This study was a randomized control trial. The purpose of this study was threefold: 1) to determine if intramuscular temperature (IMt) increases in the semitendinosus (ST) are similar to the vastus lateralis (VL) during standard WBV static squatting; 2) to determine if changes in intramuscular temperature of the hamstrings is different from a standard static semi-squat when undergoing WBV in a static stretching position; and 3) to determine if shorter overall durations as is typically used for stretching protocols (i.e. 5 repetitions of 30s each), will result in IMt increases. Twelve subjects (all males), with tight hamstrings completed this study (age 23.5 ± 1.5 years; body mass 76.3 ± 17.7 kg; height 177.8 ± 15.2 cm). Subjects were randomly assigned to treatment order of three groups: semi squat vibration (SQ), vibration with static stretch (VS), and static stretch only (SS). Subjects reported to the lab 3x, each visit separated by one week to receive all treatments. Each treatment day consisted of baseline temperature measurements in the VL and ST and following each of 2 sets (5x60-second for SQ, 5x30-second for VS and SS, with 30 seconds rest in between reps). Post-hoc comparisons revealed that VL temperature increases were significantly greater from baseline than the hamstrings at all three time periods (p<.0001). There were no significant differences found in ST IMt when comparing 5-minutes of total WBV in the VS condition (both sets of 2.5 minute bouts) to 5-minutes of vibration in the SQ condition (p=1.000), or between VS and SS after 5 minutes (p=.9827). Post-hoc comparisons between SS and VS conditions revealed no significant differences after 2.5 minutes (p=1.000), 5 minutes (p=.8812), and 10-minutes post vibration (p=.9844) in ST or VL (p=1.000, p=.0540, and p=.1815 respectively) temperature. The results of our study show that the ST does not exhibit similar increases in IMt as the VL when performing standard semi-squat WBV training. The IMts seen in the static stretch both with and without vibration seem to suggest that factors other than IMt most likely contribute to flexibility changes seen in prior WBV flexibility studies.

The purpose of the study was to quantify the relative contribution of low back flexibility and hamstring flexibility in the sit and reach test item of the AAHPERD Health Related Fitness Test in order to examine the validity of the sit and reach test. Subjects were 100 female students, 13 to 15 years of age in physical education classes. Hamstring flexibility was measured using the Leighton flexometer. Spinal mobility was measured using a tape measure. The sit and reach test was performed according to instructions given in the AAHPERD Test Manual. Data were analyzed using correlation, linear regression, and multiple regression. Conclusions of the investigation were (1) hamstring flexibility is moderately related to the sit and reach test, (2) low back flexibility has a very small relationship to the sit and reach test, and (3) the sit and reach test is an inadequate measure of low back and hamstring flexibility.

The purpose of this study was to examine the criterion-related validity of the sit and reach test as a measure of hamstring and low back flexibility in adult males and females. Subjects were 52 males and 52 females, 20 to 45 years of age. Hamstring flexibility was measured using a goniometer. Spinal flexibility was measured using a tape measure and an inclinometer. The sit and reach test was performed according to the AAHPERD Health Related Fitness Test Manual. Data were analyzed using correlations and appropriate descriptive statistics. Conclusions of the investigation were: 1) in adult males 20 to 45, the sit and reach test is a valid measure of hamstring flexibility but has questionable validity as a measure of low back flexibility, 2) in adult females 20 to 45, the sit and reach test is a moderately valid measure of hamstring flexibility and is not a valid measure of low back flexibility.

M.Tech. (Chiropractic) / Purpose: According to Jonhagen, Nemeth and Erikson (1994), hamstring muscle injury as a result of weakness is prevalent. Hoskins and Pollard (2005) states that a previous or recent hamstring muscle injury is the most recognized risk factor for future injury. Given the high reoccurrence rate, hamstring injuries provide a significant challenge to the treating clinician. Knowledge surrounding the optimal treatment is critical to improve hamstring muscle strength in preventing these injuries. The aim of this study is to determine the most effective treatment method, when comparing sacroiliac joint manipulation with or without dry needling and the effect it has on hamstring strength. Design: Thirty participants between the ages of 18 and 35 years old presenting with SI joint dysfunction and hamstring trigger points, were considered for this study. The participants were randomly divided into two groups of 15 participants each (group A and B). Group A received manipulation to the sacroiliac joint and group B received manipulation to the sacroiliac joint, as well as dry needling of the active myofascial trigger points in the semimembranosus muscles. Each participant was treated six times over a period of three weeks. Measurements: All measurements were collected at the first, third and fifth consultation prior to treatment and on the seventh consultation where no treatment was performed. Subjective measurements included the McGill questionnaire and a visual analogue pain scale. Objective measurements included algometer, readings of pressure pain threshold of the hamstring muscle trigger points and hamstring muscle strength recorded using a dynamometer instrument. Results and Conclusion: Group A and group B proved to have a statistical and clinical improvement overall. Group A had a better improvement in both subjective tests and in the objective tests. In comparing the statistically significant data for hamstring muscle strength in this study, it would appear that Group A responded better to treatment than Group B. Although both groups did improve, it suggests that Group A achieved the greatest overall improvement. Therefore it can be suggested that myofascial dry needling of the hamstring muscle was found not to have an additive effect for improving vii hamstring muscle strength, it actually appears to have done worse. The reason for this might be due to the post treatment soreness after needling. This may cause muscle inhibition and decreased muscle contraction, due to the pain or tenderness, which could have affected the muscle strength. In conclusion, the results in this study show that chiropractic manipulation combined with dry needling did not have better results in improving hamstring strength.

No description available.

Anterior cruciate ligament reconstruction utilizing a hamstring autograft is a surgical technique that has gained popularity among orthopedic surgeons caring for adolescent patients. While utilization of a hamstring autograft is a revered technique, harvest of the hamstring yields significant pain. Sciatic peripheral nerve blockade has proven to reliably provide analgesia at the hamstring donor site. Single-injection sciatic peripheral nerve blockade is considered a basic and effective technique, making its use following anterior cruciate ligament reconstruction standard practice in many institutions. The duration of action of a single-injection sciatic peripheral nerve blockade may fail to outlast the pain arising from the hamstring donor site, prompting some clinicians to employ continuous sciatic peripheral nerve blockade via an indwelling catheter. A lack of comparative effectiveness studies exists in the literature regarding the duration of action of peripheral nerve blockade necessary to adequately provide pain control following hamstring autograft harvest, resulting in disagreement among clinicians as to best pain control practices. Proponents of continuous sciatic peripheral nerve blockade assert that while more costly, the extended duration of analgesia afforded by this technique improves pain control postoperatively and decreases the use of other pain medications. Advocates of single-injection sciatic peripheral nerve blockade cite concerns associated with continuous sciatic peripheral nerve blockade known to be detrimental to rehabilitation, such as decreased active knee flexion and increased risk of falls. The purpose of this research is to compare the effect of single-injection sciatic PNB to continuous sciatic PNB on 1) postoperative pain control as measured by self-reported pain scores, pain medication use, and unplanned hospital admission due to poor pain control, 2) active knee flexion, and 3) patient satisfaction with pain control following ACL reconstruction with a hamstring autograft. The findings of this study have the potential to guide informed clinical reasoning and decision making regarding sciatic peripheral nerve blockade techniques following hamstring autograft harvest in adolescents undergoing anterior cruciate ligament reconstruction.

M.Tech. (Chiropractic) / Background: In sporting activity, especially rugby, soccer, cricket and hockey, re-occurring hamstring injuries are a common sight that suggests that there is an opening for an improvement in the treatment and management of these injuries. This can be debilitating to any sportsman as it results in recurrent time away from his/her sporting activity. A study by Fyfer, Yelverton and Sher (2005), found that sacroiliac manipulation alone had a positive effect in the treatment of recurrent hamstring injuries. Cibuklka, Rose, Delitto and Sinacore (1986), proposed a possible link between hamstring muscle injuries and sacroiliac joint dysfunction. A study conducted by Donahue, Docherty and Schrader (2010), on the effects of Graston technique on pressure pain threshold, revealed a significant improvement in the patient’s pain threshold due to the fact that the instrument assisted technique effectively broke down scar tissue and correct fascial restrictions. The FAKTR approach to soft tissue dysfunction combines instrument-assisted soft tissue mobilization (Graston Technique) with proprioceptive (functional) techniques to reduce pain and return to function (Hyde and Doerr, 2012). Objective: This blinded, randomised pilot study was done to investigate the effects of sacroiliac joint manipulative therapy versus functional and kinetic treatment with rehabilitation on hamstring flexibility in previously injured hamstring muscle. Design: The study consisted of 30 participants recruited from the University of Johannesburg by word of mouth and posters, which met the inclusion criteria. They were equally and randomly divided into 2 groups. Group 1 received chiropractic therapy of the sacroiliac joint. Group 2 received functional and kinetic treatment with rehabilitation. Objective measurements consisted of digital inclinometer which measured the flexibility and range of motion of the hamstring muscle. The pressure algometry was used to measure pain pressure threshold. Procedure: Both group participants hamstring flexibility and ranges of motion were tested. Group 1 participants were motion palpated to determine sacroiliac joint dysfunction and treated with a high velocity, low amplitude trust to restricted segment, group 2 received functional and kinetic treatment with rehabilitation. Results: The statistical results should be viewed with regards that this study only represent a small group of thirty participants and therefore no assumption can be made with respect to whole population. The p-value was set at 0.05 and represents the level of significance of the results. If the p-value was less or equal to 0.05 (p≤0.05) there was a statistical significance finding. If the p-value is greater than 0.05 (p>0.05) vi there was no statistical finding. Statistical significance only means that a given result is unlikely to have occurred by chance. Analysis included demographic data analysis of age and gender. Objective data were collected using Digital Inclinometer and Pressure Algometry. Intra-group and inter-group analysis was done on straight leg raise, passive knee extension, hip extension, lateral rotation of the hip and medial rotation of the hip. The Shapiro-Wilk test was performed to determine normality. As normality could not be assumed, non-parametric testing were used to do intra-group analysis. The Non-parametric Friedman test was used to determine if a change occurred over time. As change did occur over time the Wilcoxon Signed Rank Test was use to determined where the change within each group occurred. The Mann-Whitney U test was also used to determine if any difference between the groups were present at any given time. At the end of the study both test groups showed significant clinical as well as statistical improvement over the three week course of the study. Conclusion: The FAKTR treatment did clinically have the greatest improvement, however the changes seen was not statistically superior to those seen with the sacroiliac joint manipulation treatment. A statistical significant improvement was seen in both treatment protocols, concluding that both the spinal manipulative therapy and the functional and kinetic treatment with rehabilitation could be proficient protocols in treating hamstring flexibility.

M.Tech. / Purpose: In soccer the re-injury rate of Hamstring muscle strains is between 12 and 14 percent. A previous or recent Hamstring injury is the most recognised risk factor for future injury. On recurrence of the injury, it tends to be more severe and disabling than the initial injury. Given the high recurrence rates, Hamstring injuries provide a significant challenge to the treating clinician. Knowledge surrounding optimal treatment and preventative measures is therefore critical (Hoskins and Pollard 2005). The aim of this study is to assess the effectiveness of lower lumbar spine segment adjustment, namely the L4/5 spinal level, in the contractile strength of the Hamstring muscle group in professional soccer players that have a history of a Hamstring strain. Design: Forty professional soccer players between the ages of 15 and 34 years with a history of a grade one or grade two Hamstring strain were considered for this study. Participants in this research were obtained from the University of Johannesburg inter-residence players and from the University of Johannesburg first soccer team. Two groups of twenty players were randomly assigned to one of two groups. Group A received spinal adjustive therapy (SAT) to the L4/5 spinal segment with an ultrasound treatment to their Hamstring muscle group and Group B will receive only the ultrasound treatment to the hamstring muscle group. Each participant was treated five times over a period of three weeks. Measurements: Before any intervention was given to either of the groups, Hamstring muscle contractile strength was first recorded using a Cybex system 2000. Hamstring contractile muscle strength measurements were taken again after the fifth treatment for both groups and compared to ascertain if there had been any change in the contractile strength of the Hamstring muscles. Results and Conclusion: Even though the two groups did not start at the same contractile strength for the Hamstring muscle in knee flexion, as measured a CCybex system 2000 possibly due to the selection criteria used in the study in terms of age and body weight of the participants, results showed that spinal adjustive therapy was more effective in improving the muscle contractile strength of the Hamstring muscle in knee flexion since there was a favourable difference in both Group A and Group B following intervention, but more so in Group A (in the once injured leg) which received spinal adjustive therapy due to a greater increase in the overall muscle contraction in the Hamstring muscle group. For the Chiropractic profession this opens huge potential with regards to the Chiropractic benefits and improving the functioning of professional soccer players.

Masters of Science / BACKGROUND: Hamstring injuries remain a growing concern within a large variety of sports from the elite athlete to the weekend warrior. A copious amount of research has been performed in an attempt to reduce these injuries. The aim of this study was to understand the changes in lengthened state eccentric strength of the hamstrings following four separate protocols. METHODS: A quantitative research approach, using a true experimental design, was adopted for this study. A convenience sample of non-sedentary, 35 male participants, between the ages of 18 and 35 within the City of Cape Town was used. Participants were randomly allocated to one of four groups namely; Control group (C), resistance training alone (RT), neuromuscular electrical stimulation alone (NMES), or NMES superimposed with RT (NMES&RT). Participant’s eccentric hamstring strength was tested in a lengthened state, on the Biodex system 4 Pro™ for the pre- and post-test. The intervention spanned over four weeks. SPSS version 25 was used for data analysis. RESULTS: All groups demonstrated a mean increase in relative peak torque. However, a repeated-measures analysis of variance (ANOVA) showed no interaction effect (p = 0.411) between the four groups. Further analysis using Magnitude-based inferences (MBI), to identify the magnitude of changes, showed a small positive effect for both the NMES and NMES&RT group when compared to the C and RT groups. CONCLUSION: Although there are no statistically significant differences between the four groups employed in this study (C, RT, NMES, NMES&RT), NMES and NMES&RT did show small positive effects compared to C and RT with a very low likelihood of negative effects. Thus, using NMES either alone or superimposed with resistance training will be beneficial for trained athletes but it is not a necessity and the use of specific resistance training may be just as effective. / 2019-04-30

The objective of this study was to investigate the influence of cyclic loading on the extensibility of hamstring muscle-tendon units in vivo.Study Design: A test-retest randomised controlled trial with repeated measures was undertaken.Background: Stretching has been commonly promoted to increase the passive extensibility of the muscle-tendon units, yet the mechanism behind its proposed effects remains ambiguous. In vivo studies of stretching have mostly been limited to the viscoelastic characteristic of stress-relaxation. Few studies have investigated the characteristic of creep. Animal and cadaver in vitro creep experiments have consistently shown increases in the length of the soft tissues, with associated changes in their resistance and stiffness. These results however, might not be representative of human muscle-tendon units under in vivo conditions. Additionally, those in vivo human studies that have investigated creep phenomenon have contrasting results. To date, no known in vivo study has examined passive cyclic loading of human hamstrings to a constant load level.Method: Using a repeated measures design the extensibility of the hamstring muscles were assessed by a passive knee extension test (PKE) to maximal stretch tolerance using a KinCom® dynamometer. Those participants in the intervention group underwent 45 continuous passive cyclic loadings as the KinCom® dynamometer moved the knee joint into extension until torque reached 85% of maximal passive resistance torque measured in the passive knee extension test. The control group sat quietly relaxed during the intervention period. Measurements of hamstring passive extensibility using the PKE test were repeated at the end of the intervention.Results: Following the intervention, the PKE test showed for the cyclic loading group there was a significant (p < 0.05) increase in both maximal passive resistance torque (mean 23%) and knee joint angle (mean 6.3%). A significant (p < 0.05) decrease in passive resistance torque (mean 11.8%) when re-measured at the baseline position of maximal passive knee angle was observed. A significant increase (p < 0.05) was found for passive stiffness over the final 10% of the knee torque-angle curve. No significant difference (p > 0.05) was found for passive stiffness for the full (100%) of the torque-angle curve. Of the control group, no significant differences (p > 0.05) were observed for all variables of the PKE test. Analysis of cycle one compared to forty-five of the cyclic loading intervention procedure showed a significant (p < 0.05) increase in both passive knee joint angle (mean 5.2%) and passive stiffness (mean 28.6%) over the final 10% of the knee joint torque-angle. No significant difference (p > 0.05) was found for passive stiffness across the full (100%) knee joint torque-angle.Conclusion: The findings of the current study demonstrated that after cyclic loading the hamstring muscles lengthened and became stiffer over the final gained range of knee joint motion. Although the current study cannot determine the mechanism behind the changes in the variables of interest, these findings do provide some evidence that most likely a combination of altered stretch tolerance and local mechanical effects within the muscle-tendon unit, i.e. creep lengthening were responsible.