Stretch Therapy Should Be More Than an Afterthought — Here's Why It's Important

What is stretch therapy?

Stretch therapy encompasses a wide range of techniques, including foam rolling, massage, myofascial release, and active range of motion movements, in addition to traditional passive stretches.

Stretch therapy is the scientific application of these techniques to treat certain physical problems associated with tight muscles and restricted joints. When performed properly, stretch therapy can help prevent injuries and improve performance.

While you’re likely familiar with some of the techniques used in stretch therapy, the proper application of stretching for maximum benefit requires more than idly reaching for your toes before hitting the treadmill.

With a little bit of education, you’ll be more than prepared to effectively incorporate stretch therapy techniques into your training program.

Reminder

Always consult your healthcare provider before beginning any stretching program. If you have a chronic or unresolved injury, seeking professional guidance is crucial to ensuring you don’t risk additional injury.

The science of stretch therapy

Most stretching protocols are primarily aimed at increasing the range of motion of a joint, and the overall goal is to improve movement patterns involving that joint.

While many factors affect movement patterns, range of motion is a major one. Improved range of motion at joints generally facilitates better movement overall.

Increasing the flexibility of the tissues around a joint will increase its range of motion. These tissues include muscle, tendon, and fascia tissues.

Each of these tissues has different properties. However, the flexibility of each can be improved with various stretch therapy techniques.

Muscle flexibility

Muscle flexibility is affected by several factors. Overall, neural signals to the muscle tissue play a significant role in your muscles’ ability to completely lengthen, or release.

Muscles increase their flexibility in response to techniques like stretching and foam rolling, largely due to the stimulation of receptors that tell your muscles to relax or contract.

The stimulation of these receptors leads to the relaxation of your muscle fibers in the short term. Over time, stretch therapy protocols cause more permanent elongation of your muscles through changes to the resting length of the tissue itself.

Tendon and fascia flexibility

Tendons are the tissues that connect your bone to your muscles. The tendons connect to another tissue called fascia, which surrounds the outside of your muscles, as well as sections within your muscles.

In most cases, a stiff tendon is a good thing. Still, sometimes excessive tightness in the tendons and the fascia connective tissue surrounding your muscles can restrict the normal range of motion.

Techniques such as massage and stretching can increase the extensibility of both the tendons and fascia in the long term.

The research on various stretching techniques is ongoing and occasionally conflicting or inconclusive. Yet, overall, studies suggest that the methods found in stretch therapy improve muscle and connective tissue flexibility when properly and consistently applied (4).

Short-term vs. long-term flexibility

Stretch therapy techniques increase flexibility in both the short and long term. The range of motion in a given area typically increases immediately after a stretch therapy session.

Short-term increased range of motion can improve movement in the following training session, but it will dissipate if stretch therapy ceases.

However, if you continually perform stretch therapy two to three times per week, the range of motion increases become more permanent. Connective tissue structures and resting muscle length will adapt to the stretch therapy and maintain improved flexibility.

These long-term flexibility adaptations are the goal of stretch therapy. As such, you must consistently do your stretching routine to see meaningful improvements.

Summary

Range of motion in the joints is determined by muscle, tendon, and fascia flexibility. Stretch therapy techniques improve flexibility in these tissues in the short and long term.

The benefits of stretch therapy

The overall goal of stretch therapy is to treat muscle tightness, joint imbalances, and tissue restrictions that cause movement distortions, aches and pains, and increased risk of injury.

Over time, stretch therapy improves range of motion, leading to improved movement patterns and fewer injuries.

Regardless of your occupation or preferred fitness activity, you likely engage in repetitive movements that lead to imbalances in muscle length and joint range of motion over time.

Additionally, injuries — whether current or former — can lead to altered movement patterns that cause similar restrictions, as well as further injury down the road.

If not addressed, these imbalances in your tissues will affect your movement and lead to poor movement quality, increased injury risk, decreased performance, and pain.

The effects of muscle imbalance compound over time and affect people of all fitness levels. The good news is that stretch therapy is effective for many groups of people, including older individuals, younger individuals, and athletes.

Research has shown that older adults can improve their range of motion through a variety of techniques used in stretch therapy (1).

Additional research found that younger athletes who perform proper stretch therapy techniques can reduce their risk of non-contact injury during training and competition (2).

That said, individual responses to stretching vary, and your specific athletic and medical history may affect the result of a specific stretching method (3).

Still, regardless of your fitness goals, age, or overall lifestyle, stretch therapy techniques are likely to increase your range of motion, improve your performance, and reduce your overall risk of injury.

Summary

Stretch therapy increases range of motion, improves movement quality, and reduces injury risk.

Risks of stretch therapy

While stretch therapy offers many benefits, you should be aware of a few situations in which stretching should be modified or avoided.

Maximal strength and power events

While the overall risks of stretch therapy are low, performing static stretching before events that require maximal strength and power may decrease performance.

Some studies suggest that static stretching longer than 60 seconds before powerlifting, sprinting, or jumping events may temporarily hinder performance.

Given that the overall data on this effect is mixed, you may want to try some of the many alternative warmup methods, including active stretches (9).

You should use static stretching at your discretion if you’re warming up for a strength or power activity. However, if you’re currently treating a movement issue with stretch therapy, your best bet is to avoid maximal effort activities until your issue is resolved.

Hypermobility

Hypermobility is a condition in which your joints can move beyond the normal ranges of motion, which can cause injury and overall instability.

If you have hypermobile joints, stretching should be avoided unless under direct supervision from a qualified healthcare practitioner.

Foam rolling and myofascial release are safe for hypermobile individuals, but static and dynamic stretches that take you to your end ranges of motion should be avoided if you’re hypermobile.

Summary

Stretch therapy should be modified for athletic events that require maximal strength or power. Also, those with hypermobile joints should avoid end-range stretches.

Stretch therapy techniques

Stretch therapy techniques involve a variety of activities that improve movement and range of motion. These include:

• massage techniques, including self-massage with foam rollers or other devices
• passive stretching techniques
• active or dynamic stretching techniques
• partner-assisted stretching techniques

Massage, foam rolling, and myofascial release

In the context of exercise science, techniques that apply external pressure directly to tissues are termed myofascial release.

This includes traditional massage techniques practiced by massage therapists, as well as foam rolling, lacrosse ball massage, and other self-massage techniques.

While more research is required, multiple studies suggest that foam rolling and similar massage techniques improve range of motion and reduce muscle stiffness. Additionally, research suggests that foam rolling may enhance post-workout recovery (5, 6).

Overall, research suggests that self-myofascial release is most effective when performed for 30–120 seconds on the targeted areas.

You will likely find so-called “trigger points,” where the muscle is especially tender. These are the locations you want to apply the pressure (7).

Self-myofascial release can be performed before or after working out, or as a separate session.

To perform self-myofascial release:

1. Locate the target muscle based on the joint where you desire an increase in range of motion.
2. Roll a foam roller or lacrosse ball along the muscle until you locate a trigger point.
3. Hold the trigger point for 30 or more seconds. You should feel a slight release in the area.
4. Perform 1–3 holds per area.

While you can target many areas with self-myofascial release, the following are some common areas that benefit from this technique. A quick YouTube search will yield how-to videos for each of these joints:

• Ankle: calves, feet
• Hip: quadriceps/hip flexors, glutes, piriformis, hamstrings
• Shoulder: lats, pectorals, rear delts

Passive stretching techniques

Of all the stretch techniques, you may be most familiar with passive stretching. This type of stretch involves stretching your muscle to the point of mild discomfort and holding the stretch for 20–30 seconds or more.

A large body of research shows that passive stretching techniques improve the range of motion in associated joints (8).

If you experience tightness or restrictions in specific joints that limit your overall movement, passive stretching can be performed after warming up the area.

For general flexibility maintenance or improvements, perform passive stretching after your main workout or as part of a separate session. Just make sure it’s always preceded by a warmup.

To perform passive stretching:

1. Determine the target joint and respective muscle to be stretched.
2. Warm up the area with 5–10 minutes of movement. Walking, squats, cycling, or other gentle motion should do the trick.
3. Move your limb to stretch the muscle until the point of mild discomfort.
4. Hold the stretch for 20–30 seconds.
5. Repeat 1–2 times per muscle.

You can use passive stretching techniques on many muscles. Again, searching for videos online is a great way to learn how to stretch each muscle.

The following are just a few joints and respective muscles you can target with passive stretching:

• Ankle: calves
• Hip: quadriceps, glutes, hamstrings
• Shoulder: lats, pectorals

Dynamic stretching techniques

Dynamic, or active, stretching techniques involve moving a joint through a range of motion, and the goal is to increase the range through repetition.

Typically, you’ll perform multiple repetitions of each active stretch and increase the range of motion each time.

For stretch therapy, active stretches are best performed after self-myofascial release and passive stretching. Additionally, active stretches are excellent for warming up before traditional strength and fitness training sessions.

Once you have warmed up, perform your myofascial release and passive stretches, then perform 3 sets of each active stretch to mobilize your newfound range of motion in a more functional pattern.

To learn how to perform active stretches, it’s best to consult a trainer to learn the correct movement pattern.

Partner-assisted stretches

One of the biggest benefits of visiting a professional for stretch therapy is access to partner-assisted stretches.

Nevertheless, if you aren’t seeing a professional physical therapist or other fitness professional, you can still benefit from having a training partner assist you in stretching.

The most effective partner stretches are proprioceptive neuromuscular facilitation (PNF) stretches. PNF techniques encompass several methods, all of which rely on your partner providing manual resistance and assistance through the stretching procedure.

Overall, PNF techniques rely on creating tension in your muscles before relaxing into the stretch, which ultimately facilitates a deeper stretch and greater improvement in your range of motion.

The three main PNF techniques are hold-relax, contract-relax, and hold-relax with agonist contraction. If you’re unfamiliar with how these partner stretching techniques work, it’s best to consult a physical therapist or personal trainer.

It’s important to note that this stretching technique is not recommended for people under 18 years of age.

Summary

Myofascial release and passive stretching can be easily added to your fitness routine. Dynamic, or active, stretching techniques and partner-assisted stretches are very useful, but they should be learned from a professional.

Structuring your stretch therapy routine

Regardless of which joint you’re targeting with stretch therapy, the overall structure is the same. Begin with 5–10 minutes of light to moderate aerobic exercise, such as brisk walking, to elevate your body temperature.

From there, perform myofascial release followed by static stretches, then active stretches or PNF if you have a partner available.

Stretch therapy session structure:

1. 5–10 minutes of a brisk aerobic warmup
2. 2–3 holds with a foam roller for 30 seconds at each trigger point
3. 2–3 passive stretches per muscle holding for 30 seconds
4. 2–3 active or PNF stretches

Perform this routine at least twice per week to see results. Within just a few weeks, your range of motion should significantly improve, as well as the overall quality of your movement.

Additionally, with improved movement, your risk of injury during sports, fitness training, and day-to-day physical activity will decrease substantially.

Summary

Stretch therapy involves a variety of techniques you can perform on your own or with a partner. Proper structuring of the techniques is needed for optimal results.

The bottom line

Stretch therapy encompasses a variety of training techniques structured together to address stiffness in muscles and joints, which can lead to movement dysfunction and increased injury risk.

Stretch therapy protocols can be used on many areas of the body and are based on the location of your specific imbalances. Overall, proper stretch therapy methodology is beneficial for both the athletic and general population.

With a few specific exceptions, stretch therapy techniques are safe and useful for most people.