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Let’s Stretch – For Your Health

by | Feb 6, 2021

We may be doing lesser amount of aerobic exercise these days as we stay at home more often.

How about incorporating more stretching exercise into your physical exercise routine instead? Stretching exercise can be done at the comfort of your own home and may require less space.

Stretching exercise may be better known for its benefits in musculoskeletal health such as increasing flexibility and range of motion, reducing risk of injuries, rehabilitation, etc.

However, stretching has much broader health benefits than one might think, far beyond musculoskeletal health, and including other physiological health such as lowering blood pressure, improving heart health, reducing blood glucose levels, etc.

In this article, I share evidence-based information on the health benefits of stretching exercise.

Let’s stretch – for your health!

Benefits of Stretching on Musculoskeletal Health

Here is a summary of musculoskeletal health benefits associated with stretching:1–6,23,24,30,33,34

  • Increases joint range of motion (ROM) and reduced muscle-tendon stiffness associated with the stretched muscles and joint.
  • Increases ROM of contralateral and non-local (i.e., non-stretched) joints since stretching a particular muscle group/joint, can exert global stretch-induced effects on other (non-stretched) parts of the body.
  • Improves ROM and postural balance among elderly.
  • Enhances athletic performance of certain physical activity, by allowing more expansive movements with less resistance.
  • Reduces risk of injuries of muscles and tendons.
  • Helps to manage and reduce certain chronic pains associated with musculoskeletal conditions (strain, stiffness, tension) including neck, and lower back pain.
  • Supports rehabilitation for physical strain and injury, muscle disorders associated with certain illness (incl. Parkinson’s disease, multiple sclerosis).

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Benefits of Stretching on Other Physiological Health

Regular stretching exercise have many physiological health benefits as described below.

Stretching exercise is generally a more gentle and accessible form of exercise compared to more intense aerobic and resistance exercises, especially for people with certain health conditions. It is therefore a good form of exercise to incorporate into one’s physical exercise routine.

Improvement in Blood Vessel and Cardiovascular Health

Clinical studies have found that passive stretching can improve blood vessel function and cardiovascular health, thus reducing the risk of heart disease.7,35

Stretch-relaxation cycles induce alteration in blood flow and act as an effective stimulus that improves vascular function and structure, and reduces arterial stiffness; all of which are important markers for cardiovascular health.7,8,35

The observed improvements not only occur locally on arteries feeding the stretched muscles, but also on non-local arteries in other parts of the body.7

Regular passive stretching exercise can help to maintain these benefits.7,35

Studies also showed that flexibility training is more effective compared to strength training or combined strength and aerobic training in improving arterial health.9

In addition, poor flexibility is correlated with higher arterial stiffness compared to those with good flexibility.10,11

Blood Pressure Reduction

Regular aerobic exercise (for at least a total of 150 minutes per week, e.g., 30-min exercise, 5 times per week) at moderate intensity has long been known and recommended to reduce blood pressure (BP) in people with prehypertension (systolic BP/diastolic BP of 120-139 mmHg/80-89 mmHg) and hypertension (systolic BP/diastolic BP of 140/90 mmHg and above).

Recent studies have shown that regular stretching exercise (~30 minutes per session, ~5 times a week) can also reduce BP and is more effective compared to brisk walking (which is considered a moderate intensity exercise).8,12–15

The reduction in BP is attributed to improved vascular function and structure, and reduced arterial stiffness, as discussed above.

In addition, stretching increases activation of the parasympathetic nervous system and reduces activation of sympathetic nervous system, which result in blood vessel dilation.12

Poor flexibility has been found to correlate with higher BP compared to those with good flexibility.11

Blood Glucose Control

Physical exercise is one of the essential management and prevention strategies for type-2 diabetes, in conjunction with diet and lifestyle strategies.17

 Aerobic exercise, resistance exercise, or a combination of both are the most well recognized forms of physical exercise for the management of type-2 diabetes as these exercises have been shown by clinical studies to reduce blood glucose levels and improve insulin response, if done regularly (i.e., at least 150 minutes of moderate to vigorous exercise, spread over 3 to 7 days/week).17

Recent clinical studies have shown that passive stretching is also effective in blood glucose control among type-2 diabetes patients.18–20 Passive stretching exercise was found to be as effective as resistance exercise in reducing blood glucose levels.19

In addition, passive stretching exercise was found to exert both short term (immediate) and long term effects (if done regularly) in blood glucose level reduction.18–20

Stretching increases metabolic activity of muscle cells and alter blood flow, which in turn facilitate glucose transport into cells, thus reducing blood glucose levels.18–20

Passive stretching exercise session of 20 to 40 minutes, performed at least 3 times a week was found to produce positive results.18–20

Management of Fibromyalgia

Fibromyalgia is characterized by a plethora of symptoms including chronic and diffuse musculoskeletal pain, fatigue, sleep disorders and the associated mental disorders including anxiety and depression.22

Exercise therapy is one of the treatment components for fibromyalgia. The right types, intensity and frequency of exercise need to be carefully chosen such that the physical movement does not exacerbate the pain, causing physical trauma and emotional stress.21, 22

Aerobic, resistance and stretching exercises, when chosen adequately, have all been found to be beneficial for managing symptoms and conditions of fibromyalgia.22

Stretching exercise involving major muscle groups was found to be effective in reducing pain, improving physical functioning and quality of life (including vitality and mental health). One study comparing active stretching exercise and resistance exercise found that stretching exercise was more effective in reducing pain and improving physical functioning. 21, 22

Management of Respiratory Diseases/Conditions

Passive stretching exercise of the respiratory muscles (including the chest, upper back, side of neck, rib cage, diaphragm) was shown to improve chest expansion, breathing pattern and functional exercise capacity, among patients with chronic obstructive pulmonary disease (COPD).25,26

Respiratory muscle stretching was also found to be a beneficial rehabilitation program for post-stroke patients with hemiparesis, by improving chest wall expansion and breathing pattern.27

Stress Management and Mental Health

Stress is prevalent in our modern living.

Chronic stress can be a major culprit that increase the risk of many health conditions and diseases, including heart disease, type-2 diabetes, suppressed immune function, gut/digestive disorders, Alzheimer’s disease/dementia, etc. (For more information on how stress affects our health, see my previous article: Why Stress is the Culprit.)

Chronic stress also contributes to chronic inflammation, which in turn is a major culprit to many chronic diseases/disorders. (For more details on chronic inflammation, see my previous article: Why Adopt an Anti-inflammatory Diet & Lifestyle and How?.)

Yoga stretching was found to be effective in reducing stress hormone (cortisol) levels and increasing the activation of parasympathetic nervous system (the part of the nervous system that is responsible for “rest and digest”), thus mitigating the harmful effects of stressors.28,31

Study showed that stretching exercise implemented at the workplace helped to reduce anxiety levels and improve mental health.32

Sleep Improvement

Poor sleep quality, sleep deprivation and sleep disorders can contribute to many health issues and increase the risk of many chronic diseases/disorders. (For more information, see my previous article: Tips for Better Sleep to Support Your Immune Health and Overall Health.)

Stretching exercise has been found to improve sleep quality, reduce insomnia severity, and reduce tension-anxiety among people with sleep disorders.29

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Related Articles

Why Stress is the Culprit

Why Adopt an Anti-inflammatory Diet & Lifestyle and How?

Tips for Better Sleep to Support Your Immune Health and Overall Health

References

  1. Behm DG, Alizadeh S, Anvar SH, Drury B, Granacher U, Moran J. Non-local Acute Passive Stretching Effects on Range of Motion in Healthy Adults: A Systematic Review with Meta-analysis [published online ahead of print, 2021 Jan 18]. Sports Med. 2021;10.1007/s40279-020-01422-5. doi:10.1007/s40279-020-01422-5
  2. Chaouachi A, Padulo J, Kasmi S, Othmen AB, Chatra M, Behm DG. Unilateral static and dynamic hamstrings stretching increases contralateral hip flexion range of motion. Clin Physiol Funct Imaging. 2017;37(1):23-29. doi:10.1111/cpf.12263
  3. Tunwattanapong P, Kongkasuwan R, Kuptniratsaikul V. The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: a randomized controlled trial. Clin Rehabil. 2016;30(1):64-72. doi:10.1177/0269215515575747
  4. Lawand P, Lombardi Júnior I, Jones A, Sardim C, Ribeiro LH, Natour J. Effect of a muscle stretching program using the global postural reeducation method for patients with chronic low back pain: A randomized controlled trial. Joint Bone Spine. 2015;82(4):272-277. doi:10.1016/j.jbspin.2015.01.015
  5. Fontana Carvalho AP, Dufresne SS, Rogerio de Oliveira M, et al. Effects of lumbar stabilization and muscular stretching on pain, disabilities, postural control and muscle activation in pregnant woman with low back pain. Eur J Phys Rehabil Med. 2020;56(3):297-306. doi:10.23736/S1973-9087.20.06086-4
  6. Sherman KJ, Cherkin DC, Wellman RD, et al. A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain. Arch Intern Med. 2011;171(22):2019-2026. doi:10.1001/archinternmed.2011.524
  7. Bisconti AV, Cè E, Longo S, et al. Evidence for improved systemic and local vascular function after long-term passive static stretching training of the musculoskeletal system. J Physiol. 2020;598(17):3645-3666. doi:10.1113/JP279866
  8. Shinno H, Kurose S, Yamanaka Y, et al. Evaluation of a static stretching intervention on vascular endothelial function and arterial stiffness. Eur J Sport Sci. 2017;17(5):586–592. doi:10.1080/17461391. 2017.1284267
  9. Cortez-Cooper MY, Anton MM, Devan AE, Neidre DB, Cook JN, Tanaka H. The effects of strength training on central arterial compliance in middle-aged and older adults. Eur J Cardiovasc Prev Rehabil. 2008;15(2):149–155. PubMed ID: 18391640 doi:10.1097/HJR. 0b013e3282f02fe2
  10. Nishiwaki M, Kurobe K, Kiuchi A, Nakamura T, Matsumoto N. Sex differences in flexibility-arterial stiffness relationship and its application for diagnosis of arterial stiffening: a cross-sectional observational study. PLoS One. 2014;9(11):e113646 PubMed ID: 25427157 doi:10.1371/journal.pone.0113646 25.
  11. Yamamoto K, Kawano H, Gando Y, et al. Poor trunk flexibility is associated with arterial stiffening. Am J Physiol Heart Circ Physiol. 2009;297(4):H1314–H1318. PubMed ID: 19666849 doi:10.1152/ ajpheart.00061.2009
  12. Ko J, Deprez D, Shaw K, et al. Stretching is Superior to Brisk Walking for Reducing Blood Pressure in People With High-Normal Blood Pressure or Stage I Hypertension [published online ahead of print, 2020 Dec 18]. J Phys Act Health. 2020;1-8. doi:10.1123/jpah.2020-0365
  13. Kato M, Nihei Green F, Hotta K, et al. The Efficacy of Stretching Exercises on Arterial Stiffness in Middle-Aged and Older Adults: A Meta-Analysis of Randomized and Non-Randomized Controlled Trials. Int J Environ Res Public Health. 2020;17(16):5643. Published 2020 Aug 5. doi:10.3390/ijerph17165643
  14. Yeo S. Adherence to walking or stretching, and risk of preeclampsia in sedentary pregnant women. Res Nurs Health. 2009;32(4):379–390. PubMed ID: 19415672 doi:10.1002/nur.20328
  15. Wong A, Figueroa A. Eight weeks of stretching training reduces aortic wave reflection magnitude and blood pressure in obese postmenopausal women. J Hum Hypertens. 2014;28(4):246–250. PubMed ID: 24132138 doi:10.1038/jhh.2013.98
  16. Taheri N, Mohammadi HK, Ardakani GJ, Heshmatipour M. The effects of passive stretching on the blood glucose levels of patients with type 2 diabetes. J Bodyw Mov Ther. 2019;23(2):394-398. doi:10.1016/j.jbmt.2018.02.009
  17. Kirwan JP, Sacks J, Nieuwoudt S. The essential role of exercise in the management of type 2 diabetes. Cleve Clin J Med. 2017;84(7 Suppl 1):S15-S21. doi:10.3949/ccjm.84.s1.03
  18. Taheri N, Mohammadi HK, Ardakani GJ, Heshmatipour M. The effects of passive stretching on the blood glucose levels of patients with type 2 diabetes. J Bodyw Mov Ther. 2019;23(2):394-398. doi:10.1016/j.jbmt.2018.02.009
  19. Gurudut P, Rajan AP. Immediate effect of passive static stretching versus resistance exercises on postprandial blood sugar levels in type 2 diabetes mellitus: a randomized clinical trial. J Exerc Rehabil. 2017;13(5):581-587. Published 2017 Oct 30. doi:10.12965/jer.1735032.516
  20. Park SH. Effects of passive static stretching on blood glucose levels in patients with type 2 diabetes mellitus. J Phys Ther Sci. 2015;27(5):1463-1465. doi:10.1589/jpts.27.1463
  21. Assumpção A, Matsutani LA, Yuan SL, et al. Muscle stretching exercises and resistance training in fibromyalgia: which is better? A three-arm randomized controlled trial. Eur J Phys Rehabil Med. 2018;54(5):663-670. doi:10.23736/S1973-9087.17.04876-6
  22. Sosa-Reina MD, Nunez-Nagy S, Gallego-Izquierdo T, Pecos-Martín D, Monserrat J, Álvarez-Mon M. Effectiveness of Therapeutic Exercise in Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Biomed Res Int. 2017;2017:2356346. doi:10.1155/2017/2356346
  23. Garrett TR, Neibert PJ. The effectiveness of a gastrocnemius-soleus stretching program as a therapeutic treatment of plantar fasciitis. J Sport Rehabil. 2013;22(4):308-312. doi:10.1123/jsr.22.4.308
  24. Seidman AJ, Varacallo M. Trochanteric Bursitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; June 29, 2020.
  25. Rehman A, Ganai J, Aggarwal R, Alghadir AH, Iqbal ZA. Effect of Passive Stretching of Respiratory Muscles on Chest Expansion and 6-Minute Walk Distance in COPD Patients. Int J Environ Res Public Health. 2020;17(18):6480. Published 2020 Sep 6. doi:10.3390/ijerph17186480
  26. Wada JT, Borges-Santos E, Porras DC, et al. Effects of aerobic training combined with respiratory muscle stretching on the functional exercise capacity and thoracoabdominal kinematics in patients with COPD: a randomized and controlled trial. Int J Chron Obstruct Pulmon Dis. 2016;11:2691-2700. Published 2016 Oct 28. doi:10.2147/COPD.S114548
  27. Rattes C, Campos SL, Morais C, et al. Respiratory muscles stretching acutely increases expansion in hemiparetic chest wall. Respir Physiol Neurobiol. 2018;254:16-22. doi:10.1016/j.resp.2018.03.015
  28. Eda N, Ito H, Akama T. Beneficial Effects of Yoga Stretching on Salivary Stress Hormones and Parasympathetic Nerve Activity. J Sports Sci Med. 2020;19(4):695-702. Published 2020 Nov 19.
  29. D’Aurea CVR, Poyares D, Passos GS, et al. Effects of resistance exercise training and stretching on chronic insomnia. Braz J Psychiatry. 2019;41(1):51-57. doi:10.1590/1516-4446-2018-0030
  30. Kwok JYY, Kwan JCY, Auyeung M, et al. Effects of Mindfulness Yoga vs Stretching and Resistance Training Exercises on Anxiety and Depression for People With Parkinson Disease: A Randomized Clinical Trial. JAMA Neurol. 2019;76(7):755-763. doi:10.1001/jamaneurol.2019.0534
  31. Eda N, Ito H, Shimizu K, Suzuki S, Lee E, Akama T. Yoga stretching for improving salivary immune function and mental stress in middle-aged and older adults. J Women Aging. 2018;30(3):227-241. doi:10.1080/08952841.2017.1295689
  32. Effectiveness of a stretching program on anxiety levels of workers in a logistic platform: a randomized controlled study]. Aten Primaria. 2013;45(7):376-383. doi:10.1016/j.aprim.2013.03.002
  33. Halabchi F, Alizadeh Z, Sahraian MA, Abolhasani M. Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurol. 2017;17(1):185. Published 2017 Sep 16. doi:10.1186/s12883-017-0960-9
  34. Palmer TB, Agu-Udemba CC, Palmer BM. Acute effects of static stretching on passive stiffness and postural balance in healthy, elderly men. Phys Sportsmed. 2018;46(1):78-86. doi:10.1080/00913847.2018.1421396
  35. Kruse NT, Scheuermann BW. Cardiovascular Responses to Skeletal Muscle Stretching: “Stretching” the Truth or a New Exercise Paradigm for Cardiovascular Medicine?. Sports Med. 2017;47(12):2507-2520. doi:10.1007/s40279-017-0768-1
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