Background: Self-myofascial release using a foam roller has short-term effects for improving muscle function and joint range of motion (ROM) and reducing delayed onset muscle soreness (DOMS) after exercise. Objectives: The purpose of our study was to examine the muscle physiological changes for each set in self-myofascial release of the hamstring muscles using a foam roller in order to provide basic data for the most effective program composition for improving muscle tension, stiffness, and flexibility of the hamstring muscles. Design: A quasi-experimental clinical trial. Methods: To confirm the effect of self-myofascial release of the hamstring muscles using a foam roller, muscle tone and stiffness of the hamstring muscles were measured. As an intervention method, the study subject performed four sessions of self-myofascial release by moving a foam roller back and forth on the posterior thigh muscle of the right leg. Results: There were statistically significant changes in the stiffness of the biceps femoris and the flexibility of the hamstring muscles. Conclusion: Self-myofascial release with foam rolling is an effective intervention method for increasing hamstring flexibility and ROM, and it is recommended as effective to perform self-myofascial release for three to four sessions to maintain normal muscle tone and stiffness of the hamstring muscles.

Background: The Nordic hamstring exercise is effective as a representative exercise for strengthening eccentric contraction that can activate the hamstring at high levels, improve eccentric contraction strength and ability, and significantly reduce injury rates. Objectives: To investigated a comparison with the lunge exercise to determine the effect of the Nordic hamstring exercise on muscle activity and balance ability in a sample of adult amateurs and football players. Design: Randomized controlled trials. Methods: The subjects of the study were stratified samples of 28 professional and amateur football players and two groups (Nordic hamstring group and lunge group) of 14 people each were studied. Surface electromyography using, was performed to measure the hamstring muscle activity, and the good morning exercise was selected as the measurement exercise. For balance ability, the surface area ellipse and length were measured with BioRescue, while for static balance, the posture of closing the eyes and single-limb standing was measured, and for dynamic balance the one-legged squat was measured. Results: The %MVIC of the semitendinosus and the biceps femoris improved in the Nordic hamstring exercise group and showed statistically significant increase (P<.05). The static and dynamic balance improved in the Nordic hamstring exercise group and showed statistically significant decrease (P<.05). Conclusion: The Nordic hamstring exercise can be useful as an exercise to improve the hamstring muscle activity and balance ability of professional and amateur football players.

Background: Lower back pain (LBP) is a major cause of disability and a common musculoskeletal disorder encountered at some point in life. Dysfunction of the lumbar vertebrae has been associated with decreased flexibility of the hamstrings, which exhibited a strong positive correlation with LBP. Hamstring tension affects lumbar pelvic rhythm. We aimed to activate pelvic stability with compression by Active Therapeutic Movement (ATM), muscle energy technique (MET) was applied to increase the flexibility of the hamstring. Objects: In this study, we aimed to investigate the effects of MET with ATM and general MET were applied to the hamstring of adults, who were in their twenties with nor without LBP, on their pelvic inclination and the length of their hamstring. Methods: A total of 32 subjects were briefed about the purpose of this study and agreed to participate voluntarily. Before the experiment, all subjects were pre-examined, and they were divided into an LBP group and a no lower back pain group accordingly. Thereafter, all subjects participated in both in a crossover manner. After at least one week, they switched to another group and participated in the same experiment. Results: The study results revealed that both groups demonstrated significant results in the modified active knee extension test (p < 0.01) and the sit and reach test (p < 0.01) performed to assess the hamstring flexibility; an interaction (p < 0.05) was noted. Moreover, a more significant difference was observed between the MET with ATM and the general MET. Although significant results were obtained for the pelvic inclination (p < 0.01), interaction was not noted. Conclusion: Conclusively, in this study, when the MET with ATM was applied to the two groups, there was a significant difference compared to the general MET for hamstring flexibility, but it was confirmed that there was no significant difference for the pelvic inclination.

Background: Muscle activities of gluteus maximus (GM) and hamstring (HAM) have important roles in the stability and mobility of the hip joint during various functional activities including bridge and prone hip extension exercises. Objects: The purpose of this study is to investigate muscle activities of GM, multifidus (MF) and HAM during three different bridge exercises in healthy individuals. Methods: Twenty healthy subjects were participated. Electromyography device was used to measure muscle activities of GM, MF and HAM. Each subject was asked to perform three different bridge exercises with hip abduction (0°, 15°, 30°) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Statistical significance was set at α = 0.01. Results: The muscle activity of GM was significantly different among three conditions (hip abduction 0°, 15°, 30°) (adjusted p-value [Padj] < 0.01). The muscle activity of GM was significantly greater during bridge exercise with hip abduction 30° compared to 0° and 15° (Padj < 0.01). There was no significant difference in the muscle activity of MF and HAM muscle (Padj > 0.01). The ratio of muscle activity (ratio = GM/HAM) during bridge exercise with hip abduction 30° was significant greater compared to the hip abduction angles 0° and 15° (Padj < 0.01). Conclusion: Bridge exercise with hip abduction 30° can be recommended to selectively facilitate the muscle activity of GM and improve the ratio of muscle activity between GM and HAM.

Background: Although rectus femoris (RF) eccentric training and static stretching (SS) have been reported effectively on lumbar flexibility, and muscle architecture, most studies are results using machines and long-term effects. Therefore, we want to investigate the effect of Reverse Nordic Hamstring Exercise (RNHE), a self-eccentric training, by immediately comparing it with SS. Objectives: To compare the RNHE and SS of RF to show the effects of lumbar flexibility, and fascicle length (FL). Design: Randomized controlled trial. Methods: A total of 30 study subjects were randomly allocated into an experimental group(Reverse Nordic Hamstring Exercise) and a control group(Static Stretching). Before and after the intervention, the subject performed fingertip to floor test (FFT) to evaluate the flexibility of the lumbar spine and measured FL through the SONON 300L (Healcerion Inc., Seoul, South Korea). Results: There was a significant effect on lumbar flexibility within both groups (P<.05), also there were clear results between the two groups (P<.05). FL showed a significant increase in RNHE (P<.05), but not in SS, and there was a no significant difference between the two groups. Conclusion: RNHE is effective in improving lumbar flexibility, and FL of RF muscle.

Background: The flexion-relaxation phenomenon (FRP) refers to a sudden onset of activity in the erector spinae muscles that recedes or fades during full forward flexion of the trunk. Lumbar spine and hip flexion are associated with many daily physical activities that also impact trunk flexion. Shorter hamstring muscles result in a reduction of pelvic mobility that eventually culminates in low back pain (LBP). Many studies have explored the FRP in relation to LBP. However, few studies have investigated the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Objects: This study aimed to investigate the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Methods: Thirty subjects were divided into three groups according to hamstring length measured through an active knee extension test. The 30 participants consisted of 10 subjects who had a popliteal angle of 20˚ or less (Group 1), 10 subjects who had a popliteal angle of 21˚–39˚ (Group 2), and 10 subjects who had a popliteal angle of 40˚ or more (Group 3). A one-way analysis of variance was used to compare the difference in muscle activity of the erector spinae muscles during trunk flexion. Results: The subjects with a shorter hamstring length had significantly higher muscle activity in their erector spinae muscles during trunk flexion and full trunk flexion (p < 0.05). The subjects with a shorter hamstring length also had a significantly higher flexion-relaxation ratio (p < 0.05). Conclusion: The results of this study demonstrate that differences in hamstring muscle length can influence the FRP in relation to the erector spinae muscles. This finding suggests that the shortening of the hamstring might be associated with LBP.

Background: Flexion-relaxation phenomenon (FRP) was a term which refers to a sudden onset of myoelectric silence in the erector spinae muscles of the back during standing full forward flexion. Hamstring muscle length may be related to specific pelvic and trunk movements. Many studies have been done on the FRP of the erector spinae muscles. However, no studies have yet investigated the influence of hamstring muscle flexibility on the FRP of the hamstring muscle and lumbopelvic kinematics during forward bending. Objects: The purpose of this study was to examine the flexion-relaxation ratio (FRR) of the hamstring muscles and lumbopelvic kinematics and compare them during forward bending in subjects with different hamstring muscle flexibility. Methods: The subjects of two different groups were recruited using the active knee extension test. Group 1-consisted of 13 subjects who had a popliteal angle under 30°; Group 2-consisted of 13 subjects who had a popliteal angel above 50°. The kinematic parameters during the trunk bending task were recorded using a motion analysis system and the FRRs of the hamstring muscles were calculated. Differences between the groups were identified with an independent t-test. Results: The subjects with greater hamstring length had significantly less lumbar spine flexion movement and more pelvic flexion movement. The subjects with greater pelvic flexion movement had a higher rate of flexion relaxation during full trunk bending (p<.05). Conclusion: The results of this study suggest that differences in hamstring muscle flexibility might cause changes in people’s hamstring muscle activity and lumbopelvic kinematics.

This study aims to identify the effects of extracorporeal shock wave therapy and stretching technique on flexibility, muscle tone and pressure pain threshold of a shortened hamstring. A total of 40 patients with hamstring shortening was randomly assigned to either the extracorporeal shock wave therapy group (n=20) or extracorporeal shock wave therapy with stretching technique group (n=20) to identify the effects of the two different forms of physical therapy intervention. All the participants underwent extracorporeal shockwave therapy twice a week for 3 weeks, and the extracorporeal shockwave therapy with stretching technique group performed stretching techniques with the same frequency for 3 weeks. To measure hamstring flexibility before and after intervention, the passive straight leg raising test was performed, and muscle tone and pressure pain threshold were assessed. The flexibility of the hamstrings significantly improved, while the pressure pain threshold increased in both groups. These findings suggest that the effective in improving hamstring flexibility, reducing muscle tone, and increasing pressure pain threshold in adults with hamstring shortening.

The purpose of this study was to compare the onset times of muscle activities and the order of muscle firing in hamstring gluteus maximus, and lumbar erector spinae muscle during active hip extension between subjects with low back pain (LBP) and healthy subjects. Thirty subjects, 15 with LBP and 15 healthy subjects, participated in this study. Electromyographic activity was recorded during active hip extension in prone and standing position. Relative onset times of these muscle activities were determined. Similar muscle firing order in hamstring, gluteus maximus, and lumbar erector spinae muscle showed in both groups and positions. However, the onset time of gluteus maximus was significantly later in prone and standing active hip extension in subjects with LBP than in healthy subjects. The onset time of lumber erector spinae muscle activity was significantly delayed in subjects with LBP in standing active hip extension, The delayed onset times of gluteus maximus and lumbar erector spinae muscles' activities were probably related to LBP. Further studies are needed to identify whether the delayed onset times of gluteus maximus and lumbar erector spinae muscle activities are the contributing factors to LBP.