Hamstring shortness is a common musculoskeletal issue among young adults. While several therapeutic approaches exist to address this condition, there is ongoing debate regarding the most effective treatment methods.
Objective
This single-blind active controlled randomized study aimed to compare the immediate effects of muscle energy technique (MET) and percussive therapy (PT) on individuals with hamstring shortness.
Methods
Thirty college students age between 18 and 25 years were randomly allocated to either the MET or PT group for the study. All participants were evaluated using two assessments: pre-intervention and immediate post-intervention. The Sit and Reach Test was the primary outcome measure, while hamstring strength, assessed with a MicroFET2® manual muscle tester, served as the secondary outcome. PT group received a 6-min massage-gun treatment, targeting each hamstring head for 2 min. MET group received anterior and posterior innominate techniques for 3 min each, totaling 6 min.
Results
Both groups evidenced substantial enhancements in sit and reach scores and muscle strength following the intervention when compared to the baseline values (p < 0.05). There was no significant difference between groups in terms of hamstring flexibility and strength scores (p > 0.05).
Conclusions
In conclusion, both MET and PT are effective interventions for improving hamstring flexibility and strength. MET's active mechanism may provide greater immediate benefits, while PT remains a valuable passive alternative. The choice between these techniques should be guided by individual patient needs and therapeutic objectives. Future research should focus on long-term outcomes, diverse populations, and combined strategies to enhance clinical applicability and patient outcomes.
PurushothamanVK. Myofascial release therapy versus muscle energy technique on hamstring flexibility in physically inactive students–A randomized controlled trial. 2022.
2.
DunstanDW, et al.Too much sitting–a health hazard. Diabetes Res Clin Pract2012; 97: 368–376.
3.
ArabAMNourbakhshMR. Hamstring muscle length and lumbar lordosis in subjects with different lifestyle and work setting: comparison between individuals with and without chronic low back pain. J Back Musculoskelet Rehabil2014; 27: 63–70.
4.
DanielssonA, et al.The mechanism of hamstring injuries–a systematic review. BMC Musculoskelet Disord2020; 21: 1–21.
5.
HerringtonL. The effect of pelvic position on popliteal angle achieved during 90: 90 hamstring-length test. J Sport Rehabil2013; 22: 254–256.
6.
GajdosikRLAlbertCRMitmanJJ. Influence of hamstring length on the standing position and flexion range of motion of the pelvic angle, lumbar angle, and thoracic angle. J Orthop Sports Phys Ther1994; 20: 213–219.
7.
KhanSPatelBLimbaniB. Immediate effect of active release technique versus muscle energy technique in subjective with hamstring tightness: a rendomized clinical trial. Indian J Physiother Occup TherPrint-(ISSN 0973-5666) and Electronic–(ISSN 0973-5674)2021; 15: 59–64.
8.
VakhariyaPPanchalSPatelB. Effects of various therapeutic techniques in the subjects with short hamstring syndrome. Int J Physiother Res2016; 4: 1603–1610.
9.
KrishnaHPkSDhoteC. Comparison between immediate effect of neural mobilization and myofascial release of suboccipital muscle on hamstring length in younger adults—an interventional study. Int J Sci Healthc Res2021; 6: 438–445.
10.
RazzaqM, et al.Comparative effects of Mulligan’s two leg rotation technique and muscle energy technique on hamstring flexibility. Pakistan J Med Health Sci2022; 16: 102–102.
11.
JiangW-B, et al.Effectiveness of craniosacral therapy in the human suboccipital region on hamstring muscle: a meta-analysis based on current evidence. Medicine (Baltimore)2023; 102: e32744.
12.
LópezLL, et al.Effects of neurodynamic treatment on hamstrings flexibility: a systematic review and meta-analysis. Phys Ther Sport2019; 40: 244–250.
13.
KimD-HLeeJJ. Effects of instrument-assisted soft tissue mobilization technique on strength, knee joint passive stiffness, and pain threshold in hamstring shortness. J Back Musculoskelet Rehabil2018; 31: 1169–1176.
14.
PannalalPV. Comparison between the effect of Nordic eccentric hamstring exercise versus positional release therapy on hamstring flexibility and endurance in male cricketers. 2020.
15.
SkinnerBDunnLMossR. The acute effects of theragun™ percussive therapy on viscoelastic tissue dynamics and hamstring group range of motion. J Sports Sci Med2023; 22: 496.
16.
FossumC, et al.Foundations of osteopathic medicine. In: Foundations of osteopathic medicine. 3rd ed. Philadelphia (PA): Wolters Kluwer Health/Lippincott Williams & Wilkins, 2011, pp.853–864.
17.
MassoudArabARezaNourbakhshMMohammadifarA. The relationship between hamstring length and gluteal muscle strength in individuals with sacroiliac joint dysfunction. J Manual Manipul Ther2011; 19: 5–10.
18.
AldabeD, et al.A systematic review of the morphology and function of the sacrotuberous ligament. Clin Anat2019; 32: 396–407.
FaulF, et al.Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behav Res Methods2009; 41: 1149–1160.
21.
Nazary-MoghadamS, et al.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. J Bodyw Mov Ther2023; 35: 151–157.
22.
AyalaF, et al.Reproducibility and criterion-related validity of the sit and reach test and toe touch test for estimating hamstring flexibility in recreationally active young adults. Phys Ther Sport2012; 13: 219–226.
23.
Mayorga-VegaDMerino-MarbanRVicianaJ. Criterion-related validity of sit-and-reach tests for estimating hamstring and lumbar extensibility: a meta-analysis. J Sports Sci Med2014; 13: 1.
24.
MentiplayBF, et al.Assessment of lower limb muscle strength and power using hand-held and fixed dynamometry: a reliability and validity study. PloS one2015; 10: e0140822.
25.
GibbonsJ. Muscle energy techniques: A practical guide for physical therapists. Berkeley (CA): North Atlantic Books, 2022.
26.
ChaitowSFritzS. Chaitow's muscle energy techniques E-Book. St. Louis, MO: Elsevier Health Sciences, 2023.
27.
PeloquinK, et al.The immediate effect of percussion myofascial release therapy on hamstring flexibility and hip flexion range of motion among active young adults. Int J Res Ex Phys2022; 17: 48–61.
28.
FerreiraRM, et al.The effects of massage guns on performance and recovery: a systematic review. J Function Morphol Kinesiol2023; 8: 138.
29.
NakamuraM, et al.The acute effect of percussive massage intervention with and without heat application on plantar flexor Muscles’ passive and active properties. J Sports Sci Med2024; 23: 73.
30.
SatheSS, et al.Comparison between immediate effects of post isometric relaxation and reciprocal inhibition techniques on hamstring flexibility in patients with hamstring tightness: an experimental study. Indian J Forensic Med Toxicol2020; 14: 6871–6875.
31.
BhuttaAH, et al.Comparative analysis of muscle energy techniques and hamstring Nordic lower training on hamstring tightness and agility run test in young athletes. Sport Sci Health2024; 20: 899–904.
32.
MajeedA, et al.Comparison of static stretching and muscle energy techniques on hamstring tightness in asymptomatic females. Foundation Univ J Rehabil Sci2021; 1: 19–23.
33.
KhalilE, et al.Prevalence of hamstrings tightness and its impact on lower extremity function in asymptomatic individuals with prolonged standing hours. Int J Nat Med Health Sci2022; 1: 27–30.
34.
SailorS, et al.A comparative study of muscle energy technique and positional release technique on hamstring flexibility in healthy individuals. J Integr Health Sci2018; 6: 64–68.
35.
VachhaniRSharmaH. Effectiveness of suboccipital muscle inhibition technique versus muscle energy technique on hamstring muscle flexibility in college going students. Pain2021; 11: 12.
36.
GohilPA. Comparative study between the efficacy of muscle energy technique and static passive stretching on hamstring flexibility in healthy Indian college athletes. Indian J Physiother Occup Ther2013; 7: 172.
37.
GhafoorF, et al.Comparison of effectiveness of muscle energy technique versus PNF in individuals with hamstring shortness. Biom J Sci Tech Res2023; 50: 41234–41241.
38.
AteşR, et al.A comparison of the acute effects of percussion massage therapy and static stretching on hamstring elasticity. Ethiop J Health Sci2023; 33: 695–703.
39.
LeabeaterAJ, et al.Under the gun: percussive massage therapy and physical and perceptual recovery in active adults. J Athl Train2024; 59: 310–316.
40.
RoehmerCKhanSSherwoodD. ID: 15833 paracervical muscle edema after the use of high-percussion massage gun. Neuromodul: Technol Neural Interface2022; 25: S56.
41.
ReyesAG, et al.Traumatic cataract induced by improper use of a percussion massage gun. Am J Ophthalmol Case Rep2024; 33: 101995.
42.
BooraMSharmaS. Study on effectiveness of static stretching and massage on hamstring flexibility in normal adults. IOSR J Sports Phys Educ2016; 3: 01–05.
