The purpose of the present study was to compare the effects of muscle stretching and myofascial release on muscular flexibility and performance. PubMed, Cochrane Library, Embase, Physiotherapy Evidence Database (PEDro), and Google Scholar were searched for studies published before July 2019. Studies comparing muscle stretching with myofascial release (SAFM), muscle fascia release (MFR), and/or foam rolling (FR) were included. Clinical outcomes analyzed included range of motion (ROM), distance of motion (sit to reach scores and knee to a wall), and muscle strength. A total of 23 articles, totaling 443 cases, were included in this study. Results showed that ROM was significantly improved after muscle stretching, compared with myofascial release (MD -1.44 (-2.66 to -0.22), p = 0.02). Myofascial release and muscle stretching did not show significant differences in terms of distance of motion (MD 0.04 (-0.32 to 0.40), p = 0.82). However, the effects of muscle stretching on muscle strength were significantly lower than those obtained by myofascial release (MD 0.14 (0.06 to 0.21), p = 0.0005). Muscle stretching increased flexibility, compared with muscle fascia release. Interestingly, muscle fascia release was more efficient in improving muscle strength. Present findings, however, require more high-quality studies with long-term follow-ups for confirmation.

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