TENTATIVE TITLE OF THE STUDY:

EFFECTIVENESS OF HOLD- RELAX TECHNIQUE VERSUS MYOFASCIAL RELEASE

TECHNIQUE TO INCREASE HAMSTRING FLEXIBILITY IN YOUNG ADULTS : A
COMPARATIVE STUDY
MINI RESEARCH(MPT 2nd SEM)22MPT0113R
SUBMITTED BY:
PRITAM DEBNATH
ENROLLMENT NO:ADTU/2022-24/MPT/012
ASSAM DOWN TOWN UNIVERSITY

GUIDE:
DR. ABHIJIT DUTTA
PROFESSOR,DEAN
FACULTY OF PARAMEDICAL SCIENCE
CO-GUIDE:
DR. ABHIJIT KALITA(PT)
ASSISTANT PROFESSOR
FACULTY OF PHYSIOTHERAPY AND
REHABILITATION
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 INTRODUCTION
In human anatomy hamstring comprises of 3 muscles Semitendinosus,
Semimembranosus, Biceps femoris (long and short head) The three muscles cross the hip
and knee joint and are involve in knee flexion and hip extension. The short head of
biceps femoris crosses only one joint (knee) and hence is involved only in knee flexion.
[1]
Hamstring muscle plays an important role in the performance of daily activities such
as controlled movement of trunk, walking, running and jumping and it is an important
muscle involved in maintaining balance and posture. [1] Flexibility is a key component for
Prevention of injury and rehabilitation, stretching decreases injury and improves
performance in sports for overall fitness. Increased flexibility: While stretching your
hamstring can increase flexibility and improve your range of motion in your joints. [3]

Proprioceptive Neuromuscular Facilitation (PNF) is a most used and effective form of

stretching technique that includes both the stretching and contraction of the muscle
group that is being targeted.

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PNF stretching was originally developed as a form of rehabilitation programme. [4]

Myofascial release (MFR) is one of the commonly utilized manual techniques to facilitate
the stretching of corresponding tissue continuously or enhance the extensibility of soft tissue
through compression while restoring restricted fascia or normal muscular length. Self-MFR
is an affordable and easily available method to help patients ease their muscular and fascia
pain and maintain flexibility.[7]

The MFR is a “curative” tool for treatment of the tightness. It is a manual therapy technique
that uses applied pressure and stretching to muscles and fascia with the intent to improve
movement of the muscles and the surrounding fascia. The MFR is one of many techniques
used to increase mobility in a joint or series of joints and also improve athletic performance.
It is using body weight or force onto an object such as a foam roller or lacrosse ball to place
pressure along a muscle with the intent to target the adhesions in fascia to improve
movement. Performing MFR may be done through massages or through tools, usually done
by a therapist, but more commonly, Self-MFR (SMR) is performed by individuals
themselves. [5] 3
NEED OF THE STUDY

Hamstring flexibility is the ability of the hamstring muscles to lengthen and allow a full ROM
at the hip and knee joints. The lack of flexibility is the predisposing factor of hamstring strain.

• Some techniques used to increase the flexibility in muscle include static stretching ,
Myofascial release, neurodynamic sliding and PNF hold-relax technique. PNF hold-relax
technique may be a beneficial alternative to the more traditional stretching techniques.

• In addition no research has compared PNF hold – relax technique with Myofascial release
technique on effectiveness of increase hamstring flexibility. Hence this study is to
determine the effect of PNF hold relax technique and MFR on the hamstring in young
adult.

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 STATEMENT OF THE PROBLM

Hamstring flexibility is a common problem for many people, especially those who are
sedentary, have poor posture, sit for long period of time or engage in sports that involve
sprinting or stretching movements. Hamstring tightness can lead to decreased flexibility,
increased risk of injury, and decreased athletic performance. Protective muscle
contraction of hamstring found in the presence of neural mechanosensitivity leads to
hamstring tightness and subsequent muscle strain injury.

OBJECTIVE OF THR STUDY

• Determine the effectiveness of PNF hold relax technique to increase hamstring
flexibility in young adults
• Determine the effect of myofascial release to decrease the hamstring muscle tightness in
young adults
• The aim of the study is to compare the effectiveness of PNF hold relax technique and
myofascial release in young adult individuals.

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 REVIEW OF LITERATURE
AUTHOR TITLE NAME OF FINDINGS
JOURNAL
1. Dr. Ketaki Nitin Effectiveness of International 30 Amateur football players * age group 18- 30
Sakhalkar , Dr. Jaywant MFR Versus Journal of fitting in inclusion criteria. 2 group taken by simple
Nagulkar et.al (8,2022) Passive Stretching Health Sciences random sampling using odd even method. G-A
on Hamstring and Research received MFR for 5-10 minutes for 6 session/1week.
Flexibility in And G-B received PS holding for 60 secs for 6
Amateur Football sessions/1week. AKE angle was measured pre and
Players: A post intervention. T test for data analyzing.
Comparative Study RESULT: The study concluded that MFR was more
effective than Passive Stretching.

2. Keisuke Itotani, Myofascial Multidisciplinar MFR on the hamstrings was performed on 17 young
Kanta Kawahata et.al Release of the y Digital adults. Physical function and physical performance
(6,2021) Hamstrings Publishing were measured before, immediately after, and 5 days
Improves Physical Institute after the MFR intervention: FFD, ROM of the
Performance—A SLR ,SLJ,SJ, functional reach test (FRT),
Study of Young comfortable walking speed, and maximum speed.
Adults RESULT: MFR improve performance and flexibility

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AUTHOR TITLE NAME OF FINDINGS
JOURNAL

3. Reena R , Jibi To compare the International 100 male and female subjects were divided into 2
Paul et.al (2,2020) effectiveness of passive Journal and group* Age 18-25yrs G-A received passive
stretching VS PNF hold Exercise Science stretching G-B received hold relax PNF technique.
and relax technique on Outcome measures : Finger Tip to Floor test, Back
hamstring tightness in Saver Sit and Reach test. RESULT: PNF Hold
young individuals: A Relax technique has showed greater improvement
comparative study on hamstring flexibility.

4. Fiza Raza Rizvi , The Effect of Static International 30 females of aged between 18- 25 years*
Nilofar Rasheed Stretching and PNF Journal of hamstring tightness with knee extension range >20
et.al (11,2020) Hold-Relax Stretching Science and degrees*randomly divided into 2 groups. G-1
on Increasing Research (IJSR) static stretching, G- 2 PNF Hold-Relax stretching.
Flexibility of Shortened Both groups were tested for 5 days a week for
Hamstring Muscle consecutive 4 weeks. outcome measure: Active
among Sedentary knee Extension test (AKET) for knee extension as
Living Female Students in both groups. RESULT: PNF Hold-relax
: Randomized Stretching has showed improvement range of knee
Controlled Trial extension and hamstring flexibility.

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AUTHOR TITLE NAME OF FINDINGS
JOURNAL

5. Deepak Immediate Effects Journal of 60 badminton players were recruited for the study during
Panwar,Siddhartha of MFR on Muscle Clinical 10 months. They were into 3 groups. Vertical jump
Sen(5,2021) Flexibility, Vertical Diagnostic height, Knee flexion angle, Popliteal Angle (PA) and
Jump Height in Research distance from the wall (Lunge test) was measured pre
Recreational intervention and post intervention. The MFR technique
Badminton was applied as an intervention. t-test was used to find
Players: an out the immediate effect. RESULT: MFR has immediate
interventional effect on increasing muscle flexibility and muscle power.
study

6. Mohd Yusof Effect of PNF American 14 female athletes participated in this study. They were
Baharuddin , Stretching and Journal of divided randomly into G-A (PNF stretching), and G- B
Kamaleen Ophart Foam Roller on Sciences and (PNF stretching + Foam Roller), and both groups
Perased et.al Hamstring Engineering underwent different intervention programs for a total of
(12,2020) Flexibility among Research 12 sessions for 4 weeks. G- A applied contract-relax
Female Athletes: A techniques, while G- B used both PNF stretching and
cross-sectional foam roller. The hamstring flexibility measured using the
study sit and reach test.

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AUTHOR TITLE NAME OF FINDINGS
JOURNAL
7. Jihye Junga , Immediate effect Physical Therapy
22 adult subjects were evaluated for flexibility and
Wonjae Choi et.al of self- Rehabilitation
(3,2017) myofascial Science hamstring pain threshold. Self-MFR application areas
release on
were the sub occipital region, hamstring, and plantar
hamstring
flexibility regions by using a wooden pole for total 4 minutes
for 3 days. SRT, AROM, and PROM were used to
determine changes in flexibility. Pre/post-self-MFR
effectiveness was tested using a paired t-test.
RESULT: Self-MFR easily alleviates Myofascial pain
while maintaining flexibility.

8. Mariana Oliveira Comparison European Journal

757 studies identified, 19 were included in the
Borges, Diulian Muniz between static of Physiotherapy
Medeiros et.al stretching and systematic review, but only 12 had suitable data for
(7,2017) proprioceptive
the meta-analysis. Outcomes: SLR and knee
neuromuscular
facilitation on extension test (KET). SLR showed no difference
hamstring
between SS and PNF. RESULT: both SS and PNF
flexibility:
systematic stretching can be effective in increasing hamstring
review and meta-
flexibility
analysis

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AUTHOR TITLE NAME OF FINDINGS
JOURNAL

9. Tejashree Bhor, Immediate effect of Indian Journal of 40 subjects fitting in inclusion criteria. They were
Deepak B. Anap et.al Mulligun Bent Leg Physical Therapy divided in 2 groups by simple randomization method.
(6,2016) Raise Technique VS G- A mulligan BLR Technique and G-B self MFR
MFR on hamstring technique for HT. Outcome: SRT tests were measured
tightness in young pre intervention and post intervention. t-test for data
adults : A analyzing. RESULT: The single intervention of
randomized control Mulligan BLR and self MFR is equally effective in
trial improving flexibility of hamstring.

10. Amit Kumar Neurodynamic International 60 subjects with hamstring tightness were divided
Singh, Sibbala sliding VS PNF Journal of into two groups. Outcome measure used was AKE
Nagaraj et.al stretching on Physical test. Subjects of G-A received PNF hold relax
(12,2016) hamstring Education, stretching, G-B received Neurodynamic sliding
flexibility in Sports and technique. The technique was performed 3 times a
collegiate students: Health week for a total training period of 4 weeks. RESULT:
A comparative PNF (Hold-Relax) stretching technique is more
study effective for improving hamstring flexibility.

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OUTCOME MEASURES

• VAS: Visual analog scale for assessing pain.

• Sit and reach test: for measure hamstring tightness
• Straight leg rise test
• Passive knee extension test
• Active knee extension test

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 REFERENCES

1. Dr. Ketaki Nitin Sakhalkar, Dr. Jaywant Nagulkar et.al .Effectiveness of MFR Versus Passive Stretching on
Hamstring Flexibility in Amateur Football Players: A Comparative Study. International Journal of Health
Sciences and Research Vol.12; Issue: 8; August 2022 Website: www.ijhsr.org
2. Keisuke Itotani, Kanta Kawahata et.al ; Myofascial Release of the Hamstrings Improves Physical Performance
—A Study of Young Adults; Multidisciplinary Digital Publishing Institute. Healthcare 2021, 9, 674.
https://doi.org/10.3390/healthcare9060674
3. Reena R , Jibi Paul et.al ;To compare the effectiveness of passive stretching VS PNF hold and relax technique
on hamstring tightness in young individuals: A comparative study ;International Journal and Exercise Science;
IJMAES, Vol 6 (1), 668-675 , March 2020
4. Fiza Raza Rizvi , Nilofar Rasheed et.al; The Effect of Static Stretching and PNF Hold-Relax Stretching on
Increasing Flexibility of Shortened Hamstring Muscle among Sedentary Living Female Students : Randomized
Controlled Trial ;International Journal of Science and Research (IJSR) Paper ID: SR201031153117 DOI:
10.21275/SR201031153117
5. Deepak Panwar, Siddhartha Sen ; Immediate Effects of MFR on Muscle Flexibility, Vertical Jump Height in
Recreational Badminton Players: an intervantional study ;Journal of Clinical Diagnostic Research; DOI:
10.7860/JCDR/2021/48093.14932 12
6. Mohd Yusof Baharuddin , Kamaleen Ophart Perased et.al(12,2020) ; Effect of PNF Stretching and Foam Roller
on Hamstring Flexibility among Female Athletes: A cross-sectional study ; American Journal of Sciences and
Engineering Research; E-ISSN -2348 – 703X, Volume 3, Issue 6, 2020
7. Jihye Junga , Wonjae Choi et.al (3,2017) ;Immediate effect of self-myofascial release on hamstring flexibility;
Physical Therapy Rehabilitation Science; https://doi.org/10.14474/ptrs.2017.6.1.45

8. Mariana Oliveira Borges, Diulian Muniz Medeiros et.al (7,2017) ;Comparison between static stretching and
proprioceptive neuromuscular facilitation on hamstring flexibility: systematic review and meta-analysis;
European Journal of Physiotherapy; 2017 https://doi.org/10.1080/21679169.2017.1347708

9. Tejashree Bhor, Deepak B. Anap et.al (6,2016) ; Immediate effect of Mulligun Bent Leg Raise Technique VS
MFR on hamstring tightness in young adults : A randomized control trial ; Indian Journal of Physical Therapy;
VOLUME 4 ISSUE 1 (JANUARY – JUNE 2016) deepak.anap@hotmail.com
10. Amit Kumar Singh, Sibbala Nagaraj et.al (12,2016) ; Neurodynamic sliding versus PNF stretching on hamstring
flexibility in collegiate students: A comparative study ; International Journal of Physical Education, Sports and
Health; www.kheljournal.com

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THANK YOU

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