I, Hamilton A. Long-term athlete development update. SportscoachUK FHS 2003;20:6-8 6. Bird S, Black N, Newton P. Sports Injuries. Causes, diagnosis, treatment and prevention. Stanley Thornes Ltd, Cheltenham 1997. ISBN 0748731814. Page 122 7. Shrier I. Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clinical Journal of Sport Medicine 1999;9:(4)221-227 8. Stewart DR and Burden SB. Does generalised ligamentous laxity increase seasonal incidence of injuries in male first division club rugby players? British Journal Sports Medicine 2004;38:457-460

9. Sapega AA, Quendenfeld TC, Moyer RA, Butler RA. Biophysical factors in range-of-motion exercise. The Physician and Sportsmedicine 1981;9:12,57-65 10. Roberts JM, Wilson K. Effect of stretching duration on active and passive range of motion in the lower extremity. British Journal of Sports Medicine 1999;33:259-263 11. McNair P. Acute responses to stretches with isokinetic dynamometers. sportEX medicine 2007;34:6-9 12. Bandy WD, Irion JM, Briggler M. The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Physical Therapy 1997;77:10,1090-1096 13. Kibler WB, Chandler TJ. Range of motion in junior tennis players participating in an injury risk modification program. Scandinavian Journal of Medicine and Science in Sports 2003;6:(1),51-62 14. Henricson AS, Fredriksson K, Persson I. The effect of heat and stretching on the range of hip motion. Journal of Orthopedic and Sports Physical Therapy 1984;6:110-115 15. Shrier I, Gossal K. Myths and truths of stretching. The Physician and Sports Medicine 2000;28:(8),21-26 16. Strickler T, Mallone T, Garrett WE. The effects of passive warming on muscle injury. American Journal of Sports Medicine 1990;1:2,141-145 17. Taylor DC, Dalton JD, Seaber AV, Garrett WE. Viscoelastic properties of muscle-tendon units: the biomechanical effects of stretching. American Journal of Sports Medicine 1990;18:3,300-

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18. Al Frihidy Y. The effect of static stretching duration on active and passive flexibility of the hamstring muscles. Unpublished dissertation in part completion of the MSc in Sports Physiotherapy, Manchester Metropolitan University 2005 19. Bandy WD, Irion JM. The effect of time on static stretch of the flexibility of the hamstring muscles. Physical Therapy 1994;74:845- 850

20. Feland JB and Marin HN. Effect of submaximal contraction intensity in contract-relax proprioceptive neuromuscular facilitation stretching. British Journal of Sports Medicine 2004;38:460 21. Waddington PJ. in Practical Exercise Therapy. Ed by M Hollis. Blackwell Scientific Publications, 1976. ISBN 0632001895. Chapters 22,23,25

22. Feland B, Myrer W, Merrill M. Acute changes in hamstring flexibility: PNF versus static stretch in senior athletes. Physical Therapy in Sport 2001;2: 186-193

23. Funk DC, Swank AM, Mikla BM, Fagan TA. Impact of prior exercise on hamstring flexibility: A comparison of proprioceptive neuromuscular facilitation and static stretching. Journal of Strength and Conditioning Research 2003;17:(3),489-492

24. Sady SP, Wortman M, Blanke MD. Flexibility training: ballistic, static or proprioceptive neuromuscular facilitation. Archives of Physical Medicine and Rehabilitation 1982;63:261-263

25. Lucas R, Koslow R. Comparative study of static, dynamic and proprioceptive neuromuscular facilitation stretching techniques on flexibility. Perceptual and Motor Skills 1984;58:615-618 26. Siatras T, Papadopoulos G, Mameletzi D, Gerodimos V, Kellis S. Static and dynamic acute stretching effect on gymnasts’ speed in vaulting. Pediatric Exercise Science 2003;15:(4),383-391 27. Young WB, Behm DG. Effects of running, static stretching and practice jumps on explosive force production and jumping performance. Journal of Sports Medicine and Physical Fitness 2003;43:(1),21-27

28. Behm DG, Bambury A, Cahill F. and Power K. Effect of acute static stretching on force, balance, reaction time, and movement time. Medicine and Science in Sports and Exercise 2004;36:1397- 1402

29. Larsen R, Lund H, Christensen R, Røgind H, Danneskiold- Samsøe B and Bliddal H. Effect of static stretching of quadriceps and hamstring muscles on knee joint position sense. British Journal of Sports Medicine 2005;39:43-46 30. Ghaffarinejad F, Taghizadeh S and Mohammadi F. Effect of static stretching of muscles surrounding the knee on knee joint position sense. British Journal of Sports Medicine 2007;41:684-687 31. Power K, Behm D, Cahill F, Carroll M. and Young W. An acute bout of static stretching: effects on force and jumping performance. Medicine and Science in Sports and Exercise 2004;36:1389- 1396

32. Behm DG, Bradbury EE, Haynes AT, Hodder JN, Leonard AM and Paddock NR. Flexibility is not related to stretch-induced deficits in force or power. Journal of Sports Science and Medicine 2006; 5:33-42.

THE AUTHOR TH

Lynn Booth is a chartered physiotherapist currently working with the national teams of the English Ladies’ Golf Association and the Ladies’ Golf

and with four of the regional boys’ squads and the national

’ Golf Union (Great Britain and Ireland squad) ’ squads and the national U16, U18 and

U21 squads for the English Golf Union. She also works with squads from English hockey. Lynn was Chairman of the British Olympic Association’s Physiotherapy Committee from 1992-2004. She worked at the 1988 and 1992 Olympic Games with the Great Britain Women’s Hockey Squad and was head physiotherapist for Team GB at the 1996, 2000 and 2004 Olympic Games.

This article has been modified from an original article first published in In Touch, Spring Issue 2007 No 118. The Journal for Physiotherapists in Private Practice. Our thanks go to In Touch for permission to reproduce this article

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