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Meta-Analysis
. 2025 Mar;55(3):597-617.
doi: 10.1007/s40279-024-02143-9. Epub 2024 Nov 30.

Optimising the Dose of Static Stretching to Improve Flexibility: A Systematic Review, Meta-analysis and Multivariate Meta-regression

Lewis A Ingram  1 , Grant R Tomkinson  2 , Noah M A d'Unienville  2 , Bethany Gower  2 , Sam Gleadhill  2 , Terry Boyle  3 , Hunter Bennett  2
Affiliations
Meta-Analysis

Optimising the Dose of Static Stretching to Improve Flexibility: A Systematic Review, Meta-analysis and Multivariate Meta-regression

Lewis A Ingram et al. Sports Med. 2025 Mar.

Abstract

Background: Static stretching is widely used to increase flexibility. However, there is no consensus regarding the optimal dosage parameters for increasing flexibility.

Objectives: We aimed to determine the optimal frequency, intensity and volume to maximise flexibility through static stretching, and to investigate whether this is moderated by muscle group, age, sex, training status and baseline level of flexibility.

Methods: Seven databases (CINAHL Complete, Cochrane CENTRAL, Embase, Emcare, MEDLINE, Scopus, and SPORTDiscus) were systematically searched up to June 2024. Randomised and non-randomised controlled trials investigating the effects of a single session (acute) or multiple sessions (chronic) of static stretching on one or more flexibility outcomes (compared to non-stretching passive controls) among adults (aged ≥ 18 years) were included. A multi-level meta-analysis examined the effect of acute and chronic static stretching on flexibility outcomes, while multivariate meta-regression was used to determine the volume at which increases in flexibility were maximised.

Results: Data from 189 studies representing 6654 adults (61% male; mean [standard deviation] age = 26.8 ± 11.4 years) were included. We found a moderate positive effect of acute static stretching on flexibility (summary Hedges' g = 0.63, 95% confidence interval 0.52-0.75, p < 0.001) and a large positive effect of chronic static stretching on flexibility (summary Hedges' g = 0.96, 95% confidence interval 0.84-1.09, p < 0.001). Neither effect was moderated by stretching intensity, age, sex or training status, or weekly session frequency and intervention length (chronic static stretching only) [p > 0.05]. However, larger improvements were found for adults with poor baseline flexibility compared with adults with average baseline flexibility (p = 0.01). Furthermore, larger improvements in flexibility were found in the hamstrings compared with the spine following acute static stretching (p = 0.04). Improvements in flexibility were maximised by a cumulative stretching volume of 4 min per session (acute) and 10 min per week (chronic).

Conclusions: Static stretching improves flexibility in adults, with no additional benefit observed beyond 4 min per session or 10 min per week. Although intensity, frequency, age, sex and training status do not influence improvements in flexibility, lower flexibility levels are associated with greater improvement following both acute and chronic static stretching. These guidelines for static stretching can be used by coaches and therapists to improve flexibility.

Clinical trial registration: PROSPERO CRD42023420168.

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Conflict of interest statement

Declarations. Funding: No funding was received for the preparation of this article. Conflict of interest: Lewis Ingram, Grant Tomkinson, Noah d’Unienville, Bethany Gower, Sam Gleadhill, Terry Boyle, and Hunter Bennett have no conflicts of interest that are directly relevant to the content of this article. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Availability of data and material: The data and materials necessary to reproduce the findings reported in this article are available at https://osf.io/eh537/ . Code availability: Not applicable. Authors’ contributions: LI, GT and HB contributed to the conception and design of the review and meta-analysis. LI and HB performed the initial search of databases. LI, GT, ND, BG, SG and HB screened and selected the eligible studies. LI performed the data extraction, which was verified by ND. LI and ND assessed the risk of bias of the included studies. LI and HB performed the GRADE analysis. HB performed the statistical analysis, which was verified by TB. LI, GT and HB drafted the manuscript. All authors reviewed, provided critical revisions, refined and approved the final manuscript.

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