The Effects of Soft Tissue Therapy and Exercise on Hamstring Tightness

The Effects of Myofascial Decompression and Neurodynamic Sliding on the Hamstring for Division I Track and Field Athletes With Hamstring Tightness

The purpose of this study is to investigate the effects of myofascial decompression (cupping) and neurodynamic sliding technique for the hamstring on Division I Track and Field athletes who complain of hamstring tightness. Research questions will be: how do these techniques affect hamstring range of motion and flexibility; isometric strength of the hamstring muscle; muscle activation; and rate of force development. The hypotheses of this study are that neurodynamic sliding will have an effect on all variables and myofascial decompression will only have an effect on range of motion.

Study Overview

• Status: Completed
• Conditions: Musculoskeletal Pain; Myofascial Pain; Hamstring Tightness
• Intervention / Treatment: Other: Neurodynamic Sliding; Other: Myofascial Decompression; Other: Diathermy

Detailed Description

Predisposing factors to hamstring injury include neural tension and muscle flexibility restrictions due to fascial adhesions. The sciatic nerve can produce symptoms of pain, decreased range of motion, and increased resting muscle tone when it is overstretched. The nerve can be overstretched after a hamstring injury and cause adhesions on the nerve and abnormal mechanosensitivity leading to perceived hamstring tightness.The purpose of this study is to investigate the effects of myofascial decompression (cupping) and neurodynamic sliding technique for the hamstring on Division I Track and Field athletes who complain of hamstring tightness. Research questions will be: how do these techniques affect hamstring range of motion and flexibility; isometric strength of the hamstring muscle; muscle activation; and rate of force development. The hypotheses of this study are that neurodynamic sliding will have an effect on all variables and myofascial decompression will only have an effect on range of motion.

• Study Type: Interventional
• Enrollment (Actual): 21
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Oklahoma
    • Stillwater, Oklahoma, United States, 74078
      • Applied Neuromuscular Physiology Lab

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 25 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Must be in the Sprints, Jumps, or Multi (heptathlon, pentathlon, or decathlon) groups
• complain of hamstring tightness and/or injury in the last calendar year
• have less than 80⁰ for Active Knee Extension test.

Exclusion Criteria:

• Past history or current neurological disorders or orthopedic diseases
• Surgery of the lower extremity that involves an autograft on the tested leg
• Past history of hamstring surgery
• Receiving current treatment for a hamstring injury
• Received any form of myofascial therapy or neurodynamic techniques within the last week unhealed wounds
• active TB
• leukemia
• hemophilia
• thrombocytopenia
• fever
• influenza
• moderate/severe anemia
• high blood pressure
• cardiac conditions
• late stages of pregnancy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Neurodynamic Sliding; neurodynamic sliding consists of 2 movements; 1) movement 1 involves sitting on the edge of the treatment table the bringing their neck to their chest along with bending their knee and pointing their ankle to the ground. Movement 2 is performed by facing their head towards the ceiling and straightening their knee while pointing their ankle towards their nose. Subjects will alternate these 2 active movements for 60s and repeated 5 times, with rest period of 15s between sets.	Other: Neurodynamic Sliding; Subjects in the neurodynamic sliding group perform 2 movements; 1) movement 1 involves sitting on the edge of the treatment table the bringing their neck to their chest along with bending their knee and pointing their ankle to the ground. Movement 2 is performed by facing their head towards the ceiling and straightening their knee while pointing their ankle towards their nose. Subjects will alternate these 2 active movements for 60s and repeated 5 times, with rest period of 15s between sets. A metronome will be set at 30 beats per minute for 15 full slides per minute to standardize the amount of slides per session.
Experimental: Myofascial Decompression; For the group receiving the cupping treatment, the subject will lay on their stomach and their affected hamstring will be exposed. Cocoa butter will be applied to the hamstring prior to the application of the cups. 5 cups will be placed along the hamstring and calf muscles. Using a handheld suction pump, each cup will be pumped so that skin fills up half of the cup. The cups will stay in place for five minutes and the clinician will instruct the subject to perform 5 repetitions of active quad sets and 5 repetitions of ankle pumps .	Other: Myofascial Decompression; For the group receiving the cupping treatment, the subject will lay on their stomach and their affected hamstring will be exposed. Cocoa butter will be applied to the hamstring prior to the application of the cups. 5 cups will be placed along the hamstring and calf muscles. Using a handheld suction pump, each cup will be pumped so that skin fills up half of the cup. The cups will stay in place for five minutes and the clinician will instruct the subject to perform 5 repetitions of active quad sets and 5 repetitions of ankle pumps .
Sham Comparator: Diathermy; The control group will receive a sham heat (diathermy treatment). The subjects will be asked to sit and relax for five minutes and the machine will not be turned on with a timer timing the treatment.	Other: Diathermy; The control group will receive a sham heat (diathermy treatment). The subjects will be asked to sit and relax for five minutes and the machine will not be turned on with a timer timing the treatment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hamstring Flexibility change	Using the 'Active Knee Extension test', subjects are placed supine with both the hip and knee positioned at 90° of flexion and then asked to extend lower leg until point of limitation. A digital inclinometer is used to measure the angle of the knee joint in this position to examine flexibility of the hamstring muscle group.	Baseline, 5 minutes after intervention, and within 24 hours of intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hamstring muscle strength change	Peak torque production of the hamstring muscles will be assessed using an isokinetic dynamometer with the subjects performing a maximum voluntary isometric contraction with the knee in a slightly flexed position.	Baseline, 5 minutes after intervention, and within 24 hours of intervention
Time of Force Development	Time to reach peak force torque	Baseline, 5 minutes after intervention, and within 24 hours of intervention
Electromyographic (EMG) Muscle Activation of the Hamstring muscles	The electrical activation signaling of the hamstring muscles will be measured using electromyography during the isometric contraction.	Baseline, 5 minutes after intervention, and within 24 hours of intervention
Disablement of the Physically Active patient outcome survey	The Disablement of the Physically Active Scale (DPAS) paper survey will be used to assess subject perceptions of impairment, limitation, disability and quality of life related to their hamstring discomfort. The scale ranges from 0 (No disability) to 64 (Severe disability) in which the scores will be compared.	Baseline, 5 minutes after intervention, and within 24 hours of intervention
Functional Patient Outcome survey	The Lower Extremity Functional Scale is a questionnaire containing 20 questions about a subject's ability to perform everyday tasks. Scores range from 0-4 and represent 'extreme difficulty' or 'unable to perform activity' to 'no difficulty'. The maximum score on the survey is 80 points, with lower total scores indicating a greater perceived disability.	Baseline, 5 minutes after intervention, and within 24 hours of intervention

Collaborators and Investigators

• Sponsor: Oklahoma State University
• Investigators: Study Chair: Aric Warren, EdD, Oklahoma State University

Study record dates

Study Major Dates

• Study Start (Actual): March 27, 2017
• Primary Completion (Actual): April 10, 2017
• Study Completion (Actual): June 12, 2017

Study Registration Dates

• First Submitted: March 29, 2018
• First Submitted That Met QC Criteria: August 28, 2018
• First Posted (Actual): August 29, 2018

Study Record Updates

• Last Update Posted (Actual): August 31, 2018
• Last Update Submitted That Met QC Criteria: August 28, 2018
• Last Verified: August 1, 2018

More Information

Terms related to this study

• Keywords: cupping; Hamstring tightness; myofascial decompression; neurodynamic sliding
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Muscular Diseases; Musculoskeletal Pain
• Other Study ID Numbers: ED174

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No