Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending

Felipe Jose Jandre Reis, Adriana Ribeiro Macedo, Felipe Jose Jandre Reis, Adriana Ribeiro Macedo

Abstract

Study design: Cross-sectional study.

Purpose: To verify the association of hamstring tightness and range of motion in anterior pelvic tilt (PT), lumbar motion (LM), and trunk flexion (TF) during forward bending.

Overview of literature: Increased hamstring stiffness could be a possible contributing factor to low back injuries. Clinical observations have suggested that hamstring tightness influences lumbar pelvic rhythm. Movement restrictions or postural asymmetry likely lead to compensatory movement patterns of the lumbar spine, and subsequently to increased stress on the spinal soft tissues and an increased risk of low back pain (LBP).

Methods: Hamstring muscle tightness was measured using the self-monitored active knee extension (AKE) test. A bubble inclinometer was used to determine the range of motion of PT, LM, and TF during forward bending. Statistical analysis included descriptive statistics, comparisons between groups and a correlation between hamstring tightness (AKE) and anterior PT, TF, and regional LM with p≤0.05.

Results: The LBP group was composed of 36 participants, and the asymptomatic group consisted of 32 participants. The mean for PT in the control group was 66.7°, 64.5° for LM and 104.6° for TF. Respective values in the symptomatic group were 57.0°, 79.8°, and 82.2°.

Conclusions: Participants with LBP showed restriction in the pelvis and TF range of motion, but had higher amplitudes in the lumbar spine during forward bending.

Keywords: Low back pain; Muscle tonus; Range of motion; Spine.

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

References

    1. Sandler RD, Sui X, Church TS, Fritz SL, Beattie PF, Blair SN. Are flexibility and muscle-strengthening activities associated with a higher risk of developing low back pain? J Sci Med Sport. 2014;17:361–365.
    1. Dionne CE, Dunn KM, Croft PR, et al. A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine (Phila Pa 1976) 2008;33:95–103.
    1. Deyo RA, Dworkin SF, Amtmann D, et al. Report of the NIH Task Force on research standards for chronic low back pain. Pain Med. 2014;15:1249–1267.
    1. Murray CJ, Atkinson C, Bhalla K, et al. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310:591–608.
    1. Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64:2028–2037.
    1. Sahrmann S. Diagnosis and treatment of movement impairment syndromes. St. Louis (MO): Mosby; 2002.
    1. Esola MA, McClure PW, Fitzgerald GK, Siegler S. Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain. Spine (Phila Pa 1976) 1996;21:71–78.
    1. Gajdosik RL, Hatcher CK, Whitsell S. Influence of short hamstring muscles on the pelvis and lumbar spine in standing and during the toe-touch test. Clin Biomech (Bristol, Avon) 1992;7:38–42.
    1. Lopez-Minarro PA, Alacid F. Influence of hamstring muscle extensibility on spinal curvatures in young athletes. Sci Sports. 2010;25:188–193.
    1. Norris CM, Matthews M. Correlation between hamstring muscle length and pelvic tilt range during forward bending in healthy individuals: an initial evaluation. J Bodyw Mov Ther. 2006;10:122–126.
    1. Nachemson AL. Disc pressure measurements. Spine (Phila Pa 1976) 1981;6:93–97.
    1. Norris CM, Matthews M. Inter-tester reliability of a self-monitored active knee extension test. J Bodyw Mov Ther. 2005;9:256–259.
    1. Gajdosik R, Lusin G. Hamstring muscle tightness: reliability of an active-knee-extension test. Phys Ther. 1983;63:1085–1088.
    1. Mayer TG, Tencer AF, Kristoferson S, Mooney V. Use of noninvasive techniques for quantification of spinal range-of-motion in normal subjects and chronic low-back dysfunction patients. Spine (Phila Pa 1976) 1984;9:588–595.
    1. Ng JK, Kippers V, Richardson CA, Parnianpour M. Range of motion and lordosis of the lumbar spine: reliability of measurement and normative values. Spine (Phila Pa 1976) 2001;26:53–60.
    1. Raftry SM, Marshall PW. Does a 'tight' hamstring predict low back pain reporting during prolonged standing? J Electromyogr Kinesiol. 2012;22:407–411.
    1. Halbertsma JP, Goeken LN, Hof AL, Groothoff JW, Eisma WH. Extensibility and stiffness of the hamstrings in patients with nonspecific low back pain. Arch Phys Med Rehabil. 2001;82:232–238.
    1. Marshall PW, Mannion J, Murphy BA. Extensibility of the hamstrings is best explained by mechanical components of muscle contraction, not behavioral measures in individuals with chronic low back pain. PM R. 2009;1:709–718.
    1. Li Y, McClure PW, Pratt N. The effect of hamstring muscle stretching on standing posture and on lumbar and hip motions during forward bending. Phys Ther. 1996;76:836–845.
    1. Fox M. Effect on hamstring flexibility of hamstring stretching compared to hamstring stretching and sacroiliac joint manipulation. Clin Chiropr. 2006;9:21–32.
    1. Carregaro RL, Coury HJ. Does reduced hamstring flexibility affect trunk and pelvic movement strategies during manual handling? Int J Ind Ergon. 2009;39:115–120.
    1. Johnson EN, Thomas JS. Effect of hamstring flexibility on hip and lumbar spine joint excursions during forward-reaching tasks in participants with and without low back pain. Arch Phys Med Rehabil. 2010;91:1140–1142.
    1. Van Dillen LR, Gombatto SP, Collins DR, Engsberg JR, Sahrmann SA. Symmetry of timing of hip and lumbopelvic rotation motion in 2 different subgroups of people with low back pain. Arch Phys Med Rehabil. 2007;88:351–360.
    1. Rose SJ, Sahrmann SA, Norton BT. Quantitative assessment of lumbar-pelvic rhythm. Phys Ther. 1988;68:824.
    1. Mooney V, Robertson J. The facet syndrome. Clin Orthop Relat Res. 1976;(115):149–156.
    1. Congdon R, Bohannon R, Tiberio D. Intrinsic and imposed hamstring length influence posterior pelvic rotation during hip flexion. Clin Biomech (Bristol, Avon) 2005;20:947–951.
    1. Massoud Arab A, Reza Nourbakhsh M, Mohammadifar A. The relationship between hamstring length and gluteal muscle strength in individuals with sacroiliac joint dysfunction. J Man Manip Ther. 2011;19:5–10.
    1. Stutchfield BM, Coleman S. The relationships between hamstring flexibility, lumbar flexion, and low back pain in rowers. Eur J Sport Sci. 2006;6:255–260.
    1. Mikkelsson LO, Nupponen H, Kaprio J, Kautiainen H, Mikkelsson M, Kujala UM. Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study. Br J Sports Med. 2006;40:107–113.

Source: PubMed

3
Se inscrever