Stretching is a common principle used to improve resistance during activity, when feeling a sensation of tightness, or to lengthen a short muscle.  But how much is enough?  We as practitioners prescribe 30 second holds, repeat 30 second holds, or to hold for up to 2 minutes.  Some studies show a benefit from holding for those lengths of time.  But that is in the short-term.

What is the effect in the long term?

A randomized controlled study by Youdas et al. assessed the effects of a closed-kinetic chain stretch of the ankle dorsiflexors over a 6 week period.  They compared a control group versus 3 experimental groups (30 second hold, 1 minute hold, and 2 minute holds).  This was conducted 1 time a day.  Sixty to seventy-two hours later after the final day of the 6 week period the ankle range of motion was taken again.  They found no significant change in the range of motion between the experimental and the control groups.

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So what does that mean?

As practitioners, we know that stretching will help with lengthening a muscle.  We prescribe the stretch for multiple times a day and hope that is followed.  But in reality, how many people are able to set time aside (three, four, or five times a day) to complete the prescribed home exercise program as well as remember to complete in their busy schedules.

Should we be prescribing stretching multiple times a day or should we prescribe the stretch 1 time a day but combine it with functional activities that make use of that range gained from the stretching?  Example, complete a calf stretch for 60 seconds and then teach them to walk with a longer step length and trying to keep the heel down a little longer during terminal stance to use that increased motion.

We can know and educate individuals the right thing to do for themselves with stretching or exercise but the carryover comes from incorporating it into everyday life.

 

Reference:

Youdas JW, Krause DA, Egan KS, Therneau TM, Laskowski ER. The effect of static stretching of the calf muscle-tendon unit on active ankle dorsiflexion range of motion. J Orthop Sports Phys Ther. 2003; 33(7):408-417.

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