Hamstring Flexibility, Hamstring Muscle Tightness
Conditions
Keywords
hamstring flexibility, football, Propioceptive Neuromuscular Facilitation, Neuromuscular Electrical Stimulation, Sports Injury Prevention, Athletic Performance, Muscle Stretching, Hamstring Muscle Function
Brief summary
Hamstring muscle injuries are common in sports like football and often lead to extended periods of inactivity. This study aims to compare the effects of two different stretching programs on hamstring flexibility, with a secondary focus on jumping performance in young football players. One group will perform a proprioceptive neuromuscular facilitation (PNF) stretching protocol combined with neuromuscular electrical stimulation (NMES), while the other group will follow the same PNF protocol with a placebo NMES.
Detailed description
Hamstring strains are increasingly common in sports, particularly in football, where they are among the most frequent injuries. Stretching techniques such as proprioceptive neuromuscular facilitation (PNF) are commonly used to improve muscle flexibility and reduce injury risk. A specific variant, contract-relax PNF (crPNF), involves alternating passive stretching with voluntary muscle contractions. Recent approaches suggest that applying neuromuscular electrical stimulation (NMES) during the contraction phase of crPNF may further enhance its effectiveness. This study aims to compare the short-term effects of two active stretching protocols on hamstring flexibility in young male football players. One group will perform crPNF with sham NMES, while the other will perform crPNF with NMES during the contraction phase. A secondary objective is to assess whether either protocol affects vertical jump performance, a key ability in football.
Interventions
NMES is applied during each 10-second isometric hamstring contraction using an Enraf Nonius TensMed S82 stimulator delivering biphasic, symmetric rectangular pulses at 50 Hz with a 250 µs pulse width. Two 5 × 5 cm self-adhesive electrodes are placed on the hamstrings-one approximately two finger-breadths below the gluteal fold and the other over the distal third of the muscle belly. Stimulation intensity is individually titrated to each participant's maximal motor threshold-eliciting a strong, yet painless, contraction-and the exact milliamperage is recorded for each leg. Elastic straps over the pelvis and distal thigh maintain pelvic anteversion and knee extension. During each session, one researcher secures limb positioning while a second adjusts and logs NMES intensity and cues the timing of the 10 s contraction and ensuing 30 s passive stretch.
Sham NMES is delivered during each 10 s isometric hamstring contraction using an Enraf Nonius TensMed S82 stimulator with biphasic, symmetric rectangular pulses (50 Hz, 250 µs pulse width). Two 5 × 5 cm self-adhesive electrodes are placed on the hamstrings-one two finger-breadths below the gluteal fold and one over the distal third of the muscle belly. Intensity is individually set to the sensory threshold, defined as the minimal current producing a slight tingling without any visible muscle response; this milliamperage is recorded for each leg. Elastic straps over the pelvis and distal thigh maintain pelvic anteversion and full knee extension. During each session, one researcher secures limb positioning while a second adjusts and logs the NMES intensity and cues the 10 s contraction timing.
The crPNF Group engages in an isolated contract-relax proprioceptive neuromuscular facilitation (crPNF) stretching protocol. Participants are positioned in a long sitting posture with maximum knee extension until they feel a moderate-strong stretch sensation, without pain. Each stretch lasts for 30 seconds, followed by a 10-second maximal voluntary isometric contraction of the hamstrings. Participants complete three cycles of stretch and contraction. One researcher maintains the stretch position while a second researcher controls the timing of the stretching and contractions.
Sponsors
Study design
Eligibility
Inclusion criteria
* Active football players who train at least 3 days a week. * Ages between 10 and 18 years.
Exclusion criteria
* Are currently engaged in a structured hamstring-stretching programme. * Present with acute low back pain. * Have sustained a hamstring injury within the past 6 months. * Have undergone spinal or abdominal surgery within the past 6 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Popliteal Angle Test | Before and inmediately after the intervention | The Popliteal Angle Test is validated for measuring hamstring extensibility. Participants are placed in the supine position. A researcher holds the hip at a 90° flexion and passively extends the knee until the participant feels a strong stretch without pain. The examiner records the knee extension degrees at that moment using an inclinometer. The test is repeated three times, and the average is obtained. A full knee extension corresponds to a value of 0 degrees, and a higher number of degrees indicates greater hamstring shortening. |
| The Sit & Reach Test | Before and inmediately after the intervention | The Sit & Reach Test has high intra-examiner reliability and is validated for measuring hamstring extensibility. For its execution, participants are placed in a long sitting position with the soles of their feet against the base of the measurement box. Keeping their knees extended, they reach for the maximum possible distance in the box with their fingers. The test is repeated three times, and the average is obtained. Values are recorded in centimeters, where a greater distance indicates a higher degree of hamstring extensibility. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Counter Movement Jump | Before and inmediately after the intervention | The Counter Movement Jump is validated and standardized in adolescents for measuring jumping ability. The instructions by Petrigna et al. are followed to perform the jump. The My Jump App is used, which has high reliability and validity for measuring vertical jump height in centimeters. A greater height indicates a greater jumping ability. |
Countries
Spain