Combined effect of myofascial release and passive stretching on plantar pressure in individual with hamstring tightness- an experimental study.

INTRODUCTION: The lower kinetic chain is known to be affected by hamstring tightness which causes biomechanical alterations. As per the literature, short hamstring might cause prolonged forefoot loading, which can cause higher repeated stress on the plantar fascia. There is evidence supporting the use of various stretching and myofascial release techniques for hamstring tightness, further research is needed to investigate their impact on plantar pressure. Hence the study aims to determine combined effect of myofascial release and passive stretching on plantar pressure in individual with hamstring tightness. METHODS: This was an experimental pre-post study design with 67 randomised screenings from asymptomatic health care science students aged 18 to 25. From this scientific survey, a sample size of 47 students having HMS tightness based on the popliteal angle were recruited using a universal goniometer. An intervention was proposed that included MFR and passive stretching in 3 sessions on alternate days. Plantar pressure of these individuals was noted by using the "Harris and Beath foot printing mat" before and after the intervention. RESULT: Significant pressure changes were observed after intervention: great toe of right side (p = 0.001), toes 2 to 5 of right side (p = 0.010) and left side (p = 0.008), first metatarsal of left side (p = 0.010), lateral forefoot of right side (p = 0.019) and left (p = 0.018), medial heel (p = 0.044), and lateral heel of right side (p = 0.025). These values substantiate the enhancement in plantar pressure. CONCLUSION: The combined effect of Myofascial release and passive stretching in an individual with hamstring tightness resulted in a significant increase in popliteal angle and plantar pressure.

The Effects of Dry Needling on Hamstring Range of Motion: A Critically Appraised Topic.

CLINICAL SCENARIO: Hamstring range of motion (ROM) and the influence it has on injury risk is among great discussion in the literature. Hamstring injury may result from hamstring tightness, poor flexibility, or decreased ROM, and many argue that this can be prevented through various intervention strategies. In active populations, risk of further injury, pain, and complications throughout the kinetic chain can occur if minimal hamstring ROM is left untreated. One therapeutic intervention that has been applied to varying parts of the body to help improve function while relieving pain is dry needling (DN). This intervention includes the application of needles to structures to induce responses that might benefit healing and overall stimulation of a neurological response. In this review, the intent is to identify evidence and the effects of DN on hamstring ROM. CLINICAL QUESTION: What are the effects of DN on hamstring ROM? SUMMARY OF KEY FINDINGS: Among total 11 articles, 1 single-blinded randomized controlled trial and 2 double-blinded randomized controlled trials were included in this critically appraised topic. All 3 articles had inconclusive evidence to isolate the application of the DN intervention. There was insufficient evidence to identify if DN independently improved hamstring ROM; however, in combination with interventions such as exercise and stretch plans, there were improvements on ROM. CLINICAL BOTTOM LINE: DN does not significantly increase or decrease the ROM of the hamstrings. When combined with exercise and stretch plans, DN could increase ROM. STRENGTH OF RECOMMENDATION: The grade of B is recommended by the Strength of Recommendation Taxonomy for inconsistent or limited-quality patient-oriented evidence.

Comparing right and left hamstring flexibility and its association to nonspecific lowr back pain among women of different age groups.

BACKGROUND AND OBJECTIVES: Decreased hamstring flexibility has been associated with LBP (lower back pain). Increased tightness or shortening of hamstring muscle may cause pelvis imbalance or tilt and create instability and increase LBP risk. This study was conducted to pinpoint the differences between right and left hamstring length and their association to LBP in Israeli adult and elderly women. METHODS: N = 109 women which were divided into two groups: Adult group, 41 women (aged 45-60) and older group, 68 women (aged 60-75), with LBP that exercise regularly (minimum twice weekly) were selected based on inclusion criteria. Hamstring flexibility was measured using the Passive Straight Leg Raise test and Sit and Reach test, and LBP was measured using the Oswestry Disability Index (OS), the Roland-Morris questionnaire (RM), and a personal information questionnaire. FINDINGS: Findings indicate a statistically significant difference (p < .05) in hamstring flexibility between right and left legs in PSLR test, with the left being shorter than the right. A significant negative correlation was found between hamstring shortening to function in OS and RM questionnaires in the older group, no significant correlation was found between left -right hamstring flexibility differences and reduced function with LBP in the OS and RM questionnaires. CONCLUSION: s: Hamstring shortening in adult and elderly women exists despite regular exercise. Future studies must be incorporated to improve hamstring flexibility with emphasis on balance of left and right legs to examine how this will affect LPB reports and compare women who exercise versus women who do not.

The Acute Effects of Theragun™ Percussive Therapy on Viscoelastic Tissue Dynamics and Hamstring Group Range of Motion.

Handheld percussive therapy (PT) massage guns have seen a rapid rise in use and with-it increased attention within injury prevention and sport performance settings. Early studies have proposed beneficial effects upon range of motion (ROM), however the mechanism behind these increases remains unreported. This study aimed to determine the influence of a minimal frequency PT dose upon ROM and myotonometry outcomes. Twenty participants (N = 20; 13 males and 7 females, height 1.78cm ± 9.62; weight 77.35kg ± 8.46) participants were allocated to either a PT group receiving 2 x 60-seconds (plus 30-seconds rest) via a Theragun™ Pro4 to the hamstrings covering a standardised 20 lengths from proximal to distal via the standard ball attachment at 1 bar of pressure or a control group (CON) of 2-minutes 30-seconds passive supine rest. Pre and post intervention outcomes were measured for ROM via passive straight leg raise (PSLR) and tissue dynamics via MyotonPro (Tone, Stiffness, Elasticity, Relaxation Time). Results showed significant within-group increases (p < 0.0001, ηp2 0.656, +11.4%) in ROM following PT and between group difference against CON (P < 0.026). Significant within-group differences in stiffness (p < 0.016, ηp2 0.144, -6%), tone (p < 0.003, ηp2 0.213, +2%) and relaxation time (p < 0.002, ηp2 0.232, +6.3%) were also reported following PT. No significant difference was reported in elasticity (P > 0.05) or any other between group outcomes. PT therapy can provide an acute increase in hamstring group ROM following a resultant decrease in tissue stiffness.

Hamstrings fascicle length and physical performance changes after a single bout of dynamic stretching or neurodynamic gliding in healthy young and older adults.

INTRODUCTION: The physiological and structural alterations have been less reported in response to dynamic stretching (DS) or neurodynamic nerve gliding (NG). Accordingly, this study investigated the changes in fascicle lengths (FL), popliteal artery velocity, and physical fitness in response to a single bout of DS or NG. METHODS: The study included 15 healthy young adults (20.9 ± 0.7 yrs) and 15 older adults (66.6 ± 4.2 yrs) who randomly performed three different interventions (DS, NG, and rest control) for 10 min and 3 days apart. The biceps femoris and semitendinosus FL, popliteal artery velocity, sit and reach (S&R), straight leg raise (SLR), and fast walking speed were measured before and immediately after the intervention. RESULTS: After NG intervention, S&R was largely greater by 2 cm (1.2, 2.8 cm) and 3.4 cm (2.1, 4.7 cm) with largely increased SLR angles of 4.9° (3.7°, 6.1°) and 4.6° (3.0°, 6.2°) with all p < 0.001 for the older adults and young groups, respectively. A similar magnitude improvement in the S&R and SLR testing was also seen for both groups after DS (p < 0.05). Moreover, no changes were seen in FL, popliteal artery velocity, fast gait speed, and age effect following all three intervention occasions. CONCLUSION: Stretching with DS or NG immediately increased flexibility, which appeared to be largely due to changes in stretch tolerance rather than an increase in fascicle length. Furthermore, age dependency in response to stretching exercise was not seen in the present study.

Comparison of utilizing modified hold-relax, muscle energy technique, and instrument-assisted soft tissue mobilization on hamstring muscle length in healthy athletes: Randomized controlled trial.

INTRODUCTION: The hamstring muscle shortness is the primary risk factor for sports-related injuries. Numerous treatments are available for lengthening of hamstring muscle. The main purpose of this study was to compare the immediate effect of modified hold-relax, muscle energy technique (MET), and instrument assisted soft tissue mobilization-Graston techniques (IASTM-GT) on length of hamstring muscle in young healthy athletes. METHODS: 60 athletes comprising of 29 females and 31 males were recruited in the present study. Participants were allocated to 3 groups of IASTM-GT (N = 20, 13 male, 7 female), Modified Hold-relax (N = 20, 8 male, 12 female), and MET (N = 20, 7 male, 13 female). Active knee extension and passive straight leg raising (SLR), and toe touch test were performed before and immediately after the intervention by a blinded assessor. For the comparison of dependent variables across time, 3*2 repeated measure ANOVA was utilized. RESULTS: Interaction of group by time was significant for passive SLR (P < 0.001). Interaction of group by time was not significant for active knee extension (P = 0.17). The results showed that dependent variables increased significantly in all groups. The effect size (Cohen's d) in the groups of IASTM-GT, modified Hold-relax, and MET was 1.7, 3.17, and 3.12, respectively. CONCLUSION: Although the measures were improved in all groups, it seems that IASTM-GT can be used as a safe and efficient treatment, which can be a suitable candidate alongside modified hold-relax and MET for increasing the hamstrings muscle length in healthy athletes.

The immediate effects of foam rolling of the hamstrings muscle group on the contractile properties of the knee muscles in football players.

INTRODUCTION: Excessive amounts of intense training, without adequate recovery time, can overload the musculoskeletal, immune, and metabolic systems, resulting in a potentially negative effects on later exercise performance. During the competitive period, the ability to recover after intense training and competition is an important factor of success in soccer. The purpose of this study was to determine the effect of hamstring foam rolling on the knee muscle contractile properties in soccer players, after a sports-specific load. METHODS: 20 male professional soccer players were included and contractile properties of the biceps femoris, rectus femoris, vastus medialis and vastus lateralis muscles were measured with tensiomyography, before and after a Yo-Yo interval test and after 5 × 45 s of hamstring foam rolling. Additionally, active and passive knee extensibility before and after the intervention were measured. A mixed linear model was performed to determine the differences between the mean values of the groups. The experimental group performed foam rolling, while the control was resting. RESULTS: Five repetitions of 45 s of hamstring foam rolling had no statistically significant effect (p > 0.05) on any of the measured muscles following the Yo-Yo interval test or foam rolling intervention. There were no statistically significant differences in delay time, contraction time and maximum muscle amplitude between groups. Active and passive knee extensibility did not differ between groups. DISCUSSION AND CONCLUSION: It seems that foam rolling does not affect mechanical properties of the knee muscles or hamstring extensibility in soccer players, after a sports-specific load.

The Effect of Remote Myofascial Release on Chronic Nonspecific Low Back Pain With Hamstrings Tightness.

CONTEXT: Anatomy trains theory states that performing techniques in any part of the superficial myofascial backline can remotely treat other parts of this pathway. Due to the connections of different parts of the superficial backline, it is possible to influence the hamstring by performing the technique in the lumbar area. As chronic nonspecific low back pain (LBP) may lead to or be caused by hamstring tightness, remote myofascial release (MFR) techniques using the superficial backline can help improve hamstring tightness. OBJECTIVE: This study aimed to evaluate the effect of remote MFR on hamstring tightness for those with chronic nonspecific LBP. DESIGN: Single-blind, parallel design. SETTING: The present study was performed at the clinical setting of Tarbiat Modares University in Iran. METHODS: This study included 40 participants (20 males and 20 females) who were 40.5 (5.3) years old with chronic nonspecific LBP and hamstring tightness. INTERVENTIONS: Participants were randomly divided into the lumbar MFR (remote area) and hamstring MFR groups. Participants underwent 4 sessions of MFR for 2 weeks. MAIN OUTCOME MEASURES: A passive knee-extension (PKE) test was used for muscle tightness evaluation 3 times. RESULTS: Repeated-measure analysis of variance test showed that after the lumbar and hamstring MFR, the PKE was significantly reduced in both legs: lumbar MFR (right knee: from 61.04° [2.17°] to 51.01° [4.11°], P ≤ .003 and left knee: from 63.02° [3.12°] to 52.09° [2.48°], P ≤ .004) and hamstring MFR (right knee: from 62.01° [4.32°] to 50.50° [7.18°], P ≤ .001 and left knee: from 63.11° [2.56°] to 51.32° [5.31°], P ≤ .002). Least Significant Difference (LSD) post hoc test results showed that the 2 groups were not significantly different after the MFR (P ≥ .05). Also, the intraclass correlation coefficient index showed that the PKE test has excellent reliability (intraclass correlation coefficient, .910 for the right limb and .915 for the left limb). The minimal detectable change at the 95% confidence interval indicated that a change greater than or equal to 6° is required to exceed the threshold of the error PKE test, respectively. CONCLUSION: The present study showed that the remote MFR technique to the lumbar region demonstrated the same significant results in decreasing hamstring tightness as was noted in hamstring MFR to both limbs in patients with chronic nonspecific LBP.

Instrument-Assisted Soft Tissue Mobilization Increased Hamstring Mobility.

CONTEXT: Limited research reveals that the use of different soft tissue mobilization techniques increases tissue mobility in different regions of the body. OBJECTIVE: The purpose of this study was to determine whether there is a difference between administering instrument-assisted soft tissue mobilization (IASTM) and therapeutic cupping (TC) on hamstring tightness. DESIGN: Subjects attended one session wherein treatment and leg order were randomized before attending the session. A statistical analysis was completed using a 2 (intervention) × 2 (time) repeated-measures analysis of variance at α level ≤ .05. PARTICIPANTS: Thirty-three subjects between the age of 18-35 years old with bilateral hamstring tightness participated in this study. INTERVENTIONS: The IASTM and TC were administered on different legs for 5 minutes and over the entire area of the hamstring muscles. One TC was moved over the entire treatment area in a similar fashion as the IASTM. MAIN OUTCOME MEASURES: The intervention measurements included soreness numeric rating scale, Sit-n-Reach (single leg for side being tested), goniometric measurement for straight-leg hip-flexion motion, and superficial skin temperature. The timeline for data collection included: (1) intervention measurements for the first randomized leg, (2) 5-minute treatment with the first intervention treatment, (3) intervention measurements repeated for postintervention outcomes, and (4) repeat the same steps for 1 to 3 with the contralateral leg and the other intervention. RESULTS: There was a main effect over time for Sit-n-Reach, measurement (pre-IASTM-29.50 [8.54], post-IASTM-32.11 [8.31] and pre-TC-29.67 [8.21], post-TC-32.05 [8.25]) and goniometric measurement (pre-IASTM-83.45 [13.86], post-IASTM-92.73 [13.20] and pre-TC-83.76 [11.97], post-TC-93.67 [12.15]; P < .05). CONCLUSION: Both IASTM and TC impacted hamstring mobility during a single treatment using only an instrument-assisted soft tissue mobilization technique without any additional therapeutic intervention.

A Comprehensive Evaluation of Minimally Invasive Achilles Tendon Reconstruction with Hamstring Graft Indicates Satisfactory Long-Term Outcomes.

Background and objectives: The Achilles tendon, the largest tendon in the body, is vulnerable to injury because of its limited blood supply and the combination of forces to which it is subjected. Given the relevance of the Achilles tendon in the proper function of the foot and ankle, the primary goal of the present study was to use a holistic approach for a comprehensive evaluation of Achilles tendon reconstruction results on multiple levels. Materials and Methods: The study was designed in the following way: 30 patients with partial or total Achilles tendon tears were subjected to the minimally invasive Achilles tendon reconstruction. Patients were then subjected to the clinical, functional and isokinetic tests 12 and 24 months after the treatment. The clinical evaluation included calf circumference measurements and subjective patient-reported tests: ATRS, EQ-5D-5L and VAS scales. The functional evaluation was based on three tests: the weight-bearing lunge test, the heel rise test and single leg hop. Isometric and isokinetic evaluation was performed using a Biodex 3 dynamometer. Results: The calf circumference of the operated limbs was significantly lower than the non-operated limb 12 months after the surgical procedure, however this improved at the second evaluation. All subjective outcomes improved significantly 24 months after the surgery. Significantly better results in the function of the operated limbs were also obtained 24 months after the surgery. However, most of the muscle strength parameters of the operated limbs were already comparable to non-operated ones 12 months after the surgery and were comparable between two evaluation times. Conclusions: The overall results of this extensive evaluation are highly satisfactory and patients returned to their normal physical activity. From a medical point of view, it is assumed that the healing process is completed 12 months after the surgery, however, importantly, our results indicate that we should consider the healing process and the rehabilitation process separately.

Hold-relax PNF is more effective than unilateral lumbar mobilization on increasing hamstring flexibility: A randomized clinical trial.

BACKGROUND: Although lumbar mobilization (LM) and proprioceptive neuromuscular facilitation (PNF) are used to increase flexibility in clinical practice, remains unclear which technic is the most effective. This study aims to verify and compare the immediate effect of unilateral LM and hold-relax PNF on hamstring flexibility. METHOD: A randomized, blinded, crossover trial carried out in university research laboratory. Thirty healthy young adults were randomly allocated to three groups, each group receive unilateral, central posterior-anterior LM grade III to the L4 joint, hold-relax PNF and control intervention in a different order with 48 h of washout period. Hamstring flexibility was measured using photogrammetry before and immediately after intervention through range of motion (ROM) change in the Straight Leg Raise Test. T-tests were used to compare ROM within groups, and ANOVA repeated measure followed by Bonferroni post-hoc tests was used for between groups comparison. RESULTS: Two participants were lost to follow-up, leaving 28 for analysis (21.6 ± 2.2 years-old). LM increased 4.5° (95% CI 2.3-6.5°, p = 0.001, d = 0.29) on the straight leg raise test and PNF increased 10.0° (95% CI 7.7-12.2°, p = 0.001, d = 0.7). No statistically significant increase was observed on the control group (p = 0.151, d = 0.08). Further, the technique used significantly influenced ROM (p = 0.001, η²p = 0.37). On the between group analysis, PNF was better than LM (p = 0.005) and control (p = 0.001), whereas LM was no better than the control for hamstring flexibility (p = 0.68). CONCLUSIONS: Although hold-relax PNF and unilateral LM techniques increased ROM, hold-relax PNF was more effective on increasing hamstring flexibility.

Is Myofascial Decompression Effective at Increasing Hamstring Flexibility in the Athletic Population? A Critically Appraised Topic.

CLINICAL SCENARIO: There are a variety of therapeutic modalities used to treat flexibility issues in athletes, which can be the main cause of hamstring injuries. Myofascial decompression is one modality used to treat these patients. FOCUSED CLINICAL QUESTION: Is myofascial decompression effective at increasing hamstring flexibility in the athletic population? Summary of Search, "Best Evidence" Appraised, and Key Findings: The literature was searched for studies of level 2 evidence or higher that investigated the use of myofascial decompression to increase hamstring flexibility, that were published in the last 5 years. Two high-quality randomized controlled trials were included and one cohort study. CLINICAL BOTTOM LINE: There is not enough consistent, clinically significant, high-level evidence to support the use of myofascial decompression to increase hamstring flexibility. STRENGTH OF RECOMMENDATION: There is level B evidence to support that myofascial decompression is effective at increasing hamstring flexibility.

Muscle Contraction Adaptations in Top-Level Karate Athletes Assessed by Tensiomyography.

BACKGROUND: This paper aimed to compare the involuntary stimulated neuromuscular response of thigh muscles in top-level karate athletes and recreational groups. METHODS: The study included 13 male karate athletes (KAs) and 14 non-athlete male individuals (NAs). Tensiomyographic (TMG) measurements were obtained from the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF) and semitendinosus (ST). RESULTS: Statistically significant differences were observed between KAs and NAs in knee extensor/flexor delay time (Td), contraction time (Tc), total contraction time (Tct), maximal radial displacement of the muscle belly (Dm) and rate of muscle tension development (RMTD). On a group level, KA dominant-leg extensors and flexors and also non-dominant-leg knee flexors had significant differences when compared to NA. Tct is a TMG parameter in which the KAs and NAs differ the most in the case of the knee extensors, while flexor muscles differ the most in the RMTD parameter. CONCLUSIONS: The lower Tct values indicate an improved ability of top-level karateka to make fast contractions of the agonist muscles. KAs' higher RMTD values suggest on strength characteristics needed in breaking actions of the antagonist muscles. Existence of contraction-relaxation-contraction neuromuscular pattern in the RF muscle suggests on implementation of training strategies that involves both rapid muscle contractions and relaxations.

Comparison of A Single Vibration Foam Rolling and Static Stretching Exercise on the Muscle Function and Mechanical Properties of the Hamstring Muscles.

Knee extension and hip flexion range of motion (ROM) and functional performance of the hamstrings are of great importance in many sports. The aim of this study was to investigate if static stretching (SS) or vibration foam rolling (VFR) induce greater changes in ROM, functional performance, and stiffness of the hamstring muscles. Twenty-five male volunteers were tested on two appointments and were randomly assigned either to a 2 min bout of SS or VFR. ROM, counter movement jump (CMJ) height, maximum voluntary isometric contraction (MVIC) peak torque, passive resistive torque (PRT), and shear modulus of semitendinosus (ST), semimembranosus (SM), and biceps femoris (BFlh), were assessed before and after the intervention. In both groups ROM increased (SS = 7.7%, P < 0.01; VFR = 8.8%, P < 0.01). The MVIC values decreased after SS (-5.1%, P < 0.01) only. Shear modulus of the ST changed for -6.7% in both groups (VFR: P < 0.01; SS: P < 0.01). Shear modulus decreased in SM after VFR (-6.5%; P = 0.03) and no changes were observed in the BFlh in any group (VFR = -1%; SS = -2.9%). PRT and CMJ values did not change following any interventions. Our findings suggest that VFR might be a favorable warm-up routine if the goal is to acutely increase ROM without compromising functional performance.

The acute effects of different hamstring muscle stretching techniques on reducing muscle resistance to movement by ultrasound elastography.

OBJECTIVE: Many stretching methods are applied on the hamstring muscles for reducing muscle resistance on movement. The aim of our study to investigate the acute effects of static stretching and the Mulligan traction straight leg raise (TSLR) technique administered to the hamstring muscles on reducing its resistance to movement. METHODS: The study included 22 healthy male volunteers (19.5 ± 0.98 years). After the individuals were randomly divided into two groups, static stretching was administered to the hamstring muscles in the first group and the Mulligan TSLR technique was administered on the same muscle in the second group. Active knee extension angles of the individuals were evaluated by a digital goniometer and muscle strain was assessed by ultrasound elastography. RESULTS: While there was a significant difference in all parameters in both groups after the treatment, the changes in the active knee extension angle and the strain index value of the biceps femoris musculotendinous junction were higher in the Mulligan TSLR group compared to the static stretching group (p < 0.05). CONCLUSION: It was concluded that, static stretching and the Mulligan TSLR technique administered to the hamstring muscles are effective ways to increase the range of motion. The Mulligan TSLR technique, however, can be opted in healthy individuals and patients since it is painless and more effective in reducing muscle resistance to movement and range of motion.

Is Tecar Therapy Effective on Biceps Femoris and Quadriceps Rehabilitation? A Cadaveric Study.

BACKGROUND: Capacitive-resistive electric transfer therapy is an interesting rehabilitation treatment to use in musculoskeletal injuries. The purpose is to analyze the temperature change and current flow in superficial and deep biceps femoris and quadriceps tissues when applying different protocols of capacitive-resistive electric transfer therapy. METHODS: Five cryopreserved cadavers (10 legs) were included in this study. Four interventions (high/low power) were performed for 5 minutes. Dynamic movements were performed to the biceps femoris and quadriceps. Superficial, middle, and deep temperature were recorded at 1-minute intervals and 5 minutes after the treatment using invasive temperature meters placed with ultrasound guidance. RESULTS: Low-power applications have generated a very low thermal effect and an important current flow. The high-power capacitive application achieves a greater increase in superficial temperature compared with low power (P < .001). The high-power resistive application recorded a greater increase in superficial, middle, and deep temperatures with a greater current flow compared with the other applications (P < .001). CONCLUSION: This study could serve as basic science data to justify the acceleration of the processes of muscle recovery, improving cell proliferation without increasing the temperature in acute muscle injuries and increasing the temperature and viscoelasticity of the tissues in chronic processes with this therapy.

The Effects of a Self-Myofascial Release Program on Isokinetic Hamstrings-to-Quadriceps Strength Ratio and Range of Motion of the Knee Joint Among Athletes With Hamstring Shortness.

CONTEXT: Range of motion (ROM) and muscular strength are the main factors that affect athletic performance. Self-myofascial release is a flexibility technique, which is used to inhibit overactive muscle fibers. OBJECTIVE: To investigate the effects of the 8-week self-myofascial release on the isokinetic hamstrings-to-quadriceps strength ratio (H/QRatio) and the ROM of the knee joint among male athletes with the hamstring shortness. DESIGN: A randomized controlled trial. SETTING: Research laboratory. PARTICIPANTS: Twenty-four college-aged male athletes with hamstring shortness were selected for this study and were randomly assigned to a foam rolling group (FOAM, n = 12) and a control group (n = 12). INTERVENTIONS: Participants in the FOAM group performed supervised self-myofascial release program 3 times per week for 8 weeks. The control group received no intervention. METHODS: Data were analyzed via 2-way repeated-measure analysis of variance at the significance level of .05. MAIN OUTCOME MEASURES: ROM and the H/QRatio at the velocities of 60°/s, 120°/s, and 180°/s were measured by an isokinetic dynamometer. RESULTS: The results of 2-way repeated-measure analysis of variance demonstrated that hamstring ROM increased in FOAM group (P = .001). No significant changes were found in H/QRatio after self-myofascial release for FOAM group (P ≥ .05). CONCLUSIONS: When compared with other methods of stretching, self-myofascial release with foam rolling may be beneficial in increasing ROM without decreasing H/QRatio in people with the hamstring shortness.

Effect of Whole-Body Vibration Exercise on Hamstrings-to-Quadriceps Ratio, Walking Performance, and Postural Control in Children With Hemiparetic Cerebral Palsy: A Randomized Controlled Trial.

OBJECTIVE: The purpose of this study was to investigate the effect of whole-body vibration (WBV) exercises combined with traditional physiotherapy on the hamstrings-to-quadriceps (H:Q) ratio, walking ability, and control of posture in children with hemiparetic cerebral palsy (CP). METHODS: A total of 34 children with spastic hemiparetic CP (boys and girls) participated in this 2-arm, parallel, randomized controlled trial. The inclusion criteria were spasticity ranging from 1 to 1+, gross level skills (I and II), at least 1 meter tall, standing alone, and walking forward and backward. They were randomly allocated to the control group (traditional physiotherapy) and study group and were treated by the same physiotherapy program combined with WBV training (3 times per week for 2 successive months). Quadriceps and hamstring muscle strength, walking performance, and postural control were evaluated before and after intervention by a blinded assessor. RESULTS: The post-intervention values of the hamstring and quadriceps muscle force, gross motor function, and stability indices of the 2 groups were higher than the pre-values (P < .05). In addition, the post-values of the study group were higher than those of the control group (P < .05). Regarding the H:Q ratio, there was no significant difference between pre-values or the post-values of both groups (P = .948 and P = .397, respectively). There were no significant differences between the pre- and post-values of each group (P = .500 and P = .195, respectively). CONCLUSION: Eight weeks of WBV training combined with traditional physiotherapy was more effective than traditional physiotherapy alone in improving walking ability and postural control. Furthermore, the combined intervention strengthened the quadriceps and hamstring muscles, with no change in the H:Q ratio in children with hemiparetic CP.

Effects of Kinesio Taping and Transcutaneous Electrical Nerve Stimulation Combined With Active Stretching on Hamstring Flexibility.

ABSTRACT: Adhitya, IPGS, Yu, W-Y, Bass, P, Kinandana, GP, and Lin, M-R. Effects of Kinesio taping and transcutaneous electrical nerve stimulation combined with active stretching on hamstring flexibility. J Strength Cond Res 36(11): 3087-3092, 2022-Active stretching (AS), Kinesio taping (KT), and transcutaneous electrical nerve stimulation (TENS) are frequently used to ameliorate pain and improve the ranges of motion (ROM) of athletes; however, the effectiveness of KT and TENS combined with AS in ameliorating short hamstring syndrome is yet to be determined. In this single-blinded randomized trial, 135 male soccer players with bilateral short hamstring syndrome were assigned to 3 intervention groups-AS, KT + AS, and TENS + AS-through block randomization. Each subject received the intervention twice per week for 4 weeks. The ROM of both legs was assessed through passive knee extension and straight leg raising tests at baseline and the end of the intervention. After the 4-week intervention, significant ROM changes in both legs were detected in the AS (9.5°-18.4°), KT + AS (14.9°-22.4°), and TENS + AS (14.9°-22.3°) groups. Compared with the AS group, both the KT + AS (3.8°-5.7°) and TENS + AS (3.9°-5.7°) groups showed significantly increased ROM in both legs over the intervention period, and no significant differences were observed in ROM changes between the KT + AS and TENS + AS groups. In conclusion, both KT and TENS in combination with AS may increase ROM more than AS alone, and the improvements obtained using KT with AS and TENS with AS may be similar.

Sonographic measures and sensory threshold of the normal sciatic nerve and hamstring muscles.

PURPOSE: The sciatic nerve innervates the hamstring muscles. Occasionally, the sciatic nerve is injured along with a hamstring muscle. Detailed biomechanical and sensory thresholds of these structures are not well-characterized. Therefore, we designed a prospective study that explored high-resolution ultrasound (US) at multiple sites to evaluate properties of the sciatic nerve, including cross-sectional area (CSA) and shear-wave elastography (SWE). We also assessed SWE of each hamstring muscle at multiple sites. Mechanical algometry was obtained from the sciatic nerve and hamstring muscles to assess multi-site pressure pain threshold (PPT). METHODS: Seventy-nine asymptomatic sciatic nerves and 147 hamstring muscles (25 males, 24 females) aged 18-50 years were evaluated. One chiropractic radiologist with 4.5 years of US experience performed the evaluations. Sciatic nerves were sampled along the posterior thigh at four sites obtaining CSA, SWE, and algometry. All three hamstring muscles were sampled at two sites utilizing SWE and algometry. Descriptive statistics, two-way ANOVA, and rater reliability were assessed for data analysis with p ≤ 0.05. RESULTS: A significant decrease in sciatic CSA from proximal to distal was correlated with increasing BMI (p < 0.001). Intra-rater and inter-rater reliability for CSA was moderate and poor, respectively. Elastographic values significantly increased from proximal to distal with significant differences in gender and BMI (p = 0.002). Sciatic PPT significantly decreased between sites 1 and 2, 1 and 3, and 1 and 4. Significant correlation between gender and PPT was noted as well as BMI (p < 0.001). Hamstring muscle elastographic values significantly differed between biceps femoris and semitendinosus (p < 0.001) and biceps femoris and semimembranosus (p < 0.001). All three hamstring muscles demonstrated increased PPT in males compared to females (p < 0.001). In addition, PPT of the biceps femoris correlated with BMI (p = 0.02). CONCLUSION: High-resolution US provided useful metrics of sciatic nerve size and biomechanical properties. PPT for the normal sciatic nerve and hamstring muscles was obtained for future clinical application.