Investigators have begun two large studies of stretching,
asking about its effectiveness in much the way scientists
might ask about a new drug or medical device. They’re
actively recruiting thousands of volunteers to participate,
in the United States and elsewhere, and randomly assigning
participants to use the method, or not. That is the only way,
researchers say, to detect the subtle effects that most treatments
and exercise interventions might be expected to evoke.
The studies are being done independently, one by researchers
based in Norway and Australia and the other by a group in
the United States.
The studies are not identical, reflecting perhaps the different
views of stretching worldwide. People in Norway and Australia
stretch for different reasons than people in the United States
and do slightly different stretches. Yet exercisers and coaches
everywhere, the researchers report, tend to have passionate
convictions about the merits of stretching, or lack thereof.
Researchers say those strong feelings pro and con show in
themselves that it will take a large study to see what, if
anything, stretching really accomplishes. If stretching were
remarkably effective, athletes would notice its effects right
away and everyone would agree on when to stretch and what
stretching does.
The study in Norway was the inspiration of Dr. Andy Oxman,
a senior scientist at the Norwegian Knowledge Center for the
Health Services. He had just completed what he calls a public
clinical trial. It was a sort of reality show on public television
that asked whether the nutritional supplement Valerian helped
with insomnia;
405 people signed up to receive Valerian or a placebo and
reported on their sleep by logging onto a Web site. Some participants
insisted that because they slept so well they were taking
Valerian. Or they said they knew they had taken the placebo
because their sleep didn’t improve.
Then, the results were announced on the TV show and published:
Valerian had little or no effect on sleep. Some who maintained
they had the supplement actually had the placebo and vice
versa.
After that, Dr. Oxman and his colleagues cast about for another
good subject for a public clinical trial. A colleague in Australia
suggested stretching, pointing out that there were no good
data on its effects. The studies that were done were almost
always small and inadequate.
The first question, though, was what is stretching supposed
to help with? Dr. Oxman’s group surveyed people in Norway
and Australia and heard that they tended to stretch to prevent
soreness and injuries and enhance well being and performance.
In Norway, people stretched after they exercised; in Australia,
they stretched before exercise.
The investigators designed a 13-week study that would include
walkers, runners, cyclists, swimmers and soccer players. That
way, said Gro Jamtvedt, the principal investigator and a researcher
at the Norwegian Knowledge Center, their findings will not
be specific to any one sport they should apply across
the board.
And they decided that to get meaningful results they needed
at least 2,300 volunteers who exercised at least once a week
and were willing to be randomly assigned to stretch or not.
Participants enroll on the Internet and report back once
a week on the study’s Web site, telling about muscle
soreness, injuries and feelings of looseness. Those who are
randomized to stretch are asked to do a 10-minute program
before and after exercise, stretching muscles in their legs,
hips and back. Those randomly assigned not to stretch must
continue their normal exercise routine but refrain from stretching
for 13 weeks. (http://stretchingstudy.nokc.no/study-stretching-web/innhold/welcome.faces)
Subjects include Luciana Macedo, 28, a physiotherapist in
Sydney. She plays soccer once a week for an hour and a half
and was assigned to the stretching group. She believes stretching
helps her loosen up. “It’s almost like if after
a stretch you were able to do a bit more,” she wrote
in an e-mail message.
Another participant is Christian Rafn, 59, a management consultant
in Oslo. He plays tennis once or twice a week and occasionally
rides a mountain bike. He thinks stretching prevents soreness.
In the study, though, he was assigned to the group that does
not stretch.
So far, the investigators have more than 1,700 participants
and are looking for more there is no limit to the number
they can accept, Ms. Jamtvedt said.
The stateside study is sponsored by USA Track & Field,
but is the inspiration of Alan Roth, a 65-year-old runner,
who is a marketing consultant and a partner at a start-up
company, and his orthopedist, Dr. Daniel Pereles of Montgomery
Orthopedics in Kensington, Md.
Dr. Pereles, a marathoner, a triathlete and a member of an
advisory board for Runner’s World magazine, mentioned
to Mr. Roth that he wanted to do a clinical trial of stretching
but didn’t know where to find enough subjects.
Mr. Roth was intrigued and conferred with the track and field
association. The group agreed to cooperate and Mr. Roth also
enlisted the Road Runners Club of America. He found a statistician
in his local running club and, he said, he got help from the
Centers for Disease Control and Prevention in designing questions
for participants.
THE study (http://www.usatf.org/stretchStudy/)
began last August. It continues to recruit people who run
at least 10 miles a week. It is not asking about soreness
that’s not why people in the United States stretch,
Mr. Roth said. Instead, it is asking whether stretching before
exercise affects the injury rate.
Participants are given a static stretching program for their
hamstrings, quadriceps and calf muscles, the sort of routine
done by most runners who stretch, Mr. Roth said. Participants
agree to do the stretches before running, or to abstain from
stretching before their runs, for three months. They also
have to report their injuries during that time. So far, the
study has enrolled 1,905 runners of whom 795 have completed
their assigned regimens and submitted reports.
The researchers will keep recruiting participants until they
see at least a 5 percent difference in injury rates between
the stretchers and nonstretchers or until it becomes clear,
because they have accumulated data from so many thousands
of runners, that there is no difference.
In the meantime Mr. Roth, at least, still stretches the way
he always has: never before exercise, nor afterward. Instead,
he stops and stretches during
runs and “at odd times during the day,” he said.
Nevertheless, he said he was agnostic about stretching and
was looking for runners who feel the same way.
“If you listen to coaches or trainers, they are very
opinionated about stretching,” Mr. Roth said. “Some
say, ‘Don’t ever stretch before you run.’
Others say, ‘You just have to stretch before you run.’
We say, if you feel strongly that you must stretch or you
must not stretch, don’t join the study.”