The effects of dynamic stretching on plantar flexor muscle-tendon tissue properties

Comparative Analysis of Various Rotator Cuff Stretching Techniques: Efficacy and Recommendations for Gym Enthusiasts

Shoulder pain is a common complaint among gym-going individuals, particularly those engaged in upper limb workouts. The rotator cuff, comprising four muscles, plays a crucial role in stabilizing the shoulder joint during movements and supporting its mobility. Imbalances or weaknesses in these muscles can lead to shoulder injuries, affecting performance and overall well-being. The main aim of this review is to explore the benefit of one of the approaches in preventing shoulder pain and improving performance among gym-going individuals. Specific rotator cuff stretching exercises target the entire shoulder complex to enhance the mobility, control, and stabilization of the joint. The dynamic warm-up routine will actively engage the relevant muscles in various planes of motion, promoting the increased range of motion and reduced inflammation. Ultimately, the results from this review can serve as important knowledge for gym-going individuals, trainers, and fitness enthusiasts, guiding them in incorporating evidence-based warm-up strategies to optimize their workouts. Empowering individuals to take proactive measures in caring for their shoulder health can lead to improved overall performance and a better training experience in the gym.

Acute effects of static and dynamic stretching for ankle plantar flexors on postural control during the single-leg standing task

Static stretching (SS) and dynamic stretching (DS) are widely used as warm-ups before sports. However, whether stretching affects postural control remains unclear. We compared the effects of SS and DS on the plantar flexors and postural control during single-leg standing. Fifteen healthy young participants performed SS, DS, or no stretching (control). The stretch condition consisted of four sets lasting 30 s each. The control condition was a rest with standing for 210 s. Center of pressure (COP) displacement was measured using a force plate before and after each intervention to assess postural control during the single-leg standing task. The COP area, COP velocity, and anteroposterior (COPAP) and mediolateral (COPML) range were calculated. DS significantly decreased in the COPML range (21.5 ± 4.1 to 19.0 ± 2.5 mm; P = 0.02), COP velocity (33.8 ± 7.6 to 29.8 ± 6.5 mm/s; P < 0.01), and COP area (498.6 ± 148.3 to 393.3 ± 101.1 mm2; P < 0.01), whereas SS did not change in the COP parameters (COP area 457.2 ± 108.3 to 477.8 ± 106.1 mm2, P = .49; COP velocity 31.2 ± 4.2 to 30.7 ± 5.8 mm/s, P = 0.60; COPAP 25.4 ± 3.1 to 25.3 ± 3.2 mm, P = 0.02; COPML 20.7 ± 3.3 to 21.1 ± 2.5 mm, P = 0.94). Therefore, DS of the plantar flexors enhances postural control during single-leg standing and may be effective for both injury prevention and performance enhancement.

Acute and Prolonged Effects of 300 sec of Static, Dynamic, and Combined Stretching on Flexibility and Muscle Force

Static stretching (SS), dynamic stretching (DS), and combined stretching (CS; i.e., DS+SS) are commonly performed as warm-up exercises. However, the stretching method with the greatest effect on flexibility and performance remains unclear. This randomized crossover trial examined acute and prolonged effects of SS, DS, and CS on range of motion (ROM), peak passive torque (PPT), passive stiffness, and isometric and concentric muscle forces. Twenty healthy young men performed 300 sec of active SS, DS, or CS (150-sec SS followed by 150-sec DS and 150-sec DS followed by 150-sec SS) of the right knee flexors on four separate days, in random order. Subsequently, we measured ROM, PPT, and passive stiffness during passive knee extension. We also measured maximum voluntary isometric and concentric knee flexion forces and surface electromyographic activities during force measurements immediately before, immediately after, and 20 and 60 min after stretching. All stretching methods significantly increased ROM and PPT, while significantly decreasing isometric knee flexion force (all p < 0.05). These changes lasted 60 min after all stretching methods; the increases in ROM and PPT and the decreases in isometric muscle force were similar. All stretching methods also significantly decreased passive stiffness immediately after stretching (all p < 0.05). Decreases in passive stiffness tended to be longer after CS than after SS or DS. Concentric muscle force was decreased after SS and CS (all p < 0.05). On the other hand, concentric muscle force was unchanged after DS, while the decreases in surface electromyographic activities during concentric force measurements after all stretching methods were similar. Our results suggest that 300 sec of SS, DS, and CS have different acute and prolonged effects on flexibility and muscle force.

Hamstrings fascicle length and physical performance changes after a single bout of dynamic stretching or neurodynamic gliding in healthy young and older adults

INTRODUCTION

The physiological and structural alterations have been less reported in response to dynamic stretching (DS) or neurodynamic nerve gliding (NG). Accordingly, this study investigated the changes in fascicle lengths (FL), popliteal artery velocity, and physical fitness in response to a single bout of DS or NG.

METHODS

The study included 15 healthy young adults (20.9 ± 0.7 yrs) and 15 older adults (66.6 ± 4.2 yrs) who randomly performed three different interventions (DS, NG, and rest control) for 10 min and 3 days apart. The biceps femoris and semitendinosus FL, popliteal artery velocity, sit and reach (S&R), straight leg raise (SLR), and fast walking speed were measured before and immediately after the intervention.

RESULTS

After NG intervention, S&R was largely greater by 2 cm (1.2, 2.8 cm) and 3.4 cm (2.1, 4.7 cm) with largely increased SLR angles of 4.9° (3.7°, 6.1°) and 4.6° (3.0°, 6.2°) with all p < 0.001 for the older adults and young groups, respectively. A similar magnitude improvement in the S&R and SLR testing was also seen for both groups after DS (p < 0.05). Moreover, no changes were seen in FL, popliteal artery velocity, fast gait speed, and age effect following all three intervention occasions.

CONCLUSION

Stretching with DS or NG immediately increased flexibility, which appeared to be largely due to changes in stretch tolerance rather than an increase in fascicle length. Furthermore, age dependency in response to stretching exercise was not seen in the present study.

Effects of Speed and Amplitude of Dynamic Stretching on the Flexibility and Strength of the Hamstrings

Dynamic stretching for more than 90 seconds is useful for improving muscle strength, although dynamic stretching for 30 seconds or less is commonly used in sports settings. The effects of dynamic stretching are influenced by the speed and amplitude of stretching, but no study examined these factors for 30 seconds of dynamic stretching. Therefore, the purpose of the present study was to examine the effects of speed (fast- or slow-speed) and amplitude (normal- or wide amplitude) of dynamic stretching for 30 seconds on the strength (peak torque during maximum isokinetic concentric contraction) and flexibility (range of motion, passive torque at maximum knee extension angle, and muscle-tendon unit stiffness) of the hamstrings. The passive torque and muscle-tendon unit stiffness reflect stretching tolerance and viscoelastic properties of the hamstrings, respectively. Fifteen healthy participants performed 4 types of 30 seconds of dynamic stretching. The muscle strength and flexibility were measured before and immediately after the dynamic stretching. The range of motion did not change after dynamic stretching at low speed and normal amplitude (p = 0.12, d = 0.59, 103.3%), but it was increased by other interventions (p < 0.01, d = 0.90-1.25, 104.5-110.1%). In all interventions, the passive torque increased (main effect for time, p < 0.01, d = 0.51 - 0.74, 111.0 - 126.9%), and muscle-tendon unit stiffness did not change. The muscle strength increased only after dynamic stretching at fast speed with normal amplitude (p < 0.01, d = 0.79, 107.1%). The results of the present study indicated that 30 seconds of dynamic stretching at fast speed and with normal amplitude can be beneficial for the measured parameters.

The effect of two different stretching exercises on the muscle tendon unit and range of motion

BACKGROUND: Stretching is commonly used for clinical and sports reason but the effects vary on time and the technique used. PURPOSE: To determine the acute effects of static and dynamic stretching of gastrocnemius muscle on muscle-tendon unit (MTU) and dorsiflexion range of motion (ROM) in the same individuals; to find out how long the stretching effects endure. METHODS: Twenty-eight males (mean age: 22.18 ± 2.58 years) were included in the study. A 45-s static stretching (SS) exercise was applied to the right leg 5 times and dynamic stretching (DS) of same duration to the other leg. Change in MTU was assessed by ultrasonography and active and passive ROM was measured with goniometer. All evaluations were performed before, immediately following, 5-min, 15-min and 30-min after stretching. RESULTS: Muscle thickness and pennation angle did not change over time with either techniques (p> 0.05). A significant muscle-tendon junction (MTJ) displacement occurred after the techniques (p< 0.05); the highest change was achieved after DS (p< 0.05). Both techniques improved active ROM values similarly (p< 0.05), but only dynamic stretching increased passive ROM significantly (p< 0.05). Active and passive ROM and MTJ displacement values at 30th – min were still higher than the baseline ones on the DS side (p< 0.05). However, SS increased active ROM angle immediately after application but this increment declined until the final measurement. CONCLUSION: We recommend using the dynamic stretching technique to achieve greater and longer lasting increases in tendon length and range of motion.

Effects of Self-myofascial Release Using a Foam Roller on Range of Motion and Morphological Changes in Muscle: A Crossover Study

ABSTRACT

Yoshimura, A, Inami, T, Schleip, R, Mineta, S, Shudo, K, and Hirose, N. Effects of self-myofascial release using a foam roller on range of motion and morphological changes in muscle: a crossover study. J Strength Cond Res 35(9): 2444-2450, 2021-Self-myofascial release using a foam roller (FR) is effective in improving range of motion (ROM) in at least some conditions. However, its mechanism is still unclear. Therefore, this study investigated potential acute muscle morphological changes after the FR intervention and aimed to clarify the mechanism of increases in ROM by the FR intervention. We hypothesized that the FR intervention may increase ROM because of changes in fascicle length (FL) and aponeurosis displacement. This crossover study, involving 22 male university students (21.5 ± 1.3 years, 170.6 ± 4.0 cm, and 64.1 ± 8.9 kg; mean ± SD), compared the FR intervention targeting the gastrocnemius muscle with the control trial. The outcome measures were maximum passive ankle ROM, morphology of the gastrocnemius muscle (FL and aponeurosis displacement) during passive ankle plantar flexor movement, degree of pain during the FR intervention, and sensation of the triceps surae muscle. Although ROM of both dorsiflexion and plantar flexion increased significantly after the FR intervention (p < 0.01), no significant differences were found in FL and aponeurosis displacement before and after the FR intervention. The mean perception of pain during the FR intervention was rated as "slightly uncomfortable," corresponding to a 2.3 ± 2.4-cm on a 9.5-cm visual analog scale. We found that the FR intervention did not influence the morphology of muscle. It is necessary to investigate other factors related to ROM as the next step of this study.

Changes in neural drive to calf muscles during steady submaximal contractions after repeated static stretches

KEY POINTS

Repeated static-stretching interventions consistently increase the range of motion about a joint and decrease total joint stiffness, but findings on the changes in muscle and connective-tissue properties are mixed. The influence of these stretch-induced changes on muscle function at submaximal forces is unknown. To address this gap in knowledge, the changes in neural drive to the plantar flexor muscles after a static-stretch intervention were estimated. Neural drive to the plantar flexor muscles during a low-force contraction increased after repeated static stretches. These findings suggest that adjustments in motor unit activity are necessary at low forces to accommodate reductions in the force-generating and transmission capabilities of the muscle-tendon unit after repeated static stretches of the calf muscles.

ABSTRACT

Static stretching decreases stiffness about a joint, but its influence on muscle-tendon unit function and muscle activation is unclear. We investigated the influence of three static stretches on changes in neural drive to the plantar flexor muscles, both after a stretch intervention and after a set of maximal voluntary contractions (MVCs). Estimates of neural drive were obtained during submaximal isometric contractions by decomposing high-density electromyographic signals into the activity of individual motor units from medial gastrocnemius, lateral gastrocnemius and soleus. Motor units were matched across contractions and an estimate of neural drive to the plantar flexors was calculated by normalizing the cumulative spike train to the number of active motor units (normalized neural drive). Mean discharge rate increased after the stretch intervention during the 10% MVC task for all recorded motor units and those matched across conditions (all, P = 0.0046; matched only, P = 0.002), recruitment threshold decreased for motor units matched across contractions (P = 0.022), and discharge rate at recruitment was elevated (P = 0.004). Similarly, the estimate of normalized neural drive was significantly greater after the stretch intervention at 10% MVC torque (P = 0.029), but not at 35% MVC torque. The adjustments in motor unit activity required to complete the 10% MVC task after stretch may have been partially attenuated by a set of plantar flexor MVCs. The increase in neural drive required to produce low plantar-flexion torques after repeated static stretches of the calf muscles suggests stretch-induced changes in muscle and connective tissue properties.

Acute Effects of Gastrocnemius/Soleus Self-Myofascial Release Versus Dynamic Stretching on Closed-Chain Dorsiflexion

CONTEXT

Limited ankle dorsiflexion (DF) range of motion has been correlated with decreased flexibility of the gastrocnemius/soleus complex. Decreased ankle DF range of motion can lead to an increase in lower-extremity injuries, for example, acute ankle sprains, Achilles tendinopathy.

OBJECTIVE

The purpose of this study was to determine whether a single application of the intervention to the gastrocnemius/soleus complex via multidirectional self-myofascial release using a foam roller, multiplanar dynamic stretch performed in downward dog, or a combination of both techniques acutely improved ankle DF.

DESIGN

Subjects were assigned to groups via random card selection. Investigators provided verbal cues as needed to yield correct performance of interventions. Both interventions were performed twice for 1 minute using a dynamic walking rest of 30.48 m at a self-selected pace between interventions. Statistical analyses were completed using a 1-way analysis of variance, at α level ≤ .05.

SETTING

A convenience sample study.

PARTICIPANTS

A total of 42 asymptomatic physical therapy students (18 females and 24 males) with mean age of 26.12 (4.03) years volunteered to participate.

INTERVENTIONS

Multidirectional self-myofascial release using a foam roller, multiplanar dynamic stretch performed in downward dog, or a combination of both techniques.

MAIN OUTCOME MEASURES

Weight-bearing right ankle DF measurements were recorded in centimeters using a forward lunge technique (intraclass correlation coefficient = .98, .97, and .96).

RESULTS

Data analysis revealed no significant difference between the 3 groups in all pre-post measurements (P = .82). Mean (SD) measurements from pretest to posttest for myofascial release, dynamic stretching, and combination interventions were 0.479 (0.7) cm, 0.700 (0.7) cm, and 0.907 (1.4) cm, respectively.

CONCLUSION

Until further studies are conducted, the selection of technique to increase ankle DF range of motion should be based on each individual patient's ability, preference, and response to treatment.

Acute effects of dynamic stretching on neuromechanical properties: an interaction between stretching, contraction, and movement

PURPOSE

The present study aimed to investigate the acute effects of dynamic stretching on neurophysiological and mechanical properties of plantar flexor muscles and to test the hypothesis that dynamic stretching resulted from an interaction between stretching, movement, and contraction.

METHODS

The dynamic stretching conditioning activity (DS) was compared to static stretching (SS), passive cyclic stretching (PCS), isometric contractions (IC), static stretching followed by isometric contractions (SSIC), and control (CO) conditions. Stretching amplitude (DS, SS, PCS and SSIC), contraction intensity (DS, IC and SSIC) and duration (all 6 conditions) were matched. Thirteen volunteers were included. Passive torque, fascicle length, and stiffness were evaluated from a dynamometer and ultrasonography during passive dorsiflexion. Neuromuscular electrical stimulation was used to investigate contractile properties [peak twitch torque (PTT), and rate of torque development (RTD)] and muscle voluntary activation (%VA). Gastrocnemius lateralis electromyographic activity (GL EMG/Mwave) was obtained during maximal voluntary contraction. All of these parameters were measured immediately before and 10 s after each experimental condition.

RESULTS

Peak twitch torque, RTD, %VA, GL EMG/Mwave remained unaltered, while passive torque was significantly reduced after DS (- 8.14 ± 2.21%). SS decreased GL EMG/Mwave (- 7.83 ± 12.01%) and passive torque (- 2.16 ± 7.25%). PCS decreased PTT (- 3.40 ± 6.03%), RTD (- 2.96 ± 5.16%), and passive torque (- 2.16 ± 2.05%). IC decreased passive torque (- 7.72 ± 1.97%) and enhanced PTT (+ 5.77 ± 5.19%) and RTD (+ 7.36 ± 8.35%). However, SSIC attenuated PTT and RTD improvements as compared to IC.

CONCLUSION

These results suggested that dynamic stretching is multi-component and would result from an interaction between stretching, contraction, and movement.

M-Mode Ultrasound Examination of Soleus Muscle in Healthy Subjects: Intra- and Inter-Rater Reliability Study

Objective: M-mode ultrasound imaging (US) reflects the motion of connective tissue within muscles. The objectives of this study were to evaluate inter-rater and intra-rater reliability of soleus muscle measurements between examiners with different levels of US experience in asymptomatic subjects and to investigate the level of soleus muscle isometric activity in two positions (knee extended and knee flexed at 30°). Methods: Thirty volunteers without a history of ankle pain were evaluated with US examinations of the soleus muscle. Each muscle was scanned independently by two evaluators. Muscle at rest thickness, maximal isometric contraction thickness, time and velocity measures were detailed and blinded to the other examiner. Results: Intra- and inter-rater reliability at rest, in maximal isometric contraction thickness, contraction time and contraction velocity measures for both positions (extended and flexed knee) were reported from good to excellent for all outcome measurements. The position with the knee extended reported a statistically significant increase in thickness after motion showing 1.33 ± 0.27 mm for measurements at rest thickness with knee extended versus 1.50 ± 0.29 mm for measurements at end thickness with the knee in flexed position (p = 0.001), as well as 1.31 ± 0.23 mm for rest thickness with the knee in flexed position measurements with respect to 1.34 ± 0.24 mm for maximal isometric contraction thickness with extended knee measurements (p = 0.058). Conclusions: This study found that intra- and inter-examiner reliability of M-mode ultrasound imaging of the soleus muscle was excellent in asymptomatic subjects and the soleus muscle activity was different between the position with the knee extended and the position with the knee flexed.

Effects of Self-Massage Using a Foam Roller on Ankle Range of Motion and Gastrocnemius Fascicle Length and Muscle Hardness: A Pilot Study

Context: Several studies have reported that self-massage using a foam roller (FR) increased joint range of motion (ROM) immediately. However, the mechanism of increasing ROM by the FR intervention has not been elucidated. Objective: To clarify the mechanism by investigating properties and morphological changes of muscles targeted by the FR intervention. Design: An interventional study. Setting: An athletic training laboratory. Participants: Ten male college volunteers with no injuries in their lower limbs (mean [SD]: age 23.8 [3.2] y, height 173.2 [4.9] cm, weight 69.5 [8.6] kg). Intervention: The FR intervention on the right plantar flexors for 3 minutes. Main Outcome Measures: Maximum ankle ROM, muscle hardness, and fascicle length of the gastrocnemius muscle at the neutral (0°), maximum dorsiflexion, and maximum plantar flexion positions. All measurements were conducted before (PRE) and after (POST) the FR intervention. Results: Dorsiflexion ROM increased significantly at POST (PRE: 13.6° [8.0°], POST: 16.6° [8.4°]; P < .001), although plantar flexion ROM did not change significantly between PRE and POST (PRE: 40.0° [6.1°], POST: 41.1° [4.9°]). There was no significant difference in muscle hardness and fascicle length between PRE and POST in any of the angles. Conclusions: Dorsiflexion ROM increased significantly by the FR intervention in the present study; however, muscle hardness and fascicle length did not change. FR may affect not only the muscle but also the fascia, tendon, and muscle-tendon unit. The FR protocol of the present study can be applied in clinical situations, because it was found to be effective to increase ROM.

Changes in Flexibility and Force are not Different after Static Versus Dynamic Stretching

In this study, we examined the effects of static and dynamic stretching on range of motion (ROM), passive torque (PT) at pain onset, passive stiffness, and isometric muscle force. We conducted a randomized crossover trial in which 16 healthy young men performed a total of 300 s of active static or dynamic stretching of the right knee flexors on two separate days in random order. To assess the effects of stretching, we measured the ROM, PT at pain onset, passive stiffness during passive knee extension, and maximum voluntary isometric knee flexion force using an isokinetic dynamometer immediately before and after stretching. Both static and dynamic stretching significantly increased the ROM and PT at pain onset (p<0.01) and significantly decreased the passive stiffness and isometric knee flexion force immediately after stretching (p<0.01). However, the magnitude of change did not differ between the two stretching methods for any measurements. Our results suggest that 300 s of either static or dynamic stretching can increase flexibility and decrease isometric muscle force; however, the effects of stretching do not appear to differ between the two stretching methods.

Acute Effects of Dynamic Stretching on Muscle Flexibility and Performance: An Analysis of the Current Literature

Stretching has long been used in many physical activities to increase range of motion (ROM) around a joint. Stretching also has other acute effects on the neuromuscular system. For instance, significant reductions in maximal voluntary strength, muscle power or evoked contractile properties have been recorded immediately after a single bout of static stretching, raising interest in other stretching modalities. Thus, the effects of dynamic stretching on subsequent muscular performance have been questioned. This review aimed to investigate performance and physiological alterations following dynamic stretching. There is a substantial amount of evidence pointing out the positive effects on ROM and subsequent performance (force, power, sprint and jump). The larger ROM would be mainly attributable to reduced stiffness of the muscle-tendon unit, while the improved muscular performance to temperature and potentiation-related mechanisms caused by the voluntary contraction associated with dynamic stretching. Therefore, if the goal of a warm-up is to increase joint ROM and to enhance muscle force and/or power, dynamic stretching seems to be a suitable alternative to static stretching. Nevertheless, numerous studies reporting no alteration or even performance impairment have highlighted possible mitigating factors (such as stretch duration, amplitude or velocity). Accordingly, ballistic stretching, a form of dynamic stretching with greater velocities, would be less beneficial than controlled dynamic stretching. Notwithstanding, the literature shows that inconsistent description of stretch procedures has been an important deterrent to reaching a clear consensus. In this review, we highlight the need for future studies reporting homogeneous, clearly described stretching protocols, and propose a clarified stretching terminology and methodology.

Dynamic stretching is not detrimental to neuromechanical and sensorimotor performance of ankle plantarflexors

The acute effects of two dynamic stretching (DS) protocols on changes in the ankle range of motion (RoM), neuromechanical, and sensorimotor properties of the plantarflexor muscle group were examined. Eighteen participants received slow (SDS) or fast dynamic stretching (FDS) on two separate days. Outcome measures were assessed pre- and 2 minutes post-interventions, and included maximum dorsiflexion angle, maximum isometric torque at neutral ankle position, maximum concentric and eccentric torques, force matching capacity, joint position sense and medial gastrocnemius muscle and tendon strain. Possibly and likely small increases in dorsiflexion RoM were observed after SDS (mean ± 90% confidence intervals; 1.8 ± 1.2°) and FDS (2.1 ± 1.2°), respectively. Very likely moderate decreases in muscle strain after SDS (-38.0 ± 20.6%) and possibly small decrease after FDS (-13.6 ± 21.2%) were observed. SDS resulted in a likely beneficial small increase in tendon strain (25.3 ± 29.7%) and a likely beneficial moderate increase after FDS (41.4 ± 44.9%). Effects on strength were inconsistent. Possibly small effect on positional error after SDS (-27.1 ± 37.5%), but no clear effect after FDS was observed. Both DS protocols increased RoM, and this was more due to an increase in tendon elongation rather than the muscle. However, SDS showed greater improvement than FDS in both neuromechanical and sensorimotor performance, and hence, SDS can be recommended as part of warm-up in sporting contexts.

Acute Effects of Stretching on Leg and Vertical Stiffness During Treadmill Running

Pappas, PT, Paradisis, GP, Exell, TA, Smirniotou, AS, Tsolakis, CK, and Arampatzis, A. Acute effects of stretching on leg and vertical stiffness during treadmill running. J Strength Cond Res 31(12): 3417-3424, 2017-The implementation of static (SS) and dynamic (DS) stretching during warm-up routines produces significant changes in biological and functional properties of the human musculoskeletal system. These properties could affect the leg and vertical stiffness characteristics that are considered important factors for the success of athletic activities. The aim of this study was to investigate the influence of SS and DS on selected kinematic variables, and leg and vertical stiffness during treadmill running. Fourteen men (age: 22.58 ± 1.05 years, height: 1.77 ± 0.05 m, body mass: 72.74 ± 10.04 kg) performed 30-second running bouts at 4.44 m·s, under 3 different stretching conditions (SS, DS, and no stretching). The total duration in each stretching condition was 6 minutes, and each of the 4 muscle groups was stretched for 40 seconds. Leg and vertical stiffness values were calculated using the "sine wave" method, with no significant differences in stiffness found between stretching conditions. After DS, vertical ground reaction force increased by 1.7% (p < 0.05), which resulted in significant (p < 0.05) increases in flight time (5.8%), step length (2.2%), and vertical displacement of the center of mass (4.5%) and a decrease in step rate (2.2%). Practical durations of SS and DS stretching did not influence leg or vertical stiffness during treadmill running. However, DS seems to result in a small increase in lower-limb force production which may influence running mechanics.

Effects of an acute bout of dynamic stretching on biomechanical properties of the gastrocnemius muscle determined by shear wave elastography

AIMS

The aim of this study was to examine the acute effects of dynamic stretching (DS) exercise on passive ankle range of motion (RoM), resting localized muscle stiffness, as measured by shear wave speed (SWS) of medial gastrocnemius muscle, fascicle strain, and thickness.

METHODS/RESULTS

Twenty-three participants performed a DS protocol. Before and after stretching, SWS was measured in the belly of the resting medial gastrocnemius muscle (MGM) using shear wave elastography. DS produced small improvements in maximum dorsiflexion (+1.5° ±1.5; mean difference ±90% confidence limits) and maximum plantarflexion (+2.3° ±1.8), a small decrease in fascicle strain (-2.6% ±4.4) and a small increase in SWS at neutral resting angle (+11.4% ±1.5). There was also a small increase in muscle thickness (+4.1mm ±2.0).

CONCLUSIONS

Through the use of elastography, this is the first study to suggest that DS increases muscle stiffness, decreases fascicle strain and increases muscle thickness as a result of improved RoM. These results can be beneficial to coaches, exercise and clinical scientists when choosing DS as a muscle conditioning or rehabilitation intervention.

COMPARISON OF FUNCTIONAL ACTIVITIES ON STRUCTURAL CHANGES OF THE INFERIOR PATELLAR POLE

Background

It is well known that eccentric and concentric exercise produce varied amounts of stress on the connective tissues. Diagnostic ultrasound has been used to measure these structural changes by observing fascicle length, angle, and thickness; however, there is a lack of evidence comparing the structural changes as it relates to eccentric, concentric, and stretching protocols.

Purpose

The purpose of this study was to compare the acute effects of static stretching, eccentric, concentric, and a combination of eccentric/concentric exercises on structural changes of the muscle tendon unit at the inferior patellar pole utilizing the diagnostic ultrasound.

Study Design

A repeated measures 2 × 4 within factorial study design with repeated measures on both factors was used to determine the differences in patellar tendon thickness within and between groups.

Methods

Forty-seven healthy subjects were screened for any lower extremity deficits or orthopaedic pathology. Forty-four (N=44) subjects completed all four protocols; the attrition was due to injuries to the lower extremity, occurring unrelated to the study. A baseline measurement of the anterior inferior patellar tendon was performed with the diagnostic ultrasound prior to each participant completing one of the four interventions per week over a four-week period. Interventions completed by each participant included static stretching, concentric, eccentric, and combined concentric and eccentric exercises. Immediately following each intervention, a post-intervention inferior patellar tendon measurement was recorded using the diagnostic ultrasound.

Results

Significant differences in anterior to posterior tendon thickness of the inferior patellar tendon were observed between pre (4.983 ± 0.041mm) and post (5.198 ± 0.055mm) measurements (p<0.0005) for the main effect of time. However, no differences in tendon thickness were noted comparing each intervention to one another (p=0.351).

Conclusion

Differences in tendon thickness were noted acutely for pre- to post measurements across all interventions. Further research is needed to determine if differences in tendon thickness exist with a longer duration of exercise over time and with different types of intervention.

Changes in joint range of motion and muscle-tendon unit stiffness after varying amounts of dynamic stretching

The purpose of this study was to examine the effects of varying amounts of dynamic stretching (DS) on joint range of motion (ROM) and stiffness of the muscle-tendon unit (MTU). Fifteen healthy participants participated in four randomly ordered experimental trials, which involved one (DS1), four (DS4) and seven (DS7) sets of DS, or control conditions/seated at rest (CON). Each DS set consisted of 15 repetitions of an ankle dorsiflexion-plantarflexion movement. The displacement of the muscle-tendon junction (MTJ) was measured using ultrasonography while the ankle was passively dorsiflexed at 0.0174 rad · s^‒1 to its maximal dorsiflexion angle. Passive torque was also measured using an isokinetic dynamometer. Ankle ROM was significantly increased after DS4 and DS7 compared with the pre-intervention values (P < 0.05), but there were no significant differences in ankle ROM between DS4 and DS7. No differences were observed in ankle ROM after DS1 and CON. In addition, the stiffness of the MTU, passive torque and displacement of the MTJ at submaximal dorsiflexion angles did not change in any of the experimental conditions. These results indicate that DS4 increased ankle ROM without changing the mechanical properties of the MTU, and that this increase in ankle ROM plateaued after DS4.

Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties

The purpose of this study was to investigate the influence of a single static, ballistic, or proprioceptive neuromuscular facilitation (PNF) stretching exercise on the various muscle‐tendon parameters of the lower leg and to detect possible differences in the effects between the methods. Volunteers (n = 122) were randomly divided into static, ballistic, and PNF stretching groups and a control group. Before and after the 4 × 30 s stretching intervention, we determined the maximum dorsiflexion range of motion (RoM) with the corresponding fascicle length and pennation angle of the gastrocnemius medialis. Passive resistive torque (PRT) and maximum voluntary contraction (MVC) were measured with a dynamometer. Observation of muscle‐tendon junction (MTJ) displacement with ultrasound allowed us to determine the length changes in the tendon and muscle, respectively, and hence to calculate stiffness. Although RoM increased (static: +4.3%, ballistic: +4.5%, PNF: +3.5%), PRT (static: −11.4%, ballistic: −11.5%, PNF: −13,7%), muscle stiffness (static: −13.1%, ballistic: −20.3%, PNF: −20.2%), and muscle‐tendon stiffness (static: −11.3%, ballistic: −10.5%, PNF: −13.7%) decreased significantly in all the stretching groups. Only in the PNF stretching group, the pennation angle in the stretched position (−4.2%) and plantar flexor MVC (−4.6%) decreased significantly. Multivariate analysis showed no clinically relevant difference between the stretching groups. The increase in RoM and the decrease in PRT and muscle‐tendon stiffness could be explained by more compliant muscle tissue following a single static, ballistic, or PNF stretching exercise.

Effects of long-term self-massage at the musculotendinous junction on hamstring extensibility, stiffness, stretch tolerance, and structural indices: A randomized controlled trial

OBJECTIVES

The purpose of this study was to examine the effect of long-term self-massage at the musculotendinous junction on hamstring extensibility, stiffness, stretch tolerance, and structural indices.

DESIGN

Single-blind, randomized, controlled trial.

SETTING

Laboratory.

PARTICIPANTS

Thirty-seven healthy men.

INTERVENTION

The right or left leg of each participant was randomly assigned to the massage group, and the other leg was assigned to the control group. The participants conducted self-massage at the musculotendinous junction for 3 min daily, five times per week, for 12 weeks.

MAIN OUTCOME MEASURES

Hamstring extensibility, stiffness, stretch tolerance, and structural indices were measured by a blinded examiner prior to the massage intervention and after 6 and 12 weeks of intervention.

RESULTS

The maximum hip flexion angle (HFA) and the maximum passive pressure after 6 and 12 weeks of intervention in the massage group were significantly higher than prior to intervention. The visual analog scale (for pain perception) at maximum HFA, the stiffness of the hamstring, and the structural indices did not differ in either group over the 12 week period.

CONCLUSIONS

Our results suggest that long-term self-massage at the musculotendinous junction increases hamstring extensibility by improving stretch tolerance. However, this intervention does not change hamstring stiffness.

CLINICAL TRIAL REGISTRATION NUMBER

University Hospital Medical Information Network registration number UMIN000011233.

In vivo passive mechanical properties estimation of Achilles tendon using ultrasound

A methodology is proposed for estimating Achilles tendon tangent modulus in vivo, to account for its large deformations and non-linear behavior. True stress is found dividing the axial force by the tendon true cross-sectional area (CSA), whose shrinking caused by axial tension is estimated with Poisson׳s coefficient. The true strain is calculated as the integral of incremental deformations along the tendon length change. Triceps surae tendon CSA and ankle moment arm, with the foot at relaxed equilibrium position, are estimated from subject-personalized data. Healthy males (N=19) volunteered for the study. The test consisted of passive ankle mobilization at the dynamometer with 5°/s velocity, from 30° of plantar flexion to the limit of dorsiflexion. Ultrasound was used to track myotendinous junction (MTJ) and tendon elongation, with the probe oriented over the medial gastrocnemius. Non-linear tendon stiffness pattern was observed during the joint range of motion, reaching 200N/mm peaks for the subjects with greater amplitudes of maximum dorsiflexion. The maximum values of modulus of elasticity, calculated from usual engineering stress and strain, (188.56±99.19MPa) were smaller than those reported in the literature for active maximum voluntary contractions tests. Maximum values for tangent modulus from true stress and strain were 312.38±171.95MPa. Such differences are likely to increase in large deformations.

Assessment of muscle architecture of the biceps femoris and vastus lateralis by ultrasound after a chronic stretching program

OBJECTIVE

To evaluate the chronic effects of a static stretching program on the muscle architecture of biceps femoris (BF) and vastus lateralis (VL) muscles in ultrasound (US) images.

DESIGN

Randomized controlled longitudinal trial.

SETTING

Biomechanics Laboratory of Physical Education School of the Army, Rio de Janeiro, Brazil.

PARTICIPANTS

The study included 24 healthy and physically active male volunteers (19.05 ± 1.40 years, 1.73 ± 0.07 m, and 73.15 ± 8.33 kg), randomly allocated to 1 of 2 groups: stretching group (SG, n = 12) and control group (n = 12).

INTERVENTIONS

The SG was submitted to 3 sets of 30 seconds of static stretching 3 times a week during 8 weeks.

MAIN OUTCOME MEASURES

Ultrasound equipment (7.5 MHz) was used for the evaluation of BF and VL muscle architecture variables (pennation angle, fiber length, muscle thickness, and fascicle displacement) before and after training. Knee range of motion (ROM) and isometric flexion and extension torque (TQ) were also measured.

RESULTS

There were no significant changes in muscle architecture, TQ, and maximum knee flexion angle (P > 0.05). However, maximum knee extension angle (MEA) increased significantly in the SG (pretraining: 159.37 ± 7.27 degrees and posttraining: 168.9 ± 3.7 degrees; P < 0.05).

CONCLUSIONS

Volume or intensity (or both) of the stretching protocol was insufficient to cause structural changes in the VL and BF muscles. The increase in MEA could not be explained by muscle architecture changes.

CLINICAL RELEVANCE

To describe changes in the VL and BF muscle tendon unit using US after a long-term stretching program to identify which structures are responsible for ROM increase.

Contributions of biarticular myogenic components to the limitation of the range of motion after immobilization of rat knee joint

BACKGROUND

Muscle atrophy caused by immobilization in the shortened position is characterized by a decrease in the size or cross-sectional area (CSA) of myofibers and decreased muscle length. Few studies have addressed the relationship between limitation of the range of motion (ROM) and the changes in CSA specifically in biarticular muscles after atrophy because of immobilization. We aimed to determine the contribution of 2 distinct muscle groups, the biarticular muscles of the post thigh (PT) and those of the post leg (PL), to the limitation of ROM as well as changes in the myofiber CSAs after joint immobilization surgery.

METHODS

Male Wistar rats (n = 40) were randomly divided into experimental and control groups. In the experimental group, the left knee was surgically immobilized by external fixation for 1, 2, 4, 8, or 16 weeks (n = 5 each) and sham surgery was performed on the right knee. The rats in the control groups (n = 3 per time point) did not undergo surgery. After the indicated immobilization periods, myotomy of the PT or PL biarticular muscles was performed and the ROM was measured. The hamstrings and gastrocnemius muscles from the animals operated for 1 or 16 weeks were subjected to morphological analysis.

RESULTS

In immobilized knees, the relative contribution of the PT biarticular myogenic components to the total restriction reached 80% throughout the first 4 weeks and decreased thereafter. The relative contribution of the PL biarticular myogenic components remained <20% throughout the immobilization period. The ratio of the myofiber CSA of the immobilized to that of the sham-operated knees was significantly lower at 16 weeks after surgery than at 1 week after surgery only in the hamstrings.

CONCLUSIONS

The relative contribution of the PT and PL components to myogenic contracture did not significantly change during the experimental period. However, the ratio of hamstrings CSAs to the sham side was larger than the ratio of medial gastrocnemius CSAs to the sham side after complete atrophy because of immobilization.

Acute effects of short and long duration dynamic stretching protocols on muscle strength

Objective Compare the acute effects of dynamic stretching protocols on the isokinetic performance of the quadriceps and hamstring muscles at two velocities in adult males.Methodology Included the participation of 14 males (21 ± 2.6 years; 178 ± 0.4 cm; 73.2 ± 20.9 kg) were assessed using an isokinetic dynamometer before and after following a short or long-duration dynamic stretching protocol or a control protocol. The results were assessed by a two-way ANOVA and a Scheffé’s post hoc test at a 5% significance level.Results No difference was found in the variables assessed at 180°/s after LDDS. At 60°/s, LDDS reduced the power of the knee flexors. The control protocol reduced the power of the knee flexors and increased the power of the extensors. At 60°/s, the work of the knee flexors exhibited a reduction after LDDS. The control protocol resulted in a reduction in the work of the flexors. The peak torque angle exhibited a reduction in the extensors and flexors after LDDS and SDDS.Conclusion Dynamic stretching did not cause any change in the peak torque, which points to its possible use in activities involving velocity and muscle strength. The executing dynamic stretching before physical activities such as running and high-intensity sports might be beneficial by promoting increases in heart rate and in body temperature.

Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis

BACKGROUND

Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta-analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations.

METHODS

Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclusion if they assessed the effect of a non-surgical intervention on ankle joint dorsiflexion in healthy populations. Studies were quality rated using a standard quality assessment scale. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and results were pooled where study methods were homogenous.

RESULTS

Twenty-three studies met eligibility criteria, with a total of 734 study participants. Results suggest that there is some evidence to support the efficacy of static stretching alone (SMDs: range 0.70 to 1.69) and static stretching in combination with ultrasound (SMDs: range 0.91 to 0.95), diathermy (SMD 1.12), diathermy and ice (SMD 1.16), heel raise exercises (SMDs: range 0.70 to 0.77), superficial moist heat (SMDs: range 0.65 to 0.84) and warm up (SMD 0.87) in improving ankle joint dorsiflexion ROM.

CONCLUSIONS

Some evidence exists to support the efficacy of stretching alone and stretching in combination with other therapies in increasing ankle joint ROM in healthy individuals. There is a paucity of quality evidence to support the efficacy of other non-surgical interventions, thus further research in this area is warranted.

The effects of dynamic stretching on the passive properties of the muscle-tendon unit

The purpose of this study was to examine the effects of dynamic stretching on the passive biomechanical properties and isometric muscle strength of the knee flexors. Fourteen healthy men (mean ± s: age = 24 ± 3 years) performed passive range of motion assessments and isometric maximal voluntary contractions of the knee flexors at knee joint angles of 35°, 50°, 65°, 80°, and 95° below full knee extension before and after dynamic stretching. In addition, electromyographic amplitude was recorded from the biceps femoris during the maximal voluntary contractions. Passive stiffness and passive resistive torque were measured during pre- and post-dynamic stretching. The dynamic stretching included the participant extending their right leg outwards to the end range motion and pulling their leg back towards the body while seated in the isokinetic dynamometer for four 30-s bouts with 20-s rest between bouts. Passive range of motion increased while passive stiffness and passive resistive torque decreased following dynamic stretching. Peak torque decreased at knee joint angles of 65° and 80° below full extension, while electromyographic amplitude decreased following dynamic stretching. Dynamic stretching resulted in changes to passive stiffness and passive resistive torque that are typically reported following static stretching, however, there were decreases in peak torque at two of the knee joint angles.