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But Expert Questions Study Findings

Aug. 30, 2002 -- From elite athletes to weekend warriors, few active people would think of engaging in strenuous exercise without first stretching those triceps, biceps, hamstrings, and quads. The idea that stretching reduces the risk of injury during exercise is a rarely questioned tenet of sports medicine, but new research suggests it may be wrong.

Researchers reviewing five major studies concluded that stretching prior to or after exercise does little to prevent either injury or muscle soreness. They estimate that stretching would prevent one training-related injury in 23 years.

Study author Robert D. Herbert of the University of Sidney in Australia tells WebMD the studies offer convincing evidence that stretching is of little value for preventing injury and soreness.

"The (injury) findings were in army recruits, so it is not clear if they apply to other groups like professional or recreational athletes," he says. "We would like to see the studies replicated in these populations, but the best evidence we have does not support a role for stretching."

Sports medicine expert Angela D. Smith, MD, disagrees. She tells WebMD the clinical evidence on stretching is contradictory and incomplete. A former competitive ice skater, Smith is an orthopaedic surgeon and the immediate past president of the American College of Sports Medicine. She has also coached skating and was the team doctor for the U.S. world skating team.

"It is very difficult to do a good study on this, and many are not very well designed," she says. "In the army recruit studies [cited in this review], injuries like ankle sprains, contusions [bruises], and fractures were included. These are injuries that have nothing to do with flexibility."

She says her own research on young ice skaters strongly suggests that appropriate stretching helps reduce knee injuries. And studies in the elderly have shown that stretching helps prevent falls and hip fractures.

The pre-activity regimen Smith recommends starts with a warm-up exercise such as sit ups, push ups, or jumping rope, followed by isolated stretching of the muscles to be used. Athletes who primarily use their upper bodies, such as swimmers, pitchers, and racket sports players, should focus on their triceps and biceps. Those who use the muscles in their lower body most, such as runners, should stretch hip flexors, quadriceps, hamstrings, and calves. Each stretch should last 15 or 20 seconds.

"The vast majority of people need to warm up and get their muscles ready for strenuous activity," Smith says. "That is true for serious athletes and weekend warriors alike."

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