|Year : 2017 | Volume
| Issue : 2 | Page : 110-114
Extended sitting can cause hamstring tightness
Ghulam Fatima1, Muhammad Mustafa Qamar2, Jawad Ul Hassan3, Ayesha Basharat2
1 Department of Physiotherapy, Advance Life College of Medical Sciences, Lahore, Pakistan
2 Department of Physical Therapy, Sargodha Medical College, UOS, Pakistan
3 Bhatti International Hospital, Lahore, Pakistan
|Date of Web Publication||6-Jun-2017|
Muhammad Mustafa Qamar
Department of Physical Therapy, Sargodha Medical College, UOS
Objective: Sedentary lifestyle has emanated as a new attention for research on exercise and health. The objective of this study was to find the correlation between prolonged sitting (minimum 6–8 h) and tightness of hamstrings in students.
Materials and Methods: In a cross-sectional study, 200 students were taken. Probability sampling was used on random basis to assess the flexibility of hamstring muscles using the straight leg raising (SLR) and active knee extension test. A manual goniometer was used for range measurement. All information was taken on predesigned pro forma.
Result: The mean age of 200 students was 20.3 ± 1.63 years. The mean value of SLR was found to be 60.97 ± 10.21, and mean value of popliteal angle was 47.65 ± 8.06. Most of the students, 164 (82%), had tightness according to SLR test. There was a statistically significant difference between the popliteal angle and chair sitting hours (P = 0.010), and an inverse correlation was found between SLR angle and chair sitting hours (r = −0.56, P = 0.000).
Conclusion: Tightness of hamstrings is observed in a majority of the students. Long-duration sitting can be a contributory factor in hamstring tightness.
Keywords: Hamstring tightness, popliteal angle, prolonged sitting, straight leg raising
|How to cite this article:|
Fatima G, Qamar MM, Ul Hassan J, Basharat A. Extended sitting can cause hamstring tightness. Saudi J Sports Med 2017;17:110-4
|How to cite this URL:|
Fatima G, Qamar MM, Ul Hassan J, Basharat A. Extended sitting can cause hamstring tightness. Saudi J Sports Med [serial online] 2017 [cited 2017 Sep 26];17:110-4. Available from: http://www.sjosm.org/text.asp?2017/17/2/110/207574
| Introduction|| |
Flexibility is a vital component of fitness required for most desirable musculoskeletal functioning and maximizing the performance of physical activities. Flexibility dysfunction is a widespread problem faced by common as well as sportspersons, especially in case of hamstring group of muscles., Hamstring tightness is not only a causative factor for reduced range of motion but it can also lead to various other musculoskeletal problems. Length-tension relationship of muscle as well as shock absorbing ability of the limb is affected by tightness of muscle. Reduced flexibility generates a vicious circle of range reduction and resulting increase in postural problems. Tight muscles also compress the blood vessels and lead to reduced optimal performance.
Hamstring strain is one of the most commonly suspected complaints resulting from hamstring tightness. According to Gajdosik et al., 2011, pelvic as well as thoracic angle and range of motion are affected by hamstring flexibility in forward bending. Hamstring tightness also influences the lumbar pelvic rhythm. Hamstring tightness is also associated with the development of plantar fasciitis  as well as patellar tendinopathy and patellofemoral pain syndrome. An association between hamstring tightness and mechanical low back pain is also found in studies showing a positive correlation between hamstring tightness and severity of low back pain.
Tight hamstring muscles limit anterior tilt of the pelvis in spinal flexion resulting in aggravated muscle and ligamentous tension in the lumbar region which leads to significantly higher compressive loads on the lumbar spine. Other postural changes associated with tightness of hamstrings can influence stability of sacroiliac joint in an indirect way. Hence, flexibility of hamstring muscles is crucial for overall well-being and optimal physical fitness.
The main reason of muscular tightness is a reduction in ability of muscle to deform, leading to a lower range available at concerned joint for motion. Tight hamstrings are associated with a dysfunctional motor control pattern leading to a submaximal firing pattern of postural muscles resulting in function of hamstrings as stabilizers rather than their main function of prime movers. This change in primary function leads to the presentation of hamstring tightness.
Many reasons can lead to the development of hamstring tightness such as genetic predisposition, injury to muscle, and adaptive shortening due to some chronic condition. Modern sedentary style of living is one of the main reasons for postural abnormalities evident in modern society. The prolonged sitting hours required in most of the jobs, and educational setups can affect flexibility of soft tissues, especially two joint muscles.
The current study is aimed to verify the notion that prolonged sitting can lead to tightness of hamstrings as very rare research work is available to prove this notion. The study focuses at young university students who have to attend long sedentary hours of teaching. This study will help in policy-making regarding sitting arrangements for students in educational setups plus need of cocurricular physical activities. This study will help to create awareness about the lack of normal flexibility maintenance, especially among students.
| Materials and Methods|| |
It was a cross-sectional study comprised over a period of 24 weeks. Bliss software was used for calculating sample size, with the power of 90 and two-tailed level of significance 0.05 based on the mean straight leg raising (SLR) value of the pilot study. As per sample size calculation, 200 students were included in this study using probability sampling for data collection. We had selected only those students who have more than 6 h of sitting and their age range between 16 and 30 years. Students with any recent trauma history (within last 3 months), previous surgery, acute spasm of hamstring muscles, any spinal deformity or any limb length discrepancy, congenital or acquired anomalies, or neuromuscular disorders of the lower extremity were excluded from this study.
Two hundred students fulfilling the inclusion criteria were included. After taking consent and necessary personal data including name, age, sex, weight, and height, sitting hours per day were inquired. Angle of SLR (passive SLR) was measured with the help of a universal goniometer. After proper positioning on therapeutic couch, the leg was raised passively while keeping the knee in extension. The angle subtended at the hip joint was measured for both extremities, and mean was calculated.
For the measurement of popliteal angle, active knee extension test was used. After proper positioning, the hip was flexed at an angle of 90°, and the participant was asked to extend his/her leg at the knee joint. The angle subtended at the knee joint was measured. The measurement was taken for both lower extremities and then mean was recorded.
All data were presented and evaluated using SPSS version 16 (Released 2007. SPSS for Windows, SPSS Inc., Chicago). Mean and standard deviation was used for presenting quantitative data. Contrarily, percentages and frequency tables were used for qualitative data.
Pearson's correlation analysis was used to see the correlation between sitting hours and tightness of hamstrings. Chi-square analysis was also used to see associations in qualitative variables. P< 5% is considered as significant.
| Results|| |
Two hundred healthy university students fulfilling the inclusion criteria were examined for hamstring tightness. The basic demographic data of participants are shown in [Table 1].
|Table 1: Demographic data of students presented in mean±standard deviation and range|
Click here to view
The most number of 44 students had SLR angle at 55. The mean value of straight raising angle 61 ± 10.22 was observed [Figure 1]. The mean value of popliteal angle was observed as 47.7° ± 8.07° [Figure 2].
There were 79 (39.5%) students who had 6–8 chair sitting hours per day while the students with 8–12 chair sitting hours were 54 (27%). There were 43 (21.5%) students who had 10–12 chair sitting hours per day.
An inverse correlation was found between SLR and chair sitting hours (r = −0.56, P = 0.000) [Figure 3].
|Figure 3: Correlation of chair sitting hours per day with mean of straight leg raising (r = −0.56, P = 0.000)|
Click here to view
The mean value of popliteal angle of students with 6–8 h of sitting was observed as 45.41° ± 7.79° [Table 2].
|Table 2: Description about chair sitting hours in relation with tightness according to popliteal angle of students|
Click here to view
| Discussion|| |
This study is one of its own kinds providing basic information regarding impact of extended sitting on hamstring flexibility. To our knowledge, no such study is conducted to observe the impact of extended sitting on flexibility in educational setups, especially in young and healthy, asymptomatic university students. The important finding was an alarming high rate of hamstring tightness among most of students, and a significant positive correlation found among extended sitting hours and hamstring tightness.
The mean value of straight raising angle 61 ± 10.22 was observed in the results of the current study which falls below the border line and shows tightness of hamstring while Adar found the average SLR in the whole research population to be 65.4°, which is approximately 15° below the normal standard. There is a difference of 5° on average between two studies, but it is consistent with the findings of study conducted by Adar who claims that hamstring tightness increases with the increasing age. Adar in his study took data from 303 primary school pupils aged 7–13 years  while mean age of students in the current study was 20.3 ± 1.63 years. Same finding was supported by Akinpelu et al. who claimed in his study that hamstring tightness has a tendency to increase with age up to the age of 30–49 years. In turn, it can lead to muscle weakness. Different researchers studied that long-term strength training can improve muscle strength in elderly.,
In a study conducted by Mistry et al., a correlation coefficient of r = −0.526 was observed with P< 0.001, showing a significant moderate and negative correlation between hamstring tightness and age among males. For females, value of correlation coefficient was r = 0.219 and P = 0.174 showing weak negative correlation between age and hamstring tightness. Another study claims that maximum flexibility is found in the mid-twenties for both males and females, and maximum tightness is observed after the 40s. Contrary to this claim, we found a significant reduction in flexibility in young population in their twenties. One main reason for this is prolonged sitting hours and sedentary lifestyle of students.
It was hypothesized in the current study that tightness of hamstring is a very common problem in students, especially the students having prolonged sitting hours, and in results, it was seen that majority of the population have hamstring tightness. One hundred and sixty-two (82%) students had tightness according to SLR. Only a minor percentage 18% of student had range above borderline, and a significant difference was seen between the popliteal angle and chair sitting hours, i.e., P = 0.010. This trend was also seen in studies conducted by Adar and Akinpelu et al., and they also documented hamstring tightness to be a common problem and found all the subgroups to present with hamstring tightness., Another study conducted among adolescents also found hamstring tightness to be a common complaint.
In another study conducted among young military men, 600 men were examined for hamstring tightness, and hamstring tightness was a very common complaint among this population too. In SLR testing, only 43% right legs examined and 35% left legs examined reached the normal SLR range. More than half of population showed a reduction in flexibility, and this is in accordance with the findings of the current study.
In the current study, it was seen that there is a tendency of increase in hamstring tightness with increase in the sitting hours. Highly significant difference between mean of SLR angle and chair sitting hours per day, i.e., P = 0.000 was seen. Adar also claimed prolonged sitting to be a main danger for the development of hamstring tightness, and according to the results of his study, a decrease in the range of hamstrings was seen with increase in the number of sitting hours (P = 0.007), and overall reduction in flexibility of the hip and pelvis was seen with increase in sitting hours  (P = 0.002).
On the opposite note, Arab claimed that there is no impact of work setting and sedentary lifestyle in the development of hamstring tightness, especially in low back pain patients. Flexibility of hamstring muscles is not affected by the work environment or the lifestyle adopted. The difference in findings with the current study can be due to a larger age range of 20–65 years and diverse population working in different work settings.
Uniform age group and same educational setup are the strengths of this study. However, the main limitation is methodological as the study is a cross-sectional study, and it cannot establish extended sitting as a main cause of hamstring tightness. Many other etiological factors can be responsible for reduced flexibility. Further research with more vigorous methodology is required to establish a cause-effect relationship between sitting hours and hamstring tightness. We concluded that long sitting hours may be a contributing factor for reduced hamstring flexibility. However, further studies are required with a large sample size to get deep insight about cause effect relationship.
| Conclusion|| |
It is concluded that tightness of hamstrings is observed in a majority of the students. Long-duration sitting can be a contributory factor in hamstring tightness.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Phrompaet S, Paungmali A, Pirunsan U, Sitilertpisan P. Effects of pilates training on lumbo-pelvic stability and flexibility. Asian J Sports Med 2011;2:16-22.
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. [Full text]
Weerasekara I, Kumari I, Weerarathna N, Withanage C, Wanniarachchi C. The prevalence of hamstring tightness among the male athletes of University of Peradeniya in 2010, Sri Lanka. Int J Phys Med Rehabil 2013;1:2.
Houston MN, Hodson VE, Adams KK, Hoch JM. The effectiveness of whole-body-vibration training in improving hamstring flexibility in physically active adults. J Sport Rehabil 2015;24:77-82.
Vidhi S, Anuprita T, Asmita K, Twinkle D, Unnati P, Sujata Y. Comparison of PNF technique with NDS technique for Hamstrings tightness in asymptomatic subjects. Indian J Physiother Occup Ther 2014;8:158.
Kage V, Ratnam R. Immediate effect of active release technique versus mulligan bent leg raise in subjects with hamstring tightness: A randomized clinical trial. Int J Physiother Res 2014;2:301-4.
Gajdosik RL, Hatcher CK, Whitsell S. Influence of short hamstring muscles on the pelvis and lumbar spine in standing and during the toe-touch test. Clin Biomech (Bristol, Avon) 1992;7:38-42.
Labovitz JM, Yu J, Kim C. The role of hamstring tightness in plantar fasciitis. Foot Ankle Spec 2011;4:141-4.
Hopper D, Deacon S, Das S, Jain A, Riddell D, Hall T, et al.
Dynamic soft tissue mobilisation increases hamstring flexibility in healthy male subjects. Br J Sports Med 2005;39:594-8.
Radwan A, Bigney KA, Buonomo HN, Jarmak MW, Moats SM, Ross JK, et al
. Evaluation of intra-subject difference in hamstring flexibility in patients with low back pain: An exploratory study. J Back Musculoskelet Rehabil 2015;28:61-6.
Whitley CR, Dufek JS. Effects of backward walking on hamstring flexibility and low back range of motion. Int J Exerc Sci 2011;4:4.
Massoud Arab A, Reza Nourbakhsh M, Mohammadifar A. The relationship between hamstring length and gluteal muscle strength in individuals with sacroiliac joint dysfunction. J Man Manip Ther 2011;19:5-10.
Nishikawa Y, Aizawa J, Kanemura N, Takahashi T, Hosomi N, Maruyama H, et al.
Immediate effect of passive and active stretching on hamstrings flexibility: A single-blinded randomized control trial. J Phys Ther Sci 2015;27:3167-70.
Kaur G, Reza MK. Efficacy of eccentric training and muscle energy technique on hamstring flexibility in sedentary college students. Indian J Physiother Occup Ther 2013;7:93.
Loutsch RA, Baker RT, May JM, Nasypany AM. Reactive neuromuscular training results in immediate and long term improvements in measures of hamstring flexibility: A case report. Int J Sports Phys Ther 2015;10:371-7.
Krohn K, Castro D, Kling J. The effects of kinesio tape on hamstring flexibility. Logan edu 2011; 1-12.
Adar BZ. Risk Factors of Prolonged Sitting and Lack of Physical Activity in Relate to Postural Deformities, Muscles Tension and Backache among Israeli Children. A Clinical Cross Sectional Research. Semmelweis University Budapest Doctoral School. 2004. p. 66.
Akinpelu AO, Bakare U, Adegoke BO. Influence of age on hamstring tightness in apparently healthy Nigerians. J Niger Soc Physiother 2005;115:35-41.
Qamar MM. Long-Term Strength Training Reverses the Effects of Aging on Skeletal Muscle of Health Elderly Men [D]. School of Health and Medical Sciences. Orebro University; 2012.
Qamar MM, Qamar MF. Strength training restores morphological changes occur during aging. Med Channel 2014;20:79-82.
Mistry GS, Vyas NJ, Sheth MS. Correlation of hamstrings flexibility with age and gender in subjects having chronic low back pain. Int J Ther Rehabil Res 2014;3:1.
Muyor JM, López-Miñarro PA, Casimiro AJ. Effect of stretching program in an industrial workplace on hamstring flexibility and sagittal spinal posture of adult women workers: A randomized controlled trial. J Back Musculoskelet Rehabil 2012;25:161-9.
Harreby M, Nygaard B, Jessen T, Larsen E, Storr-Paulsen A, Lindahl A, et al.
Risk factors for low back pain in a cohort of 1389 Danish school children: An epidemiologic study. Eur Spine J 1999;8:444-50.
Hellsing AL. Tightness of hamstring- and psoas major muscles. A prospective study of back pain in young men during their military service. Ups J Med Sci 1988;93:267-76.
Arab AM, Nourbakhsh MR. Hamstring muscle length and lumbar lordosis in subjects with different lifestyle and work setting: Comparison between individuals with and without chronic low back pain. J Back Musculoskelet Rehabil 2014;27:63-70.
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]