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ORIGINAL ARTICLE
Year : 2016  |  Volume : 16  |  Issue : 1  |  Page : 28-31

Effect of muscle energy technique on flexibility of hamstring muscle in Indian national football players


Department of Physiotherapy, Tilak Maharashtra Vidyapeeth, Pune, Maharashtra, India

Date of Web Publication7-Jan-2016

Correspondence Address:
Roshan Adkitte
Department of Physiotherapy, Tilak Maharashtra Vidyapeeth, Pune, Maharashtra
India
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DOI: 10.4103/1319-6308.173467

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  Abstract 

Introduction: Football (soccer) is certainly one of the most popular sports worldwide. Football is a dynamic sport that requires the athlete to perform many different movements and skills such as rapid acceleration and deceleration, quick changes of directions, jumping, kicking, and sliding. Compared with other sports, football is vigorous sporting activity with relatively high incidence of injury. Tightness in hamstring muscle leads to hamstring muscle injury. Prevalence of hamstring injury is common in football players due to its tightness. Purpose of Study: The purpose of this study was to find out the effect of muscle energy technique (MET) on the flexibility of hamstring muscle in national level football players. The players were given 6 days MET on hamstring muscle to improve its flexibility. Hamstring length was checked using the sit and reach test presession as well as postsession, and both values were compared. Result: The increase in hamstring length following the 6 days MET on hamstring proved to be statistically significant (P < 0.01) when compared with the presession (24.31) and postsession (26.77) values. Conclusion: It is concluded that MET increases the flexibility of hamstring muscle in Indian National Football Players and hence it can prevent the injuries and improves their performance.

  Abstract in Arabic 

تأثير تقنية طاقة العضلة (muscle energy technique MET)على مرونة أوتار عضلات الركبة فى الفريق الهندى لكرة القدم :
خلفية الدراسة: تعد كرة القدم تحديداً إحدى أكثر الرياضات شعبية في العالم وتتميز كرة القدم بأنها مليئة بالقوة والنشاط وتتطلب من الرياضين أداء العديد من الحركات المختلفة والمهارات مثل زيادة السرعة او تقليلها والتغير السريع للاتجهات ( القفز والركل والتزحلق ) ومقارنه بالرياضات الأخرى تعد كرة القدم رياضة عنيفة تتميز بارتفاع نسبة الإصابات. وقد يتطلب على لاعبيها الضغط على أوتار عضلات الركبة والذى قد يؤدى إلى اصابة العضلة والذى يشيع بين لاعبي كرة القدم.
الهدف من الدراسة: كان الهدف من هذه الدراسة معرفة أثر تقنية طاقة العضلة (MET)على مرونة أوتار عضلات الركبة على مستوى اداء الفريق الوطني الهندى لكرة القدم.
وسياة البحث: تم إعطاء اللاعبين 6 ايام للعمل على تقنية طاقة العضلة (MET)على عضلة أوتار الركبة لتحسين مرونتها. وتم قياس طول العضلة قبل وبعد الجلسة وباستخدام اختبار الجلوس والتمدد ومقارنة القياسات ومقارنتها.
النتيجة: كان هناك زيادة فى طول العضلة بعد 6 أبام من استخدام تقنية طاقة العضلة (MET) وأثبت فرقاً احصائياً مميزا0.01 > P بالمقارنة مع قبل الجلسات( 24.31) وبعدها ( 26.77) .
الخلاصة: تقنية طاقة العضلة (MET) تؤدى إلى زيادة مرونة أوتار عضلة الركبة لدى لاعبي كرة القدم وهذا من شأنه تعزيز إمكانية الوقاية من الاصابات وتحسين أداء اللاعبين .

Keywords: Muscle energy technique, national level male football players, sit and reach test, tightness of hamstring muscle


How to cite this article:
Adkitte R, Rane SG, Yeole U, Nandi B, Gawali P. Effect of muscle energy technique on flexibility of hamstring muscle in Indian national football players. Saudi J Sports Med 2016;16:28-31

How to cite this URL:
Adkitte R, Rane SG, Yeole U, Nandi B, Gawali P. Effect of muscle energy technique on flexibility of hamstring muscle in Indian national football players. Saudi J Sports Med [serial online] 2016 [cited 2020 Apr 7];16:28-31. Available from: http://www.sjosm.org/text.asp?2016/16/1/28/173467


  Introduction Top


Football (soccer) is certainly one of the most popular sports worldwide. It has been reported that more than 2,00,000 professional and 240 million amateur players play football.[1] Compared with other sports, football is vigorous sporting activity with relatively high incidence of injury.[1] Football is a dynamic sport that requires the athlete to perform many different movements and skills such as rapid acceleration and deceleration, quick changes of directions, jumping, kicking, and sliding.[2] Hamstrings contribute to posture stabilization and the control of the pelvis region.[2] Hamstring muscles have the ability to generate high forces rapidly through their eccentric and concentric contractions due to their high composition of type 2 muscle fibers.[2]

A hamstring muscle's length can change by up to one third as a result of of eccentric or concentric contraction and is subject to high forces in closed and open kinetic chain activities.[2] In football, hamstring injuries mainly occur while running or sprinting in the biceps femoris with the muscle-tendon junction being the most common injury site, therefore, it is important to look at running and sprint mechanics. Of the three hamstring muscles, the bicep femoris has the greatest muscle-tendon length and is stretched the most during sprinting, hence being the most frequently injured muscle.[2] Football also requires quick change of direction and speed and this may also be a factor to the higher rate of bicep femoris injuries as they act as lateral rotators when the knee is semi-flexed and the hip is extended.[2] In the first half of the stance phase, the hamstrings remain active through a concentric contraction, resisting knee extension distally while extending hip.[2] The hamstrings act to decelerate knee extension distally while proximally assisting hip extension in the later stage of swing phase while running.[2] During the eccentric contraction of the hamstrings at the end of the swing phase, the muscle reaches maximal length, and it is suggested this is when strain injury is most likely to occur just before heel strike.[2] The causes of hamstring injuries have been attributed to a lack of strength in the hamstrings, lack of hamstring flexibility as well as imbalance or lack of strength between the lower extremities in quadriceps and hamstring muscle. Most of the epidemiological studies pointed out that the number of injuries during competition is about 4–6 times more than that in training.[1] Over 65% of football injuries are classified as minor 25% moderate and 10%serious.[1] In males, the highest rate of sports injuries is in football.[3] Sports injuries are not because of single causative variable but because of a variety of factors that interact at the time of injury. They may be intrinsic (personal, host), extrinsic (environmental).[3] Tightness in hamstring muscles leads to hamstring muscle injury so to decrease the number of injuries preventive programs are highly recommended. Stretching is important for reducing injuries and improving performance in sports and overall fitness. Muscle energy technique (MET) is a procedure that involves voluntary contraction of a patient's muscle in a precisely controlled direction, at varying levels of intensity. It is unique in its application as the client provides the initial effort while the practitioner facilitates the process. The benefits of MET include: Restoring normal tone in hypertonic muscles, strengthening weak muscles, preparing the muscle for subsequent stretching, improved joint mobility.[4] It includes two techniques postisometric relaxation technique and reciprocal inhibition.[4] Hamstring tightness is a common problem faced by the general population as well as sports players. The MET is a widely accepted method for treating hamstring tightness and sit and reach test is a procedure used to measure hamstring flexibility. The sit and reach test is the most common flexibility test used in health related fitness test batteries.[5] It is also suggested to use this test to evaluate hamstring flexibility because the test have acceptable reproducibility, have moderate validity, simple procedure that is easy to administer, require minimal skills training and particularly useful in large scale flexibility evaluation.[6] Thus, in this study, the postisometric relaxation technique is used to study the effectiveness of MET in improving hamstring flexibility. Hence, the aim of present study was to evaluate the effectiveness of MET on flexibility of hamstring muscle in Indian National Football Players.


  Materials and Methods Top


Design of the study

This study was a pretest posttest randomized controlled experimental design study. Following assessment of sit and reach test, all participants with hamstring tightness were treated with MET (postisometric relaxation technique).

Procedure

The study was approved by the Institutional Ethical Committee of Department of Physiotherapy, Tilak Maharashtra Vidyapeeth, Pune. The study was experimental design study. Thirty national level football players with mean age group (26.3 ± 3.63) years, mean height (160.13 ± 6.93) cm, mean weight (64.13 ± 6.97) kg, mean body mass index (23.10 ± 2.86) kg/m 2 were randomly selected according to the following criteria.

Inclusion criteria

Thirty male Indian National football Players with hamstring tightness.

Exclusion criteria

Any lower limb surgical history, history of any lower limb musculoskeletal disorders, goalkeepers, females.

All participants signed an informed consent form according to the university guidelines. All participants were assessed in accordance with the evaluation form. The procedure, benefits, and potential risks of the study were explained to the participants before signing the informed consent form and starting the 6 days treatment program. The treatment was given as one treatment session in a day for 6 consecutive days. Measurements were taken as a baseline on the 1st day, posttest on the 6th day, and follow-up on the 10th day (follow-up measurements were not considered as there were no significant changes in the readings). This was followed by taking baseline measurements (sit and reach test) presession. The subjects were asked to perform the test 3 times, and the average readings were noted.

Muscle energy technique

Muscle energy technique was applied using postisometric relaxation technique. While the subject was lying in the supine position, the subject's hip was passively flexed by the therapist until the bind was felt. From this position, the subject's lower leg was placed onto the therapist's right shoulder. Then the subject was asked to apply pressure over the shoulder of the therapist for 7–10 s. After the contraction of the hamstrings and during the relaxation phase, the therapist passively took the leg into further flexion with 30 s hold. Then the subject's leg was lowered on the treatment table for a short resting period with duration of approximately 10 s. This procedure was repeated again with the frequency of 2 reps.

Sit and reach test was used to measure hamstring flexibility. The subjects sat on the floor and fully extended both legs so that the sole of the foot was flat against the end of the box. They extended their arms forward, placing one hand on top of the other. With palms down, the subject reached forward with the hands along the measuring scale as far as possible without bending the knees. Three trials were taken, and the average was recorded by the therapist.

Outcome measurement

Sit and reach test was used to measure hamstring flexibility.

Statistical analysis

Statistical analysis was conducted using the SPSS software version 19.0 (IBM Corporation, Armonk, NY).

Paired t-test was used for comparing the values of presession and postsession.


  Results Top


Statistical analysis using the paired t-test revealed a statistically significant improvement in the presession values (P < 0.001) as well as postsession values (P < 0.001) [Figure 1], [Table 1] and [Table 2].{Figure 1}{Table 1}{Table 2}

Comparison between the presession and postsession. Data show a significant difference between the presession values (P< 0.001) and postsession values (P< 0.001) following the 6-day treatment program.


  Discussion Top


The results of the study revealed that following a 6-day treatment program of MET, subjects have shown significant improvement (P < 0.001) in the flexibility of hamstring muscle. The subject in the present study was national level football players. Ivan [7] discussed that MET is an effective, nontraumatic manipulative technique. The use of MET is said to inhibit motor activity via the Golgi tendon organs or the muscle spindles. Postisometric relaxation technique to a reduction of the tone of the muscles. The latency period of approximately 10 s that is present after the isometric phase. During this period, the movement toward the new position of a joint or muscle can be easier (due to the reduction in tone). According to Zuzana, the changes within the connective tissues display mechanical properties relating to both fluid (viscous) and elastic components. “Creep” represents the temporary elongation of connective tissue during stretch as a result of its viscoelastic properties.[8] Permanent “plastic” changes occur as a result of micro-tearing and remodeling of connective tissue fibers. MET may produce increased muscle length by a combination of creep and plastic changes in the connective tissues. If the relaxation phase in MET would be performed for 30 s, it could be lead to a prolongation of the muscle due to creep and also due to plastic changes in the connective tissue.[8]

Ahmed [9] have discussed that the application of postisometric relaxation technique produce greater changes in muscle extensibility. It has been shown by Abreham [10] that MET is a better technique in improving hamstring flexibility when compared with ballistic stretching. Ramesh and Sivasankar [11] discussed in their study that in MET an increase in muscle length may be due to the biomechanical event, neurophysiological changes, and increase in tolerance to stretching. MET is more effective than ultrasound therapy with active static stretching and passive static stretching in improving hamstring flexibility in individuals with hamstring tightness.[5] The present study goes with the same technique revealed an increase in hamstring flexibility which in turn reduces the risk of hamstring injury. Gibbson,[4] sports osteopath discussed earlier that MET as opposed to indirect because the muscular effort is from a controlled position, in a specific direction against a distant counterforce. Dynamic stretching as well as MET proved to be effective in improving the hamstring flexibility.[9] Dynamic stretching protocol was followed daily by the players so in our present study, only MET was used. The present study revealed that MET had a positive effect on hamstring muscle flexibility which may be the result of postisometric relaxation technique.


  Conclusion Top


Muscle energy technique has been shown to be an effective technique in increasing the flexibility of hamstring muscle in Indian National Football Players.

Future scope

There is a huge amount of scope to conduct this present study in different regions of India and Abroad as the MET increases the flexibility of hamstring muscles thereby decreasing the rate of hamstring injury. The present study can be conducted on female athletes as well as athletes from different sports.

 
  References Top

1.
Rahnama N. Prevention of football injuries. Int J Prev Med 2011;2:38-40.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Al Ramahi A. (Hons) Sport and Exercise Science. Biomechanical Factors Contributing to Hamstring Injuries in Football: Strength and Conditioning Coach's Perspective on Preventing this Common Injury, Optimum health; 01 October, 2013.  Back to cited text no. 2
    
3.
Sreekaarini I, Eapen C, Zulfeequer CP. Prevalence of sports injuries in adolescent athletes. J Athl Enhanc 2014;3:5.  Back to cited text no. 3
    
4.
Gibbons J. Muscle energy technique. Int Ther 2011;97:26-28.  Back to cited text no. 4
    
5.
Baltaci G. Comparison of three different sit and reach tests for measurement of hamstring flexibility in female university students. Br J Sports Med 2003;37:59-61.  Back to cited text no. 5
    
6.
Ayala F. Reproducibility and criterian-related validity of the sit and reach test and toe touch test for estimating hamstring flexibility in recreationally active young adults. Physical Therapy in Sport 2012;13:219-26.  Back to cited text no. 6
    
7.
Ivan Z. Anatomy, physiology and biomechanics of hamstring injury in football and effective strength and flexibility exercises for its prevention. Journal of Human Sport Exerc 2012;7:S208-17. [Proc1].  Back to cited text no. 7
    
8.
Holuskova Z. Efficacy of Post-Isometric Relaxation Technique on Muscle Tissue and its Viscoelastic Properties after Physical Activity. Praha, Duben; 2012.  Back to cited text no. 8
    
9.
Ahmed AR. A comparative study of muscle energy technique and dynamic stretching on hamstring flexibility in healthy adults. Bull Fac Phys Ther Cairo Univ 2011;16:1-5.  Back to cited text no. 9
    
10.
Abreham SS. The effect of MET vs Ballistic stretching in increasing muscle flexibility in male athletes. Bangalore: Rajiv Gandhi University of Health Science; 2012.  Back to cited text no. 10
    
11.
Ramesh M, Sivasankar P. Comparison of three different physiotherapeutic interventions in improving hamstring flexibility in individuals with hamstring tightness. Int J Health Sci Res 2014;4:129-34.  Back to cited text no. 11
    


    Figures

  [Figure 1]SaudiJSportsMed_2016_16_1_28_173467_f1.jpg
 
 
    Tables

  [Table 1]SaudiJSportsMed_2016_16_1_28_173467_t2.jpg, [Table 2]SaudiJSportsMed_2016_16_1_28_173467_t3.jpg



 

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Abstract
Introduction
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