Philip Jamtvedt and colleagues published a large pragmatic randomized trial in the BMJ in 2009. They enrolled 2,377 community-dwelling adults aged 18 and older who were about to start a new physical activity program, randomly assigning them to either stretch before and after activity or not stretch.

The stretching group performed a standardized routine targeting major muscle groups before and after each session. Over the study period, stretching did not produce statistically significant reductions in all-injury risk overall. However, stretching did reduce the risk of injuries specifically to muscles, ligaments, and tendons - the soft-tissue injuries that make up the majority of exercise-related problems.

This finding is important because it suggests that stretching targets a specific injury type rather than providing blanket protection. Bone injuries, joint dislocations, and overuse injuries may have different causes that stretching alone cannot address, but the musculotendinous injuries that most people worry about when they stretch did occur less often in the stretching group.

Rob Herbert and colleagues from the University of Sydney published a systematic review in the Research in Sports Medicine journal in 2008 examining the efficacy of static stretching as part of a warm-up for preventing exercise-related injuries. They identified 4 randomized controlled trials and 3 controlled clinical trials.

While 3 of the 4 randomized controlled trials concluded that static stretching was ineffective in reducing overall exercise-related injury incidence, there was preliminary evidence suggesting static stretching may reduce musculotendinous injuries specifically - meaning pulls, strains, and tears of muscles and the tendons connecting them to bones.

This distinction matters because musculotendinous injuries are the type most directly related to muscle flexibility and compliance. Stretching increases the length and elasticity of muscle-tendon units, which could plausibly protect against the kind of sudden overstretching that causes muscle strains during explosive movements.

Thorborg and colleagues published a systematic review in the British Journal of Sports Medicine in 2017 analyzing the evidence on the FIFA 11+ warm-up program, which was developed by FIFA''s Medical Assessment and Research Centre. The program includes a structured sequence of dynamic stretching, running exercises, balance training, and strength exercises performed before practice and games.

Across multiple randomized controlled trials, the FIFA 11+ program reduced overall injury rates by 30% to 46%. Some studies found even larger effects for specific injury types, with up to 50% fewer knee and ankle injuries. The program was particularly effective at reducing non-contact injuries - the kind caused by landing, cutting, or sudden changes of direction.

While the FIFA 11+ is more than just stretching - it includes strengthening and neuromuscular training - the dynamic stretching component is a core part of the protocol. The program demonstrates that a structured warm-up routine that includes stretching as part of a comprehensive approach can meaningfully reduce injury rates in competitive athletes.

Woods, Bishop, and Jones published a review article in Sports Medicine in 2007 examining the scientific rationale behind warm-up and stretching for injury prevention. The review synthesized evidence from physiology and biomechanics research to explain why these practices could theoretically prevent injuries.

Warming up increases muscle temperature by 1-2 degrees Celsius, which reduces the stiffness of muscle-tendon units by about 10-15%. This means the muscle can stretch further before reaching the point where fibers begin to tear. Blood flow to the muscles also increases, improving oxygen delivery and waste removal. The combined effect is a muscle that is more pliable, more responsive, and less likely to be damaged by sudden forceful movements.

The review noted that most muscle strains occur during eccentric contractions - when the muscle is being forcibly lengthened, such as when decelerating or landing. Stretching before exercise may raise the threshold at which eccentric damage occurs by pre-conditioning the muscle-tendon unit to tolerate greater lengths.

A review article published in Sports in 2023 examined the potential effects of dynamic stretching on injury incidence in athletes. Unlike static stretching (holding a position), dynamic stretching involves controlled movements through the full range of motion, such as leg swings, walking lunges, and arm circles.

The review found that dynamic stretching improves several neuromuscular factors that protect against injury. These include improved joint position sense (knowing where your limbs are in space), better muscle activation timing, enhanced balance and stability, and increased readiness of the nervous system to respond quickly to unexpected movements.

Non-contact injuries - such as anterior cruciate ligament (ACL) tears during landing and ankle sprains during direction changes - often result from poor neuromuscular control rather than lack of flexibility. Dynamic stretching addresses this by activating the motor patterns and stabilizing reflexes that the athlete will need during the upcoming activity.

Rogan and colleagues published this randomized controlled trial in the Journal of Sport Rehabilitation in 2015, studying 862 high school soccer players. Teams were randomized to three groups: dynamic stretching warm-up, a combined static and dynamic stretching warm-up, or a control warm-up without stretching.

The combined stretching group showed a reduction in overall injury incidence compared to the no-stretching control group. The study tracked injuries over a full competitive season, giving it real-world applicability for young athletes in team sports.

This study is notable because it tested stretching in the specific context where many people actually do it - before athletic competition. The finding that a combined approach including both dynamic and static stretching was beneficial suggests that the type and combination of stretching matters, and that dismissing all pre-exercise stretching as useless may be premature.

A panel of international stretching and sports medicine experts published consensus recommendations in PMC in 2025 using the Delphi method - a structured process where experts independently provide and refine their opinions until they converge on shared recommendations.

The panel reached consensus that dynamic stretching before exercise is recommended for sports involving explosive movements. Activities such as sprinting, jumping, and rapid direction changes place high demands on muscle-tendon units, and dynamic stretching prepares these structures for the forces they will experience.

The experts distinguished between static and dynamic stretching, noting that the type of stretching matters more than simply whether or not stretching is performed. Dynamic stretching before exercise was viewed favorably, while prolonged static stretching immediately before explosive activity was not recommended due to potential temporary decreases in power output.

McHugh and Cosgrave published this narrative review in the Scandinavian Journal of Medicine and Science in Sports in 2010, synthesizing the clinical and basic science evidence on stretching and injury prevention, with particular focus on the relationship between flexibility and muscle strain risk.

The review concluded that there is evidence supporting the role of pre-exercise stretching in reducing muscle strains specifically. The biological rationale centers on the fact that muscle strains occur when a muscle is stretched beyond its capacity, and stretching before exercise increases the immediate tolerance of the muscle-tendon unit to lengthening.

The authors acknowledged that the evidence base has significant gaps and that more well-designed randomized controlled trials are needed. They noted that the relationship between stretching and injury prevention is complex and depends on the type of stretching, the sport, and the specific injury type being considered.