Is there still a place for workplace stretching? Moving beyond static stretch. Presented by Carmen Shafer, CSP, CHST

1. Is There Still a Place for Workplace
Stretching? Moving Beyond Static Stretch.
Carmen Shafer, CSP, CHST

2. Topics
Topics
Evaluating the Arguments
Review of Stretching
Recent Studies
Application and Next Steps

3. Arguments Against Stretching
Arguments Against Stretching
• Exercise science studies declare that stretching can be
detrimental to performance.
• Many exercise science studies examining the effect of
stretching on athlete injuries are inconclusive.
• Many studies examining the effect of stretching on workplace
ergonomic injury prevention are inconclusive. Therefore,
resources are better spent on engineering controls.

4. Evaluating the Arguments
Evaluating the Arguments
• Studies on the effect of stretching on athletic performance
indicate that different stretching methods have varied
effects on performance.
• Exercise science studies vary widely in population and
application, which are very different from most workplaces.
• Workplace studies vary widely in population, injury risks,
type of intervention, duration and measurement.

5. What Are We Missing?
What Are We Missing?
• Reasons for implementing stretching programs tend to focus on a
single concept – increase flexibility and range of motion to reduce
injury risk (Choi et al., 2017).
• Arguments for implementing (or rejecting) stretch and flex
programs primarily focus on injury rate reduction and return on
investment.

6. Stretching: A type of exercise which focuses on lengthening
target muscles, typically to improve range of motion (ACSM, 2022;
Smith, 1994).
Stretching is an administrative control for prevention of ergonomic injuries
(Choi et al., 2017) as part of a larger ergonomic injury prevention program
(NIOSH, 2007).
Stretching: A type of exercise which focuses on lengthening
target muscles, typically to improve range of motion (ACSM, 2022;
Smith, 1994).
Stretching is an administrative control for prevention of ergonomic injuries
(Choi et al., 2017) as part of a larger ergonomic injury prevention program
(NIOSH, 2007).
What is Stretching?

7. Types of Stretching
Types of Stretching
Stretching
Technique
Static Active (Self)
Passive (Partner)
Dynamic Active
Ballistic
Pre-Contraction PNF* and Related
Techniques
Adapted from Page
(2012) *Proprioceptive Neuromuscular Facilitation

8. Dynamic Stretching
Dynamic Stretching
• Also known as active stretching (Page, 2012), dynamic stretching is a
slow, cyclical elongating static stretch followed by a shortening of
muscles (Herda et al., 2013)
• The ACSM (2022) encourages dynamic stretching prior to exercise
– Other types of stretching (static, ballistic, PNF) are not encouraged prior to
exercise activities. (ACSM, 2022)
• Few studies have been conducted examining the relationship
between acute dynamic stretching and muscle fatigue. (Heuser & Pincivero,
2010; Laur, et al., 2003; Mangueira et al., 2018)

9. Effects of Stretching
Flexibility and
Elasticity
Increase Range of
Motion
Assumes reduction in
risk of strains
Fatigue and
Endurance
Most studies report
perception of fatigue
or max repetitions
Studies show slight
increase in fatigue
with stretching
Power and
Strength
Some studies report
improvements (Hess &
Hecker, 2003; Gasibat et
al., 2017)
Stretch-induced
strength loss with
static stretching

10. Year Authors Population Intervention Duration Measurements Results
2018
Mangueira
et al.
Recreationally
trained women
Varying durations
of static and PNF
stretching
sessions
12 sessions
Perception of effort,
maximum repetitions
PNF returned ↑ perceived effort for
longer duration stretches. Passive
static stretch returned ↑ perceived
effort with no reduction in max
repetitions.
2016 Kim et al.
University
Students
(mobile phone
users)
Stretching and
stabilizing
exercises
3 days
sEMG – Median
Frequency
↓ Fatigue in stretch and exercise
groups
2015
Goldenhar &
Stafford
Construction
Industry
Safety and
health
professionals
Survey and
interviews (mixed
methods)
Varied Varied
Improved comradery, collaboration &
communication. Where MSD Injuries
↓, stretching was not the only
intervention
Recent Relevant Research
Note: ↑ represents increase, ↓ represents decrease

11. If you've seen one construction worksite stretch and flex program
…you've seen one construction worksite stretch and flex program
by Linda Goldenhar and Pete Stafford (2015)
If you've seen one construction worksite stretch and flex program
…you've seen one construction worksite stretch and flex program
by Linda Goldenhar and Pete Stafford (2015)
• 56% of total respondents reported having implemented a
stretch and flex program relative recently (within 2-5 years)
• 48% reported either no current stretch and flex program in
place or had never implemented a program
• 6% reported discontinuing their stretch and flex program due
to lack of evidence for ROI and limited evidence that the
program reduced ergonomic injuries

12. If you've seen one construction worksite stretch and flex program
…you've seen one construction worksite stretch and flex program
by Linda Goldenhar and Pete Stafford (2015)
If you've seen one construction worksite stretch and flex program
…you've seen one construction worksite stretch and flex program
by Linda Goldenhar and Pete Stafford (2015)
• Responses of Note:
– 79% performed stretches at the beginning of the shift
– 60.3% sessions lasted 6-10 minutes
– 92.1% mandated attendance for both employees and
subcontractors, however 60.3% did not require participation due
to liability concerns
– 83.1% did not use incentives to promote participation
– 69% indicated there was no separate budget for the program

13. If you've seen one construction worksite stretch and flex program
…you've seen one construction worksite stretch and flex program
by Linda Goldenhar and Pete Stafford (2015)
If you've seen one construction worksite stretch and flex program
…you've seen one construction worksite stretch and flex program
by Linda Goldenhar and Pete Stafford (2015)
• Stated goals for having a program was to “warm-up and stretch”, “like
athletes”, to prevent injury due to straining of tight muscles and overexertion
• While most common benefit cited was reduction of strains and sprains, only
48% used injury data to evaluate the effectiveness of the program
• Most interventions were accompanied by other ergonomic injury reduction
initiatives
• 69.4% indicated that the stretch program was combined with their daily safety
meeting

14. If you've seen one construction worksite stretch and flex program
…you've seen one construction worksite stretch and flex program
by Linda Goldenhar and Pete Stafford (2015)
If you've seen one construction worksite stretch and flex program
…you've seen one construction worksite stretch and flex program
by Linda Goldenhar and Pete Stafford (2015)
• Study Conclusions
– Stretching routines varied widely and indicated tailoring of programs to
match need
– Not mandating participation had little impact
– Perception that the program is expensive to implement, but it is seen as
valuable anyway
– Variety of benefits observed including an increase in engagement with the
team and providing an opportunity for workers to get focused on their work

15. Year Authors Population Intervention Duration Measurements Results
2021 King et al.
Perioperative
Hospital Staff
10 min Stretch 2X-
3X/Wk.
Not structured
6 months
Incident reports, W/C
claims, sick leave,
Qualitative feedback and
perception
Odds ↓ 60% for MSD injury, ↓ 50% for W/C
claim, ↓ 20% sick leave, Positive feedback
2020 Villanueva et al. Office workers
Stretch and
stabilization of core
and scapula
6 weeks
Discomfort scores,
muscle tone
↓ dom . side muscle tone, ↑ in non dom.
side muscle tone, ↓ neck and upper back
discomfort.
2019 Kim
Hospital
Housekeeping
Staff
Trainer led
stretching program
10 min. 3X/Wk.
3 weeks
Qualitative feedback,
flexibility, range of motion
Positive feedback, ↓ pain
2016
Tunwattanapong
et al.
Office workers
with neck pain
Shoulder Stretches
3X/day 5X/Wk.
4 weeks
Pain visual analog scale,
Pain Questionnaire
Neck pain ↓, improved function
2015 Caldwell
Transportation
Maintenance
4.5 min. video, 15 s.
static stretches
5X/Wk.
5 weeks
Qualitative feedback and
perception
Discomfort ↓, positive report of “daily life”
effects outside of work
Workplace Stretching Research

16. A workplace stretching program for the prevention of
musculoskeletal disorders in perioperative staff: A mixed
methods implementation study by Alison King et al. (2020)
A workplace stretching program for the prevention of
musculoskeletal disorders in perioperative staff: A mixed
methods implementation study by Alison King et al. (2020)
• Location: NSW Australia
• N=42 participants of 85 total staff – high MSD risk occupation
• 6-month duration
• Data collected on MSD disorders, discomfort, sick leave,
MSD incidents and workers compensation claims before and
after study
• Interviews and survey of participants at completion

17. A Workplace Stretching Program for the Prevention of
Musculoskeletal Disorders in perioperative staff: A mixed
methods implementation study by Alison King et al. (2020)
A Workplace Stretching Program for the Prevention of
Musculoskeletal Disorders in perioperative staff: A mixed
methods implementation study by Alison King et al. (2020)
• Stretching station located near working areas
• Orientation and briefing by PI with physiotherapist
support
• Stretching Posters
• 10 minutes stretching 2-3 times per week during
breaks, before or after work (employee choice)

18. A Workplace Stretching Program for the Prevention of
Musculoskeletal Disorders in perioperative staff: A mixed
methods implementation study by Alison King et al. (2020)
A Workplace Stretching Program for the Prevention of
Musculoskeletal Disorders in perioperative staff: A mixed
methods implementation study by Alison King et al. (2020)
• Results and Discussion
– Implementing a successful stretching program can be complex
– Staff participated for different reasons – some to prevent injuries, others
to address existing discomfort
– Availability of a dedicated space was appreciated
– Several reported the program contributed to increased morale and
improved the workplace culture
– Feedback included a request to involve the staff in designing the
program
– Setting aside the time to take a stretching break was a barrier
– Lack of confidence in ability to perform stretches correctly was a barrier

19. Lessons Learned
• Stretching is only one part of a comprehensive MSD injury
reduction program (Goldenhar & Stafford, 2015)
• Stretching or warm-up exercises must suit the workplace needs
• Stretching does increase ROM and flexibility, however, static
stretching is not as beneficial as other interventions
• Workers report improvements in communication and self image
• In several studies, workers report reduced pain or discomfort

20. Things to Consider
• Work with a professional such as an occupational
therapist
• Include employees in the conversation to design the
program
• Consider employee population limitations – age,
health, balance, pre-existing injuries
• Try alternative exercises, dynamic stretches, warm-
ups, strengthening exercises, etc.
• Make a connection with overall health and wellness

21. Questions?