Does stretching before exercise help prevent injury?

Date First Published:
November 2, 2005
Last Updated:
August 11, 2009
Report by:
Michael Callaghan, Research Physiotherapist (Centre for Rehabilitation Science, MRI)
Search checked by:
Claire Suff, Centre for Rehabilitation Science, MRI
Three-Part Question:
In [adults performing sport and exercise] does [a stretching routine] reduce prior to exercise reduce[injury]?
Clinical Scenario:
A young adult who is keen on sport asks you about a suitable stretching routine for the lower limb in order to prevent injury. You are unsure which, if any, is effective and seek out the evidence.
Search Strategy:
MEDLINE 1950 to week 1 May 2009, via OVID interphase
Search Details:
{[(stretch$.mp)] AND [(exp athletic injuries OR exp leg injuries OR exp sprains and strains OR exp soft tissue injuries or injur$.mp) LIMIT to "therapy (sensitivity)" and human and English language}.<br><br>Searches also conducted in CINAHL, AMED, SPORTDiscus, EMBASE, via the OVID interface, the Cochrane database and PEDro.
Outcome:
The Medline search produced 341 studies. Several studies of varying quality were identified; however, a 2008 systematic review conducted a thorough search for all studies comparing stretch before exercise with a control. The review is detailed in the table
Relevant Paper(s):
Study Title Patient Group Study type (level of evidence) Outcomes Key results Study Weaknesses
A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Small K, Mc Naughton L, Matthews M. 2008, UK 3532 Soldiers + 421 recreational runners + 298 army trainees + 195 college football players + five school football teams, (number unknown) in seven studies. Subjects allocated to static stretching before exercise and control groups 1992–2003. Systematic review Rate of injury causing absence from training or competition No significant difference in six of seven studies between stretch and control groupsOne study (298 army trainees, scoring 45/100 for methodology) found a significant difference (p = 0.02) Well conducted reviewConsiderable heterogeneity between studiesExercise undertaken by soldiers may differ from that by an athlete in training
Author Commentary:
The studies detailed above vary considerably in design, subjects and exercise.
Bottom Line:
Stretching before exercise will not reduce the risk of injury.
References:
  1. Small K, Mc Naughton L, Matthews M.. A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury.