Abstract
Purpose
This study evaluated the acute effects of two different stretch intensities on muscle damage and extensibility.
Methods
Twenty-two physically active women (age 20 ± 1.0 years) were divided into two matched groups and undertook eight sets of 30-s passive hamstring stretching. One group stretched to the point of discomfort (POD) and the other to the point of pain (POP). Hamstring passive torque, sit and reach (S&R), straight leg raise (SLR), and markers of muscle damage were measured before, immediately after stretching and 24 h later.
Results
S&R acutely increased and was still increased at 24 h with median (interquartile range) of 2.0 cm (0.5–3.75 cm) and 2.0 cm (0.25–3.0 cm) for POP and POD (p < 0.05), respectively, with no difference between groups; similar changes were seen with SLR. Passive stiffness fully recovered by 24 h and there was no torque deficit. A small, but significant increase in muscle tenderness occurred at 24 h in both groups and there was a very small increase in thigh circumference in both groups which persisted at 24 h in POP. Plasma CK activity was not raised at 24 h.
Conclusion
Stretching to the point of pain had no acute advantages over stretching to the discomfort point. Both forms of stretching resulted in very mild muscle tenderness but with no evidence of muscle damage. The increased ROM was not associated with changes in passive stiffness of the muscle but most likely resulted from increased tolerance of the discomfort.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- CK:
-
Creatine kinase
- CON:
-
Concentric contraction
- DOMS:
-
Delayed onset of muscle soreness
- EMG:
-
Electromyography
- ISO:
-
Isometric contraction
- MTU:
-
Muscle tendon unit
- ROM:
-
Range of motion
- S&R:
-
Sit and reach
- SLR:
-
Straight leg raise
References
Apostolopoulos N, Metsios GS, Flouris AD et al (2015a) The relevance of stretch intensity and position—a systematic review. Front Psychol. doi:10.3389/fpsyg.2015.01128
Apostolopoulos N, Metsios GS, Nevill AM et al (2015b) Stretch intensity vs. inflammation: a dose-dependent association? Int J Kinesiol Sports Sci. doi:10.7575/aiac.ijkss.v.3n.1p.27
Apostolopoulos N, Metsios GS, Taunton J et al (2015c) Acute inflammation response to stretching: a randomised trial. Ital J Sports Rehabil Posturol 2:368–381
Armstrong RB (1984) Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc 16:529–538
Behm DG, Chaouachi A (2011) A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol 111:2633–2651. doi:10.1007/s00421-011-1879-2
Behm DG, Kibele A (2007) Effects of differing intensities of static stretching on jump performance. Eur J Appl Physiol 101(5):587–594. doi:10.1007/s00421-007-0533-5
Behm DG, Blazevich AJ, Kay AD, McHugh M (2016) Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab Physiol Appl Nutr Metab 41:1–11. doi:10.1139/apnm-2015-0235
Blazevich AJ, Cannavan D, Waugh CM et al (2014) Range of motion, neuromechanical, and architectural adaptations to plantar flexor stretch training in humans. J Appl Physiol 117:452–462. doi:10.1152/japplphysiol.00204.2014
Cabido CET, Bergamini JC, Andrade AGP et al (2014) Acute effect of constant torque and angle stretching on range of motion, muscle passive properties, and stretch discomfort perception. J Strength Cond Res 28:1050–1057. doi:10.1519/JSC.0000000000000241
Castellote-Caballero Y, Valenza MC, Martín-Martín L et al (2013) Effects of a neurodynamic sliding technique on hamstring flexibility in healthy male soccer players. A pilot study. Phys Ther Sport 14:156–162. doi:10.1016/j.ptsp.2012.07.004
Chen C-H, Chen TC, Jan M-H, Lin J-J (2015) Acute effects of static active or dynamic active stretching on eccentric-exercise-induced hamstring muscle damage. Int J Sports Physiol Perform 10:346–352. doi:10.1123/ijspp.2014-0206
Dantas EHM, Salomão PT, Vale RDS, Achour Júnior A, Simão R, Figueiredo NMA (2008) Scale of perceived exertion in the flexibility (PERFLEX): a dimensionless tool to evaluate the intensity. Fit Perform J 7(5):289–294. doi:10.3900/fpj.7.5.289.e
Dempsey AL, Branch TP, Mills T, Karsch RM (2010) High-intensity mechanical therapy for loss of knee extension for worker’s compensation and non-compensation patients. Sports Med Arthrosc Rehabil Ther Technol SMARTT 2:26. doi:10.1186/1758-2555-2-26
Favero J-P, Midgley AW, Bentley DJ (2009) Effects of an acute bout of static stretching on 40 m sprint performance: influence of baseline flexibility. Res Sports Med Print 17:50–60. doi:10.1080/15438620802678529
Freitas SR, Vilarinho D, Vaz JR et al (2015) Responses to static stretching are dependent on stretch intensity and duration. Clin Physiol Funct Imaging 35:478–484. doi:10.1111/cpf.12186
Freitas SR, Andrade RJ, Nordez A et al (2016) Acute muscle and joint mechanical responses following a high-intensity stretching protocol. Eur J Appl Physiol 116:1519–1526. doi:10.1007/s00421-016-3410-2
Fridén J, Sfakianos PN, Hargens AR (1986) Muscle soreness and intramuscular fluid pressure: comparison between eccentric and concentric load. J Appl Physiol Bethesda Md 1985 61:2175–2179
Geronilla KB, Miller GR, Mowrey KF et al (2003) Dynamic force responses of skeletal muscle during stretch-shortening cycles. Eur J Appl Physiol 90:144–153. doi:10.1007/s00421-003-0849-8
Gresnigt MS, Joosten LAB, Verschueren I et al (2012) Neutrophil-mediated inhibition of proinflammatory cytokine responses. J Immunol 189:4806–4815. doi:10.4049/jimmunol.1103551
Hayes PR, Walker A (2007) Pre-exercise stretching does not impact upon running economy. J Strength Cond Res 21:1227–1232. doi:10.1519/R-19545.1
Jacobs CA, Sciascia AD (2011) Factors that influence the efficacy of stretching programs for patients with hypomobility. Sports Health 3:520–523. doi:10.1177/1941738111415233
Jones DA, Newham DJ, Round JM, Tolfree SE (1986) Experimental human muscle damage: morphological changes in relation to other indices of damage. J Physiol 375:435–448
Kamandulis S, Emeljanovas A, Skurvydas A (2013) Stretching exercise volume for flexibility enhancement in secondary school children. J Sports Med Phys Fitness 53:687–692
Kay AD, Blazevich AJ (2012) Effect of acute static stretch on maximal muscle performance: a systematic review. Med Sci Sports Exerc 44:154–164. doi:10.1249/MSS.0b013e318225cb27
Knudson D (2006) The biomechanics of stretching. J Exerc Sci Physiother 2:3
Kokkonen J, Nelson AG, Cornwell A (1998) Acute muscle stretching inhibits maximal strength performance. Res Q Exerc Sport 69:411–415. doi:10.1080/02701367.1998.10607716
Kokkonen J, Nelson AG, Tarawhiti T et al (2010) Early-phase resistance training strength gains in novice lifters are enhanced by doing static stretching. J Strength Cond Res 24:502–506. doi:10.1519/JSC.0b013e3181c06ca0
LaRoche DP, Lussier MV, Roy SJ (2008) Chronic stretching and voluntary muscle force. J Strength Cond Res 22:589–596. doi:10.1519/JSC.0b013e3181636aef
Light KE, Nuzik S, Personius W, Barstrom A (1984) Low-load prolonged stretch vs. high-load brief stretch in treating knee contractures. Phys Ther 64:330–333
Magnusson SP (1998) Passive properties of human skeletal muscle during stretch maneuvers. A review. Scand J Med Sci Sports 8:65–77
Magnusson P, Renström P (2006) The European College of Sports Sciences position statement: the role of stretching exercises in sports. Eur J Sport Sci 6:87–91. doi:10.1080/17461390600617865
Matsuo S, Suzuki S, Iwata M et al (2015) Changes in force and stiffness after static stretching of eccentrically-damaged hamstrings. Eur J Appl Physiol 115:981–991. doi:10.1007/s00421-014-3079-3
Mizuno T, Matsumoto M, Umemura Y (2013) Viscoelasticity of the muscle–tendon unit is returned more rapidly than range of motion after stretching. Scand J Med Sci Sports 23:23–30. doi:10.1111/j.1600-0838.2011.01329.x
Moore JC (1984) The Golgi tendon organ: a review and update. Am J Occup Ther 38:227–236. doi:10.5014/ajot.38.4.227
Moriyama H, Tobimatsu Y, Ozawa J et al (2013) Amount of torque and duration of stretching affects correction of knee contracture in a rat model of spinal cord injury. Clin Orthop 471:3626–3636. doi:10.1007/s11999-013-3196-z
Nelson AG, Kokkonen J, Arnall DA (2005) Acute muscle stretching inhibits muscle strength endurance performance. J Strength Cond Res 19:338–343. doi:10.1519/R-15894.1
Newham DJ, Jones DA, Edwards RH (1983) Large delayed plasma creatine kinase changes after stepping exercise. Muscle Nerve 6:380–385. doi:10.1002/mus.880060507
Newham DJ, Jones DA, Edwards RH (1986a) Plasma creatine kinase changes after eccentric and concentric contractions. Muscle Nerve 9:59–63. doi:10.1002/mus.880090109
Newham DJ, Jones DA, Tolfree SE, Edwards RH (1986b) Skeletal muscle damage: a study of isotope uptake, enzyme efflux and pain after stepping. Eur J Appl Physiol 55:106–112
Palomero J, Pye D, Kabayo T, Jackson MJ (2012) Effect of passive stretch on intracellular nitric oxide and superoxide activities in single skeletal muscle fibres: influence of ageing. Free Radic Res 46:30–40. doi:10.3109/10715762.2011.637203
Pedersen BK (2000) Exercise and cytokines. Immunol Cell Biol 78:532–535
Raiola G, Tafuri D, Gomez Paloma F (2014) Physical activity and sport skills and its relation to mind theory on motor control. Sport Sci 7:52–56
Rocha CS, Lanferdini FJ, Kolberg C et al (2012) Interferential therapy effect on mechanical pain threshold and isometric torque after delayed onset muscle soreness induction in human hamstrings. J Sports Sci 30:733–742. doi:10.1080/02640414.2012.672025
Ryan ED, Beck TW, Herda TJ et al (2008) Do practical durations of stretching alter muscle strength? A dose-response study. Med Sci Sports Exerc 40:1529–1537. doi:10.1249/MSS.0b013e31817242eb
Simic L, Sarabon N, Markovic G (2013) Does pre-exercise static stretching inhibit maximal muscular performance? A meta-analytical review. Scand J Med Sci Sports 23:131–148. doi:10.1111/j.1600-0838.2012.01444.x
Skurvydas A, Brazaitis M, Kamandulis S (2010) Prolonged muscle damage depends on force variability. Int J Sports Med 31:77–81. doi:10.1055/s-0029-1241213
Smith LL (1991) Acute inflammation: the underlying mechanism in delayed onset muscle soreness? Med Sci Sports Exerc 23:542–551
Smith LL, Brunetz MH, Chenier TC et al (1993) The effects of static and ballistic stretching on delayed onset muscle soreness and creatine kinase. Res Q Exerc Sport 64:103–107. doi:10.1080/02701367.1993.10608784
Streepey JW, Mock MJ, Riskowski JL et al (2010) Effects of quadriceps and hamstrings proprioceptive neuromuscular facilitation stretching on knee movement sensation. J Strength Cond Res 24:1037–1042. doi:10.1519/JSC.0b013e3181d09e87
Totsuka M, Nakaji S, Suzuki K et al (2002) Break point of serum creatine kinase release after endurance exercise. J Appl Physiol Bethesda Md 1985 93:1280–1286. doi:10.1152/japplphysiol.01270.2001
Toumi H, F’guyer S, Best TM (2006) The role of neutrophils in injury and repair following muscle stretch. J Anat 208:459–470
Trajano GS, Seitz L, Nosaka K, Blazevich AJ (2013) Contribution of central vs. peripheral factors to the force loss induced by passive stretch of the human plantar flexors. J Appl Physiol 115:212–218. doi:10.1152/japplphysiol.00333.2013
Usuba M, Akai M, Shirasaki Y, Miyakawa S (2007) Experimental joint contracture correction with low torque-long duration repeated stretching. Clin Orthop 456:70–78
Warren GL, Lowe DA, Armstrong RB (1999) Measurement tools used in the study of eccentric contraction-induced injury. Sports Med Auckl NZ 27:43–59
Weppler CH, Magnusson SP (2010) Increasing muscle extensibility: a matter of increasing length or modifying sensation? Phys Ther 90:438–449. doi:10.2522/ptj.20090012
Whatman C, Knappstein A, Hume P (2006) Acute changes in passive stiffness and range of motion post-stretching. Phys Ther Sport 7:195–200. doi:10.1016/j.ptsp.2006.07.002
Wyon MA, Smith A, Koutedakis Y (2013) A comparison of strength and stretch interventions on active and passive ranges of movement in dancers: a randomized controlled trial. J Strength Cond Res 27:3053–3059. doi:10.1519/JSC.0b013e31828a4842
Acknowledgements
The present study does not constitute any financial funding. We would like to thank all of participants.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all participants included in the study.
Additional information
Communicated by Olivier Seynnes.
Rights and permissions
About this article
Cite this article
Muanjai, P., Jones, D.A., Mickevicius, M. et al. The acute benefits and risks of passive stretching to the point of pain. Eur J Appl Physiol 117, 1217–1226 (2017). https://doi.org/10.1007/s00421-017-3608-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-017-3608-y