# Biomechanical, Healing and Therapeutic Effects of Stretching: A Comprehensive Review
## 3 Conclusions  
Stretching therapy and prophylaxis include passive and active stretching techniques and some partner-assisted methods precisely summarized in [5; 53; 83; 84]. In this review paper, we briefly described the experiences of international researchers and our study group with the application of stretching as a very interesting field of theoretical and practical medicine, sports sciences, and biomechanics. The accuracy and limitations of therapeutic stretching techniques were also defined. We paid special attention to the simultaneous biomechanical and healing effects of static and/or active isometric stretching, which were also applied to our in vivo model of the human knee joint. The improvements to the knee joint range of motion (ROM) and flexibility were confirmed by ultrasound measurements. An accurately applied stretching treatment led to efficient short- and long-term results: a high movement quality and the reduced risk of further joint soft-tissue injuries in different pathological states, as well as in the elderly and those engaging in sports practice. Further investigations could continue to examine and compare the healing, therapeutic, and preventive effects of static stretching (SS) exercises in different study groups: ill adult patients, old healthy individuals, young persons (well-trained and physically active), and a group of professional athletes. From a historical point of view and in the present day, the benefits and main components of mind-body exercises such as yoga (Hatha yoga) and stretching could be successfully applied in special sports platforms and programs for stretching management, prophylaxis, and treatment. The therapeutic and preventive effects of stretching exercises have also been established in different experimental modeling systems, including animal, computational, and mathematical models, which have significance for human therapies and the prophylaxis of injuries. In addition to static (passive) stretching, the authors characterized stretching therapy as the combined application of a wide range of techniques (e.g., stretching combined with foam rolling with or without vibration, massage, motion movements, etc.). The conclusions of prevalent studies suggest that when properly applied and combined with other techniques, stretching therapy could improve joint, muscle, fascia, tendon, and ligament health and flexibility and resolve problems associated with joint and muscle stiffness. The prevention of sports injuries in the morpho-functional unit of the joint-ligament-tendon-muscle could improve the health and sports performance of healthy persons and professional athletes. From a long-term perspective, increasing the flexibility and reducing the stiffness of muscles would lead to relaxation and muscle fiber elongation, which is also related to better sports performance. The synthesis and localization of the main biomechanical variables and biomarkers in the extracellular matrix of the joints and cartilage at the cellular and molecular levels, such as collagen, elastin, hyaluronic acid, and other glucosaminoglycans (GAGs), specific genes, TgF-\(\beta\)1, etc., need further investigation. The proposed combined stretching techniques could be applied in efficient therapeutic programs in medicine and sports, depending on their short- and long-term healing effects. Recent studies have determined that static progressive stretching (SPS) therapy, alone or in a combined treatment, is the main way to improve the joint range of motion (ROM) and reduce or prevent the development of anthropogenic contractures, joint capsule fibrosis,and muscle stiffness, thus positively influencing the biological structures, functions, and biomechanics of the joint-ligament-capsule-tendon-muscle unit. The therapeutic and preventive effects of static stretching (SS) need new clinical and sports applications. Further successful retrospective and prospective studies could elucidate the cellular, molecular, and biomechanical mechanisms of the effects of stretching.