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A pragmatic randomised trial of stretching before and after physical activity to prevent injury and soreness
  1. Gro Jamtvedt1,2,
  2. Robert D Herbert3,4,
  3. Signe Flottorp1,5,
  4. Jan Odgaard-Jensen1,
  5. Kari Håvelsrud1,
  6. Alex Barratt4,
  7. Erin Mathieu4,
  8. Amanda Burls6,
  9. Andrew D Oxman1
  1. 1Norwegian Knowledge Centre for the Health Services, Oslo, Norway
  2. 2Bergen University College, Bergen, Norway
  3. 3The George Institute for International Health, Sydney, Australia
  4. 4University of Sydney, Sydney, Australia
  5. 5University of Bergen, Bergen, Norway
  6. 6International Network for Knowledge about Wellbeing (ThinkWell), University of Oxford, Oxford, UK
  1. Correspondence to Dr Robert D Herbert, The George Institute for International Health, PO Box M201, Missenden Rd NSW 2050, Australia; rherbert{at}


Objective To determine the effects of stretching before and after physical activity on risks of injury and soreness in a community population.

Design Internet-based pragmatic randomised trial conducted between January 2008 and January 2009.

Setting International.

Participants A total of 2377 adults who regularly participated in physical activity.

Interventions Participants in the stretch group were asked to perform 30 s static stretches of seven lower limb and trunk muscle groups before and after physical activity for 12 weeks. Participants in the control group were asked not to stretch.

Main outcome measurements Participants provided weekly on-line reports of outcomes over 12 weeks. Primary outcomes were any injury to the lower limb or back, and bothersome soreness of the legs, buttocks or back. Injury to muscles, ligaments and tendons was a secondary outcome.

Results Stretching did not produce clinically important or statistically significant reductions in all-injury risk (HR=0.97, 95% CI 0.84 to 1.13), but did reduce the risk of experiencing bothersome soreness (mean risk of bothersome soreness in a week was 24.6% in the stretch group and 32.3% in the control group; OR=0.69, 95% CI 0.59 to 0.82). Stretching reduced the risk of injuries to muscles, ligaments and tendons (incidence rate of 0.66 injuries per person-year in the stretch group and 0.88 injuries per person-year in the control group; HR=0.75, 95% CI 0.59 to 0.96).

Conclusion Stretching before and after physical activity does not appreciably reduce all-injury risk but probably reduces the risk of some injuries, and does reduce the risk of bothersome soreness.

Trial registration 12608000044325.

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  • Funding The project was supported by the Norwegian Knowledge Centre for the Health Services and with a grant from the New South Wales Sporting Injuries Committee. RH was supported by a fellowship from the Australian NHMRC. The funders had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the University of Sydney Human Ethics Review Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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