ORIGINAL RESEARCH

A COMPARISON OF THE IMMEDIATE EFFECTS

OF ECCENTRIC TRAINING VS. STATIC
STRETCH ON HAMSTRING FLEXIBILITY IN
HIGH SCHOOL AND COLLEGE ATHLETES
Russell T. Nelson, PT, PhD, SCS, ATCa

ABSTRACT INTRODUCTION
Background. A pre-event static stretching program Most experts consider aerobic conditioning,
is often used to prepare an athlete for competition. strength training, and flexibility to be the three key
Recent studies have suggested that static stretching components of a conditioning program.1-3 By
may not be an effective method for stretching the definition, flexibility is the ability of a muscle to
muscle prior to competition. lengthen and allow one joint (or more than one
joint in a series) to move through a range of
Objective. The intent of this study was to compare
motion, and the loss of flexibility is a decrease in
the immediate effect of static stretching, eccentric
the ability of a muscle to perform.4 Reduced injury
training, and no stretching/training on hamstring
risk,1-3 pain relief,5 and improved athletic perform-
flexibility in high school and college athletes.
ance6,7 are reasons provided for incorporating
flexibility training into a training program.
Methods. Seventy-five athletes, with a mean age of
Static stretching, defined as elongation of a muscle
17.22 (+/- 1.30) were randomly assigned to one of
to tolerance and sustaining the position for a length
three groups – thirty- second static stretch one
of time,6, 8 is considered the gold standard in flexi-
time, an eccentric training protocol through a full
bility training. Some authors have questioned the
range of motion, and a control group. All athletes
importance of using static stretching to help reduce
had limited hamstring flexibility, defined as a 20°
injuries and to improve athletic performance.1-3
loss of knee extension measured with the femur
Recent studies have found that static stretching is
held at 90° of hip flexion.
not an effective way to reduce injury rates,9-11 and
Results. A significant difference was indicated by may actually inhibit athletic performance.12
follow up analysis between the control group (gain Murphy13 made a compelling argument against the
= -1.08°) and both the static stretch (gain = 5.05°) use of static stretching. Although static stretching
and the eccentric training group (gain = 9.48°). In is often used as a part of preactivity preparation,
addition, the gains in the eccentric training group Murphy13 argued that the nature of static stretching
were significantly greater than the static stretch is passive and does nothing to warm a muscle;
group. further, although the hamstring muscle is the most
frequently stretched muscle, it is also the most
Discussion and Conclusion. The findings of this
commonly strained.
study reveal that one session of eccentrically train-
ing through a full range of motion improved A better option for increasing flexibility, according
hamstring flexibility better than the gains made by to Murphy,13 would be an activity that is more
a static stretch group or a control group. dynamic by nature. Murphy,13 therefore, intro-
duced what is referred to as “dynamic range of
motion.” To dynamically stretch a muscle, the
antagonist group is contracted thus allowing the
a agonist to elongate naturally in a relaxed state. The
Christus St. Michael Outpatient Rehabilitation
Texarkana, Texas dynamic nature of the activity, in theory, would
cause a warming effect in the muscle, and the mus-

56 NORTH AMERICAN JOURNAL OF SPORTS PHYSICAL THERAPY | M AY 2 0 0 6 | VOLUME 1, NUMBER 2

cle would be more pliable and accommodating to the has been performed to determine the effects a single bout
stretch, leading to an increase in the flexibility of the of eccentric training has on flexibility. Therefore, the
muscle. purpose of the study is to determine if one bout of eccen-
tric training through a full range of motion will improve
In contrast to the belief of Murphy,13 Bandy et al15
flexibility and to compare the results with one bout of
compared the flexibility gains made by subjects partici-
static stretching and a control group.
pating in a dynamic range of motion program with gains
subjects achieved using a static stretching program. The
METHODS
gains achieved by the group in the static stretching pro-
Subjects
gram were greater than those achieved with dynamic
Eighty-seven subjects were recruited on a voluntary basis
range of motion.
to participate in the study. The authors felt attrition
More recently, Nelson and Bandy16 investigated a would be low given the design of the study. By recruiting
flexibility program which consisted of eccentrically train- eighty-seven subjects this ensured the study would have
ing a muscle through a full range of motion. Previous lit- the appropriate number needed when complete.
erature suggests that most injuries occur in the eccentric Subjects were high school football players at Texarkana,
phase of activity.9 For example, the hamstring muscles Arkansas High School and Liberty Eylau High School,
are most commonly injured when working eccentrically and college baseball players at Texarkana Community
while decelerating or landing. Eccentrically training a College. Subjects over the age of 18 signed an informed
muscle through a full range of motion, theoretically, consent form. Subjects under 18 years of age had a par-
could reduce injury rates, improve athletic performance, ent or guardian sign the informed consent form and the
and improve flexibility. Nelson and Bandy16 compared minor signed an informed assent form. This study was
the flexibility gains made over a six week period of time approved by the Institutional Review Board of the
by a control group, a static stretch group, and a group University of Central Arkansas.
who eccentrically trained the muscle through a full range
Volunteers for the study had to meet three requirements.
of motion. The findings of the study were a significant
The first requirement was the test extremity must have
increase in flexibility in the static stretch group (12.05º)
had no impairment to the hip, knee, thigh, or the low
and in the group who trained eccentrically through a full
back for the previous year. The second requirement was
range of motion (12.79º) over the control group (a 1.17º
the test extremity had to exhibit hamstring tightness. A
change). The difference in the flexibility gained between
deficit of 20º from full knee extension with the hip at 90º
the static stretch group and the eccentric training group
was defined as tight hamstrings. The subjects were also
was not significantly different. This study offers com-
all high school and college athletes between the ages of
pelling evidence to incorporate eccentric training into
15 and 21 years.
any training program.
While it has been found that eccentrically training a Equipment
muscle through a full range of motion will improve A double-armed transparent plastic goniometer was used
flexibility over a period of six weeks as well as static for measuring hamstring flexibility. The protractor
stretching, no study has been conducted to determine the portion of the goniometer was divided into one-degree
immediate effects of one bout of eccentric training com- increments. The goniometer arms were 12 inches in
pared to one bout of static stretching and comparing both length. A bubble was removed from a carpenter’s level
with a control. A pre-event stretching program is often and fixated to the goniometer to help ensure mainte-
used by coaches to prepare an individual for athletic com- nance of the hip at a 90º angle.
petitions. Some of the goals of pre-event flexibility
training program include decreasing the chances the Procedures
individual will sustain an injury, warming the muscle, Measurement of hamstring flexibility was performed
and improving the flexibility of the muscle in preparation using the 90/90 test for hamstring flexibility described by
for the activity. Theoretically, eccentric training will Reese and Bandy.17 The subjects were positioned in
decrease injury rates and warm a muscle, but no study supine with the hip and knee flexed to 90º. The

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57
 researchers palpated the lateral epicondyle of the femur black theraband was held by the ends in each hand with
and centered the goniometer over that landmark. The the mid-section of the band wrapped around the right
greater trochanter of the femur and the lateral malleolus heel. The exercise started with the right knee locked in
of the tibia were marked. The goniometer was aligned full extension and the hip in 0 degrees of extension.
with the lateral malleolus and the greater trochanter and (Figure 2) The subject then pulled the hip into full flexion
centered over the lateral epicondyle. (Figure 1) by pulling on the ends of the band with the arms. (Figure
3) The subject was to stop when he felt a gentle stretch.
The markings on the
The position where the sub-
goniometer were concealed
ject felt the gentle stretch
with a piece of paper.
was defined as full hip flex-
While one researcher
ion. As the subject pulled
held the goniometer the
the leg into hip flexion he
other researcher moved
was to resist the flexion
the leg passively toward ter-
motion by eccentrically
minal extension. The point
contracting the ham-
at which the researcher felt
string muscles. The subject
a firm resistance was
gave enough resistance to
defined as terminal exten-
slow the hip flexion
sion. When the subject
moment to take five sec-
reached terminal extension
onds to complete. The
the researcher holding the
eccentric activity was per-
goniometer made sure
Figure 1. The 90/90 test for measuring hamstring formed six times for a total
proper alignment was
flexibility. stretch time of 30 seconds.
maintained. An assisting
examiner read and recorded The static stretch group
the measurements on the blinded goniometer. Full ham- (n=26) performed a single 30 second static stretch using
string flexibility was zero degrees on the goniometer. The methods described by Bandy et al.1,15 The subject per-
subjects had no warm-up before data collection. formed the hamstring stretch by standing erect with the
left foot on the ground, toes pointed forward. (Figure 4)
Since reliability had been established previously in the
The heel of the right foot was on the seat of a chair or on
study by Nelson and Bandy,16 and the same researchers
a box. The subject’s toes on the right lower extremity
were performing the measurement, the reliability study
were pointed toward the ceiling. The subject then flexed
was not replicated. A pretest measurement was taken on
forward at the hips, while maintaining a neutral spine.
87 males using the procedures using the 90/90 test for
The subject was instructed to keep the right knee fully
hamstring flexibility described. While 87 subjects were
extended. The subject flexed forward at the hips until a
measured, 75 males met the criteria that had been estab-
gentle stretch was felt in the posterior thigh. The position
lished for the study. The subjects were randomly assigned
of stretch was held for 30 seconds.
to one of three groups.

The control group consisted of 24 subjects and was Data Analysis

measured and then later re-measured. The length of time Means (and standard deviation) for all groups and all
between the two measurements of the control group was measurements were calculated. A 3 (group) x 2 (test)
similar to those in the study group. The subjects in the analysis of variance (ANOVA) with repeated measures on
control group performed no stretching before being one variable (test) was used to analyze the data. Since an
remeasured. interaction was found, appropriate post hoc tests were
performed to interpret the findings and are described in
The eccentric training group (n=25) was measured then
the results section. An alpha level of p<.05 was consid-
performed full range of motion eccentric training for the
ered appropriate for the level of significance.
hamstring muscles. The subject lay supine with the left
lower extremity fully extended. A 3 foot (0.91 m) piece of

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RESULTS Second, a one-way ANOVA was calculated to assess
Seventy-five male subjects, with mean age of 17.22 years whether any significant differences existed in the pretest
(SD = 1.30), completed all requirements for this study. scores across the three groups. Results of these analyses
Twenty-four subjects, with a mean age of 17.18 years (SD indicated no significant difference (df = 2,72; F = .47; p
= 1.84) served the control group. The static group con- > .05). A one-way ANOVA was calculated to assess if any
sisted of 26 subjects with a mean age of 17.22 years (SD = difference existed across the posttest scores of the three
.76) and statically stretched the hamstrings muscles. groups. Results indicated a significant difference (df =
Twenty-five subjects comprised the eccentric group and 2,72; F = 5.15; p < .05). Tukey HSD post hoc analyses
had a mean age of 17.27 indicated that the mean
years (SD = 0.96). The posttest score of the static
mean values for the pretest group (mean =25.77, SD =
and post-test measure- 9.15) was significantly dif-
ments of the control group ferent from the posttest
for the degrees of knee score for the control group
extension were 31.42 (mean = 32.50, SD =
degrees (SD = 9.97) and 10.19). Also, the posttest
32.50 degrees (SD = 10.19), score for the eccentric
respectively. The ICC (3,2) group (mean = 24.12, SD
Figure 2. Above, eccentric training, initial position. Below, final
value calculated for pretest- = 9.66) was significantly
position of full hip flexion.
post-test knee extension different from the posttest
data of the control group score for the control group.
was .95. The static and eccentric
groups did not differ from
The Table presents the
each other.
means for pretest and
posttest measurements Finally, in an attempt to
and gain scores for each summarize the data, an
group. Results of the two- additional analysis using a
way ANOVA (group x test) one-way ANOVA on gain
indicated a significant dif- scores was calculated,
ference for test (df = 1,72; revealing a significant dif-
F = 59.16; p < .05), group ference between groups (df
(df =2,72; F = 1.034; p < =2; F = 25.585; p < .05).
.05) and interaction (df = Post hoc analysis using a
2,72; F = 25.59; p < .05). Tukey HSD test indicated a significant difference between
the gain in the static stretch group (mean = 5.50, SD =
In order to interpret the group x test significant interac-
4.50) and the control group (mean = -1.08, SD = 2.90),
tion, three follow-up statistical analyses were performed.
and the eccentric group (mean = 9.48, SD = 6.92) and
First, three dependent t tests were calculated on the
the control group. Finally, the eccentric group showed a
pretest to posttest change for each group. Using a
significantly greater gain than the static stretch group.
Bonferroni correction to avoid inflation of the alpha level
due to the use of multiple t tests, the alpha level was
DISCUSSION
adjusted to p < .015. The dependant t tests indicated sig-
The groups performing one bout of static stretching and
nificant increases in hamstring flexibility in the group
one bout of eccentric training showed significantly
statically stretching (df = 25; t = 5.66; p < .015) and the
greater gains in flexibility than the control group. The
eccentric group (df = 24; t = 6.85; p < .015), but no sig-
group performing one bout of eccentric training showed
nificant change in hamstring flexibility in the control
a significantly greater gain in flexibility than the static
group (df = 23; t = 1.83; p > .015).
stretch group. To date, this is the only study to compare

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 the immediate effects of one bout of eccentric training on Strength gains from eccentrically training a muscle
changes in muscle flexibility. The results support the the- would, theoretically, also improve performance. The
ory that the immediate effect of performing eccentric need to use a resistance band does make eccentric train-
training through a full range of motion is an increase in ing more difficult than static stretching, but the author of
muscle flexibility. this study believes the benefits achieved outweigh the
added complexity of using
Eccentric training has been
resistance bands.
shown to improve flexibili-
ty not only from one bout Important clinical implica-
of training as in this study, tions exist for eccentric
but also over a six week training through a full
16
training program. The range of motion. In many
gains achieved by a six cases, the goal for clinicians
week program of static and patients is a restoration
stretching and a six week of normal functional
program of eccentric train- motion. Normal motion
ing were very similar. Static requires the patient to have
stretching gained 12.04° the flexibility and the
and eccentric training strength to perform the
gained 12.79° over the six Figure 3. Static stretching position. movement. Strengthening
week training program. through a full range of
Comparing the gains made over six weeks with the gains motion will increase the likelihood that the patient will
made with one bout of stretching or training, the gains not only maintain the range achieved but will help ensure
were less with the single bout of training or stretching. that the patient is able to use the range functionally.
While the gains were less with only one bout of activity, Eccentrically training through a full range of motion, the-
the gains were still significant when compared with a oretically, will improve the functional ability of the
control. extremity by improving not only the flexibility but also
the strength in that range.
No studies to date have examined the use of eccentric
training to reduce injury rates, but the SAID (Specific A patient with weakness around a particular joint may
Adaptation to Imposed Demand) principle states that a not move the joint through a full range and structures
muscle will adapt to the imposed demands.18 If the around the area will often shorten leaving the patient
muscle adapts to the imposed demand of eccentrically with limited mobility. While static stretching has been
training, theoretically, injury rates would be lower since proven to improve flexibility, the ability of static stretch-
most injuries occur during the eccentric phase of activity. ing to strengthen through and entire range of motion is

Table. Mean and standard deviation scores (in degrees) for pretest, posttest,
and gain scores (in degrees) of knee flexion for each level of group.

Group
Control Static Eccentric
(n = 24) (n = 26) (n = 25)
x- SD x- SD x- SD
Pretest 31.42 9.97 31.27 8.70 33.60 9.89
Posttest 32.50 10.19 25.77 9.15 24.12 9.66
Gain -1.08 2.90 5.50 4.50 9.48 6.92
(difference)

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doubtful. Eccentric training is strengthening the muscle 9. Thacker SB, Gilchrist J, Stroup DF, et al. The impact of
by having it contract as it lengthens. A patient eccentri- stretching on sports injury risk: A systematic review of the
cally training through a full range of motion will be gain- literatures. Med Sci Sports Exerc. 2004;36:371-378.
ing range of motion and strength at the same time, thus, 10. Herbert RD, Gabriel M. Effects of stretching before and
making the activity more functional. This type of train- after exercising on muscle soreness and risk of injury:
Systematic review. Br Med J. 2002;325:468.
ing could also save time by combining the strengthening
and flexibility components into one activity. 11. Shier I. Stretching before exercise does not reduce the risk
of local muscle injury: A critical review of the clinical and
More research is needed to determine if tangible gains basic science literature. Clin J Sport Med. 1999;9:221-227.
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ance enhancement through the use of eccentric training. systematic and critical review of the literature. Clin J Sport
In addition, future studies should address the effects of Med. 2004;14:267-273.
eccentric training on individuals across a diverse age 13. Murphy DR. A critical look at static stretching: Are we
group and include females. doing our patient harm. Chiropractic Sports Med. 1991;
5:67-70.

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warm-up on metabolic responses to strenuous exercise.
In high school and college aged male athletes, hamstring
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(as measured by hip flexion range of motion gains) were
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group and a control group. This study provides evidence Ther. 1998;27:295-300.
that when dealing with the immediate effects of stretch- 16. Nelson RT, Bandy WD. Eccentric training and static
ing, flexibility programs may actually be enhanced by stretching improve hamstring flexibility of high school
replacing static stretching with eccentric training. males. Athletic Training. 2004;39:354-358.
17. Reese NB, Bandy WD. Joint Range of Motion and Muscle
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