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Context: Hamstring injuries are common, and lack of hamstring flexibility may predispose to injury. Static stretching not only increases range of motion (ROM) but also results in reduced muscle strength after stretching. The effects of stretching on the hamstring muscles and the duration of these effects remain unclear. Objective: To determine the effects of static stretching on the hamstrings and the duration of these effects. Design: Randomized crossover study. Setting: University laboratory. Participants: A total of 24 healthy volunteers. Interventions: The torque–angle relationship (ROM, passive torque [PT] at the onset of pain, and passive stiffness) and isometric muscle force using an isokinetic dynamometer were measured. After a 60-minute rest, the ROM of the dynamometer was set at the maximum tolerable intensity; this position was maintained for 300 seconds, while static PT was measured continuously. The torque–angle relationship and isometric muscle force after rest periods of 10, 20, and 30 minutes were remeasured. Main Outcome Measures: Change in static PT during stretching and changes in ROM, PT at the onset of pain, passive stiffness, and isometric muscle force before stretching were compared with 10, 20, and 30 minutes after stretching. Results: Static PT decreased significantly during stretching. Passive stiffness decreased significantly 10 and 20 minutes after stretching, but there was no significant prestretching versus poststretching difference after 30 minutes. PT at the onset of pain and ROM increased significantly after stretching at all rest intervals, while isometric muscle force decreased significantly after all rest intervals. Conclusions: The effect of static stretching on passive stiffness of the hamstrings was not maintained as long as the changes in ROM, stretch tolerance, and isometric muscle force. Therefore, frequent stretching is necessary to improve the viscoelasticity of the muscle–tendon unit. Muscle force decreased for 30 minutes after stretching; this should be considered prior to activities requiring maximal muscle strength. [ABSTRACT FROM AUTHOR]

Antagonist contract-relax stretching and contract-relax stretching is commonly used in sports practice and rehabilitation settings. To date, no study has compared these modalities regarding muscle stiffness and stretch tolerance. This study aimed to investigate the effects of contract-relax and antagonist contract-relax stretching on dorsiflexion range of motion (ROM), stretch tolerance, and shear elastic modulus. Forty healthy participants (24 men and 16 women) took part in the study. Participants were randomly assigned to perform either contract-relax stretching or antagonist contract-relax stretching for 2 min. Outcomes were assessed on ROM, stretch tolerance, and shear elastic modulus before and after stretching. The ROM and stretch tolerance significantly increased after both contract-relax stretching (+ 5.4 ± 5.8°, p < 0.05; + 3.5 ± 8.0 Nm, p < 0.05) and antagonist contract-relax stretching (+ 6.1 ± 4.9°, p < 0.05; + 4.2 ± 6.4 Nm, p < 0.05); however, no significant difference was found between the two groups. Alternatively, the shear elastic modulus significantly decreased after both contract-relax (–31.1 ± 22.6 kPa, p < 0.05) and antagonist contract-relax stretching (–11.1 ± 22.3 kPa, p < 0.05); however, contract-relax stretching (–41.9 ± 19.6%) was more effective than antagonist contract-relax stretching (–12.5 ± 61.6%). The results of this study suggest that contract-relax stretching instead of antagonist contract-relax stretching should be conducted to decrease muscle stiffness. However, either contract-relax or antagonist contract-relax stretching can increase ROM. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare two static stretching (SS) training programs at high-intensity (HI-SS) and low-intensity (LI-SS) on passive and active properties of the plantar flexor muscles. Forty healthy young men were randomly allocated into three groups: HI-SS intervention group (n = 14), LI-SS intervention group (n = 13), and non-intervention control group (n = 13). An 11-point numerical scale (0–10; none to very painful stretching) was used to determine SS intensity. HI-SS and LI-SS stretched at 6–7 and 0–1 intensities, respectively, both in 3 sets of 60 s, 3×/week, for 4 weeks. Dorsiflexion range of motion (ROM), gastrocnemius muscle stiffness, muscle strength, drop jump height, and muscle architecture were assessed before and after SS training program. The HI-SS group improved more than LI-SS in ROM (40 vs. 15%) and decreased muscle stiffness (−57 vs. −24%), while no significant change was observed for muscle strength, drop jump height, and muscle architecture in both groups. The control group presented no significant change in any variable. Performing HI-SS is more effective than LI-SS for increasing ROM and decreasing muscle stiffness of plantar flexor muscles following a 4-week training period in young men. However, SS may not increase muscle strength or hypertrophy, regardless of the stretching discomfort intensity. [ABSTRACT FROM AUTHOR]

Muscle strain is one of the most frequent sports injuries, having the rectus femoris (RF) muscle as the reported preferred site of quadriceps muscle strain. The decrease muscle stiffness could be an effective RF muscle strain prevention. In recent studies, a high-intensity static stretching intervention decreased passive stiffness, though no study has investigated on the effect of the different static stretching intervention intensities on quadriceps muscle stiffness. The purpose of this study was to investigate the three different quadriceps muscle stiffness intensities (120 vs. 100 vs. 80%). Eighteen healthy, sedentary male volunteers participated in the study and randomly performed three intensities. The static stretching intervention was performed in knee flexion with 30° hip extension. Three 60-second stretching intervention with a 30-second interval were performed at each stretching intensity. We measured knee flexion range of motion and shear elastic modulus of the RF muscle used by ultrasonic shear-wave elastography before and after the static stretching intervention. Our results showed that the knee flexion range of motion was increased after 100% (p < 0.01) and 120% intensities (p < 0.01) static stretching intervention, not in 80% intensity (p = 0.853). In addition, our results showed that the shear elastic modulus of the RF muscle was decreased only after 100% intensity static stretching intervention (p < 0.01), not after 80% (p = 0.365), and 120% intensities (p = 0.743). To prevent the quadriceps muscle strain, especially the RF muscle, 100%, not 120% (high) and 80% (low), intensity stretching could be beneficial in sports setting application. [ABSTRACT FROM AUTHOR]

This study investigated the effects of static stretching (SS) delivered with the same load but using two protocols – high-intensity and short-duration and low-intensity and long-duration – on range of motion (ROM) and muscle stiffness. A total of 18 healthy students participated in the study. They randomly performed high-intensity and short-duration (120% and 100 s) or low-intensity and long-duration (50% and 240 s) SS. Outcomes were assessed on ROM, passive torque at dorsiflexion ROM, and shear elastic modulus of the medial gastrocnemius before and after static stretching. The results showed that ROM increased significantly at post-stretching compared to that at pre-stretching in both high-intensity and short-duration [+6.1° ± 4.6° (Δ25.7 ± 19.9%)] and low-intensity and long-duration [+3.6° ± 2.3° (Δ16.0 ± 11.8%)]. Also, the ROM was significantly higher at post-stretching in high-intensity and short-duration conditions than that in low-intensity and long-duration. The passive torque at dorsiflexion ROM was significantly increased in both high-intensity and short-duration [+5.8 ± 12.8 Nm (Δ22.9 ± 40.5%)] and low-intensity and long-duration [+2.1 ± 3.4 Nm (Δ6.9 ± 10.8%)] conditions, but no significant differences were observed between both conditions. The shear elastic modulus was significantly decreased in both high-intensity and short-duration [−8.8 ± 6.1 kPa (Δ − 38.8 ± 14.5%)] and low-intensity and long-duration [−8.0 ± 12.8 kPa (Δ − 22.2 ± 33.8%)] conditions. Moreover, the relative change in shear elastic modulus in the high-intensity and short-duration SS was significantly greater than that in low-intensity and long-duration SS. Our results suggest that a higher intensity of the static stretching should be conducted to increase ROM and decrease muscle stiffness, even for a short time. [ABSTRACT FROM AUTHOR]

Introduction: Static stretching (SS) program are widely used in clinical and athletic settings. Many previous studies investigate the effect of SS program on muscle strength and muscle architecture (muscle thickness, and pennation angleh). However, no consensus has been reached about the effect of SS programs on muscle strength and muscle architecture. The aim of this study was to investigate the effects of 6-week SS programs performed at different weekly frequencies on muscle strength, muscle thickness and pennation angle at different ankle joint positions. Methods: A total of 24 healthy male volunteers were performed 6-week SS programs (2,160 s of SS: 360 s/week*6 weeks) and were randomized to a group that performed SS once a week, or a group that performed SS three times per week. Total time under stretching was equated between groups. The muscle strength (maximum voluntary isometric contraction) at three different ankle joints were assessed before and after the 6-week SS program. In addition, muscle thickness and pennation angle were assessed by ultrasonography before and after 6-week SS program. Results: There were no significant changes in all variables before and after the 6-week SS program, regardless of weekly frequency (p > 0.05). Conclusions: Our results suggest that 6-week SS programs do not increase muscle strength or muscle architecture at different ankle joint positions, regardless of stretching frequency; however, no negative effect on these outcomes was observed, contrary to evidence on the immediate, detrimental effects of SS. [ABSTRACT FROM AUTHOR]

Range of motion has been widely known to decrease with age; however, factors associated with its decrease in the elderly population and especially its gender difference have been unclear. Therefore, this study aimed to investigate the factors associated with ankle dorsiflexion range of motion in the older population. Both male (n = 17, mean ± SD; 70.5 ± 4.2 years; 165.4 ± 5.3 cm; 63.8 ± 7.7 kg) and female (n = 25, 74.0 ± 4.0 years; 151.2 ± 4.9 cm; 50.1 ± 5.6 kg) community-dwelling older adults participated in this study. The ankle dorsiflexion and passive torque of both legs were measured using a dynamometer, and shear elastic modulus of the medial gastrocnemius muscle at 0° ankle angle was measured using ultrasonic shear wave elastography. In this study, we defined the passive torque at dorsiflexion range of motion (DF ROM) as the index of stretch tolerance, and shear elastic modulus as the index of passive muscle stiffness. The partial correlation coefficient adjusted by age, height, weight, and side (dominant or nondominant side) was used to analyze the relationship between DF ROM and passive torque at DF ROM or shear elastic modulus of MG in each male and female participant, respectively. Our results revealed that dorsiflexion range of motion was significantly associated with passive torque at dorsiflexion range of motion in both male (r = 0.455, p = 0.012) and female (r = 0.486, p < 0.01), but not with shear elastic modulus in both male (r = −0.123, p = 0.519) and female (r = 0.019, p = 0.898). Our results suggested that the ankle dorsiflexion range of motion could be related to the stretch tolerance, but not to passive muscle stiffness in community-dwelling elderly population regardless of gender. [ABSTRACT FROM AUTHOR]

Simple Summary: It is well known that stretching interventions are effective in improving age-related changes in range of motion (ROM) and muscle stiffness. We investigated the effects of various stretching interventions, such as static stretching and hold–relax stretching, on ROM and muscle stiffness in older adults to establish the most effective stretching technique. Our results showed that static stretching and hold–relax stretching increased ROM, which could be contributed by not change in muscle stiffness, but stretch tolerance. Conversely, medial gastrocnemius muscle stiffness decreased only after a static stretching intervention and not after hold–relax stretching. Our results indicated that static stretching intervention improved ROM and muscle stiffness in older adults. Various stretching techniques are generally recommended to counteract age-related declines in range of motion (ROM) and/or increased muscle stiffness. However, to date, an effective stretching technique has not yet been established for older adults. Consequently, we compared the acute effects of hold relax stretching (HRS) and static stretching (SS) on dorsiflexion (DF) ROM and muscle stiffness among older adults. Overall, 15 elderly men and nine elderly women (70.2 ± 3.9 years, 160.8 ± 7.8 cm, 59.6 ± 9.7 kg) were enrolled, and both legs were randomized to either HRS or SS stretching. We measured DF ROM and muscle stiffness using a dynamometer and ultrasonography before and after 120 s of HRS or SS interventions. Our multivariate analysis indicated no significant interaction effects, but a main effect for DF ROM. Post-hoc tests revealed that DF ROM was increased after both HRS and SS interventions. Moreover, multivariate analysis showed a significant interaction effect for muscle stiffness. Post-hoc tests revealed that muscle stiffness was decreased significantly after only SS intervention. Taken together, our results indicated that both HRS and SS interventions are recommended to increase ROM, and SS is recommended to decrease muscle stiffness in older adults. [ABSTRACT FROM AUTHOR]

Background: Previous studies suggest that the capacity for rapid force production of ankle plantar flexors is essential for the prevention of falls in the elderly. In healthy young adults, there were significant associations between rate of force development and muscle stiffness measured by shear wave elastography. However, there has been no study investigating the association of rate of force development with shear elastic modulus in older adults. Methods: The muscle strength and shear elastic modulus of the medial gastrocnemius muscle in both legs were measured in 17 elderly men and 10 elderly women (mean ± SD; 70.7 ± 4.1 years; 160.6 ± 8.0 cm; 58.7 ± 9.5 kg). We investigated the rate of force development of plantar flexors and shear elastic modulus of medial gastrocnemius muscle using by shear wave elastography. Results: Our results showed that there were no significant associations between normalized rate of force development and shear elastic modulus of medial gastrocnemius muscle. Conclusion: This suggests that the capacity of rapid force production could be related not to muscle stiffness of the medial gastrocnemius muscle, but to neuromuscular function in older individuals. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between relative or absolute intensity and changes in range of motion and passive stiffness after static stretching. A total of 65 healthy young adults voluntarily participated in this study and performed static stretching of the plantar flexor-muscle for 120 s. Dorsiflexion range of motion and passive torque during passive dorsiflexion before and after stretching were assessed. We measured the passive torque at a given angle when the minimum angle was recorded before and after stretching. The angle during stretching was defined as the absolute intensity. Dorsiflexion range of motion before stretching was defined as 100%, and the ratio (%) of the angle during stretching was defined as the relative intensity. A significant correlation was found between absolute intensity and change in passive torque at a given angle (r = −0.342), but relative intensity and range of motion (r = 0.444) and passive torque at dorsiflexion range of motion (r = 0.259). A higher absolute intensity of stretching might be effective in changing the passive properties of the muscle-tendon unit. In contrast, a higher relative intensity might be effective in changing the range of motion, which could be contributed by stretch tolerance. [ABSTRACT FROM AUTHOR]

[Purpose] This study aimed to measure the analgesic effects and efficacy of radial extracorporeal shock wave therapy, for which no consensus has been reached regarding optimal treatment parameters. [Participants and Methods] The study included 40 feet of 40 patients with plantar fasciitis. The visual analogue scale was used to determine the immediate and cumulative effects of radial extracorporeal shock wave therapy as well as the efficacy rate. Efficacy was calculated as a percentage visual analogue scale change of ≥20 mm and visual analogue scale improvement of ≥60%. [Results] Immediate and continued efficacy of radial extracorporeal shock wave therapy was observed and recorded. Efficacy rates based on a percentage visual analogue scale change of ≥20 mm and visual analogue scale improvement of ≥60% were both 57.5%. [Conclusion] Radial extracorporeal shock wave therapy has immediate and cumulative analgesic effects on plantar fasciitis. However, cumulative results of interventions with various treatment parameters are required to determine the optimal treatment parameter settings for diffuse pressure wave therapy for plantar fasciitis., Competing Interests: There is no conflict of interest., (2024©by the Society of Physical Therapy Science. Published by IPEC Inc.)

Static stretching (SS), dynamic stretching (DS), and combined stretching (CS; i.e., DS+SS) are commonly performed as warm-up exercises. However, the stretching method with the greatest effect on flexibility and performance remains unclear. This randomized crossover trial examined acute and prolonged effects of SS, DS, and CS on range of motion (ROM), peak passive torque (PPT), passive stiffness, and isometric and concentric muscle forces. Twenty healthy young men performed 300 sec of active SS, DS, or CS (150-sec SS followed by 150-sec DS and 150-sec DS followed by 150-sec SS) of the right knee flexors on four separate days, in random order. Subsequently, we measured ROM, PPT, and passive stiffness during passive knee extension. We also measured maximum voluntary isometric and concentric knee flexion forces and surface electromyographic activities during force measurements immediately before, immediately after, and 20 and 60 min after stretching. All stretching methods significantly increased ROM and PPT, while significantly decreasing isometric knee flexion force (all p < 0.05). These changes lasted 60 min after all stretching methods; the increases in ROM and PPT and the decreases in isometric muscle force were similar. All stretching methods also significantly decreased passive stiffness immediately after stretching (all p < 0.05). Decreases in passive stiffness tended to be longer after CS than after SS or DS. Concentric muscle force was decreased after SS and CS (all p < 0.05). On the other hand, concentric muscle force was unchanged after DS, while the decreases in surface electromyographic activities during concentric force measurements after all stretching methods were similar. Our results suggest that 300 sec of SS, DS, and CS have different acute and prolonged effects on flexibility and muscle force., (© Journal of Sports Science and Medicine.)

Static stretching can increase the range of motion of a joint. Muscle-tendon unit stiffness (MTS) is potentially one of the main factors that influences the change in the range of motion after static stretching. However, to date, the effects of acute and long-term static stretching on MTS are not well understood. The purpose of this meta-analysis was to investigate the effects of acute and long-term static stretching training on MTS, in young healthy participants. PubMed, Web of Science, and EBSCO published before January 6, 2023, were searched and finally, 17 papers were included in the meta-analysis. Main meta-analysis was performed with a random-effect model and subgroup analyses, which included comparisons of sex (male vs. mixed sex and female) and muscle (hamstrings vs. plantar flexors) were also performed. Furthermore, a meta-regression was conducted to examine the effect of total stretching duration on MTS. For acute static stretching, the result of the meta-analysis showed a moderate decrease in MTS (effect size = -0.772, Z = -2.374, 95% confidence interval = -1.409 - -0.325, p = 0.018, I 2 = 79.098). For long-term static stretching, there is no significant change in MTS (effect size = -0.608, Z = -1.761, 95% CI = -1.284 - 0.069, p = 0.078, I 2 = 83.061). Subgroup analyses revealed no significant differences between sex (long-term, p = 0.209) or muscle (acute, p =0.295; long-term, p = 0.427). Moreover, there was a significant relationship between total stretching duration and MTS in acute static stretching (p = 0.011, R2 = 0.28), but not in long-term stretching (p = 0.085, R 2 < 0.01). Whilst MTS decreased after acute static stretching, only a tendency of a decrease was seen after long-term stretching., (© Journal of Sports Science and Medicine.)

"Foam Rolling" has been used in sports settings to increase range of motion and decrease muscle stiffness without decreasing muscle strength and athletic performance. However, there has been no study investigating the acute and prolonged effect of different durations of foam rolling intervention on muscle stiffness, and the minimum foam rolling intervention duration required to decrease muscle stiffness is unclear. Therefore, the purpose of this study was to investigate the acute and prolonged effect of different durations of foam rolling intervention on ROM, muscle stiffness, and muscle strength. The 45 participants were randomly allocated to 1 of 3 groups (30 s × 1 times group vs 30 s × 3 times group vs 30 s× 10 times group). The outcome measures were dorsiflexion range of motion, shear elastic modulus of medial gastrocnemius, and muscle strength before, 2 min and 30 min after foam rolling intervention. There were no significant differences before and 2 min after foam rolling intervention in 30 s×1 time group, whereas dorsiflexion range of motion was increased in both 30 s×3 times group (p = 0.042, d = 0.26) and 30 s× 10 times group (p < 0.01, d = 0.33). However, the increase in dorsiflexion range of motion was returned to baseline value after 30 minutes in both 30 s × 3 times group and 30 s × 10 times group. In addition, there were no significant changes in shear elastic modulus and muscle strength in all groups. This study suggested that foam rolling for more than 90 s or more of foam rolling was effective in order to increase the range of motion immediately without changing muscle stiffness and muscle strength., (© Journal of Sports Science and Medicine.)

In this study, we examined the effects of static and dynamic stretching on range of motion (ROM), passive torque (PT) at pain onset, passive stiffness, and isometric muscle force. We conducted a randomized crossover trial in which 16 healthy young men performed a total of 300 s of active static or dynamic stretching of the right knee flexors on two separate days in random order. To assess the effects of stretching, we measured the ROM, PT at pain onset, passive stiffness during passive knee extension, and maximum voluntary isometric knee flexion force using an isokinetic dynamometer immediately before and after stretching. Both static and dynamic stretching significantly increased the ROM and PT at pain onset (p<0.01) and significantly decreased the passive stiffness and isometric knee flexion force immediately after stretching (p<0.01). However, the magnitude of change did not differ between the two stretching methods for any measurements. Our results suggest that 300 s of either static or dynamic stretching can increase flexibility and decrease isometric muscle force; however, the effects of stretching do not appear to differ between the two stretching methods.

Dynamic stretching (DS) is often performed during warm-up to help avoid hamstring muscle injuries, increase joint flexibility, and optimize performance. We examined the effects of DS of the hamstring muscles on passive knee extension range of motion (ROM), passive torque (PT) at the onset of pain (as a measure of stretch tolerance), and passive stiffness of the muscle-tendon unit over an extended period after stretching. Twenty-four healthy subjects participated, with 12 each in the experimental and control groups. Stretching was performed, and measurements were recorded using an isokinetic dynamometer pre-intervention, and at 0, 15, 30, 45, 60, 75, and 90 min post-intervention. DS consisted of ten 30-s sets of 15 repetitions of extension and relaxation of the hamstrings. ROM increased significantly (range, 7%-10%) immediately after DS, and the increase was sustained over 90 min. PT at the onset of pain also increased immediately by 10% but returned to baseline by 30 min. Passive stiffness decreased significantly (range, 7.9%-16.7%) immediately after DS, and the decrease was sustained over 90 min. Post-DS values were normalized to pre-DS values for the respective outcomes in both groups. ROM was significantly higher (range, 7.4%-10%) and passive stiffness was significantly lower (range, 5.4%-14.9%) in the experimental group relative to the control group at all time points. Normalized PT values at the onset of pain were significantly higher in the experimental group at 0-15 min than in the controls, but the differences were smaller at 30-45 min and not significant thereafter. We conclude that DS increases ROM and decreases passive stiffness in a sustained manner, and increases PT at the onset of pain for a shorter period. Overall, our results indicate that when performed prior to exercise, DS is beneficial for the hamstring muscles in terms of increasing flexibility and reducing stiffness.