Stretching doesn't prevent injury — but a hip and core programme cut overuse injuries 39% (2024 RCT)

Static stretching is not an injury-prevention tool

Here's the uncomfortable truth: stretching before exercise does not meaningfully reduce your injury risk.

That's not an opinion — a 2024 randomised controlled trial (an RCT — people randomly split into groups and compared) put 325 novice runners through a 24-week programme and used a control group that did exactly what most gym-goers and runners do before training: static stretching — holding a muscle in a lengthened position for time. That group was the baseline. The worst-performing one (Leppänen et al., 2024).

Static stretching feels productive. It feels like care. But the evidence keeps arriving at the same place: it doesn't stop you breaking down.

The stretching group was the control group — and the one with the worst injury outcomes.

— Leppänen et al. (2024). Hip and core exercise programme prevents running-related overuse injuries. Br J Sports Med.

What actually cut injury risk: hip and core work

In the same 2024 RCT, one group swapped static stretching for a hip and core exercise programme — movements targeting the muscles around the pelvis and mid-section — done before every run (Leppänen et al., 2024).

The results were not subtle:

- 39% lower average weekly overuse injury prevalence compared to the stretching control group
- 52% fewer substantial overuse injuries — the kind that actually stop you training
- 34% lower overall injury incidence (hazard ratio 0.66)

All of those numbers come from the same training load and the same running plan. The only variable was what they did pre-run.

The mechanism makes sense. The hip and core muscles — your glutes, hip abductors, and the deep trunk muscles — act as the shock-absorbers and stabilisers for everything below them. When they're weak or unprepared, each stride shifts more load onto the knee, ankle, and foot. Strengthen the proximal chain (the muscles higher up the body, closer to the centre) and the distal joints (further from the centre — knees, ankles) take less punishment.

The ankle and foot group got more acute injuries — not fewer

The same RCT included a third group: an ankle and foot programme, targeting the smaller muscles below the knee (Leppänen et al., 2024).

That group showed no significant reduction in overuse injuries versus the stretching control. Worse, acute injury incidence was 3.6 times higher in the ankle and foot group than in the control group.

This matters for two reasons. First, it tells you the benefit of the hip and core group wasn't just "any pre-run exercise beats stretching." The location and type of preparation matters. Second, it's a reminder that poorly programmed pre-activity work can actually increase risk — more on that in a moment.

Ankle and foot prep had 3.6× the acute injury rate of the stretching control — location of the work matters enormously.

— Leppänen et al. (2024). Hip and core exercise programme prevents running-related overuse injuries. Br J Sports Med.

Does stretching do anything useful at all?

Yes — just not injury prevention.

A 2020 RCT compared dynamic stretching — moving through a range repeatedly, like leg swings — against a static control for hamstring flexibility and muscle function (Kaneda et al., 2020). Dynamic stretching improved straight-leg raise range of motion and passive knee extension angles more than the static condition.

So stretching of the dynamic variety does improve your range of motion — how far a joint can move — in the short term. That's useful. Greater range of motion before a session can help you hit positions in your lifts that you'd otherwise miss, and there's some evidence it reduces muscle stiffness acutely.

But range of motion in the warm-up and injury prevention are different things. Being more flexible doesn't mean the muscles and tendons are better protected from the loads you're about to put through them. Injury prevention comes from strength, stability, and tissue resilience — not from being able to touch your toes.

If you want the full picture on what dynamic stretching does (and doesn't do) in a warm-up, the dynamic vs static stretching article breaks down 35 studies on exactly that.

For the broader warm-up question — what order, what type, what counts as "ready" — how to warm up before lifting covers that with 4 RCTs.

What the fascia research adds — and what it doesn't prove

A 2024 narrative review on the fascial system — the connective tissue — that wraps around and between muscles explored how stretching might affect tissue tension and pain (Colonna et al., 2024). The fascia is dense with nerve receptors, and disrupted tension through it is linked to myofascial pain — a kind of aching, referred discomfort that spreads from tight trigger points.

The review is honest: evidence for treating fascial dysfunction through stretching is limited. The biology is plausible — stretch the fascia, reduce abnormal tension, reduce pain signals. But the clinical evidence trail is thin.

What it does support is the idea that tissue health is systemic. The muscles, connective tissue, and the nervous system all talk to each other. That makes the case for preparation that addresses strength, control, and movement quality — not just muscle length — even stronger.

The fascia is packed with nerve receptors. Disrupted tension through it triggers pain — but evidence for fixing that with stretching alone remains limited.

— Colonna et al. (2024). Myofascial System and Physical Exercise: A Narrative Review on Stretching. Cureus.

What to do instead: the practical version

Based on the best available evidence, here's what your pre-workout routine should actually look like:

1. Replace static stretching with movement prep.
Dynamic movements — leg swings, hip circles, bodyweight squats, glute bridges — prepare the tissue better than holding a stretch for 30 seconds (Kaneda et al., 2020). They raise tissue temperature, activate the nervous system, and mirror what you're about to do.

2. Build hip and core strength as a training priority — not just a warm-up.
The 39% overuse injury reduction in Leppänen et al. came from a consistent programme, not a one-off stretch session. This is training, not a ritual. Glute bridges, single-leg work, hip abduction exercises, and anti-rotation core work are the categories to hit.

3. Save static stretching for after the session.
If you enjoy stretching — or you use it to improve long-term flexibility — do it when the muscles are warm and when you're not about to demand high-force output from them. Post-session is fine. Pre-session for injury prevention is not the tool.

4. Don't over-engineer the lower leg before you've addressed the hip.
The ankle and foot group in the RCT fared worse than the stretching control for acute injuries. Start with the proximal chain — hips and core — before adding ankle-specific work.