PT on the Net Research

Relevance of Flexibility Training in Fitness, Sports, and Occupational Settings


In the last two decades, flexibility training and stretching has undergone a dramatic examination to determine the benefits, or lack thereof. This leads to the question: Is flexibility training important for our fitness or athlete clients? There is conflicting evidence that stretching reduces the risk of injury and improves performance. There is no evidence that increased flexibility is of benefit to all athletes. In a fitness setting, instead of stretching before a workout, the focus could be to reverse chronic occupational postures. Research on work-place stretching shows it can reduce muscle pain, improve worker satisfaction, and reduce the severity and costs of injury and pain.

Learning Objectives

  1. Explain the conflicting research on the benefits of stretching.
  2. Describe how our clients can have chronic occupational postures and how stretching can reverse these postures.
  3. Implement a program of static stretching, range of motion, and mobility exercises.

Stretching in the 21st Century

Stretching seems to be a misunderstood component of fitness. Much of the misunderstanding is because research is still unclear regarding the benefits of stretching to reduce the risk of injury and improve performance. For sports performance, some athletes who need extreme flexibility, such as gymnasts, will benefit from stretching. Whereas research on long and middle-distance runners has found that runners who have inflexible hamstrings are more economical, ie: better runners (Trehearn and Buresh, 2009 and Jones, 2002).

Most of our fitness clients need enough flexibility to perform the activities of daily living and to do their jobs. Consideration can be given to the use of flexibility training for fitness clients to reverse the chronic occupational postures they are in at work. In addition, it is a good use of flexibility training to teach clients how to stretch, and what stretches to do, at work.

In terms of the use of flexibility training during a warm-up for fitness or athletic clients, some basic static stretches can be used to “loosen up.” These can be followed by mobility training, which is controlled, voluntary movement through a full range of motion (http://www.atlasfitnessdc.com/mobility-training-need/). Mobility training may be more functional and useful for the health and performance of fitness and athlete clients. In addition, range of motion exercises for all joints can help the body warm-up before a work-out, and still increase flexibility.

Following are some mobility (also sometimes call dynamic stretches) exercises.

Scorpion 

Hip Swings – Front/Back
Anterior Contralateral Chain Stretch
Backhand/Forehand Swing
Lunge with Lateral Flexion

Does Stretching Reduce the Risk of Injury and Improve Performance?

Shier (2004) performed a review of literature to investigate if a short bout of stretching improves performance on fitness tests. Twenty-two of 23 studies suggested there was no benefit from stretching for isometric force, isokinetic torque, or jumping height. One study suggested there was improved running economy because of stretching. There were four studies on running speed - one suggested that stretching was beneficial, one suggested it was detrimental, and two had vague results. There were nine studies examining the effects of regular stretching, of which seven suggested it was beneficial, and two showed no effect. There were no studies indicating stretching was detrimental.

Small, McNaughton, and Matthews (2008) also conducted a review of literature to investigate if static stretching as part of a warm-up prevents injury. The researchers indicate there is moderate to strong evidence that static stretching does not reduce injury. They also found preliminary evidence that stretching does prevent injuries.

Baxter, et al., (2017) did a review of literature to investigate if stretching was beneficial for distance runners. The research shows neither acute or chronic static stretching was clinically beneficial for endurance runners for performance, incidence of delayed onset muscle soreness, or to prevent injury. The researchers indicate runners are at risk of injuries such as iliotibial band syndrome, stress fractures, and plantar fasciitis, and the literature suggests that stretching cannot reduce the prevalence of these injuries. Stretching has no advantage for endurance runners for improving performance or reducing injury.

Occupational and “Reversal” Stretching

Many of our fitness clients work in offices and spend hours sitting at a desk working on a computer. Other clients may drive a lot, or work in industry, or perform work where they are in unique and challenging postures. These chronic occupational postures can cause pain from “tight” or “spasmed” muscles.  It is important to stretch to reverse the chronic postures throughout the day and in a fitness program.

The research on occupational stretching focuses on work-place stretching rather than exercise program stretching, but the results can be transferred to a fitness setting. Shariat, et al., (2018) investigated the effectiveness of stretching, ergonomics, and a combination of exercise and ergonomics on office workers with neck, shoulders, and lower back pain. They found the stretching group had the most significant decrease in pain.

Aje, Smith-Campbell, and Bett (2018) evaluated the effect of an eight-minute pre-work stretching program on preventing work-related muscle injuries. The researchers found a significant decline in injury rates and time-off requests, and there were cost savings for the employer and employees.

Tunwattanapong, Kongkasuwan, and Kuptniratsaikul (2016) conducted a study to look at the effectiveness of neck and shoulder stretching for relief of neck pain in office workers. There was an exercise group and a control group. The results indicated regular stretching for four weeks decreases neck and shoulder pain and improved neck function, and quality of life for office workers who had chronic moderate-to-severe neck or shoulder pain.

Marangoni (2010) investigated the effects of stretching on pain associated with working at a computer, and if a computer prompt or hard copy of exercises was better. Thirty-six stretches were performed by the subjects for 15-17 work days. One group was reminded to stretch by a computer prompt, the second group used a hard copy of the stretches with pictures and written instructions, and a third group received no intervention. The results indicate a 72% reduction in pain for the computer-prompted stretching group, and 64% using the hardcopy exercises. The control group had an increase in pain of 1%.

Summary

As you can see, the research is conflicting on the benefits of flexibility training. For athletes, some research suggests there is a benefit, while other research suggests there is no benefit. That said, it has not been shown to be detrimental either, and depending on the sport, flexibility training is indeed necessary (ex. gymnasts). For the “occupational” individual (which is more consistent with most personal training clients), flexibility training appears to be beneficial in improving pain. So, flexibility training would be appropriate for most of the typical personal training clients, and depending on the sport, for athletes as well.

References

Aje, O.O, Smith-Campbell, B., and Bett, C. (2018). Preventing Musculoskeletal Disorders in Factory Workers: Evaluating a New Eight Minute Stretching Program. Workplace Health and Safety, 66(7):343-347.

Baxter, C., et al., (2017). Impact of stretching on the performance and injury risk of long-distance runners, Research in Sports Medicine. 25(1):78-90.

Giles, G. (2018). What is mobility training and do I need to be doing it? Retrieved from: http://www.atlasfitnessdc.com/mobility-training-need/.

Jones, A.M. (2002). Running economy is negatively related to sit-and-reach test performance in international-standard distance runners. International Journal of Sports Medicine, 23(1):40-43

Marangoni, A. H., (2010).  Effects of intermittent stretching exercises at work on musculoskeletal pain associated with the use of a personal computer and the influence of media on outcomes. Work, 36(1):27-37.

Shariat, A., et al., (2018). Effects of stretching exercise training and ergonomic modifications on musculoskeletal discomforts of office workers: a randomized controlled trial. Brazilian Journal of Physical Therapy, 22(2):144-153.

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

Small. K, McNaughton, L, Matthews, M. (2008). A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Research in Sports Medicine, 16(3):213-31.

Trehearn, T.L. and Buresh. R.J. (2009). Sit-and-reach flexibility and running economy of men and women collegiate distance runners. Journal of Strength and Conditioning Research, 23(1):158-62.

Tunwattanapong, P., Kongkasuwan, R. and Kuptniratsaikul, V. (2016). The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: a randomized controlled trial. Clinical Rehabilitation, 30(1):64-72.