Effects of Acute and Chronic Stretching on Pain Control

Abstract

While muscle stretching has been commonly used to alleviate pain, reports of its effectiveness are conflicting. The objective of this review is to investigate the acute and chronic effects of stretching on pain, including delayed onset muscle soreness. The few studies implementing acute stretching protocols have reported small to large magnitude decreases in quadriceps and anterior knee pain as well as reductions in headache pain. Chronic stretching programs have demonstrated more consistent reductions in pain from a wide variety of joints and muscles, which has been ascribed to an increased sensory (pain) tolerance. Other mechanisms underlying acute and chronic pain reduction have been proposed to be related to gate control theory, diffuse noxious inhibitory control, myofascial meridians, and reflex-induced increases in parasympathetic nervous activity. By contrast, the acute effects of stretching on delayed onset muscle soreness are conflicting. Reports of stretch-induced reductions in delayed onset muscle soreness may be attributed to increased pain tolerance or alterations in the muscle's parallel elastic component or extracellular matrix properties providing protection against tissue damage. Further research evaluating the effect of various stretching protocols on different pain modalities is needed to clarify conflicts within the literature.

Alternative Flexibility Training

“…10 Prior reviews have reported that static stretching did not have positive effects to prevent all cause injuries. 11 However, our current reviews reported reduced musculotendinous injury incidence, improved balance, 11 and reduced pain 12 with static stretching as part of the warm-up before an activity or as part of a separate training program (≥30 seconds per muscle group with a total duration of ≥5 minutes). Unilateral static stretching can also have global body effects with large magnitude ROM increases in non-stretched limbs.…”

The Effect Of Percussive Therapy On Musculoskeletal Performance And Experiences Of Pain: A Systematic Literature Review

“…Data from previous studies have indicated a relationship between stretching-based programmes and reduced hamstring, 64 low back, 65 quadriceps and anterior knee pain. 66 Interestingly, the Patel and Patel (2020) hamstring flexibility study, also considered changes in experiences of lumbar pain following the same treatment applied to hamstrings. Pain, measured using the NPRS, indicated a reduction in pre (score = 8) to post treatment (score = 2) suggesting that PT had a positive effect on experiences of back pain, and highlighting possible advantages of indirect treatment.…”

Active versus Passive physiotherapy for chronic shoulder pain: a systematic review and meta-analysis

“…These treatments do not require the active participate of the patient, such as Maitland therapy, Passive massage therapy, Passive stretching therapy, physical factor treatment, etc. [12][13][14][15]. But in practice, this biomechanical and neuroanatomical-based approach seems incapable of coping with the complex pain patterns and enormous psychological stress of the patient [16].…”