ORIGINAL ARTICLE

Does stretching increase ankle dorsiflexion range of motion? A systematic review

J A Radford¹, J Burns², R Buchbinder³, K B Landorf⁴ and C Cook¹

¹ School of Biomedical and Health Sciences, University of Western Sydney, Campbelltown, Australia
² Institute for Neuromuscular Research, Discipline of Paediatrics and Child Health Faculty of Medicine, The University of Sydney, Sydney, Australia
³ Monash Department of Clinical Epidemiology at Cabrini Hospital and Monash University, Malvern, Australia
⁴ Department of Podiatry, School of Human Biosciences, La Trobe University, Bundoora, Australia

Correspondence to:
Correspondence to:
J A Radford
Campbelltown Campus, Building 24, School of Biomedical and Health Sciences, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW, 1797, Australia; j.radford{at}uws.edu.au

Background: Many lower limb disorders are related to calf muscle tightness and reduced dorsiflexion of the ankle. To treat such disorders, stretches of the calf muscles are commonly prescribed to increase available dorsiflexion of the ankle joint.

Hypothesis: To determine the effect of static calf muscle stretching on ankle joint dorsiflexion range of motion.

Study design: A systematic review with meta-analyses.

Methods: A systematic review of randomised trials examining static calf muscle stretches compared with no stretching. Trials were identified by searching Cinahl, Embase, Medline, SportDiscus, and Central and by recursive checking of bibliographies. Data were extracted from trial publications, and meta-analyses performed that calculated a weighted mean difference (WMD) for the continuous outcome of ankle dorsiflexion. Sensitivity analyses excluded poorer quality trials. Statistical heterogeneity was assessed using the quantity I².

Results: Five trials met inclusion criteria and reported sufficient data on ankle dorsiflexion to be included in the meta-analyses. The meta-analyses showed that calf muscle stretching increases ankle dorsiflexion after stretching for 15 minutes (WMD 2.07°; 95% confidence interval 0.86 to 3.27), >15–30 minutes (WMD 3.03°; 95% confidence interval 0.31 to 5.75), and >30 minutes (WMD 2.49°; 95% confidence interval 0.16 to 4.82). There was a very low to moderate statistical heterogeneity between trials. The meta-analysis results for 15 minutes and >15–30 minutes of stretching were considered robust when compared with sensitivity analyses that excluded lower quality trials.

Conclusions: Calf muscle stretching provides a small and statistically significant increase in ankle dorsiflexion. However, it is unclear whether the change is clinically important.

Keywords: stretching; dorsiflexion; Achilles tendon; gastrocnemius; soleus

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COMMENTARY

K Rome

⁵ University of Teesside, UK; k.rome{at}tees.ac.uk

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eLetters:

Read all eLetters

Are the effects of stretch sustained?

Lisa A Harvey

BJSM Online, 8 Sep 2006 [Full text]

Are the effects of stretch sustained? (Authors reply)

Joshua Burns, et al.

BJSM Online, 4 May 2007 [Full text]