The Effects of Hamstring Stretching on Range of Motion: A Systematic Literature Review

Abstract

Study Design: Systematic literature review. Objective: Investigate the literature regarding the most effective positions, techniques, and durations of stretching to improve hamstring muscle flexibility. Background: Hamstring stretching is popular among physical therapists, athletic trainers, and fitness/coaching professionals; however, numerous stretching methodologies have been proposed in the literature. This fact establishes a need to systematically summarize available evidence in an attempt to determine the most effective stretching approach. Methods: A list of 28 pertinent manuscripts that included randomized and clinical trials was created according to specific inclusion/exclusion criteria. These manuscripts were critically reviewed for quality according to the Physiotherapy Evidence Database (PEDro) (10-point) scale and descriptive information about the stretching parameters employed in the research. Results: Cumulatively, 1338 healthy subjects were included in the reviewed studies. Methodological quality scores ranged from 2 to 8 (mean ± SD, 4.3 ± 1.6). Several methodological flaws were frequently recognized, including failure to conceal group allocation or perform blinded assessment. All studies reported improvements in range of motion after stretching. Conclusions: Overall, methodological quality was poor, with only 21.4% (6/28) of studies achieving a score between 6 and 8. Thus it was difficult to confidently identify 1 most effective hamstring stretching method. Instead, the evidence appears to indicate that hamstring stretching increases range of motion with a variety of stretching techniques, positions, and durations.

The effect of heat applied with stretch to increase range of motion: A systematic review

“…Although this subgroup comprised only a single study of Lentell et al (1992), one could speculate that the shoulder muscles may be more responsible to acute changes in muscle length than the other larger muscle groups studied. Previous systematic reviews have concluded that multiple treatments involving static stretch alone can improve ROM, and this systematic review supports this finding (Decoster et al, 2005;Harvey et al, 2002;Radford et al, 2006). In addition, the meta-analyses revealed that multiple treatments of heat combined with stretch can potentiate the effects of stretch.…”

“…The threshold score in methodological quality that can be classified as acceptable is equivocal (Decoster et al, 2005;Labelle et al, 1992;Roig et al, 2009;Sherrington et al, 2010). The RCTs in this systematic review had an average of PEDro score of 5.5 out of a possible 10 points, and three studies achieved 7 points (70%); this average is higher than the median of 4.0 and 5.0 PEDro scores recently reported for 615 sports physiotherapy trials and 11,503 other RCTs (Sherrington et al, 2010).…”

“…The blinding of subjects and clinicians when applying heat may not be feasible and it is difficult to ascertain if this would provide a strong bias towards H+S compared to stretch alone. However, blinding of assessors would be optimal, especially given the subjective nature of ROM, which has previously been acknowledged (Decoster et al, 2005;French et al, 2006;Harvey et al, 2002). We strongly recommend that future studies investigating stretching or heating modalities include blinding of assessors in the research methodology.…”

“…To further complicate the interpretation of clinical trials, stretching is often combined with other modalities, such as dynamic warm-up, massage,vibration (Feland et al, 2010), or heat. A recent systematic review concluded that hamstring stretching can achieve meaningful gains in range of motion, but the authors did not make any conclusion or recommendations regarding the best treatment parameters (Decoster et al, 2005).…”

Influência do número de séries e tempo de alongamento estático sobre a flexibilidade dos músculos isquiotibiais em mulheres sedentárias

“…O alongamento estático passivo é o método de mais fácil realização e o mais frequentemente utilizado (1,2,(7)(8)(9) . Decoster et al (10) afirmam, em sua revisão de literatura, que os indivíduos que realizam o alongamento estáti-co alcançam ganhos maiores de amplitude de movimento quando comparados com os que empregam as técnicas de facilitação neuromuscular proprioceptiva. No entanto, para os atletas obterem as vantagens dos ganhos de flexibilidade com o alongamento estático, é importante saber por quanto tempo duram os efeitos (11) .…”