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Should you stretch before exercise? After? Never? Here’s what to know

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Should you stretch before exercise? After? Never? Here’s what to know

Panamanian gymnast Hillary Heron stretches as she trains for the Olympics at the No Limits Gymnastics Center in Panama City, Saturday, June 15, 2024, ahead of the Games in Paris.
AP, File

For many people of a certain age, high school gym class began with reaching for their toes. Then, over the years, we were told it was better to stretch after exercise.

It turns out, both those things can be true, but the differing advice has created some confusion.

Stretching can help make you more flexible, improve range of motion in your joints — and feel good. David Behm, who researches human kinetics at Memorial University of Newfoundland in St. John’s, Canada, offers this advice on when to stretch and how to do it safely:

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David Behm, author of “The Science and Physiology of Flexibility and Stretching,: Implications and Applications in Sport Performance and Health” stretches.
AP

Warm up first

It’s almost always good to stretch, but it’s better if you warm up first, said Behm, author of “The Science and Physiology of Flexibility and Stretching.” He recommends a light aerobic activity such as jogging, walking or cycling for five or 10 minutes.

Follow that with some static stretching, the traditional way of reaching and holding a position (think back to that gym class). You can then do activity-specific dynamic stretching, in which you warm up the muscles with repetitive movements like leg lifts.

Behm says one minute is “the magic number” for how long to do static stretching per muscle group without fatigue.

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The Chicago Cubs mascot playfully stretches with Seiya Suzuki prior to a spring training baseball game against the Los Angeles Angels, Wednesday, March 6, 2024, in Mesa, Ariz.
AP, File

Expand your definition of ‘stretching’

Should you always stretch before exercising? If it’s traditional stretching, not necessarily.

The better question, Behm says, is, “Should people increase their range of motion? Should people have better flexibility? And that is yes, because it helps prevent injuries. It helps with health. But you don’t have to stretch to achieve that.”

Resistance training, for instance, can be an effective form of stretching, he said. Doing a chest press increases range of motion in your deltoids and pecs, whether with barbells, dumbbells or machines, so there is no need to stretch beforehand. Just make sure to start with a small amount of weight to warm up and then add more to train.

“You probably don’t have to do extra stretching unless you’re a gymnast, a figure skater, or even a golfer who needs a great range of motion through that swing,” Behm said.

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Nor do you need to stretch first if you’re going for a leisurely run. Simply start with a slow jog to warm up and then increase the pace.

Don’t do it if it hurts

After exercise, “light stretching is OK, as long as you don’t reach a point where you’re feeling pain,” Behm said. Since your muscles will be warm by that point, overdoing it makes you more likely to injure yourself.

Foam rollers can help with muscle recovery and have been shown to increases range of motion as well as stretching.

Do some static stretching before sports

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If you’re playing a sport, Behm said, static stretching beforehand helps reduce muscle and tendon injury.

“If you’re going to do an explosive movement, change of direction, agility, sprint, any of these explosive activities that involve your muscles and tendons,” he said, “you’re going to be stronger if you do static stretching.”

People can especially get in trouble when they go back to a sport they used to play, whether it’s tennis, surfing or any sort of team activity.

Also, stretch both sides equally. Lacking flexibility on one side also can lead to injury.

Sounds simple. Why all the confusion?

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Different studies over the years have either encouraged or discouraged stretching before exercise. Behm says that partly because some studies didn’t reflect real-life conditions, or were designed with elite athletes in mind, not regular people.

“If you’re Usain Bolt, it makes a difference,” said Behm. Not so much for the rest of us.

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World Fitness Bodies Release Study Supporting Exercise’s Impact on GLP-1s

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World Fitness Bodies Release Study Supporting Exercise’s Impact on GLP-1s
Fitness trade organizations from the U.S., U.K., Australia, New Zealand and Canada collaborated on a study revealing numerous benefits of an integrated care model that combines weight-loss drugs with exercise, especially strength training

Major international health and fitness organizations have joined forces to study the long-term impact exercise can have on GLP-1 users, with the findings showing optimistic results.

The white paper, which emerged from the collaboration of trade organizations including the U.S.-based Health & Fitness Association, U.K.-based ukactive, Australia-based AUSactive, Exercise New Zealand and Fitness Industry Council of Canada, finds that pairing GLP-1 therapy with regular structured exercise has multiple downstream benefits. Those include improved long-term health outcomes, reduced subsequent costs and positive economic returns across multiple countries.

The study dove into whether structured exercise can improve the long-term clinical and economic value of GLP-1 treatment by comparing the impacts of GLP-1 therapy as a standalone obesity treatment versus GLP-1 therapy combined with exercise, utilizing a health-economic model across Australia, Canada, New Zealand, the U.K. and the U.S.

The financial component of the study found:

  • U.K.: £2.7 billion in economic and societal value over 10 years and a 164% return on investment, rising to 717% and £13 billion over 30 years.
  • U.S.: $120 billion in economic and societal value over 10 years and a 496% return on investment, rising to 1,572% and $393 billion over 30 years.
  • Australia: AU$182 million in economic and societal value over 10 years and a 59% return on investment, rising to 457% and AU$1.4 billion over 30 years.
  • Canada: CA$3.5 billion in economic and societal value over 10 years and a 105% return on investment, rising to 526% and CA $17.9 billion over 30 years.
  • New Zealand: NZ$51 million in economic and societal value over 10 years and a 27% return on investment, rising to 306% and NZ$592 million over 30 years.

Meanwhile, the addition of structured exercise to a GLP-1 treatment plan had numerous positive health impacts, including:

  • Preserving muscle during weight loss
  • Maintaining strength, mobility and bone health
  • Keeping more weight off over time
  • Reducing weight regain after stopping medication
  • Lowering the risk of costly health events later on.

Additionally, the paper highlighted a reduction in acute cardiovascular events and joint replacements; improved patient longevity and quality of life; and reduced spending on medical costs and productivity losses.

Based on those results, the bodies are once again urging for the deeper integration of physical activity and strength training in GLP-1 treatment, after releasing a statement earlier this year calling on governments, health systems and international institutions to ensure that as drugs like Ozempic and Wegovy continue to dominate obesity treatment, they’re supported by lifestyle interventions including physical activity and nutrition.

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“GLP-1 medications are rapidly changing obesity treatment, but weight loss alone is not the full measure of success,” said HFA president and interim CEO Greta Wagner. 

From those results, the bodies have come up with a plan for how best to implement fitness-forward practices into a systemic treatment plan for GLP-1 users. They propose the following roadmap for policymakers, payers and healthcare systems:

  1. Recognise structured exercise, especially strength training, as an essential part of obesity care
  2. Embed exercise support into GLP-1 care models
  3. Build referral pathways between healthcare providers and qualified exercise professionals and fitness facilities
  4. Support patient access to qualified exercise professionals and fitness facilities
  5. Measure outcomes beyond weight loss, including long-term health and economic value.

The organizations also suggested policy shifts such as reimbursement, coverage, tax-preferred treatment or subsidy models that lower financial barriers to structured exercise for GLP-1 users, making exercise more widely recognized as a crucial component of GLP-1 therapy.

“The health and fitness industry has long known that lasting wellness requires more than a number on a scale, it requires strength, function and sustainable healthy life habits,” Wagner added. “This research confirms that exercise, especially strength training, helps patients sustain the benefits of GLP-1 treatment over time. It sends a clear message that exercise belongs at the center of GLP-1 care.”

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Adding Exercise to GLP‑1 Therapy Improves Long-Term Benefits, Multinational Study Finds – Health & Fitness Association

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Adding Exercise to GLP‑1 Therapy Improves Long-Term Benefits, Multinational Study Finds – Health & Fitness Association

The combination could save billions in healthcare costs, leading fitness organizations to call for deeper integration of structured exercise in GLP-1 treatment.

Pairing GLP-1 therapy with regular structured exercise would improve long-term health outcomes, reduce downstream costs, and generate positive economic returns across multiple countries, according to new multinational research by the Health & Fitness Association developed by FTI Consulting’s Center for Healthcare Economics and Policy. 

Released as a white paper entitled From Weight Loss to Lasting Value: Structured Exercise and the Economics of GLP-1 Therapy, the research compares impacts of GLP-1 therapy as a standalone obesity treatment with GLP-1 therapy combined with exercise in five countries. 

The research was developed in collaboration with the HFA Foundation and four fitness industry federations: AUSactive, Exercise New Zealand, Fitness Industry Council of Canada, and ukactive.

The white paper provides some of the strongest evidence to date that exercise significantly enhances the value of GLP-1 treatment for patients, healthcare systems, employers, and society as a whole.

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Across all five countries studied, the analysis found that a combined approach supports improved long-term health outcomes, reduced healthcare costs, and produced positive economic returns.

Combining regular exercise with GLP-1 therapy is estimated to generate:

  • United States: US$120 billion in economic and societal value over 10 years and a 496% return on investment, rising to 1,572% and US$393 billion over 30 years.
  • Australia: A$182 million in economic and societal value over 10 years and a 59% return on investment, rising to 457% and A$1.4 billion over 30 years.
  • Canada: C$3.5 billion in economic and societal  value over 10 years and a 105% return on investment, rising to 526% and C$17.9 billion over 30 years.
  • New Zealand: NZ$51 million in economic and societal  value over 10 years and a 27% return on investment, rising to 306% and NZ$592 million over 30 years.
  • United Kingdom: £2.7 billion in economic and societal  value over 10 years and a 164% return on investment, rising to 717% and £13 billion over 30 years.

The findings demonstrate that as GLP-1 use expands, exercise should play an essential role in helping patients and health systems maximize the long-term value from new generations of weight-loss drugs.

The fitness industry has an unprecedented opportunity to be part of the solution as GLP-1 usage continues to grow. 

“GLP-1 medications are rapidly changing obesity treatment, but weight loss alone is not the full measure of success,” says Greta Wagner, interim president and CEO of the Health & Fitness Association and president of the HFA Foundation. “The health and fitness industry has long known that lasting wellness requires more than a number on a scale; it requires strength, function, and sustainable healthy life habits. This research confirms that exercise, especially strength training, helps patients sustain the benefits of GLP-1 treatment over time. It sends a clear message that exercise belongs at the center of GLP-1 care.”

Based on this data, HFA, HFA Foundation, AUSactive, Exercise New Zealand, Fitness Industry Council of Canada, and ukactive are calling on policymakers, payers, and healthcare systems to integrate structured exercise into GLP-1 treatment pathways. 

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Specifically, the groups are asking that: 

  1. Structured exercise, including strength training, be recognized as an essential part of obesity care;
  2. GLP-1 care models include exercise support;
  3. Referral pathways are established between healthcare providers and qualified exercise professionals;
  4. Patient access to qualified exercise professionals and fitness facilities be supported; and
  5. Outcomes beyond weight loss be measured, including long-term health and economic value.

This call to action builds on a recent joint position statement signed by the participating fitness industry groups, the World Obesity Federation (WOF), and the World Federation of the Sporting Goods Industry (WFSGI), which emphasized the urgency of ensuring physical activity and nutrition are central to systems supporting the global roll-out of obesity medications. 

Download the complimentary full report to see how structured exercise can help unlock the full promise of GLP-1 therapy.

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From Weight Loss to Lasting Value: Structured Exercise and the Economics of GLP-1 Therapy – Health & Fitness Association

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From Weight Loss to Lasting Value: Structured Exercise and the Economics of GLP-1 Therapy – Health & Fitness Association

This white paper is complimentary.

GLP-1 medications are reshaping obesity care and creating new opportunities to improve long-term health outcomes. But weight loss alone is not the full measure of success. As use of these medications grows, policymakers, payers, healthcare providers, and patients face an important question: what helps ensure that the benefits of GLP-1 therapy are sustained over time?

This first-of-its kind multi-country research examines the health and economic value of combining GLP-1 therapy with structured exercise. The findings make clear that structured exercise help protect and extend the investment being made in GLP-1 treatment by supporting more sustainable health outcomes, reducing costly downstream medical events, and generating substantial economic value.

Across all five studied markets, the research projects that combining structured exercise with GLP-1 therapy can generate substantial health, economic, and societal value compared with GLP-1 therapy alone:

  • United States: US$120 billion in economic and societal value over 10 years and a 496% return on investment, rising to 1,572% and US$393 billion over 30 years.
  • Australia: A$182 million in economic and societal value over 10 years and a 59% return on investment, rising to 457% and A$1.4 billion over 30 years.
  • Canada: C$3.5 billion in economic and societal value over 10 years and a 105% return on investment, rising to 526% and C$17.9 billion over 30 years.
  • New Zealand: NZ$51 million in economic and societal value over 10 years and a 27% return on investment, rising to 306% and NZ$592 million over 30 years.
  • United Kingdom: £2.7 billion in economic and societal value over 10 years and a 164% return on investment, rising to 717% and £13 billion over 30 years.

If public and private payers are investing in GLP-1 therapy, they should also be asking what helps that investment produce more sustainable health and economic returns. Structured exercise is one of the clearest answers.

Methodology

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The research was conducted by by FTI Consulting’s Center for Healthcare Economics and Policy in partnership with a multinational coalition of fitness sector organizations, including the Health & Fitness Association, the HFA Foundation, AUSactive, Exercise New Zealand, Fitness Industry Council of Canada, and ukactive. 

Drawing on the existing body of research on GLP-1 therapy, weight loss, physical activity, and related health outcomes, the analysis modeled the incremental health and economic impact of adding structured exercise to GLP-1 therapy across participating markets. The model compares combined treatment against GLP-1 therapy alone over 10-year and 30-year horizons.

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