Hamstring Tightness Research Articles

Investigating the influence of Bowen technique with retro-walking on hamstring flexibility and dynamic balance in young college-going students

Abstract: BACKGROUND: Hamstring tightness is a common issue affecting individuals, leading to discomfort, pain, and increased risk of injury. The Bowen technique, a gentle myofascial release technique, and retro-walking have been suggested as potential interventions to improve hamstring flexibility and dynamic balance. This study aimed to assess the impact of combining the Bowen technique with retro-walking on hamstring flexibility and dynamic balance in college students. METHODOLOGY: A pre–post-experimental study was conducted among 50 college students aged 17–25 years. Participants were randomly allocated to either the experimental group (n = 25) receiving Bowen technique and retro-walking intervention or the control group (n = 25). Hamstring flexibility was assessed using the active knee extension test, and dynamic balance was evaluated using the Y-Balance test. The data were analyzed using paired and unpaired t-tests. RESULTS: Intragroup analysis revealed significant improvements in hamstring flexibility and dynamic balance posttreatment in the experimental group (P < 0.05), with no significant changes observed in the control group (P > 0.05). Intergroup analysis demonstrated statistically significant improvements in hamstring flexibility (P < 0.05) and dynamic balance (P < 0.05) between the experimental and control groups postintervention. DISCUSSION: The results indicate that the combination of the Bowen technique and retro-walking effectively improves hamstring flexibility and dynamic balance in college students. The Bowen technique likely enhances muscle extensibility and tissue repair, while retro-walking optimizes muscle length utilization and proprioception. These findings underscore the potential utility of these interventions in clinical practice for managing hamstring tightness and improving overall musculoskeletal health. CONCLUSION: The integration of the Bowen technique with retro-walking holds promise as a noninvasive and effective approach to enhance hamstring flexibility and dynamic balance in college students.

Correlations Among flexibility, stiffness, strength and muscle ultrasound parameters in older males afflicted with hamstrings tightness

Correlations Among flexibility, stiffness, strength and muscle ultrasound parameters in older males afflicted with hamstrings tightness

Effectiveness Of Jackknife Stretching On Hamstring Tightness With Low Back Pain Among Information Technology Professionals - Experimental Study

Background: Hamstring muscles are located at the back of the thigh and the primary action of hamstring muscles is flexion of the knee. It is an effective self-stretching technique; it combines static and dynamic stretching and can be performed without any equipment. Methods: For Jack-knife stretching, participants started in a full squat position, gripping both ankles. The subjects were instructed to extend their knees as much as possible while bringing their chest close to their thighs, holding this position for 10 seconds before returning to the starting position6 . This sequence was repeated five times with a 10-second rest period between five repetitions, performed twice a week for two weeks. Results: Results shows that Jack Knife stretching is very effective in reducing Hamstring Tightness and reduction in low back pain. There is a significant difference in pre and post-intervention scores of NPRS with P < 0.001 and QUEBEC scores with improved functional ability having P < 0.001 Conclusion: The study concludes that Jack Knife stretching is effective in reducing Hamstring Tightness and reduction in low back pain. It was also concluded that there is increased functional ability of the Hamstring muscle

Optimal cut-off values of the active knee extension test for diagnosing hamstring tightness

BackgroundActive knee extension (AKE) is widely used to assess hamstring length, and an 'AKE >20°' is often used as the criterion for diagnosing tightness. However, the scientific evidence for this is unclear. ObjectiveThis study measured and analysed AKE according to sex in two groups with different exercise participation levels to identify the appropriateness of current criteria. MethodsIn the supine position, 90° flexion of the hip and knee joints was performed. The maximal knee extension was measured using a goniometer. Cut-off values for diagnosing hamstring tightness were calculated in three different ways as 'mean-1SD', 'mean-2SD', and 'mean-3SD'. ResultsThere were significant differences in AKE between groups and between sexes. In group A, representing normal healthy adults, cut-off values defined as mean-1SD and mean-2SD were 33.5° and 19.7° in male participants and 28.0° and 15.7° in female participants, respectively. There was a weak correlation between AKE and body mass index, but not between AKE and height and between AKE and weight. ConclusionThis study found that the level of exercise participation significantly affects AKE, and female participants consistently had high flexibility regardless of exercise participation. Therefore, the current cut-off value, widely used in research and clinical settings, may not be a suitable criterion for diagnosing hamstring tightness.

Comparative effects of dry needling and instrument-assisted soft-tissue mobilization on hamstring tightness in patients with posterior pelvic tilt: A pilot study

Objectives: The objective of this study was to compare the impacts of dry needling (DN) and instrument-assisted soft-tissue mobilization on hip flexion, active knee extension (AKE), and posterior pelvic tilt (PPT) in participants with hamstring tightness. Methods: A randomized clinical pilot study was conducted at the District Headquarter Hospital and tertiary hospitals in the District Nankana Sahib, Pakistan. The study’s sample size was 36, and participants were randomized equally into two treatment groups. Group A received DN, and Group B underwent treatment with instrument-assisted soft-tissue mobilization. Hamstring tightness was assessed using an inclinometer to measure the range of motion for AKE and bilateral straight leg raise (BSLR). PPT was measured using an inclinometer at baseline and after treatment of four weeks. Results: Both groups showed a significant disparity in the mean of pre-and post-treatment values (P < 0.05) of AKE, BSLR, and PPT. A statistically significant disparity was found between both groups on AKE, BSLR, and PPT (P < 0.05) post-treatment of 4 weeks. Conclusion: Both DN and instrument-assisted soft-tissue mobilization were found to be beneficial for enhancing hamstring flexibility by improving hip and knee joint mobility. On the other hand, instrument-assisted soft-tissue mobilization was superior in increasing active knee extension, BSLR, and reducing PPT.

Comparative efficacy of muscle energy technique and Bowen technique on hamstrings muscle tightness in chronic low back pain patients.

To compare the effects of the Muscle Energy Technique (MET) and the Bowen Technique on hamstring muscle tightness in chronic low back pain (CLBP) patients. A randomized clinical trial (RCT) designed study in which 62 participants were recruited through the purposive sampling technique were divided into two groups by the lottery method. Subjects who had pain for more than six months in the back and hamstring tightness were included. The duration of the study was four months from February to May 2023 conducted at Madinah Teaching Hospital Faisalabad. Subjects in Group-A were given the Bowen technique, whereas subjects in Group-B were given the MET. Numeric pain rating scale (NPRS), Oswestry disability index (ODI), and active knee extension (AKE) tests were used for measurements of outcomes. Intra-group comparison by using Friedman test revealed that both Group-A & B subject's pain were reduced (P<0.000), their tightness in back thigh muscles were significantly reduced (P<0.000) and functional activities of subjects were also improved (P<0.000). Mann Whitney test was used to determine the between group comparison. P-value ≤ 0.05 was considered as significant. Inter Group-Analysis revealed that there was no statistically significant difference between effects of Bowen technique & MET on pain, hamstring tightness and disability as both techniques improved pain, flexibility & disability. This study revealed that both groups treated by MET and Bowen Technique had significantly reduced pain, improved flexibility of back thigh muscle and reduced functional disability.

Comparison of muscle tightness between knees in individuals with unilateral osteoarthritis and its relationship with pain and function.

Unilateral osteoarthritis (OA) affects single knees and presents a unique scenario where individuals experience varying degrees of symptoms between their affected and unaffected knees. This study aims to investigate differences in muscle tightness between symptomatic and asymptomatic knees in individuals with unilateral knee OA while exploring the interplay among pain, functionality, and muscle tightness. In this cross-sectional study, thirty knee OA patients underwent assessments for hamstring (Active Knee Extension, Straight Leg Raise), iliotibial band (Ober Test), and quadriceps tightness (Modified Thomas Test). Pain intensity was measured using the Visual Analog Scale (VAS), and functional limitations were evaluated via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). A negative correlation was observed between participants' pain and AKE (p= 0.004, r=-0.515), ASLR (p= 0.27, r=-0.403), Ober (p= 0.010, r=-0.461) values. However, no significant correlation was found with the Modified Thomas value (p= 0.204, r=-0.239). There was also a negative correlation between participants' WOMAC scores and AKE (p= 0.019, r=-0.427), OBER (p= 0.004, r=-0.510), and Modified Thomas (p= 0.022, r=-0.416) values, while ASLR (p= 0.286, r=-0.202) values showed no significant correlation. Comparisons between AKE, Ober, and Modified Thomas values showed higher values in asymptomatic extremities (AKE: p= 0.025, Ober: p= 0.021, Modified Thomas: p= 0.030). This study emphasizes the significance of muscle tightness in the symptomatic extremities of individuals with unilateral knee OA. The results indicate that increased muscle tightness makes pain worse and limits movement. It's crucial for healthcare providers treating OA to focus on improving muscle flexibility, reducing pain, and enhancing overall function.

Impact of PNF and MET technique on hamstring flexibility among university students with hamstring tightness

Background. Hamstring tightness affects pelvic posture, contributing to symptoms such as low back discomfort and improper lumbar-pelvic area motions. The purpose of this study is to determine the immediate effectiveness of both Proprioceptive Neuromuscular Facilitation (PNF) and Muscle Energy Technique (MET) interventions on hamstring tightness. A paucity of literature has left a research gap on this topic. Thus, my study aims to compare the effects of these two interventions on improving hamstring flexibility among university students with hamstring tightness. Methods. Group I, consisting of 20 subjects, received PNF for 30 minutes. Group II, also consisting of 20 subjects, received MET for 30 minutes. The study was conducted for 4 weeks. Results. The ROM variables were examined using an independent ‘t’ test with a significance level of 0.05. The mean ± SD of the difference in hamstring ROM for the PNF group was 9.77 ± 4.01° and 10.7 ± 5.21° for the MET group. This indicates that a marked difference was obtained between Group I and Group II, as well as a substantial variation between both the pre-intervention and post-intervention values. Conclusion. The findings demonstrated that both PNF and MET significantly improved (p = 0.000) ROM. Meanwhile, no significant difference (p &gt; 0.05) was found between these two interventions.

Acute Effects of Combined and Distinctive Stretching, Foam Rolling, and Eccentric Exercise in Young Men with Hamstring Tightness

Acute Effects of Combined and Distinctive Stretching, Foam Rolling, and Eccentric Exercise in Young Men with Hamstring Tightness

Comparison of proprioceptive neuro-muscular facilitation and mulligan stretching on hamstring tightness in recreational football players

Comparison of proprioceptive neuro-muscular facilitation and mulligan stretching on hamstring tightness in recreational football players

Prevalence of Hamstring Tightness in Nursing Students Using 90-90 SLR Test: A Cross-Sectional Study

Background: Flexibility is a range of movement available at a joint. Tightness of muscle is caused by a decline in the ability of muscle to disfigure. Hamstring tightness can lead to low back pain, bad posture, imbalances of muscles and knee pain. According to previously performed studies, prolonged sitting can be a factor that leads to hamstring tightness; therefore, we selected nursing students as a participant in the study who have a daily sitting time of 6-8 hours. Hence objective of the study is to find out the prevalence of hamstring tightness among nursing students. Aim: The study's aim was to find out if Nursing Students have hamstring tightness due to Prolonged Sitting using a 90-90 SLR test. Study design: Observational study. Methodology: In this cross-sectional study, 145 participants were included by verifying inclusion and exclusion criteria. Consent was taken before evaluation. Hamstring tightness was measured by a 90-90 SLR test. After that, height and weight were measured, and BMI was calculated. After evaluating all participants, prevalence was calculated. Then, it was compared with BMI. Result: 20.68 per cent of participants had hamstring tightness. Conclusion: The result indicates that the prevalence of hamstring tightness is low in nursing students. KEYWORDS: Hamstring tightness, Nursing students, 90-90 SLR test, Body Mass Index.

Effect of Proper Use of Cane and Physical Therapy Management to Reverse Hamstrings Tightness and Abductors Weakness Due to Improper Use in Knee and Hip OA Patients

Effect of Proper Use of Cane and Physical Therapy Management to Reverse Hamstrings Tightness and Abductors Weakness Due to Improper Use in Knee and Hip OA Patients

Lumbar and Cervical Concurrent Muscle Activity Analysis During Hamstring Length Testing to Design a Customized Treatment Plan: An Observational Cross-Sectional Study.

Hamstring length plays a significant role in a spectrum of clinical entities, from injury prevention and gait dysfunction to posture correction. Evidence suggests that the prevalence of hamstring tightness (HT)/reduced length is increasing. Despite the number of available tests and treatment protocols, HT is still a functional diagnosis. This study's primary goal is to evaluate concurrent muscle (CM) usage during these testing procedures to design a unique, customized treatment protocol. The study was conducted in two stages. In phase 1, Active Straight Leg Raise (ASLR), Active Total Knee Extension (ATKE), and Active Seated Total Knee Extension (ASTKE) were carried out. Next, two pressure gauges (PGs) were placed to align with the natural lumbar and cervical curvatures while testing ASLR and ATKE. After analyzing the results for pressure gauge placement, phase 2 data were collected for tests ASLR and ATKE with PG. The results of ASLR and ATKE, both with and without PG, indicate a high prevalence rate, whereas the results of ASTKE show no prevalence. Changes in the PG values indicate CM usage. Dichotomization revealed that participants with normal test scores (non-HT group) had increased usage of CM work. Positive and negative changes in PG indicate the involved CM group. In regular practice, most healthcare professionals and fitness trainers prefer ASTKE due to the ease of the testing procedure. Directing co-professionals on their choice of tests is challenging, whereas providing knowledge about CM use paves the way for creating customized treatment plans.

Effect of Hamstring Tightness, Back Pain and Disability on Sleep Quality

Background: Chronic low back pain (CLBP), defined as pain persisting for more than three months, is associated with disability, functional limitations, musculoskeletal issues, and sleep disturbances in many individuals worldwide. Objective: The main objective of this study was to determine the effect of hamstring tightness, pain intensity, and disability on sleep quality in patients with chronic low back pain. Methods: This cross-sectional study included 387 individuals aged 25-55 years, recruited from various orthopedic units. Data were collected using the Roland-Morris Questionnaire (RMQ) for disability, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Active Knee Extension (AKE) test for hamstring tightness, and the Numeric Pain Rating Scale (NPRS) for pain intensity. Statistical analysis was conducted using SPSS version 25. Descriptive statistics, including means and standard deviations, were calculated for quantitative variables, while frequencies and percentages were calculated for qualitative variables. Chi-square tests were performed to examine the associations between NPRS, RMQ, AKE scores, and PSQI scores, with a p-value of less than 0.05 considered statistically significant. Results: The mean age of the 387 participants was 41.67 ± 13.38 years; 233 were females (60.2%), and 154 were males (39.8%). The mean RMQ score was 11.45 ± 2.34, the mean PSQI score was 8.58 ± 2.60, and the mean NPRS score was 4.97 ± 1.37. The AKE test was positive in 34.6% of participants. Chi-square tests showed a significant positive association between NPRS and PSQI scores (p = 0.001), and between RMQ and PSQI scores (p = 0.048). However, the association between AKE scores and PSQI scores was not significant (p = 0.400). Conclusion: This study highlights the significant association between pain intensity, disability, and sleep quality in patients with chronic nonspecific low back pain. Pain and disability adversely affect sleep quality, while hamstring tightness does not appear to have a significant impact. These findings underscore the importance of addressing pain and disability to manage sleep disturbances in this patient population.

Examining acute impacts of soft tissue mobilization, percussion massage, and dynamic stretching on hamstring tightness

Examining acute impacts of soft tissue mobilization, percussion massage, and dynamic stretching on hamstring tightness

A tight anterosuperior intercondylar notch may increase the risk of cyclops syndrome after anterior cruciate ligament reconstruction using a quadruple semi-tendinosus short autograft

BackgroundCyclops syndrome is loss of terminal knee extension caused by a fibrous nodule developed in the anterior intercondylar notch. The many known risk factors include preoperative motion-range limitation, tibial tunnel malposition, and tight hamstrings. The primary objective of this study was to assess whether intercondylar notch size was associated with the risk of cyclops syndrome or graft tear after anterior cruciate ligament (ACL) reconstruction using a quadruple semi-tendinosis autograft. The secondary objective was to determine whether intercondylar notch size was associated with functional outcomes. HypothesisA narrow intercondylar notch is associated with higher risks of cyclops syndrome and poor functional outcomes. MethodsConsecutive patients who underwent ACL reconstruction by quadruple semi-tendinosus autograft were included retrospectively. Preoperative magnetic resonance imaging scans were assessed by a single senior surgeon, who determined the conventional notch width index (NWI) and the anterior NWI (aNWI) for each patient. ResultsThe 120 included patients had a mean follow-up of 2.4±0.8 years. Among them, 20 (16.7%) experienced cyclops syndrome and 7 (5.8%) graft rupture. At last follow-up, 26 (21.7%) had not returned to sports and only 47 (39.2%) had returned to sports at the pre-injury level. The mean Lysholm score was 87.9±13.5 and the main subjective IKDC score was 84±13. A narrow notch was significantly associated with lower likelihoods of returning to sports (p=0.001), returning to the same sport (p<0.0001), and returning to the pre-injury sport level (p=0.004). By multivariate analysis, only the aNWI index was significantly associated with the risk of cyclops syndrome (p<0.0001). An aNWI index lower than 0.18 had 85% sensitivity and 78% specificity for predicting cyclops syndrome. ConclusionA narrow anterosuperior intercondylar notch may increase the risk of cyclops syndrome after ACL reconstruction using a quadruple semi-tendinosus graft but is not associated with the risk of graft rupture. Level of evidenceIV, retrospective observational cohort study.

Sustainable effectiveness of kinetic chain stretching on active hip flexion movement and muscle activation for hamstring tightness: A preliminary investigation.

Conventional hamstring (HAM) stretching therapeutic effects are not substantiable in neuromusculoskeletal conditions with HAM tightness or shortness. We developed a kinetic chain stabilization exercise to provide a more sustainable effectiveness in adults with HAM tightness. However, its therapeutic effects and underlying motor mechanisms remain unknown. To compare the effects of traditional active HAM stretching (AHS) and kinetic chain stretching (KCS) on electromyographic (EMG) amplitude and hip flexion range of motion (ROM) in participants with HAM tightness. In this randomized controlled trial, 18 participants (mean age: 25.01 ± 2.47 years) with HAM tightness were assigned to the AHS or KCS group. Hip joint movement, EMG amplitude, and onset times were recorded in the bilateral erector spinae, HAM, transverse abdominis/internal oblique (IO), external oblique (EO), and rectus abdominis during a straight leg raise test. Compared to AHS, KCS led to greater increase in the hip flexion ROM and EMG activation amplitudes in the left and right EO and left IO. Post-test hip flexion ROM data in both the groups were higher than the pre-test data. KCS produced more sustainable effectiveness in hip flexion movement and EMG motor control patterns in participants with HAM tightness than AHS.

Clinical Features and Therapeutic Process of Sacral Fatigue Fractures in Adolescents

Background: Sacral fatigue fractures are a rare injury but should be considered as a differential diagnosis for low back and buttock pain in young adults. Collective reports are limited, most of which have focused on long-distance runners. Purpose: To investigate the characteristics of sacral fatigue fractures in adolescents. Study Design: Case series; Level of evidence, 4. Methods: We analyzed patient background characteristics, physical examination and imaging findings, and treatment courses of those diagnosed with sacral fatigue fractures using magnetic resonance imaging. Results: Among 34 patients with sacral fatigue fractures, 15 and 19 were male and female patients, respectively, with an age range of 11 to 19 years (mean age, 15.0 years). Almost all patients were athletes, and 29 patients performed their sport ≥5 times a week. Long-distance runners were the most commonly affected, comprising 7 patients, and participants in other common sports such as baseball (6 patients), basketball (4 patients), and soccer (3 patients) were also affected. Physical examination revealed tension sign (Lasègue test) on the affected side in 6 patients and tight hamstrings in 24 patients. Imaging findings included 18 patients with right-side involvement, 12 with left-side involvement, and 4 with involvement on both sides. In 11 patients, spina bifida occulta was observed at S1 and 8 patients had a history of lumbar spondylolysis with 4 patients having concurrent sacral fatigue fractures. Physical therapy was performed concurrently with the cessation of exercise, and return to exercise was permitted if the pain had been relieved after 1 month. All patients returned to sports at a median of 48 days (range, 20-226 days) after symptom onset. However, 2 patients experienced recurrence (1 patient on the ipsilateral side and 1 patient on the contralateral side). Conclusion: Sacral stress fractures are not limited to long-distance runners in this population and can manifest as lower back pain or buttock pain in athletes participating in a variety of sports. Although the course of treatment was generally good, the possibility of recurrence must always be considered.

Hip capsular pattern and chronic non-specific low back pain –A case controlled prospective study

BackgroundIndividuals with chronic nonspecific low back pain (CNLBP) presents with altered lumbosacral biomechanics, potentially stemming from compromised hip joint mobility. The objective of our study was to assess hip range of motion (ROM) and hamstring flexibility in individuals with CNLBP to ascertain the presence of a hip capsular pattern in relation to age-matched controls. MethodsThis study was conducted at a tertiary hospital between July 2017 and September 2018, with approval from the institutional review board (JIP/IEC/2017/0044). Inclusion criteria encompassed axial or non-radiating pain primarily in the back for more than 3 months with no definitive pathology. A group of individuals with CNLBP (n = 27) and a control group (n = 30) of age-matched healthy volunteers were included. The observers were blinded to grouping. Bilateral hip range of motion and hamstring flexibility were measured. ResultsIndividuals with CNLBP exhibited a significant mean reduction in hip adduction (9.68 & 8.8o) and internal rotation (7.19 & 7.09°) of the right and left hips, respectively. Additionally, there was a mean increase in flexion (7.68 & 7.71°), extension (6.99 & 8.64°), abduction (7.08 & 8.02°), and external rotation (20.4 & 20.1°) of the right and left hips, respectively, compared to controls (p < 0.01). Notably, hamstring flexibility did not show a significant difference (P > 0.05). ConclusionBased on this study, it is plausible that individuals with CNLBP may exhibit a hip capsular pattern (FABER), with the exception of flexion, when compared to age-matched normal individuals. Also, it was also noted that hamstring tightness did not accompany CNLBP.

Assessing muscle energy technique and foam roller self-myofascial release for low back pain management in two-wheeler riders.

Pain in the lower back is a major concern in today's era due to prolonged sitting in two-wheeler riders, mainly due to hamstring tightness. It also creates physical disability and impairment in activities of daily living. The study aimed to compare the efficacy of muscle energy technique (MET) and self-myofascial release (SMFR) using the foam roller on hamstring flexibility, dynamic balance, and physical disability amongst two-wheeler riders with chronic low back pain (LBP). Participants were randomized into two intervention groups, MET and SMFR using the envelope method, with each group having 20 participants. Hamstring flexibility and range of motion for knee extension and the lower back were assessed using the active knee extension test (AKE-L and AKE-R) and sit and reach test (SRT), while the dynamic balance was assessed by the star excursion balance test (SEBT) and physical disability by Roland-Morris Disability Questionnaire, (RMDQ). Measurements were taken at baseline and after 4 weeks of intervention. This study demonstrated that both SMFR using a foam roller and MET are effective in enhancing hamstring muscle flexibility, (SRT-F(1, 38) = 299.5, p < 0.001; AKE-R-F(1, 38) = 99.53, p < 0.001; AKE-L-F(1, 38) = 89.67, p < 0.001). Additionally, these techniques significantly improved dynamic balance in various directions, including anterior (ANT), anteromedial (AMED), medial (MED), posteromedial (PMED), posterior (POST), posterolateral (PLAT), lateral (LAT), and anterolateral (ALAT) directions (p < 0.01). Furthermore, there was a significant reduction in physical disability (RMDQ-F(1, 38) = 1307, p < 0.001), among two-wheeler riders suffering from chronic LBP. Compared to MET, SMFR using foam rollers was found to be more effective in enhancing hamstring flexibility, improving balance, and decreasing disability level on the RMDQ after 4weeks.