Immediate Effects of Neurodynamic Sliding versus Muscle Stretching on Hamstring Flexibility in Subjects with Short Hamstring Syndrome

Abstract

Background. Hamstring injuries continue to affect active individuals and although inadequate muscle extensibility remains a commonly accepted factor, little is known about the most effective method to improve flexibility. Purpose. To determine if an isolated neurodynamic sciatic sliding technique would improve hamstring flexibility to a greater degree than stretching or a placebo intervention in asymptomatic subjects with short hamstring syndrome (SHS). Study Design. Randomized double-blinded controlled trial. Methods. One hundred and twenty subjects with SHS were randomized to 1 of 3 groups: neurodynamic sliding, hamstring stretching, and placebo control. Each subject's dominant leg was measured for straight leg raise (SLR) range of motion (ROM) before and after interventions. Data were analyzed with a 3 × 2 mixed model ANOVA followed by simple main effects analyses. Results. At the end of the study, more ROM was observed in the Neurodynamic and Stretching groups compared to the Control group and more ROM in the Neurodynamic group compared to Stretching group. Conclusion. Findings suggest that a neurodynamic sliding technique will increase hamstring flexibility to a greater degree than static hamstring stretching in healthy subjects with SHS. Clinical Relevance. The use of neurodynamic sliding techniques to improve hamstring flexibility in sports may lead to a decreased incidence in injuries; however, this needs to be formally tested.

Figures

Figure 1

CONSORT flow diagram of patient recruitment and retention.

Figure 2

Measurement of range during passive straight leg raise test was performed by trained examiners who were blinded to subject group assignment.

Figure 3

Static stretching of the hamstring muscles was performed for 30 seconds, 6 times on their dominant leg for a total stretching time of 180 seconds.

Figure 4

Neurodynamic sciatic slider technique was performed by alternating hip flexion, knee flexion, and ankle dorsiflexion with hip extension, knee extension, and ankle plantarflexion while the subject's cervical and thoracic spine were maintained in flexion. Movements were performed for 180 seconds on their dominant leg.

Figure 5

Passive mobilization of the intrinsic foot joints with the subject in supine lying. Passive movements were applied for 180 seconds to the dominant foot.

Figure 6

Before and after mean straight leg raise (SLR) values (°) with 95% confidence intervals of hamstring extensibility among the three groups.