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Extended sitting can cause hamstring tightness

Article · January 2017

DOI: 10.4103/sjsm.sjsm_5_17

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Original Article

Extended sitting can cause hamstring tightness

ABSTRACT
Objective: Sedentary lifestyle has emanated as a new attention for research on exercise and health. The objective of this study was to find
the correlation between prolonged sitting (minimum 6–8 h) and tightness of hamstrings in students.
Materials and Methods: In a cross‑sectional study, 200 students were taken. Probability sampling was used on random basis to assess
the flexibility of hamstring muscles using the straight leg raising (SLR) and active knee extension test. A manual goniometer was used for range
measurement. All information was taken on predesigned pro forma.
Result: The mean age of 200 students was 20.3 ± 1.63 years. The mean value of SLR was found to be 60.97 ± 10.21, and mean value of
popliteal angle was 47.65 ± 8.06. Most of the students, 164 (82%), had tightness according to SLR test. There was a statistically significant
difference between the popliteal angle and chair sitting hours (P = 0.010), and an inverse correlation was found between SLR angle and chair
sitting hours (r = −0.56, P = 0.000).
Conclusion: Tightness of hamstrings is observed in a majority of the students. Long‑duration sitting can be a contributory factor in hamstring
tightness.

Keywords: Hamstring tightness, popliteal angle, prolonged sitting, straight leg raising

INTRODUCTION and range of motion are affected by hamstring flexibility

Flexibility is a vital component of fitness required for most
desirable musculoskeletal functioning and maximizing the
performance of physical activities.[1] Flexibility dysfunction
is a widespread problem faced by common as well as
sportspersons, especially in case of hamstring group of
muscles.[2,3] Hamstring tightness is not only a causative
factor for reduced range of motion but it can also lead to
various other musculoskeletal problems.[4] Length‑tension
relationship of muscle as well as shock absorbing ability
of the limb is affected by tightness of muscle. Reduced
flexibility generates a vicious circle of range reduction and
resulting increase in postural problems. Tight muscles also
compress the blood vessels and lead to reduced optimal
performance.[5]
Hamstring strain is one of the most commonly suspected
complaints resulting from hamstring tightness.[6] According
to Gajdosik et  al., 2011, pelvic as well as thoracic angle
in forward bending. Hamstring tightness also influences
the lumbar pelvic rhythm.[7] Hamstring tightness is also
associated with the development of plantar fasciitis[8] as well
as patellar tendinopathy and patellofemoral pain syndrome.[9]
An association between hamstring tightness and mechanical
low back pain is also found in studies showing a positive
correlation between hamstring tightness and severity of
low back pain.[10]
Tight hamstring muscles limit anterior tilt of the pelvis in
spinal flexion resulting in aggravated muscle and ligamentous
Ghulam Fatima, Muhammad Mustafa Qamar1,
Jawad Ul Hassan2, Ayesha Basharat1
Department of Physiotherapy, Advance Life College of Medical
Sciences, Lahore, 1Department of Physical Therapy, Sargodha
Medical College, UOS, 2Bhatti International Hospital, Lahore,
Pakistan
Address for correspondence: Dr. Muhammad Mustafa Qamar,
Department of Physical Therapy, Sargodha Medical College,
UOS, Pakistan.
E‑mail: mmustafaqamar@gmail.com

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DOI:
How to cite this article: Fatima G, Qamar MM, Ul Hassan J, Basharat A.
10.4103/sjsm.sjsm_5_17 Extended sitting can cause hamstring tightness. Saudi J Sports Med
2017;17:110-4.

110 © 2017 Saudi Journal of Sports Medicine | Published by Wolters Kluwer - Medknow
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Fatima, et al.: Extended sitting can cause hamstring tightness
tension in the lumbar region which leads to significantly
higher compressive loads on the lumbar spine.[11] Other
postural changes associated with tightness of hamstrings
can influence stability of sacroiliac joint in an indirect way.[12]
Hence, flexibility of hamstring muscles is crucial for overall
well‑being and optimal physical fitness.[13]
The main reason of muscular tightness is a reduction
in ability of muscle to deform, leading to a lower range
available at concerned joint for motion.[14] Tight hamstrings
are associated with a dysfunctional motor control pattern
leading to a submaximal firing pattern of postural muscles
resulting in function of hamstrings as stabilizers rather
than their main function of prime movers. This change in
primary function leads to the presentation of hamstring
tightness.[15]
Many reasons can lead to the development of hamstring
tightness such as genetic predisposition, injury to muscle,
and adaptive shortening due to some chronic condition.[16]
Modern sedentary style of living is one of the main reasons
for postural abnormalities evident in modern society. The
prolonged sitting hours required in most of the jobs, and
educational setups can affect flexibility of soft tissues,
especially two joint muscles.[5]
The current study is aimed to verify the notion that prolonged
sitting can lead to tightness of hamstrings as very rare research
work is available to prove this notion. The study focuses at
young university students who have to attend long sedentary
hours of teaching. This study will help in policy‑making
regarding sitting arrangements for students in educational
setups plus need of cocurricular physical activities. This
study will help to create awareness about the lack of normal
flexibility maintenance, especially among students.
MATERIALS AND METHODS
It was a cross‑sectional study comprised over a period of
24 weeks. Bliss software was used for calculating sample
size, with the power of 90 and two‑tailed level of significance
0.05 based on the mean straight leg raising (SLR) value of
the pilot study. As per sample size calculation, 200 students
were included in this study using probability sampling
for data collection. We had selected only those students
who have more than 6 h of sitting and their age range
between 16 and 30 years. Students with any recent trauma
history (within last 3 months), previous surgery, acute
spasm of hamstring muscles, any spinal deformity or any
limb length discrepancy, congenital or acquired anomalies,
or neuromuscular disorders of the lower extremity were
excluded from this study.
Saudi Journal of Sports Medicine / Volume 17 / Issue 2 / May-August 2017
Methodology
Two hundred students fulfilling the inclusion criteria were
included. After taking consent and necessary personal
data including name, age, sex, weight, and height, sitting
hours per day were inquired. Angle of SLR (passive SLR)
was measured with the help of a universal goniometer.
After proper positioning on therapeutic couch, the leg was
raised passively while keeping the knee in extension. The
angle subtended at the hip joint was measured for both
extremities, and mean was calculated.
For the measurement of popliteal angle, active knee extension
test was used. After proper positioning, the hip was flexed at
an angle of 90°, and the participant was asked to extend his/
her leg at the knee joint. The angle subtended at the knee
joint was measured. The measurement was taken for both
lower extremities and then mean was recorded.
Data analysis
All data were presented and evaluated using SPSS version 16
(Released 2007. SPSS for Windows, SPSS Inc., Chicago). Mean
and standard deviation was used for presenting quantitative
data. Contrarily, percentages and frequency tables were used
for qualitative data.
Pearson’s correlation analysis was used to see the correlation
between sitting hours and tightness of hamstrings. Chi‑square
analysis was also used to see associations in qualitative
variables. P < 5% is considered as significant.
RESULTS
Two hundred healthy university students fulfilling the
inclusion criteria were examined for hamstring tightness.
The basic demographic data of participants are shown in
Table 1.
The most number of 44 students had SLR angle at 55.
The mean value of straight raising angle 61 ± 10.22 was
observed [Figure 1]. The mean value of popliteal angle was
observed as 47.7° ± 8.07° [Figure 2].
There were 79 (39.5%) students who had 6–8 chair sitting
hours per day while the students with 8–12 chair sitting
hours were 54 (27%). There were 43 (21.5%) students who
had 10–12 chair sitting hours per day.
An inverse correlation was found between SLR and chair
sitting hours (r = −0.56, P = 0.000) [Figure 3].
The mean value of popliteal angle of students with 6–8 h of
sitting was observed as 45.41° ± 7.79° [Table 2].
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Fatima, et al.: Extended sitting can cause hamstring tightness

DISCUSSION significant moderate and negative correlation between

hamstring tightness and age among males.[19] For females,
This study is one of its own kinds providing basic information value of correlation coefficient was r = 0.219 and P = 0.174
regarding impact of extended sitting on hamstring flexibility. showing weak negative correlation between age and hamstring
To our knowledge, no such study is conducted to observe tightness.[21] Another study claims that maximum flexibility is
the impact of extended sitting on flexibility in educational found in the mid‑twenties for both males and females, and
setups, especially in young and healthy, asymptomatic maximum tightness is observed after the 40s.[22] Contrary to
university students. The important finding was an alarming this claim, we found a significant reduction in flexibility in
high rate of hamstring tightness among most of students, young population in their twenties. One main reason for this
and a significant positive correlation found among extended is prolonged sitting hours and sedentary lifestyle of students.
sitting hours and hamstring tightness.
It was hypothesized in the current study that tightness of
The mean value of straight raising angle 61 ± 10.22 was hamstring is a very common problem in students, especially
observed in the results of the current study which falls below the students having prolonged sitting hours, and in results,
the border line and shows tightness of hamstring while Adar it was seen that majority of the population have hamstring
found the average SLR in the whole research population
to be 65.4°, which is approximately 15° below the normal Table 1: Demographic data of students presented in
standard.[17] There is a difference of 5° on average between mean±standard deviation and range
two studies, but it is consistent with the findings of study Age of the Weight Height BMI
student (years) (kg) (m)
conducted by Adar who claims that hamstring tightness
Mean±SD 20.34±1.63 56.60±10.14 1.65±0.093 20.63±3.01
increases with the increasing age. Adar in his study took
Minimum 16 32 1.25 14.41
data from 303 primary school pupils aged 7–13 years[17] Maximum 27 85 1.89 35.20
while mean age of students in the current study was BMI=Body mass index, SD=Standard deviation
20.3 ± 1.63 years. Same finding was supported by Akinpelu
et al. who claimed in his study that hamstring tightness has a Table 2: Description about chair sitting hours in relation with
tendency to increase with age up to the age of 30–49 years.[18] tightness according to popliteal angle of students
In turn, it can lead to muscle weakness. Different researchers Popliteal angle (h) n Mean±SD P
studied that long‑term strength training can improve muscle 6-8 79 45.41±7.79 0.010
strength in elderly.[19,20] 8-12 54 49.16±7.78
10-12 43 48.40±8.75
In a study conducted by Mistry et al., a correlation coefficient >12 24 50.38±6.78
SD=Standard deviation
of r = −0.526 was observed with P < 0.001, showing a

50 30

44 27
40

37 23
Frequency

20 21 21
30
Frequency

18
26 26 25 17
20 15
14
12
Std. Dev = 10.22 10
10 13 10
10 11 9
Mean = 61.0 Std. Dev = 8.07

0 N = 200.00 Mean = 47.7

4 4
35.0 45.0 55.0 65.0 75.0 85.0 95.0 N = 200.00
0
40.0 50.0 60.0 70.0 80.0 90.0
25 .5
27.0
30.5

35 .5
37.0
40.5

45 5
47.0
50.5

55 5
57.0
60.5

65 5
52.0

62.0
22

32.0

42.0

.0
.
.

Straight leg raising angle Popliteal angle

Figure 1: Range of straight leg raising angle Figure 2: Range of popliteal angle

112 Saudi Journal of Sports Medicine / Volume 17 / Issue 2 / May-August 2017

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66
64
Mean of straight leg raising angle
62
60
58
56
6-8hrs 8-12hrs
chair sitting hours per day
Figure 3: Correlation of chair sitting hours per day with mean of straight leg
raising (r = −0.56, P = 0.000)
tightness. One hundred and sixty‑two (82%) students had
tightness according to SLR. Only a minor percentage 18%
of student had range above borderline, and a significant
difference was seen between the popliteal angle and chair
sitting hours, i.e., P = 0.010. This trend was also seen in
studies conducted by Adar and Akinpelu et al., and they also
documented hamstring tightness to be a common problem
and found all the subgroups to present with hamstring
tightness.[17,18] Another study conducted among adolescents
also found hamstring tightness to be a common complaint.[23]
In another study conducted among young military men, 600
men were examined for hamstring tightness, and hamstring
tightness was a very common complaint among this population
too.[24] In SLR testing, only 43% right legs examined and 35%
left legs examined reached the normal SLR range.[22] More
than half of population showed a reduction in flexibility, and
this is in accordance with the findings of the current study.[24]
In the current study, it was seen that there is a tendency of
increase in hamstring tightness with increase in the sitting
hours. Highly significant difference between mean of SLR
angle and chair sitting hours per day, i.e., P = 0.000 was
seen. Adar also claimed prolonged sitting to be a main
danger for the development of hamstring tightness, and
according to the results of his study, a decrease in the range
of hamstrings was seen with increase in the number of
sitting hours (P = 0.007), and overall reduction in flexibility
of the hip and pelvis was seen with increase in sitting
hours[17] (P = 0.002).
On the opposite note, Arab claimed that there is no impact
of work setting and sedentary lifestyle in the development of
Saudi Journal of Sports Medicine / Volume 17 / Issue 2 / May-August 2017
Fatima, et al.: Extended sitting can cause hamstring tightness
hamstring tightness, especially in low back pain patients.[25]
Flexibility of hamstring muscles is not affected by the work
environment or the lifestyle adopted.[25] The difference in
findings with the current study can be due to a larger age
range of 20–65 years and diverse population working in
different work settings.
Uniform age group and same educational setup are the
strengths of this study. However, the main limitation is
methodological as the study is a cross‑sectional study, and
it cannot establish extended sitting as a main cause of
hamstring tightness. Many other etiological factors can be
responsible for reduced flexibility. Further research with more
10-12hrs more than 12 hrs
vigorous methodology is required to establish a cause‑effect
relationship between sitting hours and hamstring tightness.
We concluded that long sitting hours may be a contributing
factor for reduced hamstring flexibility. However, further
studies are required with a large sample size to get deep
insight about cause effect relationship.
Conclusion
It is concluded that tightness of hamstrings is observed in
a majority of the students. Long‑duration sitting can be a
contributory factor in hamstring tightness.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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