Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial

Abstract

Objectives: Tight hamstrings contribute to inefficiency of movement and increased risk for injury. Static stretching is the most common intervention for this problem, but the use of alternatives like instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular facilitation (PNF) is increasing among clinicians. This study examined two prospective studies with the common aim of demonstrating the effectiveness of IASTM or PNF over static stretching for improving hamstring tightness. Methods: Nondisabled adults were recruited on a university campus. IASTM study: N = 17 (11 males and 6 females). PNF study: N = 23 (7 males and 16 females). Hip flexion range of motion was measured with a passive straight leg raise (for IASTM) or active straight leg raise (for PNF) before and after stretching. Participants performed a self-static stretch on one leg and received the alternative intervention on the contralateral leg. The two studies were analyzed separately for reliability indices and significant differences between interventions. Results: Hip flexion measures showed good reliability in both studies (intraclass correlation coefficient = 0.97) with a minimal detectable change of <4.26. Both studies showed significant interactions between time and intervention (p < 0.05). Follow-up analyses revealed PNF and IASTM interventions resulted in greater increases in hip flexion range than static stretching. Discussion: These findings demonstrate the effectiveness of PNF and IASTM techniques over static stretching for hamstring flexibility. These interventions provide more efficient alternatives for improving flexibility in the clinic, allowing greater progress in a shorter period of time than an equivalent static stretching program.Level of Evidence: 1b.

The Effectiveness of Hamstring Stretching with Proprioceptive Neuromuscular Facilitation versus Jack-Knife Stretching for Individuals with Hamstring Tightness

“…14,15 Although both PNF hamstring stretching and static hamstring stretching can effectively improve hamstring flexibility, it is unclear whether one of these exercises is superior. 5,[16][17][18] While some previous studies showed no significant differences in hamstring flexibility between the two hamstring stretching exercises, 16,17 others demonstrated that PNF hamstring stretching was superior to static hamstring stretching in terms of improved hamstring flexibility. 5,18 Although these previous studies compared the effects of static hamstring stretching to PNF hamstring stretching, 5,[16][17][18] they did not consider the newly-developed jack-knife stretching method.…”

“…5,[16][17][18] While some previous studies showed no significant differences in hamstring flexibility between the two hamstring stretching exercises, 16,17 others demonstrated that PNF hamstring stretching was superior to static hamstring stretching in terms of improved hamstring flexibility. 5,18 Although these previous studies compared the effects of static hamstring stretching to PNF hamstring stretching, 5,[16][17][18] they did not consider the newly-developed jack-knife stretching method. Comparing the PNF hamstring and jack-knife stretching methods could help clinicians determine the best strategy for improving hamstring flexibility and decreasing mechanical stress due to excessive lumbar flexion caused by hamstring tightness.…”

“…Hamstring stretching with PNF using the hold-relax (HR) technique is a method in which relaxation is induced after performing isometric contraction to the point where resistance is felt in the hamstring muscles. [5][6][7] Activation of the Golgi tendon organ…”

Myofascial Compression Interventions: Comparison of Roller Massage, Instrument Assisted Soft-Tissue Mobilization, and Floss Band on Passive Knee Motion Among Inexperienced Individuals

“…34 Researchers have found that FR may improve joint ROM at the shoulder, 35,36 lumbopelvis, 37,38 hip joint, [39][40][41][42][43][44][45] knee joint, 9,[45][46][47] and ankle. 48,49 IASTM has also been shown to improve joint ROM at the shoulder, 27,28,50,51,52 hip and knee joint, 51,53,54,55 ankle, 56 and spine. 57 The FB research has documented improved post intervention ankle joint ROM in healthy individuals.…”

Effect of Proprioceptive Neuromuscular Facilitation Stretching on Pain, Hip Joint Range of Motion, and Functional Disability in Patients with Chronic Low Back Pain

“…Birinci et al [11] reported significant improvements in elbow pain, range of motion (ROM), and arm function upon the application of PNF stretching in patients with elbow stiffness. Gunn et al [12] reported that PNF stretching is more effective for hamstring flexibility than static stretching. Malai et al [13] reported that PNF stretching immediately reduced low back pain, decreased lumbar lordosis angle, and increased transversus abdominis activation.…”