For many, stretching is the fitness equivalent of awkward small talk. It's the opening act, the thing you tolerate because you know it will be over soon.
Others have challenged the practice, suggesting that stretching isn't necessary at all. Some research has found that a preworkout stretch may even be disadvantageous, weakening muscles and hindering performance.
To put it plainly, no one seems terribly enthusiastic about touching their toes.
That's why a 2020 study on exercise and mortality was such a head-scratcher. The study found that stretching was uniquely associated with a lower risk for all-cause mortality among American adults. That's after controlling for participation in other types of exercise.
The finding seemed like a fluke, until a 2023 study found essentially the same thing.
Among Korean adults, those who did flexibility exercise at least five times a week had a 20% lower risk of dying during the follow-up period than those who didn't stretch at all. That was slightly better than the risk reduction associated with high volumes of aerobic exercise and resistance training.
How can that be ? It turns out, stretching is linked to several health benefits that you might not expect.
The Surprising Benefits of Stretching
When we talk about stretching, we usually mean static stretching — getting into and holding a position that challenges a muscle, with the goal of improving range of motion around a joint.
It doesn't need to be a big challenge. "Research shows you can get increases in flexibility by stretching to the initial point of discomfort," said David Behm, PhD, an exercise scientist at Memorial University of Newfoundland in Canada who's published dozens of studies on stretching over the past quarter-century.
That brings us to the first benefit.
Stretching Benefit #1: More Strength
At first glance, flexibility training and strength training have little in common. You lengthen muscles in the former and contract them in the latter.
But in both cases, Behm said, you're applying tension to muscles and connective tissues. Tension activates proteins called integrins, which send and receive signals across cellular membranes. Those signals are the start of a cascade that leads to protein synthesis. That's how muscles get bigger and stronger when you lift weights.
That mechanism could explain the small gains in muscle strength and size associated with static stretching, Behm said.
But can you really stretch your way to muscle growth? Theoretically, yes. But strength training is far more time-efficient, Behm says. Studies showing increases in muscle mass have typically stretched a single muscle (usually the calves, using a specialized device) for > 30 min/session, 6 d/wk for 6 weeks. And that's for just one leg.
Still, stretching may be more accessible for some patients — research suggested that older and more sedentary people are most likely to benefit from stretching-induced gains in strength.
Stretching Benefit #2: Reduced Arterial Stiffness
"Most people don't think about the cardiovascular benefits of stretching," Behm said. There are some big ones.
If your body doesn't move well, it's not unreasonable to assume your blood doesn't flow well. That is indeed the case: Poor flexibility is associated with arterial stiffness.
Stretching is associated not only with improved arterial function but also with reductions in resting heart rate and blood pressure and increased vasodilation.
Mobility improvements may have an indirect benefit on cardiovascular health as well.
"Studies show runners are more economical when they're more flexible," Behm said. If your movement is more efficient, you'll probably do more of it. Doing more, in turn, would lead to improved fitness.
Stretching Benefit #3: Improved Performance
Research is equivocal on whether stretching improves athletic performance, said Joe Yoon, a sports massage therapist in Orlando, Florida, and author of Better Stretching.
"But I've always taken the approach that if you can improve your range of motion and get into positions" required for your sport, you'll probably perform better, with less risk for injury, Yoon said.
It's worth noting that some research over the past 30 years has linked pre-exercise static stretching with a loss of strength, power, and/or speed.
But consider this: In a 2016 review, Behm and his coauthors showed that performance reductions were most likely to occur in two situations:
- When participants did extremely long stretches (duration, ≥ 60 sec per muscle).
- When researchers tested the participants' strength, power, or speed immediately after they stretched.
Avoiding those problems is easy, Behm said: Stretch each muscle for < 60 sec, and combine static stretches with more active warm-up exercises.
"Stretching can impair your performance but only if you do it wrong," he said.
Stretching Benefit #4: Fewer Injuries
When you stretch, the point where you feel tension is where the muscle is most vulnerable. "That's where injuries usually happen," Behm said.
More flexibility in those areas allows your muscles to safely generate force at longer lengths. For an athlete, that means fewer injuries when they're doing explosive movements or changing direction.
For nonathletes, flexibility reduces injuries by improving balance. Better balance reduces the risk of falling and helps mitigate the damage if you do take a tumble.
Help Your Patients Get the Benefits of Stretching
Stretching, like training for endurance or strength, can be as complex as you want to make it. But Yoon advocates a simpler approach.
"You see this flashy stuff online," he said. "But if you see those trainers in real life or you book a session with them, they go right back to the basics."
Ideally, Yoon said, a flexibility routine will work the entire body. But if that's too big a stretch for your patient, he recommends starting with one or two stretches for the most problematic area.
For example, for a stiff back, try doing the puppy pose at least once a day, although twice is better. Hold the position for 30 seconds to 2 minutes, said Yoon. Even if you combine it with a dynamic movement like the cat-cow, the two exercises would take just a few minutes a day.
"There's this misconception that you have to do a lot of it to be successful," Yoon said.
Consistency is far more important than volume. Yoon recommends "a little bit every day — the minimum viable dose."
As a bonus, stretching an area like your upper back will probably improve your shoulder mobility, Yoon said. Same with your lower body: Stretches for your hips, over time, should also benefit your knees and lower back.
And thanks to a phenomenon called nonlocal flexibility transfer, lower-body stretches should improve upper-body flexibility, at least temporarily. Shoulder stretches can also have an immediate effect on hip mobility.
"It's all connected," Yoon said, which brings us back to where we started.
If stretching can indeed reduce mortality risk, it's probably because of interconnected pathways, rather than any single mechanism.
Most obviously, stretching improves flexibility, which makes movement easier, improves balance, and reduces the risk for falls and other types of injuries. It can also lead to small improvements in strength. Less obviously, stretching improves several aspects of cardiovascular function, including circulation.
"There seems to be a global effect in everything we do," Behm said. "Whether you're stretching or weight training, the message is sent throughout your body.
https://www.medscape.com/viewarticle/stretching-now-underrated-accumulating-research-says-yes-2024a10003s2
