danny brunton

Does stretching actually prevent injury?

Our worst nightmare as a runner or athlete is getting injured. We often try all kinds of methods to prevent this…

What do we think actually causes injury?  

Do the traditional things we do to prevent injuries like stretching actually help?

A study carried out by Saragiotto et al, 2014 (SOURCE) found runners to believe that not stretching both before and after their run would leave them more likely to get injured. This is something that is  commonly discussed in the Consortium clinic with our clients. We therefore felt this to be an important topic for us to provide an evidence based opinion on to help our clients separate fact from fiction.

Can static stretching reduce my chances of getting injured?

Static stretching (holding a position to stretch a muscle for a sustained period of time) historically has been a routine of many runners/athletes prior to beginning their activities to prevent against injury. However.... more recent evidence has suggested it’s maybe not as worth your while as you first thought! Lauersen (2013) (SOURCE) found static stretching did not have any protective effects with no support found for stretching and preventing injury when carried out either before or after activity. In fact.... it has also been suggested it can instead have a negative impact on the level of your performance! Did you know static stretches held for 45 seconds or longer, prior to activity can reduce maximal strength, power and muscular explosive performance, such as when jumping and sprinting? (Simic, 2012) (SOURCE)

OK...... So 45 seconds is a long time to hold a static stretch…

So what if I stretch for a shorter time? 

Static stretching for shorter periods has been less associated with the previously mentioned negative effects but still has no benefit towards injury prevention, this may lead you to ask whether it is worth your time doing both before and after exercise? 

Should I continue to stretch? Or is there a better alternative?

One thing we do know is that gradual muscle strengthening has demonstrated the ability to reduce sporting injuries by 1/3 and over-use injuries by a 1/2 (Lauersen, 2013) (SOURCE). More recently, specific eccentric muscle strengthening (working the muscle as it lengthens) has also been shown to both improve and gain long standing muscle length through a process of ‘sarcomeregenesis’ (increasing amount of contractile units in the muscle) (O’Sullivan, 2012) (SOURCE)

So what does this actually mean? In essence, if we included and carried out a specific graded eccentric muscle strengthening routine as part of our weekly training schedule we can ‘kill two birds with one stone’. By not only improving strength, which is proven to reduce the likelihood of injuries, but also by improving your flexibility at the same time if this is one of your aims. An example of this has been demonstrated with studies around the hamstring muscles suggesting an increase in muscle fascicle length by 1/2cm by using eccentric strengthening can reduce the chances of injury by up to 70% (Askling, 2014) (SOURCE)

But I feel better after stretching… so Should I stop doing this or carry on? 

Often clients have carried out static stretches as part of their routines and ’rituals’ before races/competition/games for many years and it makes them feel good and ‘ready to go’… So if you feel happier continuing to do this it is perfectly O.K, although as we have discussed there is no evidence towards preventing injury and holding them less than 45 seconds should have no negative effects on your performance.

An alternative that you also may be aware of is dynamic stretching (using controlled movement and momentum of the body part e.g. whilst standing raising your knee towards your stomach then back to it's starting position repeatedly in a controlled manner to move the muscle from one end of its range to the other). Although this again has little evidence towards injury prevention. Instead, it may be more suited and is recommended to be included in a warm up to gradually prepare your body for the activity in hand (Behm, 2011) (SOURCE)

However, it is also worth mentioning that if your sport requires your joints to achieve sustained extremes of movement such as in Ballet or Kick boxing then static stretching is recommended to be carried out before in short duration to prevent impairment (Behm, 2011) (SOURCE).  

Summary…

To summarise, static stretching before activity is something we have done for many years with the feeling it would ‘stop us pulling a muscle’, but surprisingly the evidence towards this is in fact pretty poor. A better alternative to prevent injury is suggested to be a gradual eccentric strengthening routine included in your weekly training plan. But as mentioned above this is not to say you can’t ever carry out static stretches again… As even though this is maybe not doing what we thought it was to prevent injury, it is not going to do you much harm either.

Hope you’ve enjoyed reading our latest ‘blog’… If you have any questions or would like any further information such as, how to implement a specific eccentric strengthening routine please don’t hesitate to contact us via our Facebook page, Website or telephone and one of our team will be more than happy to help. Also if there are any specific topics you’d be keen for us to cover in our next installments of our blog please let us know.

Kind regards,  

The Consortium Team

Our staff

 

 

Graham Morgan, BSc Physiotherapy, MSc Musculoskeletal Medicine, MCSP, HCPC registered

Graham has been working as a musculoskeletal physiotherapist for nearly a decade. He has studied to gain an additional masters degree in musculoskeletal medicine alongside his previous physiotherapy degree. His main speciality is management of complex spinal conditions. This includes recent and long term spinal pain, lower back pain with leg symptoms, neck pain with arm symptoms, post operative spines and management of patients with neurological deficits. He is experienced at interpreting spinal imaging as well as recognising when imaging is appropriate. Graham is now an experienced injection therapist and is used to administering steroid and hyaluronic acid such as synvisc and ostenil to help patients manage chronic conditions. His other interests include rehabilitation of anterior knee pain and chronic tendinopathies.

 

Niall Carter, BSc Physiotherapy, MSc Advanced Musculoskeletal Physiotherapy, MCSP, HCPC registered

Niall qualified as a physiotherapist in 2004 having previously studied sports science.  He has worked locally for the NHS since 2004 during which time he has gained in depth experience in a variety of specialties.  He has held various senior posts in the NHS that have given him experience of managing patients with complex musculoskeletal conditions and neurological conditions such as stroke, multiple sclerosis and Parkinson’s.  He also works for a private provider of NHS surgical services as a Spinal Extended Scope Practitioner.

He has completed an MSc in Advanced Musculoskeletal Physiotherapy and as such is a skilled manual and exercise therapist.  He specialises in the management of complex spinal conditions, working in spinal surgical clinics and also providing physiotherapy for patients both post-operatively and as part of their conservative management.  As such he has a balanced viewpoint on the management options available to people with spinal problems.  In addition, he has particular interests in cervicogenic headaches, sacroiliac joint pain and lower limb tendinopathies.

 

Danny Brunton, BSc Physiotherapy, MCSP, HCPC registered

Danny has been working as a qualified physiotherapist for over 10 years. During this period he has gained vast experience in musculoskeletal physiotherapy, building a broad understanding of medical presentations. Alongside his physiotherapy degree he has completed additional masters level modules.

As a Clinical Lead Physiotherapist, his main interests and skills have developed around the management of knee and ankle injuries/conditions. Danny has developed his assessment and treatment skills over a long period of time by working in clinics alongside the area’s leading ankle and knee consultants.

Other special interests of Danny’s include the management of post-operative patients such as Anterior Cruciate Ligament Reconstruction (having written locally used post operation guidelines), treatment of acute/chronic tendinopathies, management of soft tissue injuries and the use of Maitland mobilisation techniques and rehabilitation with the aim of return to sporting activity and hobbies such as running.

Chris John Bsc Physiotherapy, MCSP HCPC registered 

Chris is a Specialist Musculoskeletal Physiotherapist with a special interest in sports based physiotherapy. Alongside his work at the Consortium clinic he works in professional rugby for Hull FC as a 1st team physiotherapist.  Aswell as working at the elite end of rugby league Chris has vast experience in professional football, rugby union and the NHS. Chris believes strongly in the importance of planning effective loading programmes in order to decrease the risk of getting injured during sporting activities. His expertise lies specifically in managing sports based injuries.  In addition to his degree in Physiotherapy Chris has embarked upon a Masters in Sports and Exercise Medicine in Leeds. Chris also has an advanced trauma medical management qualification endorsed by the Royal College of Surgeons. 

MASSAGE TEAM : RACHEL MARSON (Sports Massage Therapist LSCP assoc), LAURA EGAN & Jordan Mounsey

Rachel, Laura and Jordan are highly trained and vastly experienced with 25 years of clinical practice between them. They cater for both top level athletes and for clients who simply want to de-stress and enhance their well-being. To find out more about the Consortium Sports Massage service please use this link. 

Chronic pain cycle

This diagram will be familiar territory for many people living with pain. We encounter patients on a daily basis who are stuck in this cycle...

TRYING TO EXERCISE BUT YOU CAN’T BECAUSE OF PAIN? LEADING TO MORE WEIGHT GAIN, MORE TISSUE DECONDITIONING, MORE TIME OFF WORK, MORE STRESS, MORE SLEEPLESS NIGHTS, MORE DEPRESSION, MORE PAIN… 

Diagram reproduced with permission from Pete Moore/paintoolkit.org

In many patients this cycle can be minimised to varying degrees. Consortium provides physiotherapy including: pacing, CBT (Cognitive Behavioural Therapy), acupuncture, TENS therapy, education, sensibly prescribed simple and graded exercises, medications, injections and manual therapy. These are all valid ways to intervene. Alongside this we offer support, encouraging patients to reach acceptance. Many of these can be easily implemented in simple ways, without significant costs. 

There are many free, easily accessible resources available for patients living with pain. Here are two that we often direct people towards:

LEAFLET explain pain - click here 

video understanding PAIn in less than 5 minutes

Thanks for reading