As the school year begins, sports programs are starting up again. Fall season sports, such as football, soccer and cross country, have higher injury rates than most other sports; at least 10 percent of student athletes will experience an injury that will keep them benched for some or all of the season. Athletes who are both strong and flexible are less likely to get injured, which is why stretching is so important.

The most common problems are sprains (ligament injuries) and strains (muscle or tendon injuries). About 60 percent of these injuries happen during practices, and 40 percent during competition. Inexperienced athletes and those participating in contact sports are at highest risk of injury.

Stretching before and after exercise keeps joints flexible, reduces muscle soreness and improves an athlete's development of body awareness. Stretching can also help athletes mentally and physically relax by reducing muscular tension. Flexible athletes are better able to learn and perform skilled movements.

Coaches should help their athletes develop a routine that involves a warmup and stretching before practice plus a cool-down and stretching after practice. Coaches should consider the types of injuries most common in their sport and design a stretching program focused on avoiding those injuries.

Warming up before stretching increases blood flow to the muscles, making them more supple and less prone to injury. A warmup consists of at least five minutes of aerobic activity such as jogging which will increase the heart rate and raise the body temperature.

Ideally, all the joints and muscles should be stretched before a workout. Realistically, there is usually limited time and so athletes should focus on stretching the muscles they use most in their sport. For sports involving running, concentrate on the calf muscles, the hamstrings (back of the thigh), the quadriceps (front of the thigh) and the groin muscles before and after working out.

A cool-down period at the end of a workout should be at least five minutes of low-intensity activity. This will help clear lactic acid from the muscles and reduce cramping and soreness. Stretching should follow the cool-down period.

Cooling down and stretching help athletes recover from a workout more quickly. This is especially important in sports where there are rarely days off between practices and games.

Stretching tips:

• Athletes need to focus on their bodies during stretching. The tendency is to socialize while stretching, but this should be avoided for maximum benefit.

• Breathing during stretching is crucial. Athletes should learn to breathe deeply in through the nose and out through the mouth. The abdomen - not the chest - should expand with each breath.

• Stretches should be held for at least 15 seconds. There is some controversy about the ideal amount of time needed for optimal stretching, and some sources say stretches need to be held for a minute.

• Stretching should not be painful. Overstretching can cause tearing of muscle fibers and connective tissues. These torn fibers cause pain, and when they heal they may be shorter than they were originally, decreasing their flexibility.

• Focus on stretching one muscle at a time.

• Don't bounce. Stretch muscles slowly and stop before there is pain.

• Feeling sore the day after stretching is not normal; back off and do lower-intensity stretching.

• If you are on the sidelines waiting to get into the game, use that time to stretch and stay flexible. Stay warmed up by jogging in place if necessary.

Another important point in preventing sports injuries: Listen to your body and don't practice or play if you have pain. Pain means injury, and if you play with pain, your injury is going to get worse. You're not doing yourself or your team any favors by playing injured.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send your idea to

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