Flexibility's Role in Injury Prevention

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Understanding Flexibility's Role in Injury Prevention

Figure 5



Many researchers believe flexibility may help prevent injury. However, much of the current research has begun to dismiss the theory, suggesting that flexibility has no or little influence on preventing injury.

Those who postulate the injury prevention benefit look to anatomy and biomechanics to present their case as muscles with imbalances create joint stress, altering the normal arthrokinematics, creating altered neuromuscular control and potentially creating synergistic dominance, which may, over time, lead to injury (See Figures 4 & 5).

Maintaining muscular balance is theorized to be a key to optimal movement. Given the interplay of joints and their reliance on muscular and nervous system input to move correctly, maintaining optimal muscle lengths would seem beneficial to preventing injuries. However, as noted earlier, much of the research points to the acute effects of stretching prior to exercise and has found that acute stretching shows little to no improvement or influence on preventing injury. As noted in the research of Andrish and Pope, stretching the calves or lower extremities did not influence the rate of lower-limb injuries such as shin splints or plantar fasciitis (injuries theorized to be related to tight or overactive calf and lower extremity muscles). (29-31) On the contrary, the work of Shrier showed that regular bouts of stretching, as opposed to stretching right before exercise, may reduce the risk of injuries. (32) Hartig and Henderson showed that increasing the flexibility of the hamstrings reduced the number of injuries in military recruits as tested over a 13-week basic training course. Injury rates were reduced to 16.7% in the stretching intervention group versus 29.1% in the control group. (33) Amako and colleagues found that a regular static stretching regimen of military recruits reduced the rate of muscle/tendon injury and incidents of low back pain after the first month of implementation. (34) Hilyer (1990) studied the effect of flexibility on injury and cost (due to time spent injured and medical care). His study revealed a small, but significant difference on the intervention group, showing less severity of injury and lost time costs. (35) Overall, there is moderate evidence that the acute effects of pre-activity stretching may not reduce the incidence of injury; however, the regular effects of implementing a flexibility program show reduced incidence of injury, less time lost costs, and a reduced severity of injury focused more on muscle/tendon injuries versus joint injuries.


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