Research Article

The Immediate Effect of Static Hamstring Stretching on Dynamic Balance and Gait Biomechanical Variables in Athletes With Hamstring Tightness: A Preliminary Study


Introduction: Flexibility is an essential component of muscle function, and insufficient muscle flexibility may lead to muscle injuries. Decreased hamstring flexibility is one of the frequently reported risk factors for a hamstring strain and diminished athletic performance. Stretching is a commonly used intervention for increasing muscle length. There is a lack of evidence concerning the possible effects of hamstring stretching in balance and gait biomechanics. So, this study was designed to investigate the potential effects of static hamstring stretching on the range of motion (ROM), dynamic balance, and biomechanical variables of gait in athletes with hamstring tightness.
Materials and Methods: This study is a single-group, pretest-posttest clinical trial performed on semi-professional female athletes. Twelve female athletes aged 20 to 35 years with bilateral hamstring tightness received a single session of unilateral static hamstring stretching on their randomly selected side. All subjects were assessed for straight leg raise, popliteal angle (using standard goniometry), perceived hamstring tightness (using a visual analog scale). They completed single-leg standing and 15-m walking and running tasks before and immediately after the intervention. The biomechanical parameters, including gait-line length, swing duration, and stance duration in walking tasks, maximum total force and mean total force in running task, and center of pressure (COP) displacement and standard deviation during balance task were measured using OpenGo sensor insole system. The pre-post values were compared using the paired sample t-test, and the level of significance was 0.05.
Results: The values for straight leg raise and popliteal angle significantly increased (P<0.05) compared with the baseline, while perceived tightness significantly decreased following stretching (P<0.001). The amplitude (P₌0.006) and standard deviation (P₌0.016) of COP displacement in the mediolateral direction during the single leg stance balance task were significantly decreased after the intervention. Stance duration in slow walking (P₌0.004), as well as stance duration (P₌0.012) and swing duration (P<0.001) in fast walking, were significantly decreased (P<0.05) after stretching. No change was observed in gait biomechanical variables during the running test (P>0.05).
Conclusion: The results of this study indicate that static hamstring stretching can be a promising intervention not just for increasing hamstring flexibility but also for improving balance ability.

Medeni ÖÇ. Acute effect of kinesiotape muscle technique on hamstring flexibility and pain during stretching. Türk Fizyoterapi ve Rehabilitasyon Dergisi. 2015; 26(2). [DOI:10.7603/s40680-015-0011-7]

German RM. Inhibitory kinesio® tape application to the hamstring muscle group: An investigation of active range of motion and perceived tightness over time: Kent State University; 2013.

Ayala F, Sainz de Baranda P, De Ste Croix M, Santonja F. Comparison of active stretching technique in males with normal and limited hamstring flexibility. Physical Therapy in Sport: Official Journal of the Association of Chartered Physiotherapists in Sports Medicine. 2013; 14(2):98-104. [DOI:10.1016/j.ptsp.2012.03.013] [PMID]

Bandy WD, Irion JM, Briggler M. The effect of static stretch and dynamic range of motion training on the flexibility of the hamstring muscles. The Journal of Orthopaedic and Sports Physical Therapy. 1998; 27(4):295-300. [DOI:10.2519/jospt.1998.27.4.295] [PMID]

Cipriani DJ, Terry ME, Haines MA, Tabibnia AP, Lyssanova O. Effect of stretch frequency and sex on the rate of gain and rate of loss in muscle flexibility during a hamstring-stretching program: A randomized single-blind longi-tudinal study. Journal of Strength and Conditioning Research. 2012; 26(8):2119-29. [DOI:10.1519/JSC.0b013e31823b862a] [PMID]

Fasen JM, O’Connor AM, Schwartz SL, Watson JO, Plastaras CT, Garvan CW, et al. A randomized controlled trial of hamstring stretching: Comparison of four techniques. Journal of Strength and Conditioning Research. 2009; 23(2):660-7. [DOI:10.1519/JSC.0b013e318198fbd1] [PMID]

Marshall PW, Cashman A, Cheema BS. A randomized controlled trial for the effect of passive stretching on measures of hamstring extensibility, passive stiffness, strength, and stretch tolerance. Journal of Science and Medi-cine in Sport. 2011; 14(6):535-40. [DOI:10.1016/j.jsams.2011.05.003] [PMID]

Medeiros DM, Cini A, Sbruzzi G, Lima CS. Influence of static stretching on hamstring flexibility in healthy young adults: Systematic review and meta-analysis. Physiotherapy Theory and Practice. 2016; 32(6):438-45. [DOI:10.1080/09593985.2016.1204401] [PMID]

Bazett-Jones DM, Gibson MH, McBride JM. Sprint and vertical jump performances are not affected by six weeks of static hamstring stretching. Journal of Strength and Conditioning Research. 2008; 22(1):25-31. [DOI:10.1519/JSC.0b013e31815f99a4] [PMID]

Nelson RT. A comparison of the immediate effects of eccentric training vs static stretch on hamstring flexibility in high school and college athletes. North American Journal of Sports Physical Therapy: NAJSPT. 2006; 1(2):56-61. [PMID] [PMCID]

Reid DA, McNair PJ. Effects of an acute hamstring stretch in people with and without osteoarthritis of the knee. Physiotherapy. 2010; 96(1):14-21. [DOI:10.1016/] [PMID]

Decoster LC, Cleland J, Altieri C, Russell P. The effects of hamstring stretching on range of motion: A systematic literature review. Journal of Orthopaedic and Sports Physical therapy. 2005; 35(6):377-87. [DOI:10.2519/jospt.2005.35.6.377] [PMID]

Kim SY, Kang MH, Kim ER, Kim GM, Oh JS. Effects of kinesio taping on lumbopelvic-hip complex kinematics dur-ing forward bending. Journal of Physical Therapy Science. 2015; 27(3):925-7. [DOI:10.1589/jpts.27.925] [PMID] [PMCID]

Lim KI, Nam HC, Jung KS. Effects on hamstring muscle extensibility, muscle activity, and balance of different stretching techniques. Journal of Physical Therapy Science. 2014; 26(2):209-13. [DOI:10.1589/jpts.26.209] [PMID] [PMCID]

Hyong IH, Kang JH. The immediate effects of passive hamstring stretching exercises on the cervical spine range of motion and balance. Journal of Physical Therapy Science. 2013; 25(1):113-6. [DOI:10.1589/jpts.25.113]

Reddy RS, Alahmari KA. Effect of lower extremity stretching exercises on balance in geriatric population. Interna-tional Journal of Health Sciences. 2016; 10(3):389-95. [DOI:10.12816/0048733]

Behm DG, Bambury A, Cahill F, Power K. Effect of acute static stretching on force, balance, reaction time, and movement time. Medicine and Science in Sports and Exercise. 2004; 36(8):1397-402. [DOI:10.1249/01.MSS.0000135788.23012.5F] [PMID]

Whitehead CL, Hillman SJ, Richardson AM, Hazlewood ME, Robb JE. The effect of simulated hamstring shortening on gait in normal subjects. Gait & Posture. 2007; 26(1):90-6. [DOI:10.1016/j.gaitpost.2006.07.011] [PMID]

Davis Hammonds AL, Laudner KG, McCaw S, McLoda TA. Acute lower extremity running kinematics after a ham-string stretch. Journal of Athletic Training. 2012; 47(1):5-14. [DOI:10.4085/1062-6050-47.1.5] [PMID] [PMCID]

Cooney KM, Sanders JO, Concha MC, Buczek FL. Novel biomechanics demonstrate gait dysfunction due to ham-string tightness. Clinical Biomechanics. 2006; 21(1):59-66. [DOI:10.1016/j.clinbiomech.2005.08.014] [PMID]

Stöggl T, Martiner A. Validation of Moticon’s OpenGo sensor insoles during gait, jumps, balance and cross-country skiing specific imitation movements. Journal of Sports Sciences. 2017; 35(2):196-206. [DOI:10.1080/02640414.2016.1161205] [PMID] [PMCID]

Lategan L, Gouveia CH. Prevention of hamstring strain injuries in sports: A literature review. South African Journal for Research in Sport, Physical Education and Recreation. 2018; 40(1):55-69. file:///C:/Users/b.fallahi/Downloads/PreventionofHamstringInjuriesLateganGouveia2018.pdf

Farquharson C, Greig M. Temporal efficacy of kinesiology tape vs. traditional stretching methods on hamstring ex-tensibility. International Journal of Sports Physical Therapy. 2015; 10(1):45-51. [PMID] [PMCID]

Mhatre BS, Singh YL, Tembhekar JY, Mehta A. Which is the better method to improve “perceived hamstrings tight-ness”-Exercises targeting neural tissue mobility or exercises targeting hamstrings muscle extensibility? International Journal of Osteopathic Medicine. 2013; 16(3):153-62. [DOI:10.1016/j.ijosm.2013.06.002]

Gajdosik RL. Effects of static stretching on the maximal length and resistance to passive stretch of short hamstring muscles. Journal of Orthopaedic and Sports Physical Therapy. 1991; 14(6):250-5. [DOI:10.2519/jospt.1991.14.6.250] [PMID]

Ford P, McChesney J. Duration of maintained hamstring ROM following termination of three stretching protocols. Journal of Sport Rehabilitation. 2007; 16(1):18-27. [DOI:10.1123/jsr.16.1.18] [PMID]

Gribble PA, Guskiewicz KM, Prentice WE, Shields EW. Effects of static and hold-relax stretching on hamstring range of motion using the FlexAbility LE1000. Journal of Sport Rehabilitation. 1999; 8(3):195-208. [DOI:10.1123/jsr.8.3.195]

Milazzotto MV, Corazzina LG, Liebano RE. [Influência do número de séries e tempo de alongamento estático sobre a flexibilidade dos músculos isquiotibiais em mulheres sedentárias (Portuguese)]. Revista Brasileira de Medicina do Esporte. 2009; 15(6):420-3. [DOI:10.1590/S1517-86922009000700003]

Wiemann K, Hahn K. Influences of strength, stretching and circulatory exercises on flexibility parameters of the hu-man hamstrings. International Journal of Sports Medicine. 1997; 18(5):340-6. [DOI:10.1055/s-2007-972643] [PMID]

Liu Y, Sun Y, Zhu W, Yu J. The late swing and early stance of sprinting are most hazardous for hamstring injuries. Journal of Sport and Health Science. 2017; 6(2):133-6. [DOI:10.1016/j.jshs.2017.01.011] [PMID] [PMCID]

Gaudreault N, Fuentes A, Mezghani N, Gauthier VO, Turcot K. Relationship between knee walking kinematics and muscle flexibility in runners. Journal of Sport Rehabilitation. 2013; 22(4):279-87. [DOI:10.1123/jsr.22.4.279] [PMID]

Thakur D, Rose S. A study to find out the correlation between the right and left hamstring length in both genders to determine the prevalence of hamstring tightness among college students. Journal of Health and Allied Sciences NU. 2016; 6(04):46-52. [DOI:10.1055/s-0040-1708675]

Gurfinkel V, Cacciatore TW, Cordo P, Horak F, Nutt J, Skoss R. Postural muscle tone in the body axis of healthy humans. Journal of Neurophysiology. 2006; 96(5):2678-87. [DOI:10.1152/jn.00406.2006] [PMID]

Zagyapan R, Iyem C, Kurkcuoglu A, Pelin C, Tekindal MA. The relationship between balance, muscles, and anthro-pomorphic features in young adults. Anatomy Research International. 2012; 2012:146063. [DOI:10.1155/2012/146063] [PMID] [PMCID]

Palmer TB, Agu-Udemba CC, Palmer BM. Acute effects of static stretching on passive stiffness and postural balance in healthy, elderly men. The Physician and Sportsmedicine. 2018; 46(1):78-86. [DOI:10.1080/00913847.2018.1421396] [PMID]

Ahmadabadi F, Avandi SM, Aminian-Far A. Comparison the effects of short and long-term static warm up on bal-ance indices and motor performance in gymnast athletes. Middle East Journal of Rehabilitation and Health. 2016; 3(4):e39092 [DOI:10.17795/mejrh-39092]

Harbourne RT, Stergiou N. Movement variability and the use of nonlinear tools: Principles to guide physical thera-pist practice. Physical Therapy. 2009; 89(3):267-82. [DOI:10.2522/ptj.20080130] [PMID] [PMCID]

Lieber RL. Skeletal muscle structure, function, and plasticity. Pennsylvania: Lippincott Williams & Wilkins; 2002.

Little T, Williams AG. Effects of differential stretching protocols during warm-ups on high speed motor capacities in professional soccer players. Journal of Strength and Conditioning Research. 2006; 20(1):203-7. [DOI:10.1519/00124278-200602000-00033] [PMID]

Williams DS 3rd, Welch LM. Male and female runners demonstrate different sagittal plane mechanics as a function of static hamstring flexibility. Brazilian Journal of Physical Therapy. 2015; 19(5):421-8. [DOI:10.1590/bjpt-rbf.2014.0123] [PMID] [PMCID]

Jeleń P, Wit A, Dudziński K, Nolan L. Expressing gait-line symmetry in able-bodied gait. Dynamic Medicine. 2008; 7(1):17. [DOI:10.1186/1476-5918-7-17] [PMID] [PMCID]

Cichy B, Wilk M. Gait analysis in osteoarthritis of the hip. Medical Science Monitor. 2006; 12(12):CR507-513. [PMID]

Yoo SD, Kim HS, Lee JH, Yun DH, Kim DH, Chon J, et al. Biomechanical parameters in plantar fasciitis measured by gait analysis system with pressure sensor. Annals of Rehabilitation Medicine. 2017; 41(6):979-89. [DOI:10.5535/arm.2017.41.6.979] [PMID] [PMCID]

Ray J, Snyder D. Pedobarographic gait analysis on male subjects. Paper presented at: 15th Conferenc of Southern Bi-omedical Engineering. 29-31 March 1996; Dayton, OH, USA.

Sayers AL, Farley RS, Fuller DK, Jubenville CB, Caputo JL. The effect of static stretching on phases of sprint perfor-mance in elite soccer players. The Journal of Strength & Conditioning Research. 2008; 22(5):1416-21. [DOI:10.1519/JSC.0b013e318181a450] [PMID]

IssueVol 15 No 3 (2021) QRcode
SectionResearch Article(s)
Static stretching Hamstring flexibility Dynamic balance Gait biomechanical variables

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Salemi P, Shadmehr A, Fereydounnia S. The Immediate Effect of Static Hamstring Stretching on Dynamic Balance and Gait Biomechanical Variables in Athletes With Hamstring Tightness: A Preliminary Study. jmr. 2021;15(3):141-150.