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Randomized Controlled Trial
, 10, 37

The Effect of Warm-Up, Static Stretching and Dynamic Stretching on Hamstring Flexibility in Previously Injured Subjects

Randomized Controlled Trial

The Effect of Warm-Up, Static Stretching and Dynamic Stretching on Hamstring Flexibility in Previously Injured Subjects

Kieran O'Sullivan et al. BMC Musculoskelet Disord.


Background: Warm-up and stretching are suggested to increase hamstring flexibility and reduce the risk of injury. This study examined the short-term effects of warm-up, static stretching and dynamic stretching on hamstring flexibility in individuals with previous hamstring injury and uninjured controls.

Methods: A randomised crossover study design, over 2 separate days. Hamstring flexibility was assessed using passive knee extension range of motion (PKE ROM). 18 previously injured individuals and 18 uninjured controls participated. On both days, four measurements of PKE ROM were recorded: (1) at baseline; (2) after warm-up; (3) after stretch (static or dynamic) and (4) after a 15-minute rest. Participants carried out both static and dynamic stretches, but on different days. Data were analysed using Anova.

Results: Across both groups, there was a significant main effect for time (p < 0.001). PKE ROM significantly increased with warm-up (p < 0.001). From warm-up, PKE ROM further increased with static stretching (p = 0.04) but significantly decreased after dynamic stretching (p = 0.013). The increased flexibility after warm-up and static stretching reduced significantly (p < 0.001) after 15 minutes of rest, but remained significantly greater than at baseline (p < 0.001). Between groups, there was no main effect for group (p = 0.462), with no difference in mean PKE ROM values at any individual stage of the protocol (p > 0.05). Using ANCOVA to adjust for the non-significant (p = 0.141) baseline difference between groups, the previously injured group demonstrated a greater response to warm-up and static stretching, however this was not statistically significant (p = 0.05).

Conclusion: Warm-up significantly increased hamstring flexibility. Static stretching also increased hamstring flexibility, whereas dynamic did not, in agreement with previous findings on uninjured controls. The effect of warm-up and static stretching on flexibility was greater in those with reduced flexibility post-injury, but this did not reach statistical significance. Further prospective research is required to validate the hypothesis that increased flexibility improves outcomes.

Trial registration: ACTRN12608000638336.


Figure 1
Figure 1
Study design and protocol. Subjects were randomised to order of stretching days. The same procedure was repeated on both days, apart from the stretch type (Static or Dynamic Stretching). The alternative stretch was then performed on day 2. PKE ROM was measured on 4 occasions on both days; T1- T4.
Figure 2
Figure 2
Measurement of hamstring flexibility. Passive Knee Extension Range of Motion (PKE ROM) was assessed with a Myrin goniometer. This procedure was repeated 3 times for each leg at all intervals and an average of all 3 measures was taken as the mean flexibility score.
Figure 3
Figure 3
Static stretch. Participants placed their leg on an elevated surface with their knee extended and their ankle in plantarflexion. Each participant was then instructed to lean forward from the hip, with their spine in neutral until a stretch was felt in the posterior thigh. This position was held for 30 seconds, and repeated 3 times.
Figure 4
Figure 4
Dynamic Stretch. Participants actively swung the leg to be stretched forward into hip flexion until a stretch was felt in the posterior thigh whilst keeping their knee extended and their ankle in plantarflexion. This was repeated for 30 seconds, and repeated 3 times.

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