Abstract
Purpose
The purpose of this study was to compare the benefits and possible problems of 4 weeks stretching when taken to the point of pain (POP) and to the point of discomfort (POD).
Methods
Twenty-six physically active women (20 ± 1.1 years) took part in group-based stretching classes of the hamstring muscles, 4 times per week for 4 weeks, one group one stretching to POD, the other to POP. Passive stiffness, joint range of motion (ROM), maximal isometric torque and concentric knee flexion torque, were measured before training and 2 days after the last training session.
Results
Hip flexion ROM increased by 14.1° (10.1°–18.1°) and 19.8° (15.1°–24.5°) and sit-and-reach by 7.6 (5.2–10.0) cm and 7.5 (5.0–10.0) cm for POD and POP, respectively (Mean and 95% CI; p < 0.001 within group; NS between groups), with no evidence of damage in either group. Despite the large increases in flexibility there were no changes in either compliance or viscoelastic properties of the muscle tendon unit (MTU).
Conclusion
Hamstrings stretching to POP increased flexibility and had no detrimental effects on muscle function but the benefits were no better than when stretching to POD so there is no justification for recommending painful stretching. The improvements in flexibility over 4 weeks of stretching training appear to be largely due to changes in the perception of pain rather than physical properties of the MTU although less flexible individuals benefited more from the training and increased hamstring muscle length.
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Abbreviations
- CON:
-
Concentric contraction
- EMG:
-
Electromyography
- ISO:
-
Isometric contraction
- MTU:
-
Muscle tendon unit
- POD:
-
Point of discomfort
- POP:
-
Point of pain
- PRT:
-
Peak resistive torque
- ROM:
-
Range of motion
- S&R:
-
Sit and reach
- SLR:
-
Straight leg raise
- SR:
-
Stress relaxation
References
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
Ben M, Harvey LA (2010) Regular stretch does not increase muscle extensibility: a randomized controlled trial. Scand J Med Sci Sports 20:136–144. doi:10.1111/j.1600-0838.2009.00926.x
Blazevich AJ, Cannavan D, Waugh CM et al (2012) Neuromuscular factors influencing the maximum stretch limit of the human plantar flexors. J Appl Physiol 113:1446–1455. doi:10.1152/japplphysiol.00882.2012
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
Folpp H, Deall S, Harvey LA, Gwinn T (2006) Can apparent increases in muscle extensibility with regular stretch be explained by changes in tolerance to stretch? Aust J Physiother 52:45–50
Freitas SR, Mil-Homens P (2015) Effect of 8-week high-intensity stretching training on biceps femoris architecture. J Strength Cond Res 29:1737–1740. doi:10.1519/JSC.0000000000000800
Freitas SR, Andrade RJ, Larcoupaille L et al (2015) Muscle and joint responses during and after static stretching performed at different intensities. Eur J Appl Physiol 115:1263–1272. doi:10.1007/s00421-015-3104-1
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
Jones DA, Newham DJ, Clarkson PM (1987) Skeletal muscle stiffness and pain following eccentric exercise of the elbow flexors. Pain 30:233–242
Kamandulis S, Emeljanovas A, Skurvydas A (2013) Stretching exercise volume for flexibility enhancement in secondary school children. J Sports Med Phys Fit 53:687–692
Kay AD, Richmond D, Talbot C et al (2016) Stretching of active muscle elicits chronic changes in multiple strain risk factors. Med Sci Sports Exerc 48:1388–1396. doi:10.1249/MSS.0000000000000887
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
Konrad A, Tilp M (2014) Increased range of motion after static stretching is not due to changes in muscle and tendon structures. Clin Biomech Bristol Avon 29:636–642. doi:10.1016/j.clinbiomech.2014.04.013
Kubo K, Kanehisa H, Fukunaga T (2002) Effects of resistance and stretching training programmes on the viscoelastic properties of human tendon structures in vivo. J Physiol 538:219–226
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
Lima KMM, Carneiro SP, Alves D et al (2015) Assessment of muscle architecture of the biceps femoris and vastus lateralis by ultrasound after a chronic stretching program. Clin J Sport Med 25:55–60. doi:10.1097/JSM.0000000000000069
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
Mahieu NN, Cools A, De Wilde B et al (2009) Effect of proprioceptive neuromuscular facilitation stretching on the plantar flexor muscle-tendon tissue properties. Scand J Med Sci Sports 19:553–560. doi:10.1111/j.1600-0838.2008.00815.x
Marshall PWM, Siegler JC (2014) Lower hamstring extensibility in men compared to women is explained by differences in stretch tolerance. BMC Musculoskelet Disord 15:223. doi:10.1186/1471-2474-15-223
Matsuo S, Suzuki S, Iwata M et al (2013) Acute effects of different stretching durations on passive torque, mobility, and isometric muscle force. J Strength Cond Res 27:3367–3376
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
Mense S, Stahnke M (1983) Responses in muscle afferent fibres of slow conduction velocity to contractions and ischaemia in the cat. J Physiol 342:383–397
Meyer GA, McCulloch AD, Lieber RL (2011) A nonlinear model of passive muscle viscosity. J Biomech Eng 133:91007–91007–91007–91009. doi:10.1115/1.4004993
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
Moltubakk MM, Eriksrud O, Paulsen G et al (2016) Hamstrings functional properties in athletes with high musculo-skeletal flexibility. Scand J Med Sci Sports 26:659–665. doi:10.1111/sms.12488
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
Morse CI, Degens H, Seynnes OR et al (2008) The acute effect of stretching on the passive stiffness of the human gastrocnemius muscle tendon unit. J Physiol 586:97–106. doi:10.1113/jphysiol.2007.140434
Muanjai P, Jones DA, Mickevicius M et al (2017) The acute benefits and risks of passive stretching to the point of pain. Eur J Appl Physiol 117:1217–1226. doi:10.1007/s00421-017-3608-y
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
Schleip R, Duerselen L, Vleeming A et al (2012) Strain hardening of fascia: static stretching of dense fibrous connective tissues can induce a temporary stiffness increase accompanied by enhanced matrix hydration. J Bodyw Mov Ther 16:94–100. doi:10.1016/j.jbmt.2011.09.003
Simpson CL, Kim BDH, Bourcet MR et al (2017) Stretch training induces unequal adaptation in muscle fascicles and thickness in medial and lateral gastrocnemii. Scand J Med Sci Sports. doi:10.1111/sms.12822
Tian M, Hoang PD, Gandevia SC et al (2010) Stress relaxation of human ankles is only minimally affected by knee and ankle angle. J Biomech 43:990–993. doi:10.1016/j.jbiomech.2009.11.017
Vincent JFV (1982) Basic theory of elasticity and viscoelasticity. Structural biomaterials. Macmillan Education, London, pp 1–33
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
Ylinen J, Kankainen T, Kautiainen H et al (2009) Effect of stretching on hamstring muscle compliance. J Rehabil Med 41:80–84. doi:10.2340/16501977-0283
Acknowledgements
The present study does not constitute any financial funding. We would like to thank all of participants.
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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.
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Informed consent was obtained from all individual participants included in the study.
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Communicated by Olivier Seynnes.
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Muanjai, P., Jones, D.A., Mickevicius, M. et al. The effects of 4 weeks stretching training to the point of pain on flexibility and muscle tendon unit properties. Eur J Appl Physiol 117, 1713–1725 (2017). https://doi.org/10.1007/s00421-017-3666-1
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DOI: https://doi.org/10.1007/s00421-017-3666-1