Review

Does pre-exercise static stretching inhibit maximal muscularperformance? A meta-analytical review

L. Simic1, N. Sarabon2, G. Markovic1

1Motor Control and Human Performance Laboratory, School of Kinesiology, University of Zagreb, Zagreb, Croatia, 2Institute forKinesiology Research, University of Primorska, Science and Research Center, Koper, SloveniaCorresponding author: Goran Markovic, Motor Control and Human Performance Laboratory, School of Kinesiology, University ofZagreb, Horvacanski zavoj 15, 10000 Zagreb, Croatia. Tel: +385 1 3658 606, Fax: +385 1 3634 146, E-mail: gmarkov@kif.hr

Accepted for publication 3 January 2012

We applied a meta-analytical approach to derive a robustestimate of the acute effects of pre-exercise static stretch-ing (SS) on strength, power, and explosive muscular per-formance. A computerized search of articles publishedbetween 1966 and December 2010 was performed usingPubMed, SCOPUS, and Web of Science databases. Atotal of 104 studies yielding 61 data points for strength, 12data points for power, and 57 data points for explosiveperformance met our inclusion criteria. The pooled esti-mate of the acute effects of SS on strength, power, andexplosive performance, expressed in standardized units aswell as in percentages, were -0.10 [95% confidence inter-

val (CI): -0.15 to -0.04], -0.04 (95% CI: -0.16 to 0.08),and -0.03 (95% CI: -0.07 to 0.01), or -5.4% (95% CI:-6.6% to -4.2%), -1.9% (95% CI: -4.0% to 0.2%), and-2.0% (95% CI: -2.8% to -1.3%). These effects were notrelated to subject’s age, gender, or fitness level; however,they were more pronounced in isometric vs dynamic tests,and were related to the total duration of stretch, withthe smallest negative acute effects being observed withstretch duration of �45 s. We conclude that the usage ofSS as the sole activity during warm-up routine shouldgenerally be avoided.

Static stretching (SS) is commonly performed prior toexercise (ACSM, 2000) and athletic events (Beaulieu,1981; Holcomb, 2000). It is generally believed that pre-exercise SS will promote better performances and reducethe risk of injury during exercise (Shellock & Prentice,1985; Smith, 1994). However, recent reviews have sug-gested that pre-exercise SS might reduce the incidenceof some (e.g., muscle strains) (McHugh & Cosgrave,2010), but not all injuries (Herbert & Gabriel, 2002;Thacker et al., 2004), and that it may actually reduceperformance (Shrier, 2004; Rubini et al., 2007; McHugh& Cosgrave, 2010; Behm & Chaouachi, 2011). Moreimportantly, stretch-induced reductions in performanceare particularly evident in maximal and explosive mus-cular efforts that play an essential role in a number ofindividual and team sports (Markovic & Mikulic, 2010;Cormie et al., 2011). These results have already made animpact on sports and exercise professionals who nowstart to recommend avoidance of SS during warm-up forsport and exercise (Pearson, 2001; Young & Behm,2002; Knudson, 2007).

Despite an increasing number of studies that demon-strated an acute reduction in muscular performance fol-lowing SS (for recent reviews, see Magnusson &Renstrom, 2006; Rubini et al., 2007; McHugh & Cos-grave, 2010; Behm & Chaouachi, 2011), it has to be

acknowledged that many studies reported no reductionin strength, power, or explosive muscular performancefollowing SS (Bazett-Jones et al., 2005; Burkett et al.,2005; Cramer et al., 2005, 2007b; Unick et al., 2005;Little & Williams, 2006; McMillian et al., 2006;O’Connor et al., 2006; Maisetti et al., 2007; Kinseret al., 2008; Torres et al., 2008; Wallmann et al., 2008;Di Cagno et al., 2010; Haag et al., 2010; Handrakiset al., 2010; Molacek et al., 2010; Murphy et al., 2010),while some of them even reported improvement in per-formance (O’Connor et al., 2006; Gonzalez-Rave et al.,2009; Haag et al., 2010). Moreover, we still do not knowa precise magnitude of stretch-induced acute changes inmuscular performance. Finally, the total duration ofmuscle stretching in most studies in this area was muchlonger than the ranges normally used in practice andrecommended in literature, i.e., 15–30 s per musclegroup (Rubini et al., 2007; Young, 2007). Given thewidespread use of SS in exercise and rehabilitation set-tings, it is of both scientific and practical relevance todetermine a precise estimate of acute effects of SS onmuscle function and exercise performance.

While two narrative reviews (McHugh & Cosgrave,2010; Behm & Chaouachi, 2011) and one systematicreview (Kay & Blazevich, 2011) have been recently pub-lished on this topic and reported average effects of acute

Scand J Med Sci Sports 2012: ••: ••–••doi: 10.1111/j.1600-0838.2012.01444.x

© 2012 John Wiley & Sons A/S

1

SS on various performance measures, none of thosestudies actually used an appropriate statistical tool forcombining and analyzing individual study findings in aquantitative manner. Thus, the precise magnitude ofstretch-induced acute changes in muscular performanceis still unknown. In the present study, we applied a meta-analytical approach to derive a robust estimate of theacute effects of SS on muscle strength, power, and explo-sive muscular performance. We also seek to understandwhether these effects (a) were specific with respect to thesubject characteristics (age, gender, and training status)and type of performance test, and (b) depend on the totalduration of SS per muscle group.

MethodsLiterature search and study selection

Searches of PubMed, SCOPUS, and Web of Science were per-formed for studies published in English up to and includingDecember 2010. We used the following search phase (static stretchOR static stretching OR acute stretch OR acute stretching ORpassive stretch OR warm-up) AND (strength OR force OR torqueOR jump OR sprint OR throw OR performance). Reference lists inreview and original research articles identified were also exam-ined. The present meta-analysis includes studies published in jour-nals that have presented original research data on healthy humansubjects. No age or gender restrictions were imposed at the searchstage. Abstracts and unpublished theses/dissertations wereexcluded from this analysis due to lack of methodological details.Inclusion criteria applied in this study were as follows: (a) crosso-ver, randomized, and non-randomized control trials; (b) studiesthat evaluated acute effects of SS on human muscular strength,power, and explosive muscular performance; (c) studies in whichSS lasted not longer than 30 min; and (d) English language studiespublished in peer-reviewed journals. Our search strategy retrieved1168 hits in PubMed, 285 hits in SCOPUS, and 216 hits in Web ofScience. Studies that examined the acute effects of SS on otherfitness qualities (e.g., muscular or cardiorespiratory endurance,flexibility, agility, balance, repeated-sprint ability, etc.; Zakaset al., 2003, 2006c, e; Knudson et al., 2004; Young et al., 2004;Nelson et al., 2005b; Beckett et al., 2009; Sim et al., 2009; Costaet al., 2009a; Amiri-Khorasani et al., 2010; Covert et al., 2010;Samogin Lopes et al., 2010; Wilson et al., 2010) were not includedin this meta-analytical review. Also, due to significant contralateraleffect of acute SS (Cramer et al., 2005), studies that used thecontralateral (unstretched) limb as a control were not considered inthis meta-analytical review. A total of 115 articles that studied theacute effects of SS (either active or passive) on maximal musclestrength [one repetition maximum (1 RM), isometric or isokineticforce or torque], muscle power, and explosive muscular perform-ance [rate of force or torque development (RFD), jumping, sprint-ing, and throwing performance] was identified. Note that weexcluded from this list several potentially relevant studies on thegrounds of having no control (i.e., prestretch) condition (Faigen-baum et al., 2005, 2006a, b; Thompsen et al., 2007; Taylor et al.,2009). Furthermore, some studies were excluded as they combinedSS with dynamic stretching (Fletcher & Anness, 2007; Sim et al.,2009; Taylor et al., 2009). Finally, some studies were excludedbecause SS lasted more than 30 min (Avela et al., 1999, 2004), orbecause they combined stretching and maximal voluntary contrac-tions (Kay & Blazevich, 2009a, 2010). Note also that numerousstudies met our inclusion criteria but failed to report all or some ofthe results in numerical format (Kokkonen et al., 1998; Fowleset al., 2000; Behm et al., 2001, 2004, 2006; Cornwell et al., 2001,2002; Nelson et al. 2001a, b; Siatras et al., 2003, 2008; Power

et al., 2004; Papadopoulos et al., 2005; Knudson & Noffal, 2005;Wallmann et al., 2005, 2008; Little & Williams, 2006; O’Connoret al., 2006; Behm & Kibele, 2007; Ogura et al., 2007; Bradleyet al., 2007; Maisetti et al., 2007; Herda et al., 2008, 2009, 2010;Holt & Lambourne, 2008; Samuel et al., 2008; Bacurau et al.,2009; Hough et al., 2009; Kay & Blazevich, 2009a; Pearce et al.,2009). In these cases, a personal contact was made with theauthors to retrieve appropriate information. However, severalauthors did not respond to our request; therefore, we manuallycalculated the results from the figures (in combination with datafrom articles). Only one study was partly excluded (i.e., for oneprimary outcome) for poor reporting of data (Winke et al., 2010).Thus, altogether, 104 studies met our inclusion criteria and wereincluded in this meta-analytical review.

Assessment of study quality

Methodological quality was assessed with the PEDro scale (Maheret al., 2003). The quality of the included studies was assessedindependently by two assessors, and disagreements were resolvedby a third independent assessor.

Coding and classifying variables

Each study that met our inclusion criteria was recorded on acoding sheet. The major categories coded included (a) study char-acteristics; (b) subject characteristics; (c) intervention characteris-tics; and (d) primary outcome characteristics. The studycharacteristics that were coded included author(s) name, journal,year of publication, and the number of subjects. Subject charac-teristics that were coded included age, gender, and fitness level.Gender was coded as a variable representing the proportion of menin the sample (e.g., 1 for all men; 0.5 for five women and five men;and 0 for all women). Fitness level was coded as “non-athletes”(physically inactive persons and recreationally trained individuals)and “athletes” (competitive level). Intervention characteristics thatwere coded included stretched muscles and total duration ofstretching per muscle group per limb. Note that in several cases,the total duration of SS per muscle group per limb was not explic-itly defined; in these cases, we calculated it from the available data(i.e., total duration of SS, number of sets, and/or exercises). Fur-thermore, in several cases, researchers applied different number ofstretching exercises per selected muscle groups. This resulted inlarge variation in mean duration of SS per muscle group. In thesecases, we reported mean duration of SS of primary musclegroup(s) (with respect to primary outcome), together with therespective range of duration of SS per muscle group per limb.Finally, primary outcome characteristics that were coded includedtype of exercise test applied for the assessment of maximal musclestrength (1RM, isometric peak force/torque, or isokinetic peaktorque), muscle power (mean or peak power), and explosive mus-cular performance (RFD, jumping, sprinting, or throwing perform-ance). Note that many of the included studies applied a one-grouprepeated-measure design (i.e., no stretch and SS condition).Although it is possible to perform a meta-analysis on studies thatapplied different study designs (i.e., independent groups vsmatched groups; Borenstein et al., 2009), we decided to treat eachstudy included in this meta-analysis as a one-group pre-/posttestintervention (Peterson et al., 2010). Therefore, coding of perform-ance change was only carried out for groups receiving the SStreatment. Specifically, for all studies, means and standard devia-tion (SD) for pre- and poststretching condition were extracted. Incases where the author(s) measured >1 poststretching condition(i.e., time course of changes in performance after static stretching;e.g., Fowles et al., 2000; Brandenburg et al., 2007), only the firstpoststretching condition was considered.

Simic et al.

2

Data extraction and data analyses

Given that each treatment group was considered a one-group pre-/posttest intervention, the study estimate for the acute effect of SSon muscle strength, muscle power, and explosive muscular per-formance is given by the difference between the post- and pre-stretching results in primary outcomes divided by a within-groupSD (SDwithin; Borenstein et al., 2009), i.e., the standardized meandifference d. The within-group SD (SDwithin) was obtained usingthe following formula:

SDS

rwithin

diff=× −( )2 1

where Sdiff is the standard deviation of the difference scores and ris the correlation between pairs of observation (i.e., the pretest–posttest correlation of performance measures). Note that many ofthe studies did not report Sdiff. Rather, the majority of studiesobtained for this analysis included the SDs for the pre- and post-stretching performance outcomes, or sometimes the standarderrors of the mean. For all other studies, Sdiff was calculated usingthe pre- and poststretching SDs, as well as pretest–posttest corre-lation of performance measures r using the following equation(Follmann et al., 1992; Peterson et al., 2010):

SD SD SD r SD SDdiff pre post pre post= + − × × ×[ ]2 2 2

For the purpose of this meta-analysis, pretest–posttest corre-lation of performance measures r was 0.9. Note that changing rto 0.8 or to 0.7 had a little effect on pooled estimates and wouldnot change the main conclusion of this meta-analytical review.The standard error (SEd) of d is given by (Borenstein et al.,2009):

SEn

d

nrd = +

×⎛⎝⎜

⎞⎠⎟

× × −( )1

22 1

2

where n is the number of pairs.We also expressed the study estimates relative to the pre-

stretching mean value, that is, in percentage values. Percentageeffects were converted to factors (= 1 + effect/100), log trans-formed for the analysis, and then back transformed to percent-ages (Bonetti & Hopkins, 2009). In this case, the standard error(SEd) of d was approximated by the following equation (Petersonet al., 2010):

SER CV CV r CV CV

nd =

× + − × × ×[ ]pre post pre post2 2 2

where R represents the ratio of post- and prestretch performancemeasures, CV denotes the coefficient of variation equaling theratio of SD and mean at the respective time (i.e., pre- and post-stretching), r is pretest–posttest correlation of performance meas-ures, and n represents the number of participants.

A random-effects model was chosen for meta-analysis toaccount for heterogeneity in effect d among trials. The weightfactor by which the study estimates were weighted was

12 2SEd + τ

where t is the between-study variation (Borenstein et al., 2009).Separate meta-analyses were performed for maximum musclestrength (peak isometric force or torque, 1RM, concentric oreccentric isokinetic peak torque), muscle power (mean and peakpower), and explosive muscular performance (RFD, jumping per-formance, sprinting performance, and throwing performance).Furthermore, within the maximal muscle strength and explosivemuscular performance category, separate meta-analyses were per-

formed for isometric vs dynamic maximal strength, and for rate offorce/torque development vs jumping performance (vertical jumpheight and horizontal jump distance) vs sprinting performance(sprint velocity or sprint time over distances between 5 and 100 m)vs throwing performance (throwing velocity or throwing distance).Note that a number of studies reported >1 primary outcome owingto >1 performance test measured. In cases where multiple out-comes belonged to the same performance category being meta-analyzed, we computed the composite effect and the respective SEaccording to Borenstein et al. (2009). For all pooled estimates, wecalculated the 95% confidence intervals (95% CI), and we madeprobabilistic magnitude-based inferences about the true values ofthe effects, as suggested by Hopkins and co-workers (Batterham &Hopkins, 2006; Bonetti & Hopkins, 2009; Hopkins et al., 2009).An effect was deemed unclear if its 95% CI overlapped the thresh-olds for smallest positive and negative effects; equivalently, theeffect was unclear if chances of the true value being substantiallypositive and negative were both >5% (Batterham & Hopkins,2006). The probabilities for each meta-analyzed effect werederived using a published spreadsheet (Hopkins, 2007). An esti-mate of the smallest substantial change in performance is requiredto make these inferences. Based on variability in competitive ath-letic performance reported by Hopkins and co-workers (Hopkins,2004, 2005; Bonetti & Hopkins, 2010; Smith & Hopkins, 2011),we defined the threshold change in performance for benefit andharm for field-based explosive performance tests (i.e., jumping,sprinting, and throwing performance) and muscle power as 1%.For strength performance [i.e., maximal muscle strength andRFD], the corresponding threshold change were derived from thewithin-individual variability in strength performance, expressed ascoefficient of variation. The within-individual variation in musclestrength and RFD varies considerably due to the well-knownfactors like type of test, type and velocity of contraction, musclegroup being tested, subject’s characteristics, etc. (Abernethy et al.,1995; Wilson & Murphy, 1996). However, it usually rangesbetween 3% and 15%. If we conservatively take 3% as a typicalwithin-individual variation in strength performance, we mayapproximate the smallest substantial change by multiplying thisvalue with the factor of 1.5 or 2 (Hopkins, 2000). We thereforedefined this threshold change as 5%.

Heterogeneity of effects for each meta-analysis was assessedusing the quantity I2, as suggested by Higgins and co-workers(Higgins et al., 2003). In brief, I2 was calculated as follows:I2 = 100% · (Q – d.f.)/Q, where Q is Cochran’s c2 heterogeneitystatistic and d.f. is the degrees of freedom. The Cochran’s Q iscalculated by summing the squared deviations of each trial’s esti-mate from the overall meta-analytical estimate. I2 describes thepercentage of variability in point estimates which is due to hetero-geneity rather than sampling error. I2 values of 25%, 50%, and75% represent low, moderate, and high statistical heterogeneity,respectively (Higgins et al., 2003).

Publication bias, as well as evidence of outliers, was examinedby funnel plots of standard errors of the estimate of the acute effectvs calculated study estimates d. In addition, publication bias wasalso statistically evaluated by calculating rank correlationsbetween effect estimates and their standard errors (i.e., Kendall’st statistic; Begg & Mazumdar, 1994). A significant result wasconsidered to be suggestive of publication bias.

Subgroup analyses for each primary outcome included sub-ject’s training status (athletes vs non-athletes), SS categoriesformed according to stretch duration per muscle (�45 s vs 46 s to90 s vs >90 s), and type of muscular performance test (isometric vsdynamic test for maximal muscle strength; RFD vs jumping per-formance vs sprinting performance vs throwing performance forexplosive muscular performance), and were performed using aQ-test based on analysis of variance (Borenstein et al., 2009). Incases where the total duration of stretching was different amongstretched muscle groups, the average stretch duration was used in

Acute static stretching and performance

3

further analyses. Similarly, for studies that reported acute effectsof SS of different durations on a particular primary outcome (e.g.,Zakas et al. 2006a; Zakas et al. 2006b; Zakas et al. 2006d; Oguraet al., 2007; Kay & Blazevich, 2008; Ryan et al. 2008b; Winches-ter et al., 2009), along with calculation of the composite effect (seeprevious text), we averaged the total duration of stretching permuscle group. Meta-regression was used for analyzing the rela-tionship between study estimates and the selected subject or train-ing characteristics: subject’s age, gender, and total duration ofstretching per muscle (Borenstein et al., 2009). The level of sig-nificance was set to P < 0.05.

ResultsDescriptive statistics

Altogether, 104 published investigations were includedin the meta-analyses, giving 61 study estimates formaximal muscle strength, 12 study estimates for musclepower, and 57 study estimates for explosive muscularperformance. Tables 1–3 summarize the characteristicsof the included studies. Altogether, 962 subjects (593males and 369 females) were included in the meta-analysis of maximal muscle strength, 195 subjects (125males and 70 females) were included in the meta-analysis of muscle power, and 1072 subjects (719 malesand 353 females) were included in the meta-analysis ofexplosive muscular performance. The average durationof pre-exercise SS per muscle group per limb formaximal muscle strength, muscle power, and explosivemuscular performance tests was 314, 255, and 86 s,respectively.

Methodological quality of included studies

The range of quality scores was 2–5 (median 4) out of10. Often a report did not clearly specify that a criterionwas met, and, consequently, we scored the study as notsatisfying the criterion. Note that all studies failed tosatisfy the following five methodological criteria: treat-ment allocation concealment, blinding of all subjects,blinding of all therapists, blinding of all assessors, andintention to treat analyses (i.e., items 3, 5, 6, 7, and 9,respectively).

Primary outcomes

Tables 1–3 report individual changes in the primary out-comes and summarize the pooled estimates of the acuteeffects of SS on maximal muscle strength, musclepower, and explosive muscular performance.

Maximal muscle strength

For the maximal muscle strength (i.e., peak force,torque, or 1RM), pooled estimate of the acute effect ofSS, expressed in standardized units, was d = -0.10(95% CI: -0.15 to -0.04). When expressed in percent-ages, the respective pooled estimate was -5.4% (95%CI: -6.6% to -4.2%), indicating a likely negative acute

effect. The statistical heterogeneity of the acute effectof SS on muscle strength was low (I2 = 5%). Theinspection of the funnel plot as well as Kendall’s t sta-tistic (r = -0.11; P = 0.20) suggests no presence of pub-lication bias in maximal muscle strength tests. Notably,one study could be defined as outlying (Behm et al.,2001); however, its exclusion from the meta-analysisdid not affect the pooled estimate. Subgroup analysesshowed similar acute effect of SS on maximal musclestrength in both athletes and non-athletes (P = 0.97).With respect to the type of test applied, significantlylarger (P = 0.012) pooled negative acute effect of SSwas observed for isometric vs dynamic strength tests(Fig. 1(a)), although the average stretch duration permuscle group did not differ significantly between thetwo groups of tests (333 s vs 290 s; P > 0.05). Specifi-cally, pooled estimates for the acute effect of SS onisometric and dynamic strength tests were -6.5% (95%CI: -8.3% to -4.6%; almost certainly negative effect)and -3.9% (95% CI: -4.8% to -2.9%; most likelytrivial effect), respectively. With respect to the stretchduration, we observed a trend (P = 0.18) toward dimin-ishing the negative acute effect of SS on maximalmuscle strength with shorter stretch duration (Fig. 2(a)).In particular, pooled estimates for the acute effect of SSlasting �45 s, 46–90 s, and >90 s per muscle group onmaximal muscle strength were -3.2% (95% CI: -5.6%to -0.8%; most likely trivial effect), -5.6% (95% CI:-7.3% to -3.8%; likely negative effect), and -6.1%(95% CI: -7.9% to -4.3%; almost certainly negativeeffect), respectively.

Muscle power

Pooled estimate of the acute effect of SS on musclepower was d = -0.04 (95% CI: -0.16 to 0.08). Whenexpressed in percentages, the respective pooled estimatewas -1.9% (95% CI: -4.0% to 0.2%), indicating anunclear acute effect of SS on muscle power. We alsoobserved very low heterogeneity of acute effects of SSon muscle power (I2 = 3.6%). Note also that both funnelplot and Kendall’s t statistic (r = -0.36; P = 0.09)showed no evidence of publication bias in muscle powertests. Subgroup analyses showed similar acute effect ofSS on muscle power in both athletes and non-athletes(P = 0.7). Although limited by the number of studies,subgroup analysis related to stretch duration showed atrend (P = 0.10) toward reduction of the negative acuteeffect of SS on muscle power with shorter stretch dura-tion (Fig. 2(b)). Specifically, pooled estimates for theacute effect of SS lasting �45, 46–90, and >90 s permuscle group on muscle power were 0.4% (95% CI:-5.8% to 6.6%; an unclear effect), -1.7% (95% CI:-5.1% to 1.6%; possibly negative effect), and -3.3%(95% CI: -7.2% to 0.6%; a likely negative effect),respectively.

Simic et al.

4

Tabl

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size

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T(6

0/30

0°/s

)-0

.12

(0.2

0)-0

.51

to0.

27-3

.6(1

.0)

-5.5

to-1

.6Cr

amer

etal

.(20

06)*

23N-

A0/

1348

0KE

T(6

0/30

0°/s

)-0

.95

(0.9

4)-2

.79

to0.

89-2

.5(1

.5)

-5.4

to0.

3Cr

amer

etal

.(20

07b)

*23

.4N-

A8/

1048

0KE

T(-

60/-

180°

/s)

-0.0

3(0

.17)

-0.3

7to

0.31

-0.4

(2.5

)-5

.2to

4.4

Cram

eret

al.(

2007

b)*

21.5

N-A

7/14

480

KET

(60/

240°

/s)

-0.1

2(0

.20)

-0.5

1to

0.27

-3.5

(2.6

)-8

.5to

1.6

Egan

etal

.(20

06)*

20A

0/11

480

KET

(60/

300°

/s)

0.06

(0.2

4)-0

.42

to0.

541.

0(2

.7)

-4.4

to6.

3Ev

etov

ich

etal

.(20

10)

19.9

A0/

1548

0KE

T(6

0°/s

)-0

.24

(0.3

2)-0

.86

to0.

38-7

.1(2

.9)

-12.

8to

-1.4

Evet

ovic

het

al.(

2010

)21

A0/

1448

0KE

T(6

0°/s

)-0

.21

(0.2

6)-0

.73

to0.

31-5

.3(3

.6)

-12.

4to

1.9

Evet

ovic

het

al.(

2003

)*22

.7N-

A10

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0EF

T(3

0/27

0°/s

)-0

.14

(0.2

2)-0

.58

to0.

30-6

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1to

1.7

Flet

cher

and

Mon

te-C

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bo(2

010a

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21/0

30(3

0–60

)PF

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KF,H

E,HF

T(3

0°/s

)-0

.14

(0.1

7)-0

.48

to0.

20-3

.6(1

.8)

-7.2

to0.

0Fo

wle

set

al.(

2000

)21

N-A

8/4

1755

PFT

-1.2

7(1

.40)

-4.0

1to

1.47

-27.

7(3

.0)

-33.

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-21.

9Gu

rjao

etal

.(20

09)

64.6

N-A

0/23

90KE

,KF,

HET

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1(1

.99)

-5.2

1to

2.59

-7.6

(0.6

)-8

.7to

-6.6

Herd

aet

al.(

2010

)23

N-A

11/0

360

PFT

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0(0

.64)

-1.8

5to

0.65

-9.4

(2.1

)-1

3.5

to-5

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rda

etal

.(20

09)

24N-

A15

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00PF

T-0

.52

(0.6

4)-1

.77

to0.

73-1

0.2

(2.1

)-1

4.4

to-6

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rda

etal

.(20

08)*

25N-

A14

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15KF

T-0

.25

(0.3

0)-0

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to0.

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.5(2

.4)

-11.

2to

-1.8

Kay

and

Blaz

evic

h(2

008)

*25

.5N-

A4/

330

(5–6

0)PF

T(1

80°/

s)-0

.31

(0.2

6)-0

.83

to0.

21-7

.0(3

.1)

-13.

0to

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and

Blaz

evic

h(2

009b

)20

.2N-

A8/

718

0PF

T(5

°/s)

--

-5.0

(1.2

)-7

.3to

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Knud

son

and

Noffa

l(20

05)*

N/A

N-A

33/2

410

WF

F-0

.31

(0.4

1)-1

.12

to0.

50-8

.5(1

.45)

-11.

3to

-5.6

Kokk

onen

etal

.(19

98)*

22N-

A15

/15

90PF

,KE,

KF,H

F1R

M-0

.25

(0.4

4)-1

.1to

0.60

-7.9

(2.4

)-1

2.5

to-3

.3Ku

boet

al.(

2001

)25

.3N-

A7/

060

0PF

T-0

.17

(0.2

2)-0

.61

to0.

27-1

.9(1

.9)

-5.6

to1.

9

Acute static stretching and performance

5

Tabl

e1.

(con

tinue

d)

Stud

yAg

e(y

ears

)Fi

tnes

sle

vel

Sam

ple

size

M/F

Dura

tion

ofst

retc

h(s

)St

retc

hed

mus

cle

grou

psPe

rfor

man

cem

easu

reEf

fect

size

(SE)

95%

CI%

chan

ge(S

E)95

%CI

Mai

setti

etal

.(20

07)

25N-

A0/

1175

PFT

-0.5

4(0

.58)

-1.6

8to

0.60

-8.5

(2.0

)-1

2.3

to-4

.6M

arek

etal

.(20

05)*

23N-

A9/

1048

0KE

T(6

0/30

0°/s

)-0

.02

(0.1

0)-0

.22

to0.

18-0

.9(4

.3)

-9.3

to7.

4M

cBrid

eet

al.(

2007

)*21

.4N-

A8/

027

0KE

F-0

.50

(0.4

7)-1

.42

to0.

42-1

1.9

(3.5

)-1

8.7

to-5

.0M

olac

eket

al.(

2010

)*19

.9A

15/0

95(4

0–15

0)UB

1RM

-0.0

5(0

.14)

-0.3

3to

0.23

-0.6

(1.2

)-3

.0to

1.8

Nels

onet

al.(

2005

c)*

22N-

A18

/13

360

PF,K

E,KF

,HF

1RM

-0.1

4(0

.24)

-0.6

2to

0.34

-4.4

(2.4

)-9

.0to

0.3

Nels

onet

al.(

2001

a)*

22N-

A25

/30

480

KET

-0.0

3(0

.10)

-0.2

3to

0.17

-1.3

(1.9

)-5

.0to

2.4

Nels

onet

al.(

2001

b)*

24N-

A10

/590

KET

-0.3

9(0

.50)

-1.3

7to

0.59

-9.2

(2.4

)-1

3.9

to-4

.5Og

ura

etal

.(20

07)*

20A

10/0

30KF

F-0

.43

(0.4

5)-1

.31

to0.

45-5

.4(1

.6)

-8.5

to-2

.3Pa

pado

poul

oset

al.(

2005

)20

.7N-

A32

/018

0(9

0–18

0)KE

,KF

T(3

0°/s

)-0

.31

(0.4

2)- 1

.14

to0.

52-4

.5(0

.9)

-6.2

to-2

.8Pa

pado

poul

oset

al.(

2006

)19

.7N-

A10

/090

PF,K

E,KF

,HF

F-0

.03

(0.1

4)-0

.31

to0.

25-0

.8(3

.8)

-8.3

to6.

7Po

wer

etal

.(20

04)

32N-

A12

/027

0PF

,KE,

KFF

-0.4

9(0

.55)

-1.5

6to

0.58

-9.0

(2.5

)-1

3.9

to-4

.0Ry

anet

al.(

2008

b)*

22N-

A7/

612

0PF

T-0

.30

(0.3

3)-0

.95

to0.

35-4

.7(3

.2)

-10.

9to

1.6

Seki

ret

al.(

2010

)*20

A0/

1080

KE,K

FT

(60/

180°

/s)

-0.4

2(0

.32)

-1.0

4to

0.20

-9.8

(2.2

)-1

4.2

to-5

.4Si

atra

set

al.(

2008

)*22

.1N-

A20

/010

KET

0.06

(0.1

7)-0

.28

to0.

401.

4(1

.9)

-2.4

to5.

2Si

atra

set

al.(

2008

)*21

N-A

20/0

20KE

T-0

.14

(0.1

7)-0

.48

to0.

20-2

.9(2

.2)

-7.1

to1.

4Si

atra

set

al.(

2008

)*21

.1N-

A20

/030

KET

-0.7

1(0

.59)

-1.8

7to

0.45

-6.6

(1.2

)-8

.9to

-4.3

Siat

ras

etal

.(20

08)*

21.1

N-A

20/0

60KE

T-0

.82

(0.6

7)-2

.13

to0.

49-1

2.5

(1.8

)-1

6.0

to-8

.9Th

igpe

n(1

989)

*27

.3N-

A12

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90KF

T(6

0/15

0/24

0°/s

)-0

.01

(0.1

0)-0

.21

to0.

19-0

.2(1

.42)

-3.0

to2.

6To

rres

etal

.(20

08)

19.6

A11

/030

UBF

0.21

(0.2

6)-0

.31

to0.

733.

2(2

.2)

-1.0

to7.

5Vi

ale

etal

.(20

07)

23.1

N-A

7/1

390

KET

-0.4

6(0

.45)

- 1.3

4to

0.42

-8.0

(2.6

)-1

3.2

to-2

.9W

eir

etal

.(20

05)

23.1

N-A

0/15

600

PFT

-0.4

2(0

.53)

-1.4

6to

0.62

-7.1

(1.9

)-1

0.8

to-3

.3W

inch

este

ret

al.(

2009

)*22

.5N-

A10

/810

5(3

0–18

0)KF

1RM

-0.2

5(0

.26)

-0.7

7to

0.27

-8.9

(2.6

)-1

3.9

to-3

.8Ya

mag

uchi

etal

.(20

06)*

23.8

N-A

12/0

720

KE,H

FT

-0.0

2(0

.20)

-0.4

1to

0.37

-0.7

(1.4

)-3

.4to

2.1

Zaka

set

al.(

2006

b)*

18.5

A14

/017

2(4

5–30

0)KE

T(6

0/90

/150

/210

/270

°/s)

-0.3

1(0

.24)

-0.7

9to

0.17

-4.3

(1.3

)-6

.8to

-1.9

Zaka

set

al.(

2006

a)*

13A

16/0

60KE

T(3

0/60

/120

/180

/300

°/s)

-0.2

9(0

.30)

-0.8

8to

0.30

-4.2

(1.1

)-6

.5to

-2.0

Zaka

set

al.(

2006

d)*

25A

15/0

270

(30–

480)

KET

(60/

90/1

50/2

10/2

70°/

s)-0

.25

(0.2

6)-0

.77

to0.

27-3

.5(1

.2)

-5.9

to-1

.2Ov

eral

lmea

n(a

ll)22

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10/6

314

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to-4

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dyth

atre

porte

dm

ore

than

one

prim

ary

outc

ome.

A,at

hlet

es;N

-A,n

on-a

thle

tes;

PF,a

nkle

plan

tarfl

exor

s;KE

,kne

eex

tens

ors;

KF,k

nee

flexo

rs;H

E,hi

pex

tens

ors;

HF,h

ipfle

xors

;UB,

uppe

rbod

y;W

F,w

ristfl

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s;1

RM,o

nere

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ion

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imum

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peak

torq

ue;C

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nfide

nce

inte

rval

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stan

dard

erro

r.

Simic et al.

6

Explosive muscular performance

For all explosive muscular performance tests, pooledestimate of the acute effect of SS was d = -0.03 (95%CI: -0.07 to 0.01). When expressed in percentages, therespective pooled estimate was -2.0% (95% CI: -2.8%to -1.3%), indicating a very likely negative acute effectof SS on explosive muscular performance. We alsoobserved very low heterogeneity of acute effects of SSon muscle power (I2 = 1.7%). Kendall’s t statistic(r = -0.03; P = 0.71) suggests no presence of publica-tion bias in this performance category. However, a closeinspection of the funnel plot recognized one study thathad unrealistically large negative acute effect of SS onexplosive performance (d = -1.1; percent change =-38.4%; McBride et al., 2007). Although its exclusiondid not change the overall acute effect of SS on explosivemuscular performance, it did affect two subgroup meta-analyses (i.e., groups based on the type of test and stretchduration, respectively). We therefore removed that studyfrom those analyses. Subgroup analyses showed similaracute effect of SS on explosive muscular performance inboth athletes and non-athletes (P = 0.81). With respect tothe type of test applied, significant differences (P < 0.05)Ta

ble

2.Su

mm

ary

ofth

ein

vest

igat

ions

incl

uded

inth

em

eta-

anal

yses

ofac

ute

effe

cts

ofst

atic

stre

tchi

ngon

mus

cle

pow

er

Stud

yAg

e(y

ears

)Fi

tnes

sle

vel

Sam

ple

size

M/F

Dura

tion

ofst

retc

h(s

)St

retc

hed

mus

cle

grou

psPe

rfor

man

cem

easu

reEf

fect

size

(SE)

95%

CI%

chan

ge(S

E)95

%CI

Mus

cle

pow

erCh

aoua

chie

tal.

(201

0)*

20.6

A22

/060

PF,K

E,KF

,HE,

HFM

P0.

17(0

.27)

-0.3

5to

0.70

1.6

(0.9

)-0

.1to

3.3

Corn

wel

leta

l.(2

001)

*20

.6N-

A10

/090

KE,H

EPP

-0.1

8(0

.22)

-0.6

1to

0.26

-2.9

(2.2

)-7

.1to

1.4

Cram

eret

al.(

2007

b)*

23.4

N-A

15/0

480

KEM

P-0

.03

(0.1

7)-0

.36

to0.

30-0

.4(2

.5)

-5.2

to4.

4Cr

amer

etal

.(20

05)*

21.5

N-A

7/14

480

KEM

P-0

.12

(0.3

0)-0

.71

to0.

46-2

.7(3

.0)

-8.7

to3.

2Eg

anet

al.(

2006

)*20

.0A

0/11

480

KEM

P-0

.04

(0.2

2)-0

.46

to0.

380.

2(5

.0)

-9.6

to10

.1M

anoe

leta

l.(2

008)

*24

.0N-

A0/

1290

KEM

P-0

.13

(0.1

9)-0

.49

to0.

24-2

.9(2

.8)

-8.5

to2.

7M

arek

etal

.(20

05)*

22.0

N-A

9/10

480

KEM

P-0

.04

(0.1

1)-0

.26

to0.

19-1

.5(4

.0)

-9.3

to6.

23O’

Conn

oret

al.(

2006

)21

.4N-

A16

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30(2

0–40

)PF

,KE,

KF,H

E,HF

MP

0.13

(0.2

3)-0

.32

to0.

576.

1(4

.5)

-2.7

to14

.8Sa

mue

leta

l.(2

008)

22.0

N-A

12/1

290

KE,K

FM

P-1

.89

(2.9

3)-7

.63

to3.

85-3

.4(0

.2)

-3.7

to-3

.1To

rres

etal

.(20

08)

19.6

A11

/030

UBPP

0.14

(0.2

0)-0

.25

to0.

532.

2(2

.2)

-2.1

to6.

5Ya

mag

uchi

and

Ishi

i(20

05)

22.8

N-A

11/0

30PF

,KE,

KF,H

E,HF

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7(0

.31)

-0.8

9to

0.35

-5.1

(2.4

)-9

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Yam

aguc

hiet

al.(

2006

)*23

.8N-

A12

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0KE

,HF

PP-0

.44

(0.4

0)-1

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to0.

35-8

.2(1

.7)

-11.

6to

-4.8

Over

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ean

21.8

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5–

–-0

.04

(0.0

6)-0

.16

to0.

08-1

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.1)

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to0.

2

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dyth

atre

porte

dm

ore

than

one

prim

ary

outc

ome.

A,at

hlet

es;N

-A,n

on-a

thle

tes;

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nkle

plan

tarfl

exor

s;KE

,kne

eex

tens

ors;

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nee

flexo

rs;H

E,hi

pex

tens

ors;

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;UB,

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y.;M

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ean

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er;P

P,pe

akpo

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terv

al;S

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anda

rder

ror.

Fig. 1. Meta-analyzed acute effects of static stretching onmaximal muscle strength tests (a) and explosive muscular per-formance tests (b). ISOM, isometric muscle strength; DYN,dynamic muscle strength; RFD, rate of force or torque develop-ment; JUMP, jumping performance; SPRINT, sprinting per-formance; THROW, throwing performance.

Acute static stretching and performance

7

Tabl

e3.

Sum

mar

yof

the

inve

stig

atio

nsin

clud

edin

the

met

a-an

alys

esof

acut

eef

fect

sof

stat

icst

retc

hing

onex

plos

ive

mus

cula

rpe

rfor

man

ce

Stud

yAg

e(y

ears

)Fi

tnes

sle

vel

Sam

ple

size

M/F

Dura

tion

ofst

retc

h(s

)St

retc

hed

mus

cle

grou

psPe

rfor

man

cete

stEf

fect

size

(SE)

95%

CI%

chan

ge(S

E)95

%CI

Jum

pAl

lison

etal

.(20

08)

25.0

A10

/024

0(2

40–3

60)

PF,K

E,KF

,HF

CMJ

-0.5

0(0

.52)

-1.5

2to

0.52

-5.4

(1.5

)-8

.3to

-2.5

Behm

and

Kibe

le(2

007)

27.6

N-A

7/3

120

PF,K

E,KF

SJ,D

J,CM

J-0

.29

(0.2

4)-0

.76

to0.

19-4

.7(1

.7)

-8.0

to-1

.3Be

hmet

al.(

2006

)25

.0N-

A9/

990

PF,K

E,KF

DJ-0

.08

(0.1

5)-0

.36

to0.

21-2

.0(2

.7)

-7.3

to3.

3Be

hmet

al.(

2006

)21

.9N-

A12

/090

PF,K

E,KF

DJ,C

MJ

-0.0

2(0

.31)

-0.6

3to

0.60

1.1

(3.3

4)-5

.5to

7.8

Brad

ley

etal

.(20

07)

24.3

N-A

18/0

120

(120

–240

)PF

,KE,

KFCM

J,SJ

-0.1

2(0

.19)

-0.4

9to

0.26

-4.0

(3.3

)-1

0.6

to2.

6Br

ande

nbur

get

al.(

2007

)22

.3N-

A8/

890

PF,K

E,KF

CMJ

-0.1

5(0

.22)

-0.5

7to

0.28

-3.0

(2.2

)-7

.3to

1.4

Burk

ette

tal.

(200

5)20

.0A

29/0

60PF

,KE,

KF,H

E,HF

CMJ

0.08

(0.1

5)-0

.22

to0.

380.

7(0

.8)

-0.8

to2.

3Ch

aoua

chie

tal.

(201

0)*

20.6

A22

/060

PF,K

E,KF

,HE,

HFHJ

,CM

J0.

01(0

.11)

-0.2

0to

0.22

0.2

(0.7

)-1

.3to

1.6

Chur

chet

al.(

2001

)20

.3A

0/40

n-a

KE,K

F,HE

,HF

CMJ

-1.3

1(7

.73)

-16.

46to

13.8

3-1

.2(1

.1)

-3.5

to1.

0Co

rnw

elle

tal.

(200

1)*

20.6

N-A

10/0

90KE

,HE

CMJ,

SJ-0

.50

(0.5

1)-1

.49

to0.

49-4

.4(1

.2)

- 6.8

to-2

.0Co

rnw

elle

tal.

(200

2)*

22.5

N-A

10/0

180

PFCM

J,SJ

-0.1

5(0

.24)

-0.6

1to

0.31

-4.1

(4.0

)-1

1.9

to3.

8Cr

onin

etal

.(20

08)

22.7

A10

/090

KFCM

J0.

00(0

.14)

-0.2

8to

0.28

0.0

(3.9

)-7

.7to

7.7

Curr

yet

al.(

2009

)26

.0N-

A0/

2336

PF,K

E,KF

,HE,

HFCM

J-0

.18

(0.3

0)-0

.76

to0.

40-2

.9(1

.4)

-5.6

to-0

.1Da

lrym

ple

etal

.(20

10)

19.5

A0/

1245

PF,K

E,KF

,HE

CMJ

-0.2

0(0

.25)

-0.7

0to

0.30

-3.2

(2.1

)-7

.3to

0.8

DiCa

gno

etal

.(20

10)

14.1

A0/

3890

(90–

180)

PF,K

E,KF

SJ0.

00(0

.05)

-0.1

0to

0.10

0.0

(0.3

)-0

.5to

0.5

Flet

cher

and

Mon

te-C

olom

bo(2

010a

)20

.8A

21/0

30(3

0–60

)PF

,KE,

KF,H

E,HF

CMJ

-0.3

7(0

.52)

-1.3

9to

0.66

-4.3

(1.1

)-6

.4to

-2.2

Flet

cher

and

Mon

te-C

olom

bo(2

010b

)20

.5A

27/0

30(3

0–60

)PF

,KE,

KF,H

E,HF

CMJ

-0.3

8(0

.64)

-1.6

4to

0.87

-4.1

(0.9

)-5

.8to

-2.3

Gonz

alez

-Rav

eet

al.(

2009

)*21

.8N-

A8/

045

PF,K

E,KF

CMJ,

SJ0.

58(0

.41)

-0.2

2to

1.39

8.3

(1.7

)4.

9to

11.6

Hand

raki

set

al.(

2010

)*49

.9N-

A6/

490

PF,K

E,KF

,HE

HJ0.

00(0

.14)

-0.2

7to

0.26

-0.1

(1.9

)-3

.8to

3.6

Holt

and

Lam

bour

ne(2

008)

20.7

A64

/015

KE,K

F,HE,

HFCM

J0.

13(0

.20)

-0.2

6to

0.53

1.6

(1.4

)-1

.1to

4.3

Houg

het

al.(

2009

)21

.0A

11/0

30PF

,KE,

KF,H

E,HF

SJ-0

.25

(0.2

9)-0

.82

to0.

32-4

.3(2

.2)

-8.7

to0.

1Ki

nser

etal

.(20

08)*

11.3

A0/

840

HF,H

E,KF

CMJ,

SJ-0

.34

(0.3

4)-1

.00

to0.

32-6

.0(2

.4)

-10.

6to

-1.3

Knud

son

etal

.(20

01)

23.7

A10

/10

135

PF,K

E,KF

CMJ

- 0.3

0(0

.44)

-1.1

6to

0.56

-4.2

(1.4

)-7

.0to

-1.4

Koch

etal

.(20

03)

20.0

A16

/16

160

KE,K

FHJ

0.00

(0.0

8)-0

.15

to0.

150.

0(2

.1)

-4.1

to4.

1La

Torr

eet

al.(

2010

)*23

.0A

17/0

120

PF,K

ESJ

-0.2

2(0

.27)

-0.7

5to

0.31

-7.4

(2.3

)-1

2.0

to-2

.9Li

ttle

and

Will

iam

s(2

006)

n/a

A18

/030

PF,K

E,KF

,HE,

HFCM

J-0

.21

(0.3

0)-0

.80

to0.

38-2

.5(1

.2)

-4.9

to-0

.1M

cmill

ian

etal

.(20

06)

20.2

N-A

16/1

430

UB,P

F,KE

,KF,

HE,H

FHJ

0.26

(0.4

5)-0

.63

to1.

143.

2(1

.0)

1.2

to5.

1M

cNea

land

Sand

s(2

003)

13.3

A0/

1390

(60–

90)

PF,K

FDJ

-0.5

6(0

.69)

-1.9

2to

0.80

-9.6

(2.7

)4.

2to

15.0

Mur

phy

etal

.(20

10)

26.0

N-A

11/0

36PF

,KE,

HECM

J0.

37(0

.41)

-0.4

4to

1.18

4.2

(1.5

)1.

2to

7.1

Pear

ceet

al.(

2009

)22

.5N-

A11

/260

PF,K

E,KF

,HE,

HFCM

J-0

.37

(0.4

3)-1

.22

to0.

49-7

.8(2

.5)

-12.

7to

-2.9

Robb

ins

and

Sche

uerm

ann

(200

8)*

20.3

A10

/10

60(3

0–90

)PF

,KE,

KFSJ

-0.1

2(0

.16)

-0.4

4to

0.20

-2.1

(1.4

)-4

.7to

0.6

Sam

uele

tal.

(200

8)22

.0N-

A12

/12

90KE

,KF

CMJ

-0.0

7(0

.17)

-0.4

0to

0.26

--

Unic

ket

al.(

2005

)*19

.2A

0/16

90(4

5–90

)PF

,KE,

KFCM

J,DJ

0.13

(0.1

9)-0

.25

to0.

511.

9(1

.6)

-1.2

to4.

9Ve

tter

(200

7)22

.3N-

A14

/12

30PF

,KE,

KF,H

ECM

J-0

.10

(0.1

9)-0

.47

to0.

27-0

.8(0

.7)

-2.2

to0.

5W

allm

anet

al.(

2005

)26

.0N-

A8/

690

PFCM

J-0

.23

(0.2

9)-0

.80

to0.

35-5

.6(2

.9)

-11.

4to

0.1

Wal

lman

etal

.(20

08)

26.0

N-A

7/6

90PF

CMJ

0.09

(0.1

6)-0

.23

to0.

412.

9(3

.8)

-4.6

to10

.4Yo

ung

and

Behm

(200

3)*

26.0

N-A

13/4

120

PF,K

ESJ

,DJ

-0.2

1(0

.29)

-0.7

7to

0.35

-3.2

(1.8

)-6

.7to

0.3

Youn

gan

dEl

liott

(200

1)22

.0A

14/0

45PF

,KE,

HESJ

-0.1

9(0

.26)

-0.7

0to

0.31

-1.9

(1.2

)-4

.2to

0.4

Youn

get

al.(

2006

)*22

.8N-

A12

/860

PFDJ

-0.1

7(0

.21)

-0.5

8to

0.24

-3.5

(1.5

)-6

.5to

-0.5

Over

allj

ump

22.5

–12

/779

––

-0.0

3(0

.03)

-0.0

8to

0.02

-1.6

(1.5

)-2

.5to

-0.7

Simic et al.

8

Tabl

e3.

(con

tinue

d)

Stud

yAg

e(y

ears

)Fi

tnes

sle

vel

Sam

ple

size

M/F

Dura

tion

ofst

retc

h(s

)St

retc

hed

mus

cle

grou

psPe

rfor

man

cete

stEf

fect

size

(SE)

95%

CI%

chan

ge(S

E)95

%CI

RFD

Alpk

aya

and

Koce

ja(2

007)

25.1

N-A

14/1

90PF

RFD

0.12

(0.1

9)-0

.25

to0.

493.

9(3

.9)

-3.8

to11

.6Ba

zett-

Jone

set

al.(

2005

)20

.6A

10/0

90KE

,KF,

HFRF

D0.

04(0

.15)

-0.2

5to

0.32

0.9

(3.6

)-6

.2to

8.0

Gurja

oet

al.(

2009

)64

.6N-

A0/

2390

(90–

180)

KE,K

F,HE

RFD

-1.2

8(1

.94)

-5.0

8to

2.52

-14.

1(1

.1)

-16.

2to

-11.

9M

aise

ttiet

al.(

2007

)*25

.0N-

A0/

1175

PFRF

D0.

09(0

.13)

-0.1

6to

0.34

4.1

(5.0

)-5

.8to

14.0

McB

ride

etal

.(20

07)

21.4

N-A

8/0

99KE

RFD

-1.0

7(0

.97)

-2.9

7to

0.83

-38.

4(5

.5)

-49.

2to

-27.

5Pa

pado

poul

oset

al.(

2006

)19

.7N-

A10

/018

0(9

0–18

0)PF

,KE,

KF,H

FRF

D-0

.13

(0.1

9)-0

.51

to0.

25-3

.6(3

.7)

-10.

8to

3.6

Yam

aguc

hiet

al.(

2006

)*23

.8N-

A12

/072

0KE

,HF

RFD

-0.4

1(0

.37)

-1.1

3to

0.32

-16.

4(3

.2)

-22.

7to

-10.

1Yo

ung

and

Behm

(200

3)26

.0N-

A13

/412

0PF

,KE

RFD

-0.0

8(0

.15)

-0.3

7to

0.21

-2.7

(3.8

)-1

0.2

to4.

8Yo

ung

and

Ellio

tt(2

001)

22.0

A14

/045

PF,K

E,HE

RFD

-0.2

3(0

.30)

-0.8

3to

0.36

-6.1

(3.0

)-1

1.9

to-0

.3Yo

ung

etal

.(20

06)*

22.8

N-A

12/8

60PF

RFD

-0.0

9(0

.17)

-0.4

3to

0.25

- 2.3

(2.2

)-6

.6to

2.0

Over

allR

FD27

.1–

9/5

157

––

-0.0

2(0

.06)

-0.1

4to

0.10

-4.5

(2.7

)-9

.8to

0.9

Sprin

t§

Chao

uach

ieta

l.(2

010)

20.6

A22

/060

PF,K

E,KF

,HE,

HFSp

rint5

,10,

30m

-0.4

2(0

.53)

-1.4

5to

0.62

-2.4

(0.5

)-3

.3to

-1.4

Chao

uach

ieta

l.(2

008)

14.0

N-A

24/2

440

KE,K

FSp

rint1

0m

-0.1

2(0

.26)

-0.6

3to

0.39

-0.8

(0.4

)-1

.7to

0.1

Fave

roet

al.(

2009

)*22

.0A

10/0

90PF

,KE,

KF,H

E,HF

Sprin

t10,

40m

-0.1

0(0

.19)

-0.4

7to

0.27

-0.6

(0.8

)-2

.1to

0.9

Flet

cher

and

Jone

s(2

004)

23.0

A28

/020

PF,K

E,KF

,HE,

HFSp

rint2

0m

-0.2

4(0

.40)

-1.0

0to

0.52

-1.2

(0.4

5)-2

.1to

-0.3

Flet

cher

and

Jone

s(2

004)

23.0

A24

/020

PF,K

E,KF

,HE,

HFSp

rint2

0m

-0.2

6(0

.41)

-1.0

6to

0.54

-1.5

(0.5

5)-2

.6to

-0.4

Flet

cher

and

Mon

te-C

olom

bo(2

010a

)20

.8A

21/0

30PF

,KE,

KF,H

E,HF

ADD,

ABD

Sprin

t20

m0.

00(0

.09)

-0.1

7to

0.17

0.0

(0.8

)-1

.5to

1.5

Gele

n(2

010)

23.3

A26

/050

PF,K

E,KF

,HE,

HF,A

DDSp

rint3

0m

-1.1

8(1

.90)

-4.9

0to

2.54

-8.5

(0.6

)-9

.7to

7.3

Kist

ler

etal

.(20

10)

20.3

A18

/018

0PF

,KE,

KFSp

rint4

0m

-0.6

1(0

.68)

-1.9

4to

0.72

-1.4

(0.2

)-1

.8to

-1.0

Littl

ean

dW

illia

ms

(200

6)*

n/a

A18

/030

PF,K

E,KF

,HE,

HFSp

rint1

0,20

m0.

00(0

.10)

-0.2

0to

0.20

0.0

(0.5

)-0

.9to

0.9

Nels

onet

al.(

2005

a)*

20.0

A11

/512

0PF

,KF,

HESp

rint2

0m

0.00

(0.0

9)-0

.17

to0.

170.

0(0

.1)

-0.2

to0.

2Sa

yers

etal

.(20

08)

19.4

A0/

2090

PF,K

E,KF

Sprin

t30

m-0

.37

(0.5

3)-1

.42

to0.

67-2

.1(0

.6)

-3.2

to1.

0Si

atra

set

al.(

2003

)*9.

8A

11/0

30PF

,DF,

KE,K

FSp

rint5

–15

m0.

18(0

.18)

-0.1

8to

0.54

3.2

(1.9

)-0

.5to

6.9

Vette

r(2

007)

22.3

N-A

14/1

230

PF,K

E,KF

,HE

Sprin

t30

m-0

.14

(0.2

5)-0

.63

to0.

34-2

.0(1

.3)

-4.5

to0.

5W

inch

este

ret

al.(

2008

)*20

.3A

11/1

190

PF,K

E,KF

,HE

Sprin

t20–

40m

-0.0

8(0

.16)

-0.4

0to

0.24

-0.6

(1.3

)-3

.2to

2.0

Over

alls

prin

t§19

.9–

16/6

63–

–-0

.04

(0.0

4)-0

.13

to0.

05-1

.6(0

.5)

-2.6

to-0

.5Th

row

ing

Haag

etal

.(20

10)

20.3

A12

/030

UBTh

row

ing

0.47

(0.5

3)-0

.57

to1.

521.

7(0

.5)

0.8

to2.

6M

cmill

ian

etal

.(20

06)

20.2

N-A

16/1

430

UB,P

F,KE

,KF,

HE,H

FTh

row

ing

-0.0

7(0

.14)

-0.3

5to

0.21

-2.1

(2.5

)-6

.9to

2.7

Torr

eset

al.(

2008

)*19

.6A

11/0

30UB

Thro

win

g-0

.13

(0.2

6)-0

.63

to0.

37-1

.2(1

.7)

-4.5

to2.

2Ov

eral

lthr

ow20

.0–

13/5

30–

–-0

.05

(0.1

2)-0

.29

to0.

190.

2(1

.3)

-2.3

to2.

7Ov

eral

lmea

n(a

llte

sts)

22.8

–12

/686

––

-0.0

3(0

.02)

-0.0

8to

0.01

-2.0

(0.4

)-2

.8to

-1.3

*Stu

dyth

atre

porte

dm

ore

than

one

prim

ary

outc

ome.

§ Sprin

ttim

e,an

inve

rsel

ysc

aled

varia

ble,

has

been

resc

aled

befo

rem

eta-

anal

ysis

.A,

athl

etes

;N-A

,non

-ath

lete

s;AD

D,hi

pad

duct

ors;

ABD,

hip

abdu

ctor

s;PF

,ank

lepl

anta

rflex

ors;

DF,a

nkle

dors

iflex

ors;

KE,k

nee

exte

nsor

s;KF

,kne

efle

xors

;HE,

hip

exte

nsor

s;HF

,hip

flexo

rs;U

B,up

perb

ody;

CMJ,

coun

term

ovem

entj

ump;

DJ,d

epth

jum

p;HJ

,hor

izont

alju

mp;

SJ,s

quat

jum

p;RF

D,ra

teof

forc

eor

torq

uede

velo

pmen

t;CI

,con

fiden

cein

terv

al;S

E,st

anda

rder

ror.

Acute static stretching and performance

9

in pooled negative acute effects of SS were observedamong four different explosive performance categories(Fig. 1(b)). Specifically, pooled estimates for the acuteeffect of SS on RFD, jump, sprint, and throw perform-ance were -4.5% (95% CI: -9.8% to 0.8%; possiblynegative effect), -1.6% (95% CI: -2.5% to -0.7%; alikely harmful effect), -1.6% (95% CI: -2.6% to -0.5%;a likely harmful effect), and 0.2% (95% CI: -2.3% to2.7%; an unclear effect), respectively. Note that theobserved magnitudes of stretch-induced changes, par-ticularly explosive muscular performance tests, are inagreement with the corresponding average stretch dura-tion per muscle group (i.e., 157, 79, 63, and 30 s forRFD, jump, sprint, and throw performance; see Table 3).With respect to the stretch duration, we observed a sig-

nificant (P = 0.0001) reduction in the negative acuteeffect of SS on explosive muscular performance withshorter stretch duration (Fig. 2(c)). In particular, pooledestimates for the acute effect of SS lasting �45, 46–90,and >90 s per muscle group on explosive performancewere -0.8% (95% CI: -2.0% to 0.5%; possibly negativeeffect), -2.5% (95% CI: -3.8% to -1.1%; almost cer-tainly negative effect), and -4.5% (95% CI: -7.3% to-1.7%; almost certainly negative effect), respectively.

Meta-regressions

Significant negative relationships (all P < 0.001) werefound between the total stretch duration per musclegroup and individual study estimates in all three catego-ries of muscular performance tests (Fig. 3). As men-tioned already, subject’s age and gender were notsignificantly related to study estimates in selectedprimary outcomes (all P > 0.05).

Discussion

This meta-analytical review provides clear evidencefrom 104 studies that (a) pre-exercise SS induces signifi-cant and practically relevant negative acute effects onmaximal muscle strength and explosive muscular per-formance, regardless of subject’s age, gender, or trainingstatus, while the corresponding acute effects of SS onmuscle power are still unclear; (b) the acute effects of SSon maximal muscular performance are task-specific,with type of muscle contraction (isometric vs dynamic)being an important factor; and (c) negative acute effectsof acute SS on maximal muscular performance tend todiminish with reduction of stretch duration. Prior to dis-cussing these main findings, some methodological issuesdeserve to be discussed.

While a meta-analysis will yield a mathematicallyaccurate synthesis of the studies included in the analysis,if these studies are a biased sample of all relevantstudies, the mean effect computed by the meta-analysiswill reflect this bias (Borenstein et al., 2009). In thepresent study, we found no evidence of publication biasin selected primary outcomes. Furthermore, there was alow heterogeneity of effect within each meta-analysis,suggesting that all trails generally examined the sameeffects. These issues generally support the robustness ofour results; however, we have to acknowledge that weselected only studies published in peer-reviewed jour-nals; thus, there is likelihood that some smaller studieswithout significant effects remained unpublished. Also,our meta-analytical review may have been biased byinclusion only of studies reported in English. In thatregard, some caution is still warranted regarding theprecise estimates of the acute effects of SS on selectedmuscular performance tests.

The major finding of this meta-analytical review isrelated to a precise quantitative estimate of the acute

Fig. 2. Meta-analyzed acute effects of different duration ofstatic stretching on maximal muscle strength (a), muscle power(b), and explosive muscular performance (c).

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effects of SS on maximal muscular performance.Overall, our results indicate that an acute bout of SSdecreases maximal muscle strength, muscle power, andexplosive muscular performance by -5.4% (95% CI:-6.6% to -4.2%), -1.9% (95% CI: -4.0% to 0.2%), and-2.0% (95% CI: -2.8% to -1.3%), respectively. Basedon the corresponding 95% CI, and selected thresholdsfor minimal practically relevant change in athlete’s mus-cular performance (i.e., 5%, 1%, and 1%, respectively),we can conclude that these acute effects of SS werestatistically significant and practically relevant formaximal muscle strength (a likely negative acute effect)and explosive muscular performance (a very likely nega-tive acute effect), but not for muscle power (an uncleareffect). More studies are needed to clarify the acute

effects of SS on muscle power. More importantly, thisstudy shows that the observed stretch-induced reductionsin maximum muscular performance are generally inde-pendent of subject’s age, gender, and training status,suggesting that they could be generalized to young andadult athletic, but also non-athletic population of bothsexes. Obviously, factors other than age, sex, and train-ing status (e.g., stretch duration and intensity, task spe-cificity, etc.; see further paragraphs) are responsible forrelatively high variability in research results on this topic(see the first paragraph). Without considering thesefactors, the above-discussed results of meta-analysesstrongly suggest that the usage of SS as the sole activityduring warm-up routine should generally be avoided.Given that even a small reduction in maximum muscular

Fig. 3. Relationship between static stretch-induced change in performance (%) and the total duration of stretching in (a) maximalmuscle strength tests, (b) muscle power tests, and (c) explosive muscular performance tests.

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performance could be detrimental for competitive per-formance of high-level athletes in certain sports, thisconclusion particularly goes for the athletic population.Previous narrative and/or systematic reviews on thistopic also came to the same conclusion (Shrier, 2004;Magnusson & Renstrom, 2006; Rubini et al., 2007;McHugh & Cosgrave, 2010; Behm & Chaouachi, 2011;Kay & Blazevich, 2011), but without robust quantitativeevidence, obtained using an appropriate statisticalapproach.

An important factor to consider when studying theacute effects of SS on maximal muscular performance isthe type of performance test applied. In that regard, ourresults provide some new interesting findings related tothe type of contraction. First, we have demonstrated thatisometric maximal strength is significantly more nega-tively affected by an acute bout of SS compared withdynamic (concentric and eccentric) maximal strength.More interestingly, although not presented in the Resultssection, no evidence of contraction specificity in theacute effects of SS was found between the concentric vseccentric maximal strength tests. As there were no sig-nificant differences in average stretch duration permuscle group between isometric and dynamic maximalstrength tests, other factors are likely responsible for theobserved contraction-specific acute effects of SS onmaximal strength. We believe that the main candidatecould be stretch-induced transient reduction in stiffnessof the muscle-tendon complex (Weir et al., 2005; Ryanet al. 2008a). Specifically, a more compliant muscle-tendon complex would allow a less efficient transmissionof force to the skeleton (Markovic & Mikulic, 2010), andthis effect is likely to be more evident during isometriccompared with dynamic maximal contractions. Consist-ent with this notion is the fact that significantly highernegative acute effects of SS were observed in RFD (iso-metric contraction) than in jump, sprint, or throw per-formance (dynamic, high-velocity contractions). Indeed,reduced RFD and prolonged electromechanical delayhave been frequently associated with a reduction of mus-culotendinous stiffness (Costa et al., 2010; Herda et al.,2010). However, the above-mentioned difference couldalso be a result of noticeably higher mean stretch dura-tion per muscle group in RFD tests compared with theremaining explosive muscular performance tests. Thus,more studies are needed to clarify this issue. In theirrecent review article, Behm and Chaouachi (2011)argued that the negative acute effects of SS could belower in slow vs fast stretch-shortening cycle tasks. Wefound no evidence to support this viewpoint (seeTable 3), although detailed quantitative analysis in thisrespect has not been performed. Finally, pooled estimateof the acute effects of SS on throwing performance,although seriously limited by the total number of meta-analyzed studies, suggest that these effects could be lessharmful when compared with the corresponding acuteeffects on jumping and sprinting performance. Although

more studies are definitely needed in this area, we mayspeculate that the high-velocity movements that requirelarge operating ranges of motion (such as throwing) aremuch less adversely affected by an acute bout of SS.Theoretically speaking, for such movements, possiblenegative acute effects of SS on force-generating capacityof agonist muscle(s) could be counteracted by stretch-induced increase in active range of motion, therebyallowing muscles to perform similar amount of workduring propulsion in both cases (i.e., pre- and post-stretching). Alternatively, one could simply argue thatthrowing represents a complex ballistic movement thatrequires sequential action of numerous lower-body,trunk and upper-body muscles, and that the acute SS ofa particular upper-body muscle group has much lessimpact on performance. In that regard, it is interesting tonote that the most prominent negative acute effects of SSon throwing performance among selected studies is seenin a study that applied SS of both upper- and lower-bodymuscles (see Table 3). These conjectures require furtherexperimental verification.

Another important factor to consider when studyingthe acute effects of SS on maximal muscular perform-ance is the total stretch duration per muscle group. Intwo most recent review papers, the authors argued thatshorter-duration (<45 s per muscle group) pre-exerciseSS might not be detrimental to performance (Behm &Chaouachi, 2011; Kay & Blazevich, 2011). However,without the use of an appropriate statistical tool forpooling the data from available SS studies, suchconclusions lack firm scientific support. Results of ourmeta-analytical review indicate the existence of a dose–response relationship between stretch-induced perform-ance decrements and average stretch duration per musclegroup (see Figs 2 and 3), in line with the conclusions ofseveral research studies (Ogura et al., 2007; Kay &Blazevich, 2008; Ryan et al. 2008b) and reviews (Behm& Chaouachi, 2011; Kay & Blazevich, 2011). In particu-lar, stretch-induced negative acute effects on perform-ance diminished with the reduction of stretch duration inall three groups of muscular performance tests; however,they still remained negative for two muscular perform-ance categories. Thus, even short-duration pre-exerciseSS (i.e., <45 s per muscle group) could possibly beharmful to muscular performance. So, we now come toan important question for clinicians and practitioners:Should we completely exclude SS from warm-up routinesthat precede exercise or athletic events? An answer tothis question requires more than just acknowledging theresults of the performed meta-analyses. Namely, wehave to acknowledge that SS also has certain positiveacute effects during warm-up – increased range ofmotion (McHugh & Cosgrave, 2010; Behm & Cha-ouachi, 2011) and reduced incidence of muscle strains(McHugh & Cosgrave, 2010). Indeed, based on a com-prehensive literature review, McHugh and Cosgrave(McHugh & Cosgrave 2010) have recently concluded

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that pre-exercise SS is beneficial for reducing musclestrains. Thus, while the usage of SS (regardless of itsduration) as the sole activity during warm-up shouldgenerally be avoided, its incorporation into a compre-hensive warm-up could be a possible practical solutionthat would minimize the negative acute effects of SS onperformance, while still keeping its potentially positiveeffects. Related to that, Chaouachi et al. (2008) haverecently showed that the addition of short-duration (i.e.,20 s) SS of quadriceps and hamstring muscles into awarm-up routine for sprint training increased the rangeof motion and diminished the detrimental acute effectsof SS on sprint performance compared with a sprint-onlytraining program. Clearly, there is a need for additionalwell-designed studies that examine the acute effects ofshort-duration SS, incorporated into a comprehensivepre-exercise warm-up routine, on maximal muscularperformance.

This study has certain limitations. First, the PEDroscores of the studies included in the meta-analysessuggest that most studies are prone to subject and/orresearcher bias. Given that the ultimate quality of a meta-analysis depends of the quality of the primary studies onwhich it is based, our results need to be appreciated withan awareness of the limitations of the primary studies.However, we should take into account that blinding ofparticipants and therapists is impossible in exerciseinterventions. If these two items were deleted from thePEDro scale, the quality ratings of all the includedstudies would have changed substantially. Nonetheless,we recommend that future stretching studies improvetheir quality by randomizing subjects into groups, blind-ing the assessors, as well as by ensuring that treatmentallocation concealment and intention to treat analysesare performed. Second, our study did not address theeffects of several relevant factors related to acute SS,including the SS intensity, the time from cessation of thewarm-up to the performance test, the particular stretch-

ing exercises, and the time course of any stretch-inducedeffects (Young, 2007). These factors need to beaddressed in future well-designed SS studies.

Conclusions and recommendations

Our results clearly show that SS before exercise hassignificant and practically relevant negative acute effectson maximal muscle strength and explosive muscular per-formance, while the corresponding acute effects onmuscle power remain unclear. These findings are univer-sal, regardless of the subject’s age, gender, or trainingstatus. However, the magnitude of the static stretch-induced negative acute changes in performance wasmore pronounced in maximal isometric tests comparedwith maximal dynamic tests. Finally, the observedstretch-induced negative acute changes in selected mus-cular performance tests were related to the total durationof stretch, with the smallest negative acute effects beingobserved with stretch duration of �45 s, respectively.Based on the evidence from this study, we recommendthat the usage of SS as the sole activity during warm-uproutine should generally be avoided. Given the potentialpositive effect of pre-exercise SS on the reduction ofincidence of muscle strains, further studies shouldexamine the acute effects of SS of shorter duration (e.g.,15–30 s per muscle group), incorporated into a compre-hensive pre-exercise warm-up routine, on maximal mus-cular performance.

Key words: warm-up, stretch, performance, acuteeffects.

Acknowledgements

Goran Markovic was supported by the Croatian’s Ministry ofScience, Education and Sport Grant (no. 034-0342607-2623).

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