Background: Although warm-ups before exercise are widely accepted, research on sex differences in improving hamstring flexibility is limited. Differences in the physical and physiological characteristics between males and females may result in different responses to warm-ups. Objects: This study aimed to examine sex differences in the effects of specific warm-up on hamstring flexibility. Methods: This study included 24 young adults with hamstring tightness. The participants performed five maximal knee extensions and flexions at 90° flexion of the hip, and the maximal knee extension angle was measured in real-time using a smartphone clinometer application. Results: The groups did not significantly affect the maximal knee extension angle but showed a significant effect for repetition (p = 0.002) and group-repetition interaction (p = 0.002). Males had no significant change in hamstring flexibility; however, females showed a significant increase in flexibility in the 5th trial compared with the 1st trial (p = 0.041). These results demonstrated sex-specific differences in flexibility improvement over time. Conclusion: The findings of this study suggest that specific warm-up can successfully improve hamstring flexibility in females. This may be due to various factors, such as muscle stiffness of the lower extremity, estrogen levels, and temperature sensitivity. In clinical settings, specific warm-up might be helpful for females who participate in sports or activities, such as running or jumping, which require a full range of motion in the hip and knee joints.

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: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.

The purpose of this study was to investigate whether static stretching or Thera-band stretching of hamstrings is more effective in improving the flexibility of hamstrings. A total of 40 participants performed stretching 3 times a week for 4 weeks, and a sitting trunk flexion meter was used to measure the flexibility of the hamstrings. Differences in hamstring flexibility before and after the application of static and Thera-band stretching were analyzed, and differences between the stretching methods were also analyzed. As a result, hamstring flexibility increased significantly after the static stretching program (p=.000), and also increased significantly after the Thera-band stretching program (p=.000). Although both programs were effective in improving hamstring flexibility, but there was no significant difference between the two groups (p=.058). Therefore, static stretching and Thera-band stretching are effective interventions to improve and maintain hamstring flexibility.

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 evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from 15.32±5.98 to 18.16±6.95 ㎏) and knee flexor strength (p=.011, from 7.80±4.80 to 8.15±4.24 ㎏) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.

The aim of this study was to compare the duration of hamstring flexibility improvement after 3 stretching interventions in people with limited hamstring flexibility. Twenty-two subjects (12 men, 10 women) with limited hamstring flexibility of the dominant leg received 3 stretching interventions— modified dynamic stretching (MDS), hold-relax (HR), and static stretching (SS)—in a random order. All the subjects received all 3 interventions at intervals of at least 24 hours to minimize any carry-over effect. Modified dynamic stretching was applied as a closed kinetic chain exercise in the supine position by using the sling suspension system (Redcord Trainer®). The SS and HR interventions were individually performed in the straight leg raising (SLR) position, and all 3 interventions were performed for 3 minutes. Outcome measures included passive knee extension (PKE) measurements. Five post-test measurements were recorded for all subjects at 3, 6, 9, 15, and 30 minutes after the interventions. MDS was associated with a significant increase in knee extension range of motion even at 30 minutes post-treatment. In contrast, the HR and SS stretching methods showed increased hamstring flexibility for only 6 minutes post-treatment. Improvements in the range of motion of knee extension (indicating enhancement in hamstring flexibility) with MDS were maintained longer than those with the HR and SS interventions. Therefore, MDS may be more effective than the other interventions for maintaining hamstring flexibility.

The purpose of this study was to examine the acute effects of nerve mobilization, static stretching, and hold-relax on the flexibility of hamstring muscles and their surface electromyographic (EMG) responses to passive stretches in poststroke hemiparesis. This study was a randomized cross-over trial. Fourteen subjects received three treatment sessions in random order with each consisting of ten repetitions. The treatment sessions included nerve mobilization, static stretching, and hold-relax. The treatment sessions were held at least 24 hours apart to minimize any carryover effect. The outcome was measured by the distance between the greater trochanter and lateral malleolus and hamstring EMG activity during passive knee extension stretching. Repeated-measures analysis of variance showed significant changes in hamstring flexibility and EMG activity in main effect of time pre, post and followup (p<.05). However, no significant differences occurred among the three stretching techniques. No technique was consistently found to be superior. The three stretching techniques in this study make it difficult to determine the most effective technique. Therefore, clinicians use nerve mobilization of effective stretching techniques with other stretching techniques.