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USATF: don't change your pre-run stretch.

Last August, USA Track & Field (USATF) released the results of its massive study on pre-run stretching. The clinical trial involved almost 3,000 teenaged and older runners, and sought to determine the effect of pre-run stretching on running injuries. The purpose was to examine specifically if pre-run stretching of the three major leg muscle groups is beneficial for overall injury prevention or reduction.

Many studies have been conducted to understand the impact of stretching or warm-ups on the risk of injury, but with conflicting results. A broad review of "stretching" in the literature has not conclusively determined whether a pre-run static stretch protects runners from injury during their routine training.

The USATF study randomly assigned people to perform a specified pre-run stretching routine or to perform no pre-run stretching for a period of three months.

The researchers found that there was no difference in the risk of injury for those who stretched before running and those who did not. Those who completed the study and complied with their group had the same risk of injury (16%) regardless of which group they were in. Overall, stretching did not provide protection against injury.

Participants supplied information on age, gender, ordinary stretching regimen, miles run per week, number of years running, warm-up activities, measurements of flexibility, concurrent diseases and medications, level of competition, and more.

Study manager Alan Roth, PhD, said, "For the specified pre-run stretching routine that millions of runners commonly use, the study puts to rest claims for and against it, but the devil is in the details."

By this Roth means that several subsets of risk factors emerged within the basic finding that pre-run stretching isn't particularly useful. For example, in a twist that startled researchers, an additional risk factor was identified for people who normally stretch before they run. If they were assigned to stretch, they had a low risk of injury--but if they were assigned not to stretch, the injury risk was double those who kept stretching.

It might be this result that best illustrates why people consider pre-run stretching to prevent injury, despite a lack of consistent evidence for it. The present trial seems to indicate that those who are comfortable with their pre-run stretching routine should maintain it, as they may well risk injury if they discontinue it. Yet for runners comfortable without pre-run stretching, there aren't improvements in injury protection by starting a pre-run routine. To be clear: if you've been performing pre-run stretching, it's probably best to keep doing it.

Two additional variables found to significantly increase injury risk were people with a higher BMI, and people with a recent or chronic injury prior to participating in the study. (Participation was limited to runners who had no injuries for the six weeks prior to the study.)

Darby Thompson, the study statistician, commented, "We have shown that the difference in injury rates between those performing pre-run stretching and those who did not is negligible. Although we identified other very important risk factors [weight, prior injury, stopping a stretching routine], because this study was specifically investigating the effect of pre-run stretching, other risk factors may influence injury rates, but were not identified. More studies like this one should be conducted to confirm or refute the importance of other risk factors."

Certain variables that were expected to strongly influence injury rates didn't. For example, differences in mileage, flexibility or level of competition did not appear relevant. And in general, teenaged runners fared no better than older runners.

Roth says, "There is still a lot more information to present. For example, we have data on warming up, flexibility, post-run stretching, types of injuries, level of competition and more, which are correlated with injury risk.

In a future issue, we'll look at other specific analyses of the study's abundant data. As ARA/AMAA project consultant Barbara Baldwin, MPH, notes, "It would be interesting to run numbers on those runners who warmed up--no pre-run stretching--and then did post-run stretching instead." Many sports medicine professionals, including several Running & FitNews[R] editorial board members, are big proponents of pre-activity muscle preparation, but not necessarily pre-activity stretching, to reduce injury risk.

USATF, "A Large, Randomized, Prospective Study of the Impact of a Pre-Run Stretch on the Risk of Injury in Teenage and Older Runners," August 2010,

USATF Stretch Study, August 2010,

USATF Stretch Study Results, August 2010, http://www.usatforg/news/view.aspx?DUID=USATF_2010_08_20_12_13_14

USATF Pre-Run Stretch Study Protocol, August 2010,
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Title Annotation:USA Track and Field
Publication:Running & FitNews
Geographic Code:1USA
Date:Nov 1, 2010
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