Handel Et Al., 1997
Handel Et Al., 1997
Handel Et Al., 1997
ORIGINAL ARTICLE
were asked to move the joint of interest to its end position The eects of regular stretching training on muscle
by supreme eort using the muscle antagonistic to the performance have not yet been systematically investi-
one being stretched (Etnyre and Abraham 1986a; Holt et gated on a wider scale. Thus, the aim of the present
al. 1970; Lucas and Koslow 1984; Sady et al. 1982). study was to determine the changes in various relevant
Generally, stretching is classi®ed according to ®ve parameters of muscle performance due to CR stretching
dierent techniques (SoÈlveborn 1983; Wydra 1993): dy- training lasting several weeks. In particular, the follow-
namic stretching (DS), static stretching (SS), stretching ing questions were broached:
immediately after a short and almost maximal isometric
1. Can certain contractile properties of muscles be af-
contraction of the muscle (CR), stretching by antagonist
fected by stretching training in such a way that the
contraction (AC), and stretching by antagonist con-
force-velocity relationship is changed?
traction after agonist contraction (CR-AC) as a combi-
2. Does stretching change the force development or the
nation of CR and AC. In evaluating the individual
torque pro®le in the respective joint movement?
techniques, increases in ¯exibility were measured in most
3. Can possible alterations in muscle properties be ex-
cases. In this respect, dierent authors reported con-
plained by a process of morphological reorganiza-
troversial results: whereas some authors stated a higher
tion, or can they be considered to be functional
eectiveness of techniques including contraction of ag-
changes in muscle electrical activity, in the sense of a
onist or antagonist (Cornelius et al. 1992; Etnyre and
neurophysiological adaptation process?
Abraham 1986a; Holt et al. 1970; Moore and Hutton
1980; Osternig et al. 1990; Sady et al. 1982), others
found no dierences between the individual stretching Methods
techniques (de Vries 1962, Lucas and Koslow 1984). In
contrast to this, Schober et al. (1990) found positive Subjects
eects of DS, but negative eects of SS. Wydra et al.
(1991) found a highly signi®cant superiority of DS after Sixteen male athletes (eight league swimmers, six amateur foot-
ballers, two long-distance runners) collaborated in this study [age:
2 weeks. Starring et al. (1988) preferred cyclic passive 23.6 (3.9) years; body mass: 82.0 (10.3) kg; height: 182.7 (8.6) cm;
stretching rather than a single sustained stretch. mean (SD)]. The swimmers belonged to a ®rst-division swimming
As a reason for the higher eectiveness of the CR and club and trained at least three times a week; the amateur footballers
CR-AC stretching exercises, Etnyre and Abraham were members of a district league club, training twice a week with
(1986b) as well as Guissard et al. (1988) described an matches each weekend. The long-distance runners trained ap-
proximately three times a week. The volunteers were fully informed
attenuation of the H-re¯ex that occurred immediately about the training and experimental procedures and gave their
after muscle contraction, which should improve consent to participate.
distensibility of the muscle. This eect was demonstrated
by Etnyre and Abraham (1986b) only during the ®rst Stretching training
seconds after the beginning of the stretch. Guissard et al.
(1988) found a 20% attenuation of the H-re¯ex lasting A 10-min CR stretching training program (contract-relax stretch-
at least 30 s that was independent of the duration of the ing), according to Anderson and Burke (1991) and SoÈlveborn
(1983), was performed regularly three days per week over a period
preceding muscle contraction (between 1 and 30 s). of eight weeks. In part, the exercises had been modi®ed so as to
The possible eects of regular stretching training on prevent training of the contralateral side and to adapt the protocol
various muscle parameters have rarely been subject to to the subjects' sports-speci®c training conditions. The stretching
systematic investigations. Wiemann (1991) obtained exercises were performed after a short warm-up period of at least
2 min of, for example, running and jumping prior to the athletes'
partly contradictory results: whereas the isometric speci®c training program. The stretching exercises were restricted
maximum force increased signi®cantly in female volun- to the extensors and ¯exors of the knee joint and the adjacent
teers, a non-signi®cant decrease in ``explosive force'' was muscles of one side of the body; the contralateral muscle groups
observed in male subjects. Worrell et al. (1994) found a served as controls. Within the stretching program, each muscle
signi®cant increase in torque of the ¯exors in the knee group was subjected to eight CR stretching cycles comprising a 10-s
strong contraction (the athletes were told to contract their muscles
joint under eccentric load conditions at velocities of 60 with at least 70% of their maximum force), 1±2 s of relaxation and
and 120° á s)1 and under concentric load conditions at 10±15 s of passive stretching. After two cycles of CR stretching, the
120° á s)1, but not under concentric load conditions at muscles were brie¯y limbered up by shaking. The extensors and
60° á s)1. Wiktorsson-MoÈller et al. (1983) described a ¯exors were stretched alternately with two dierent exercises each
and one complete repetition of the program.
non-signi®cant decrease in maximum torque during
¯exion and extension of the knee joint under isometric
and concentric load conditions at velocities of 30 and Measurement of ¯exibility
180° á s)1 immediately after CR stretching. Flexibility was measured by reading the extreme knee joint angles
The question as to whether the observed positive (using an elongated orthopaedic goniometer above the bone points:
changes in muscle parameters are to be considered as trochanter major, epicondylus lateralis and malleolus lateralis)
consequences of structural alterations of the muscle, in during active as well as passive movement. Flexibility in ¯exion was
determined at a hip joint angle of 0° (standing position, leaning
the sense of length increases or hypertrophy, rather than against a wall); ¯exibility in extension was determined at a 90° hip
as consequences of changes in re¯ex activity or other joint angle (with the subject in a sitting position, ®xed to a mea-
electrophysiological adaptations, is also controversial. suring chair).
402
Experimental set-up dition, the work performed in the eccentric and concentric tests
during the movement between joint angles of 30° and 90° was
The eects of stretching training on the performance of the muscles calculated using the LIDO software.
acting on the knee joint were investigated using an isokinetic dy-
namometer (LIDO-Active 2.1 dynamometer, Loredan, USA).
Muscle performance was assessed on the basis of eccentric, iso- EMG recording
metric and concentric torque measurements under preset isokinetic
velocities to obtain torque-angular velocity relationships. Torque For monitoring the EMG activity, in each case a surface EMG was
curves and joint angles were recorded during de®ned isokinetic measured between two recording points (bipolar) at the extensors
movements, thereby allowing the work done during such move- and the ¯exors of the knee joint using the Myosystem 2000 (No-
ments and the angular position of maximum torque to be moni- raxon, Finland). The recording points were located proximally and
tored. In addition, the electromyographic (EMG) activity was distally, adjacent to a line half-way between the epicondylus lat-
taken into account by recording the surface EMG of the thigh eralis and trochanter major in the middle of the muscle belly at the
muscles. The evaluation of the stretching training was based on the front and back of the thigh (rectus femoris of the quadriceps fe-
¯exibility as determined by the active and passive ROM. moris, or caput longum of the biceps femoris, respectively). We
In recording the force-velocity relationship, it was necessary to used circular adhesive electrodes (``blue sensor P-00-S''; Medico-
analyse a wide range of velocities. Therefore, in preliminary ex- test, Denmark) that had an active diameter of 1 cm. The electrodes
periments the technical limits of the dynamometry were investi- were attached at a distance of 3 cm between their centres and an
gated, especially for high velocities (Handel et al. 1996). In order to indierent electrode was axed to the left olecranon. All of the
record torques under the highest possible velocities with acceptable recording points on the skin were shaved, degreased with alcohol
accuracy, a muscle group that was able to produce high torques and permanently marked. The EMG was sampled at a rate of
had to be used. In addition, the muscles under consideration had to 1000 Hz per channel. Simultaneous recording of joint angle and
be accessible to stretching training. For our investigations, we torque using the dynamometer permitted assignment to the corre-
chose the extensors and ¯exors of the knee joint, since they meet sponding phase of movement. The EMG data were integrated over
both of the above requirements. time using the Myosoft 2000 software (Noraxon) and averaged
Since we wanted to investigate the eects of long-term over the isokinetic phase of the movement between joint angles of
stretching training, the in¯uence of the regular training speci®c to 30° and 90° .
the athletes' primary sport as well as possible ¯uctuations in their
physical conditions had to be kept under control. For this reason,
the stretching training was applied to one extremity only (as, for Experimental protocol
example, by Grady and Saxena 1991). The contralateral side served
as the individual's control. In this way it was possible to ®lter out The three test series were taken immediately in the pre-training
in¯uences that uniformly aect the state of both legs (e.g. the period, and after 4 and 8 weeks of training. To make sure that the
general improvement in ®tness in the course of the training season; results represented training-induced long-term rather than short-
``adaptation'' to the measuring procedure) by examining the dif- term eects, no stretching exercises were performed for at least 24 h
ferences in muscle performance between the stretch-trained and the before the tests. Prior to each series, the subjects passed a 5-min
control leg. warm-up exercise on a bicycle ergometer at 80 W and 90 rpm. In
addition to the morphometric data (body mass and height), thigh
circumference was measured half-way between the trochanter major
Torque measurement and the epicondylus lateralis at hip joint and knee joint angles of 90°
using a measuring tape. The EMG recording points were marked at
The torque curves of the knee joint during muscle contraction were the same positions. After attachment of the adhesive electrodes, the
recorded using a LIDO-Active 2.1 dynamometer. In preliminary subjects were ®xed to the dynamometer chair with two belts at the
experiments it was frequently found that in the concentric mode shoulder and one at the hip. The thigh was ®xed at a joint angle of
high velocities (adjustable up to 400° á s)1) could not be attained 90° with a padded clamp to avoid any movement of the hip.
since the torque produced by the subjects could not overcome the Each measurement started with ®ve extensions and ¯exions of
relatively large resistance of the dynamometer during the acceler- the trained leg under concentric conditions at angular velocities of
ation phase. Therefore, in a ®rst series of measurements the reli- 240, 180, 120 and 60° á s)1. The subjects were encouraged to exert
ability of the isokinetic diagnostics in general and of the maximum force against the lever arm over the whole range of
dynamometer in particular were investigated (Handel et al. 1996). movement. After each measurement at a particular velocity a 1 min
From these ®ndings, a restriction to velocities up to 240° á s)1 had pause was enforced to minimize any fatigue eect. The complete
to be observed with respect to the expected strength of the subjects, concentric procedure was repeated in the contralateral extremity.
thus guaranteeing isokinetic conditions over the angular range of Thereafter, measurements were performed under isometric load
movement under consideration. conditions. Starting with a joint angle of 108° (¯exion), the subjects
were asked to push against the lever arm of the dynamometer with
maximum force at ®ve dierent joint positions, ®rst in the direction
Torque measurement in the subjects of extension for 4 s and then, after a break of 2 s, in the direction of
¯exion. Each isometric test was followed by a break of 10 s.
The isokinetic measurements were performed by encouraging the The eccentric investigations were performed subsequently with
subjects while in a sitting position, to develop maximum force ®ve movements of the knee joint at a velocity of 120° á s)1.
covering the whole angular range of movement between knee joint Thereby, the subjects were encouraged to decelerate the lever arm
angles of 8° (extension) and 108° (¯exion) (all angles cited ac- of the dynamometer with maximum force. After a 1-min pause the
cording to the neutral zero method commonly used in or- measurement was repeated at the slower velocity of 60° á s)1 and,
thopaedics). The tests were performed under eccentric conditions thereafter, on the contralateral leg.
( passive mode) at angular velocities of 60 and 120° á s)1, concen-
trically at 60, 120, 180 and 240° á s)1, and isometrically at ®ve
dierent joint positions (108°, 83°, 58°, 33°, 8°). Torque maxima, as Statistical methods
well as their angular positions, were read from the individual curves
using the cursor function of the LIDO software. The values repre- Averages and standard deviations were calculated from individual
sentative for the eccentric and concentric tests are means of the measurements for dierent groups of measurements. To judge the
three highest values out of a series of ®ve experiments at each signi®cance of changes occurring between the time before and after
angular velocity. In the isometric measurements we used the 4 and 8 weeks of training, the dierences in the measured values
maximum torque reached during a 4-s muscle contraction. In ad- were tested for signi®cance (P < 0.05) using a ``one-dimensional
403
Results
Table 2 Changes in torque under dierent loading conditions in the second measurement related to the torque of the ®rst one. (ecc
the stretched leg [mean value (SD); the percentile value is given Eccentric torque, isom max isometric maximum torque, conc con-
below in brackets] as related to the ®rst measurement in the con- centric torque)
sidered time period, e.g. D21 represents the dierence in torque of
Type of loading Changes in torque [Nm] under extensor loading Changes in torque [Nm] under ¯exor loading
* Signi®cant change;
** highly signi®cant change
eccentric load was particularly striking (up to 21.6%). et al. (1985), who found increases of 5±10° in the same
The increase under isometric load conditions at dierent joint after 30 days of CR stretching training. In addition,
joint positions was more pronounced in the ¯exor than in the sense of a side-eect, the stretching training
in the extensor. In the concentric tests slight changes caused an improvement in muscle performance as
were observed, of which only a few were signi®cant. characterized by the torque-angular velocity data of the
Figure 3 shows the relative changes in work per- concentric, isometric or eccentric mode. When com-
formed under dierent loads (as related to the control pared to the increases in torque recently reported by
leg). Under eccentric load conditions, greater increases Worrell et al. (1994), the eects observed in our in-
were found when compared to the concentric load (up to vestigations were twice as large in the eccentric range,
12.9%). The relative increase in concentric work, in most and were similar in the concentric case. The dierences
cases not signi®cant, was slightly higher than that in between our ®ndings and those of Worrell et al. may be
concentric maximum torque (see Fig. 2a and b). due to the type of stretching training applied, as well as
Analysis of the joint angle at the peak torque of the to the individually loaded and pre-trained muscle groups
movement yielded signi®cant changes only for an eccen- of the subjects. This would also account for the dierent
tric load at 120° á s)1 (see Table 3). Under eccentric load eects of training on the extensors and ¯exors.
conditions the torque maximum was shifted towards joint The control leg showed no signi®cant changes in the
angles corresponding to increased muscle length. torque-velocity relationship between the ®rst and the
Table 4 shows the angular position prior to the third measurement. A contralateral transfer, as observed
training period where the torque maximum was attained by Smith (1970) for example, after ``myotatic strength
under the dierent loads. It is striking that the torque training'' (a type of re¯ex training induced by abrupt
maximum under ¯exor loading occurred at a relatively muscular stretch), and by Kannus et al. (1992) after
straight position of the knee joint. At higher velocities, combined isokinetic and isometric training, appears
the ¯exor torque maximum was shifted towards joint rather improbable in our case. If such a transfer had
angles that are reached later in the course of the move- occurred in our training, it would have been very small
ment (towards greater joint angles under concentric so as to remain lower than the limit of detection. The
loads, and towards smaller angles under eccentric loads). insigni®cant alterations in the control leg argued against
any cross-over eects. Therefore, it is justi®able to relate
the changes that occurred during the stretching training
Discussion to the control muscles in order to eliminate any change
aecting equally both legs. For the same reason any
On the basis of the signi®cant (P < 0.05) and, in some alteration in isokinetic muscle performance aecting
cases, highly signi®cant (P < 0.01) improvement in both legs in a similar way when repeating the test series
¯exibility by the CR stretching training performed in our after a certain time can also be eliminated.
experiments this form of training can be considered to be According to the classical physiological force-velocity
an eective method for improving ¯exibility in man. The concept of Hill, the eccentric torque should de®nitively,
increase in ROM was similar to that observed by Wallin exceed the isometric level (Edman et al. 1978). This is
405
not valid for the torque-velocity relationships seen in ences'' in man have already been postulated by GuÈlch
Fig. 1a, however, particularly in the pre-training state. (1994) as a possible cause for the reduction in torque at
These ®ndings can be explained by the fact that the high eccentric velocities. Since these in¯uences have been
iEMG values, at least for the extensor, under eccentric found to be weakened by stretching training, this may be
load are highly signi®cantly lower than those under the considered to be an indication that the neuromuscular
corresponding concentric load at the same angular ve- activity is positively in¯uenced by stretching. It is con-
locity (Fig. 1b). This may be interpreted as mental in- ceivable that after stretching training the often painful
hibition, since many subjects only developed extending of the muscle during eccentric tests can be
submaximal forces, probably because of the rather dis- better tolerated, resulting in improved eccentric perfor-
agreeable or even painful eccentric intervention they mance as shown in Fig. 1 and Table 2.
described after the tests. Such ``inhibitory neural in¯u- Komi et al. (1978) found a 38% increase in iEMG
after 12 weeks of isometric strength training, with an
increase in the isometric maximum force of 20%. It
should be noted that, strictly speaking, CR stretching
Fig. 2a±d Relative changes in maximum torque and corresponding also involves a kind of isometric strength training during
iEMG values as compared to the control leg. a Torque during the active phase, and that the changes in the torque,
extensor load, b torque during ¯exor load, c averaged iEMG during muscle size and iEMG observed in our investigations
extensor load, d averaged iEMG during ¯exor load. The bars indicate may thus likewise be due to a kind of isometric training.
standard deviation. The open/solid columns symbolize the state after 4/
8 weeks of training, (e Eccentric load, i isometric load, c concentric Findings supporting a more ecient muscle activation
load). * Signi®cant change P < 0.05 have been reported by Moritani and de Vries (1980).
406
Fig. 3a, b Relative changes in contraction work compared to the control leg. a Extensor load, b ¯exor load. The bars indicate standard
deviation. The open/solid columns symbolize the state after 4/8 weeks of training. (e Eccentric load, c concentric load)
* Signi®cant change
After an 8-week isotonic strength training, these authors with the consequence that longer muscles are not so easily
observed a force increase of 30%, but an improvement overstretched. An increase in muscle length would also
in the iEMG of only 12%, corresponding to an actual concur well with the observed improvement in ¯exibility
improvement in the force-iEMG ratio. (see above), since its measurement was performed in such
Structural adaptations of the muscle, however, are a way that the muscle distensibility could be considered to
considered to be responsible for the improved resistance be the essentially limiting factor of the ROM.
to eccentric loads. This can explain the eects of stretch- In animal experiments, various authors (e.g. Williams
ing training on the reduction of muscle strain injuries et al. 1986) described muscle hypertrophy as a growth in
which, according to Glick (1980) and Zarins and Ciullo thickness, indicated by an increase in muscle circum-
(1983), should occur predominantly under eccentric load ference, as well as a lengthening of muscle after sus-
conditions. Such a reorganization may, for instance, oc- tained stretches that were sometimes combined with
cur in the form of an increase in the length of the muscle, electrical stimulation. The slight increase in thigh cir-
407
cumference we observed would therefore speak in favour torque maximum. An isolated increase in thickness with
of an increase in muscle thickness due to hypertrophy. an increase in the number of ®brils would lead to an
Even when underestimating the increase in muscle cross- improved torque maximum and a proportional increase
section on the basis of an increase in thigh circumference in work. A combined increase in both length and
(Young et al. 1983), this may not be sucient to explain thickness with parallel and serial addition of sarcomeres,
the enhanced torque observed, since the measured cir- however, eects the work more than the torque. This
cumferential changes were too small. The results ob- was observed in the extensor as well as in the ¯exor
tained by other authors also support the idea of a under concentric load conditions (see Figs. 2a, b and
functional rather than a structural induction of strength 3a, b). A signi®cant change in the angular position of the
improvement during strength training. torque maximum has not been found (except for ec-
Stretching training may comprise various stimuli that centric movement at 120° á s)1) (see Table 3), although
lead to muscle hypertrophy. The contraction phase of this would be dicult to detect due to the rather low
CR stretching may have the same eect as isometric reproducibility of this parameter and the comparably
muscle training. Furthermore, it is possible that during small dierences due to changes in ¯exibility. A ten-
the second CR stretching cycle the isometric contraction dency in the shift of the torque maximum towards
of the pre-stretched muscle acts as a particularly strong muscle lengthening was observed under eccentric loads.
trigger in a similar way as in animal experiments where Altered biomechanical conditions in the joints due to
muscles were stimulated under stretched conditions stretching training must also be considered. If there was
(Williams et al. 1986). In the so-called AC stretching a lengthening of joint-stabilizing structures it would then
technique, the muscle is stretched by the antagonist. In be possible that, despite the same angle in the joint,
most of these stretching programs agonist and antago- dierent lever conditions may occur not only due to a
nist are stretched alternately through the application of shift of the rotational axis, but also to dierent angles of
active tension. This may also act as isometric muscle the tendon. Consequently, the torque curve may be
training. To single out those dierent components of a changed during movement in such a way that the joint
stretching program responsible for the hypertrophic ef- angle and the magnitude of peak torque are aected
fects, comparative studies would be necessary on the without any change in muscle properties.
eects of a purely isometric training program without A change in the angular position of the peak torque
any stretching, and purely passive stretching without may also be caused by electromechanical alterations.
agonistic or antagonistic activation. Since under high shortening velocities of the ¯exor its
In our training protocol, a total contraction time torque maximum is shifted towards later phases of the
(TCT) of the extensor and ¯exor muscles of 1920 s each movement (see Table 4), the time to maximum activation
was attained (eight times 10 s on 24 days of training). of the muscle may be of importance, at least at higher
Comparing that with the protocol of Komi et al. (1978), velocities. Therefore, training eects in¯uencing this time
where a 48-day isometric training of the quadriceps with interval should also aect the angular or time course of
a TCT of 1200 s yielded a maximum voluntary con- the torque. Principally of course, it cannot be ruled out
traction increase of 20%, the torque increases under that the subjects were highly motivated and thus pro-
isometric load found in our investigations could be ex- duced higher torques after the stretching training.
plained suciently by the isometric component of the
CR stretching performed.
Structural alterations of the muscle may also provide Concluding remarks
an explanation for the changes in the torque pro®le
during motion. The basic evidence is derived from the Our results show that CR stretching training may fa-
fact that a muscle develops maximum force at an opti- vourably in¯uence the force-velocity relationship of the
mal degree of ®lament overlapping (Gordon et al. 1966). trained muscle as well as shape of the torque curve
If we assume, for simplicity, that the lever arm condi- during movements at a given velocity. This appears to be
tions of the investigated joint do not change during a positive side-eect of stretching which in the ®rst place
muscle shortening, then the angular position where the is considered to be and is applied as a method for im-
maximum torque is attained characterizes the optimum proving ¯exibility. The extent to which the observed
degree of actin-myosin overlapping. improvements in muscle performance can be applied
If a stretching training program were to lengthen the successfully to competitive sports or within the frame-
muscle tendons alone without aecting the muscle itself, work of rehabilitation programs, as well as establishing
then the torque maximum would be shifted towards which persons would bene®t most from it, could not be
greater lengths, with no eect on the shape of the torque clari®ed conclusively in this study. More distinct results
curve. On the other hand, an exclusive increase in muscle might be expected by increasing the number of volun-
length due to an increase in the number of linearly ar- teers from the same sport in additional studies. Further
ranged sarcomeres would have to lead to a widening of comparative investigations are necessary to determine
the torque curve (torque vs joint angle) during con- the proportion of the improvement in muscle perfor-
traction, and would therefore essentially eect an in- mance due either to the stretching stimulus or to the pure
crease in work without aecting the magnitude of the isometric contraction manoeuvre without stretching.
408