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Take Time to S…T…R…E…T…C…H

A young African American girl leads a stretch during gym class as part of their yoga routine.

By Dr. Mark Rieger

Adults know that stretching before they exercise helps prevent the progression of the aging process such as the tightening of muscles; stretching also helps them keep their range of motion and flexibility.

Stretching before exercise is every bit as important for children, who should stretch before they get on the field or swim, dance or ride their bike—or anytime, really.

There are many philosophies about how and why a child should stretch. Ultimately, a parent must decide what works best for their child, but here are a few things to consider:

1. Know WHY they should stretch 

In children, stretching muscles promotes growth and prevents injury.

Children’s bones grow first (before the muscle), which leaves the muscle, which are anchored into the growing bone, to tighten. In response to this tightness, the muscle then grows and lengthens.  However, a child’s muscles are always relatively shorter than the bones, especially during a rapid growth spurt. This leads to “growing pains,” a condition created by the muscles that pull a bit and cause irritation or pain. 

Stretching, even in young children who are generally more limber and loose, will help their muscles to lengthen and reduce the tension where the muscle tendon connects to the bone. If the child fails to stretch, they may get an acute tear in their muscle. Further, if their muscles remain tight, the child’s range of motion is decreased, causing them to be more prone to strains or fractures.

Marissa Bingler, PT, DPT, the Regional Clinical Director at Jag-One Physical Therapy suggests, “Stretching should be integrated into every child’s daily routine. Dedicating just ten minutes a day to an active or passive stretching program could provide great benefits including improved posture (especially important during growth spurts), decreased pain with activity and prevention of injury.’We could not agree more and advise parents to encourage their children to stretch and flex frequently, with the understanding that proper stretching doesn’t detract from their child’s formal training; rather, it enhances it and ultimately prevents injury.

2. Know HOW they should stretch

There are different pediatric stretching techniques—dynamic and active versus static and passive—and many different theories about how and when one should stretch. 

For example, proprioceptive neuromuscular facilitation – or PNF – is a stretching technique that combines passive stretching and isometric stretching for maximum flexibility. This more advanced form of flexibility training involves both the stretching and contracting of the target muscle group and is highly effective for improving flexibility and increasing range of motion and muscle strength.

In our practice, we advise that children do both active (with motion) and passive (more static) stretching before engaging in a sport or physical activity as follows: 

  • Active stretching exercises before they are active or play a sport; these may include jumping jacks, gentle lunges, squats, and moving their arms and ankles in circles, followed by
  • Passive stretches allow young athletes to focus on specific muscle groups; they may be quadricep, calf or arm-overhead stretches, the child’s pose, or cat-cow yoga poses, or simply bending down to touch the toes.

After the activity or sport, children should do additional passive stretches to keep their muscles long and limber. We recommend that parents refer to a book called “Stretching” by Bob Anderson for more ideas about the kinds of active and passive stretches your child can do.

Stretching After Injury or Treatment

When a child gets injured, their muscles shorten and tighten once again. A physical therapist or athletic trainer may apply heat and do some gentle stretching to rehabilitate the muscles. If a child needs surgery to repair an injury like a torn ACL or to treat specific congenital conditions like scoliosis or arthrogryposis, a physical therapist can help rehabilitate their muscles and improve mobility through passive stretching.  

“Elongating proper soft tissue structures, not only at the injury site, but also the surrounding areas, will provide neuromuscular feedback to the brain and set up the rehabilitation for success. Stretching can help to allow the muscles to lengthen and therefore efficiently increase the load capacity of those ““structures,” noted Adam Gresh, PT, DPT, CSCS, Director of Physical Therapy at SportsCare Physical Therapy. Read more stretching tips in “Benefits of Warming Up & Top Stretching Tips.”


At The Pediatric Orthopedic Center, we collaborate with several physical therapists who specialize in working with children who’ve been injured playing sports or who require physical therapy following orthopedic surgery. Contact us for a consultation to determine if physical therapy referral is needed for your child, or to discuss other ways to keep your young athlete limber and growing strong in the best way possible.

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