Does Stretching Actually Reduce Injury Risk?

Our physical therapist dives into the research and gives you the facts.

Stretching before or after exercise has long been promoted as a key practice for preventing injuries. We’ve all heard the advice: “Always stretch before you start.” It seems to make intuitive sense—stretching increases flexibility and prepares the muscles and joints for the demands of physical activity.

We all know that we “should” be including some form of stretching routine before or after exercising—some of us embrace stretching, while others may find it less appealing. Stretching is sort of the “eat your vegetables” of running.

Regardless of personal preferences, the pervasive notion that stretching is crucial for injury prevention has been ingrained in our collective consciousness since elementary school gym class.

But does stretching before your daily run actually keep you from getting injured?

You may be surprised to read this, and I have to admit I was shocked when I encountered the latest research, but while stretching may have its merits in improving flexibility and muscle function, it alone does not appear to significantly reduce the risk of sports injuries.

I wanted to know why, so let’s take a look at the science.

A runner stretches with question marks imposed over an orange background.
Credit: Marathon Handbook Team

What Is Stretching?

Before we delve into the research, it would be helpful to be clear about what we’re talking about, as there are many different types of stretching.

Stretching involves intentionally elongating muscles to enhance joint range of motion (ROM).

There are several types of stretching techniques commonly used:

  1. Active Static Stretching (SS): With active static stretching, runners actively lengthen a muscle until they begin to feel a stretch or reach a point of discomfort. This form of stretching is performed without external assistance and relies on the individual’s own muscle strength to hold the stretch.
  2. Passive Static Stretching (PS): Passive static stretching involves the application of an external force to elongate the muscle. This force can come from various sources, such as a coach, a colleague, or using equipment like resistance bands or straps. Unlike active static stretching, passive stretching relies on external assistance to achieve the desired stretch.
  3. Dynamic Stretching (DS): Dynamic stretching entails performing controlled movements through the joint’s full range of motion. Unlike static stretching, which involves holding a position, dynamic stretching involves continuous movements that aim to mimic some form of the motions of the activity about to be performed. Dynamic stretching helps warm up the muscles and prepares them for more vigorous activity.
  4. Proprioceptive Neuromuscular Facilitation (PNF): PNF stretching combines passive static stretching with isometric contractions to enhance flexibility. It typically involves stretching a muscle passively to its end range, followed by an isometric contraction of the muscle against resistance for a short duration, and then relaxing and stretching the muscle further.
A person stretching their back at the gym.

Does Stretching Prevent Injuries? What Does The Science Say?

So, does the scientific evidence truly support the widely held belief that you should stretch to avoid injury?

A 2013 systematic review and meta-analysis1Lauersen, J. B., Bertelsen, D. M., & Andersen, L. B. (2013). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine48(11), 871–877. https://doi.org/10.1136/bjsports-2013-092538 of randomized control trials conducted at the Institute of Sports Medicine Copenhagen evaluated the results of 25 studies encompassing 26,000 people who had encountered over 3,500 injuries between them.

The meta-analysis uncovered compelling evidence regarding the effectiveness of interventions, such as strength training and proprioception exercises, in reducing the risk of sports-related injuries.

What’s particularly intriguing are the unexpected findings regarding stretching’s efficacy in preventing sports injuries. Despite its longstanding endorsement as a cornerstone of pre-exercise routines, the study’s results challenge conventional wisdom.

The analysis revealed that stretching did not demonstrate a significant protective effect against injuries.

Specifically, strength training demonstrated an impressive reduction in injury risk, with a relative risk (RR) estimate of approximately 68.5%. Proprioception training also yielded substantial benefits, with a relative risk estimate of 52% for proprioception exercises.

Surprisingly, despite its widespread adoption as a preventive measure, stretching did not significantly reduce injury risk. The analysis revealed a relative risk estimate of 0.963 for stretching, indicating a negligible reduction in injury risk, if any.

That suggests that individuals who engaged in stretching had a 3.7% lower risk of experiencing an injury compared to those who did not.

While 3.7% may still be worth it for some, it is not statistically significant, meaning that the difference observed may have occurred due to chance rather than the intervention itself.

While the study included each type of stretching mentioned above, the data for each one will be slightly different.

A person stretching their glute.

Stretching Does Not ‘Warm Up’ The Body

Stretching before a run might seem like a good idea, but if overdone, it can actually reduce muscle power output, potentially impacting running performance.

While stretching may offer benefits like increased flexibility and psychological readiness, these benefits aren’t unique to stretching alone.

Studies show2Rubini, E. C., Costa, A. L. L., & Gomes, P. S. C. (2007). The Effects of Stretching on Strength Performance. Sports Medicine37(3), 213–224. https://doi.org/10.2165/00007256-200737030-00003 that static and passive stretching could slightly hinder performance in activities requiring power, strength, and speed.

However, this negative impact can be minimized if each stretch lasts between 30 to 60 seconds per muscle group and is followed by dynamic warm-up activities.

For runners getting ready to hit the track or trail, it’s better to begin with light jogging or brisk walking to get the body moving gently.

Then, incorporate dynamic stretching exercises such as leg swings or lunges to improve flexibility and range of motion.

Finally, wrap up the warm-up routine with sport-specific movements like high knees or low-effort running to prepare the muscles for the specific demands of running.

Stretching Does Not Speed Up Injury Recovery

A separate meta-analysis looking at “The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness”3Afonso, J., Clemente, F. M., Nakamura, F. Y., Morouço, P., Sarmento, H., Inman, R. A., & Ramirez-Campillo, R. (2021). The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Physiology12. https://doi.org/10.3389/fphys.2021.677581 deemed that, based on the evidence, stretching does not appear to offer significant benefits compared to passive recovery methods like rest.

Don’t feel guilty if the first thing you do when you get back from a run is lie down. Nothing beats a bit of rest, a big glass of water, and a hearty meal.

While stretching after exercise didn’t seem to harm recovery, it also didn’t provide clear benefits over simply resting and refueling. Therefore, current evidence may not support the recommendation to include stretching in post-exercise recovery routines.

That said, research has indicated4Jamtvedt, G., Herbert, R. D., Flottorp, S., Odgaard-Jensen, J., Havelsrud, K., Barratt, A., Mathieu, E., Burls, A., & Oxman, A. D. (2009). A pragmatic randomised trial of stretching before and after physical activity to prevent injury and soreness. British Journal of Sports Medicine44(14), 1002–1009. https://doi.org/10.1136/bjsm.2009.062232 that stretching may help decrease post-exercise soreness. Feeling sore after a run can be horrible; any measures that reduce that sensation hold a level of value.

A person stretching their hamstring.

Benefits Of Stretching

Stretching offers several benefits that contribute to overall physical well-being and performance.

Firstly, stretching plays a crucial role in improving flexibility. Regularly engaging in stretching exercises can enhance joint range of motion and muscle elasticity.

This increased flexibility not only aids in improving athletic performance by allowing for greater movement but also can, in turn, reduce the risk of injury.

Moreover, stretching can have positive effects on psychological readiness.

Incorporating stretching into a pre-exercise routine can help individuals mentally prepare for running. Stretching allows for a moment of focus and concentration, helping runners to center themselves and enter a state of readiness for an upcoming run or race.

As mentioned above, regular stretching can help reduce fatigue and alleviate delayed onset muscle soreness (DOMS) after physical activity.

Finally, a recent study5Bisconti, A. V., Cè, E., Longo, S., Venturelli, M., Coratella, G., Limonta, E., Doria, C., Rampichini, S., & Esposito, F. (2020). Evidence for improved systemic and local vascular function after long‐term passive static stretching training of the musculoskeletal system. The Journal of Physiology598(17), 3645–3666. https://doi.org/10.1113/jp279866 found that engaging in passive stretching for 12 weeks can enhance blood flow and promote cardiovascular health.

The research further indicated that regular stretching may mitigate issues within the vascular system, potentially lowering the likelihood of cardiovascular events like heart attacks and strokes.

What Role Should Stretching Play In My Running Training?

Incorporating stretching into your routine requires careful consideration of various factors. While stretching has been traditionally advocated for improving flexibility and potentially reducing injury risk, recent evidence suggests a more nuanced perspective.

Stretching can indeed enhance range of motion (ROM) when performed consistently over time, but so can other modalities like strength training, which also offers additional health benefits.

If the time allocated for stretching results in a reduction of time available for other activities, such as running, strength training, or stability exercises, it might be more beneficial to prioritize those activities instead.

Moreover, the relationship between stretching and injury prevention is unclear, as most injuries stem from multiple factors.

Although flexibility is often associated with reduced injury risk, it’s essential to note that correlation does not imply causation, and flexibility can be enhanced through various means.

What is clear is that we need to distinguish between different types of stretching—a stretching routine needs to evolve from the outdated long, slow, static stretches.

While current studies suggest stretching may not significantly reduce injury risk, future research should do more to explore different types of stretching and their timing.

Investigating active static, passive static, dynamic, and PNF stretching could reveal which methods are most effective. Moreover, studying when to stretch—before or after workouts—could provide valuable insights.

Additionally, comparing supervised versus unsupervised stretching sessions may offer guidance on proper technique. Better-designed studies in these areas will provide athletes and coaches with evidence-based recommendations for injury prevention.

Stretching is generally safe, and if it makes you feel better and reduces discomfort from post-running soreness, it may well be worth incorporating into your routine.

Even if it doesn’t necessarily prevent injuries, if stretching improves your overall sense of well-being, there’s no harm in continuing with it.

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References

  • 1
    Lauersen, J. B., Bertelsen, D. M., & Andersen, L. B. (2013). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine48(11), 871–877. https://doi.org/10.1136/bjsports-2013-092538
  • 2
    Rubini, E. C., Costa, A. L. L., & Gomes, P. S. C. (2007). The Effects of Stretching on Strength Performance. Sports Medicine37(3), 213–224. https://doi.org/10.2165/00007256-200737030-00003
  • 3
    Afonso, J., Clemente, F. M., Nakamura, F. Y., Morouço, P., Sarmento, H., Inman, R. A., & Ramirez-Campillo, R. (2021). The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Physiology12. https://doi.org/10.3389/fphys.2021.677581
  • 4
    Jamtvedt, G., Herbert, R. D., Flottorp, S., Odgaard-Jensen, J., Havelsrud, K., Barratt, A., Mathieu, E., Burls, A., & Oxman, A. D. (2009). A pragmatic randomised trial of stretching before and after physical activity to prevent injury and soreness. British Journal of Sports Medicine44(14), 1002–1009. https://doi.org/10.1136/bjsm.2009.062232
  • 5
    Bisconti, A. V., Cè, E., Longo, S., Venturelli, M., Coratella, G., Limonta, E., Doria, C., Rampichini, S., & Esposito, F. (2020). Evidence for improved systemic and local vascular function after long‐term passive static stretching training of the musculoskeletal system. The Journal of Physiology598(17), 3645–3666. https://doi.org/10.1113/jp279866

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Ben Gibbons
Ben is a qualified Personal Trainer and Sports Massage Therapist with a particular interest in running performance and injury. He has spent the last 9 years working with runners at his clinic in Brighton. Ben is a keen runner and avid cyclist. Evenly splitting his time between trail running, road biking, and MTB.

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