Foam Roller Versus Self-Performed Neurodynamic Sliding in People With Hamstring Tightness and Low Back Pain History

Effects of Self-Myofascial Release With Foam Roller Versus Self-Performed Neurodynamic Sliding on Hamstring Flexibility in People With Hamstring Tightness and a History of Low Back Pain: A Randomized Pilot Clinical Trial

This randomized crossover pilot clinical trial evaluated the effects of two self-administered physiotherapy techniques in people with hamstring tightness and a history of non-specific low back pain.

Participants were randomly assigned to one of two treatment sequences. One sequence performed self-myofascial release using a foam roller first, followed by a one-month washout period, and then performed a self-administered neurodynamic sliding technique. The other sequence performed the neurodynamic sliding technique first, followed by a one-month washout period, and then performed the foam roller intervention.

The main objective of the study was to compare the effects of both interventions on hamstring flexibility. Secondary outcomes included active knee extension range of motion, dynamic balance, pressure pain threshold, hamstring and gluteus maximus strength, and low back pain intensity.

Study Overview

• Status: Not yet recruiting
• Conditions: Low Back Pain; Hamstring Tightness
• Intervention / Treatment: Other: Self-Myofascial Release Using a Foam Roller; Other: Self-Administered Neurodynamic Sliding Technique

Detailed Description

Low back pain is a common musculoskeletal condition, and hamstring tightness has been proposed as a potential contributing factor due to its influence on pelvic and lumbar biomechanics. Different physiotherapy interventions may be used to improve hamstring flexibility, including self-myofascial release with a foam roller and neurodynamic sliding techniques.

This study was designed as a randomized, crossover, pilot clinical trial with two active interventions. Participants were people with hamstring tightness and a history of recurrent or chronic non-specific low back pain. Eligible participants were randomly assigned to one of two intervention sequences.

In one sequence, participants first performed self-myofascial release using a foam roller on the hamstring muscles. After a one-month washout period, they then performed the self-administered neurodynamic sliding technique. In the other sequence, participants first performed the self-administered neurodynamic sliding technique. After a one-month washout period, they then performed the self-myofascial release intervention using a foam roller.

The foam roller intervention consisted of bilateral self-myofascial release of the hamstring muscles for 2 minutes per leg over three consecutive days. The neurodynamic sliding intervention consisted of a seated self-administered neurodynamic sliding technique over three consecutive days, with 3 sets of 20 repetitions and 20 seconds of rest between sets.

Assessments were performed before and after each intervention period. The primary outcome was hamstring flexibility measured using the Straight Leg Raising test. Secondary outcomes included hamstring flexibility measured using the Active Knee Extension test, dynamic balance assessed with the Y-Balance Test, pressure pain threshold over myofascial trigger points, isometric strength of the hamstrings and gluteus maximus, and low back pain intensity measured with the Numeric Pain Rating Scale.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sara Perpiña Martinez, PT, PhD; Phone Number: 1032 (+34) 910053661; Email: sperpinama@upsa.es

Study Locations

• Spain
  • Madrid
    • Madrid, Madrid, Spain, 28015
      • Clínica Universitaria Salus Infirmorum, Universidad Pontificia de Salamanca
      • Contact: Sara Perpiña Martinez, PT, PhD; Phone Number: 1032 (+34) 910053661; Email: sperpinama@upsa.es

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Men and women aged 16 years or older.
• History of non-specific low back pain during the previous three months and/or recurrent or chronic non-specific low back pain.
• Limited hamstring flexibility, defined as hamstring tightness with 75 degrees or less of hip flexion with knee extension during the Straight Leg Raise test.
• No previous surgery involving the spine or lower limb.
• No hamstring stretching exercises performed in the weeks prior to participation.
• Ability and willingness to provide informed consent.
• Availability to perform both self-administered physiotherapy techniques according to the study protocol.

Exclusion Criteria:

• Pregnancy or breastfeeding.
• History of hamstring muscle or tendon injury during the previous year.
• Lumbar or lower-limb neurological deficits.
• Lower-limb length discrepancy.
• Specific spinal pathology, including tumor, infection, fracture, or inflammatory disease.
• History of lumbar disc herniation.
• History of whiplash injury.
• Any contraindication to physical exercise.
• Menstrual pain at the time of assessment or intervention.
• Scheduled surgery during the intervention or follow-up period.
• History of cardiac disease.
• Incomplete or incorrectly completed questionnaires or missing assessment data.
• Refusal to complete part or all of the study intervention.
• Development of a low back pain episode during the study intervention.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Foam Roller First, Then Neurodynamic Sliding; Participants assigned to this sequence will first perform self-myofascial release using a foam roller on the hamstring muscles. After a one-month washout period, they will perform the self-administered neurodynamic sliding technique.	Other: Self-Myofascial Release Using a Foam Roller; Participants will perform bilateral self-myofascial release of the hamstring muscles using a foam roller. The technique will be performed for 2 minutes per leg over three consecutive days.; Other: Self-Administered Neurodynamic Sliding Technique; Participants will perform a seated self-administered neurodynamic sliding technique over three consecutive days. The intervention will consist of 3 sets of 20 repetitions, with 20 seconds of rest between sets.
Experimental: Neurodynamic Sliding First, Then Foam Roller; Participants assigned to this sequence will first perform the self-administered neurodynamic sliding technique. After a one-month washout period, they will perform self-myofascial release using a foam roller on the hamstring muscles.	Other: Self-Myofascial Release Using a Foam Roller; Participants will perform bilateral self-myofascial release of the hamstring muscles using a foam roller. The technique will be performed for 2 minutes per leg over three consecutive days.; Other: Self-Administered Neurodynamic Sliding Technique; Participants will perform a seated self-administered neurodynamic sliding technique over three consecutive days. The intervention will consist of 3 sets of 20 repetitions, with 20 seconds of rest between sets.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Hamstring Flexibility Measured With the Straight Leg Raise Test	Hamstring flexibility will be assessed using the Straight Leg Raise test. The test will be performed with the participant in the supine position, and hip flexion range of motion will be measured in degrees using a goniometer. Higher values indicate greater hamstring flexibility.	Baseline of each intervention period, 24 hours after completing each intervention, and 7 days after each intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Hamstring Flexibility Measured With the Active Knee Extension Test	Hamstring flexibility will be assessed using the Active Knee Extension test. The knee extension angle will be measured in degrees using a goniometer, with the hip positioned at 90 degrees of flexion.	Baseline of each intervention period, 24 hours after completing each intervention, and 7 days after each intervention
Change in Dynamic Balance Measured With the Y-Balance Test	Dynamic balance will be assessed using the Y-Balance Test. Reach distances in the anterior, posteromedial, and posterolateral directions will be recorded in centimeters and normalized to lower limb length.	Baseline of each intervention period, 24 hours after completing each intervention, and 7 days after each intervention
Change in Pressure Pain Threshold	Isometric strength of the hamstring muscles and gluteus maximus will be assessed using a handheld dynamometer. Values will be recorded in Newtons, with higher values indicating greater muscle strength.	Baseline of each intervention period, 24 hours after completing each intervention, and 7 days after each intervention
Change in Low Back Pain Intensity	Low back pain intensity will be assessed using the Numeric Pain Rating Scale, ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.	Baseline of each intervention period, 24 hours after completing each intervention, and 7 days after each intervention

Collaborators and Investigators

• Sponsor: Universidad Pontificia de Salamanca
• Investigators: Principal Investigator: Sara Perpiña Martínez, PT, PhD, Pontifical University of Salamanca

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): August 1, 2026

Study Registration Dates

• First Submitted: May 30, 2026
• First Submitted That Met QC Criteria: May 30, 2026
• First Posted (Actual): June 4, 2026

Study Record Updates

• Last Update Posted (Actual): June 4, 2026
• Last Update Submitted That Met QC Criteria: May 30, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Low back pain; Hamstring flexibility; foam roller; Self-myofascial release; Crossover trial; Neurodynamic sliding
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Low Back Pain
• Other Study ID Numbers: UPSA_HAM_LBP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared because the study dataset contains health-related information collected in a small pilot trial. Data will be pseudonymized and stored according to applicable data protection regulations, but no formal data sharing plan has been established.

Drug and device information, study documents

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