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PREVALENCE AND SEVERITY OF HAMSTRING TIGHTNESS AMONG COLLEGE
STUDENT: A CROSS SECTIONAL STUDY
Article in International Journal of Clinical and Biomedical Research · January 2018
DOI: 10.5455/ijcbr.2018.42.14
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Original Article
PREVALENCE AND SEVERITY OF HAMSTRING TIGHTNESS AMONG COLLEGE
STUDENT: A CROSS SECTIONAL STUDY
Bhagyashree K. Koli 1 , Deepak B. Anap 2
1
PG Student, 2Professor and Head, Department of Musculoskeletal Physiotherapy,
Dr Vithalrao Vikhe Patil Foundations College of Physiotherapy, Ahmednagar, Maharashtra, India.
ABSTRACT
Background: Flexibility is important for normal biomechanical function. Muscle tightness is caused by a decrease in
the ability of the muscle to deform. Hamstring tightness leads to high risk of recurrent injury, decreases the perfor-
mance in athletes, lead to post-exercise soreness and decreases coordination among athletes. Hence, the objectives
of this study was to find out the prevalence and severity of the hamstring tightness among college going student.
Method: In this cross sectional study 50 participants with hamstring tightness were included using purposive sam-
pling. The tightness was measured by AKE test. Three measurement were taken and average of their reading was
noted. Result: Analysis showed higher prevalence of hamstring tightness among college students. More students
were affected with AKE angle between 30o-45o. Conclusion: Prevalence of hamstring tightness is very high in college
going student of age group 18-25 years.
KEYWORDS: Prevalence; Active knee extension test; Hamstring Tightness severity.
INTRODUCTION
Flexibility is considered an essential element of normal pelvis in standing due to attachment of hamstring mus-
biomechanical function. Hamstring tightness leads to cle is on ischial tuberosity. Tightness in hamstring mus-
high risk of recurrent injury, decreases the perfor- cle causes posterior pelvic tilt which lead to decrease in
mance in athletes, lead to post-exercise soreness and lumbar lordosis result in low back pain *4+. This study
decreases coordination among athletes *1+. There is was undertaken as there is lack of literature on preva-
higher percentage of prevalence of hamstring tightness lence and severity of hamstring tightness among col-
in right lower extremity *2+. The hamstring muscles are lege going student. Hence purpose of the study was to
commonly linked with movement dysfunction at the find hamstring tightness among college going student.
lumbar spine, pelvis and lower limbs, and have been MATERIAL AND METHODOLOGY
coupled with low back pain and gait abnormality *3+.
Limited flexibility causes neuro-musculoskeletal symp- Study design: This cross sectional study descriptive
toms. These musculoskeletal symptoms will lead to study
decrease in strength, stability, endurance and much
more. All these things will lead to recurrent injury and Ethics approval: Study was approved by IEC of our
might affect psychosocial aspect of the athlete *3+. Institute and written informed consent were taken
from all subjects. Detailed procedure was explained to
Decreased hamstring flexibility is a risk factor for the participants
development of patella tendinopathy and patellofemo-
ral pain hamstring injury and symptoms of muscle dam- Study location: Which was conducted at DVVPF’s Col-
age following eccentric exercise *1+. Hamstring tight- lege of Physiotherapy
ness are associated with a posterior rotation of the Sample size: which includes 50 college going students
Inclusion criteria: Sample within the age group of 18 to
DOI: 10.5455/ijcbr.2018.42.14
25 years, with a mean age of 21 years, volunteered to
participate in this study. Subjects with at least 15° loss
eISSN: 2395-0471 of knee extension, when hip held in 90° flexion were
pISSN: 2521-0394 included in the study.
Correspondence: Bhagyashree K. Koli, PG Student, Department of Musculoskeletal Physiotherapy, Dr Vithalrao Vikhe Patil
Foundations College of Physiotherapy, Ahmednagar, Maharashtra, India. Email: [email protected]
International Journal of Clinical and Biomedical Research. © 2018 Sumathi Publications.
This is an Open Access article which permits unrestricted non-commercial use, provided the original work is properly cited. 65
Bhagyashree et al. Prevalence and severity of hamstring tightness among college student: A cross sectional study.
Exclusion criteria: Subject with any past hamstring RESULT
injury with in last 2 years, low back pain since past 2
months, lumbar and lower limb neurological compro- In this study, there were total 50 participants out of
mise were excluded which 2 were male and 48 were female whose anthro-
pometric data was collected before assessing ham-
Methodology: Active knee extension test is used to string tightness. The mean of the anthropometric data
check hamstring tightness. Participants were assessed is mentioned in table 1.
on a plinth in the supine position with both lower ex-
tremities extended. Both anterior superior iliac spines Table 1. Anthropometric data
were positioned by aligning them with the vertical bars
of the apparatus. The lower extremity not being meas- Anthropometric Age BMI
ured was secured to the plinth using a strap across the data (Years) (kg/cm2)
lower third of the thigh. The participants were told to Male 23.5±6.36 23.9±3.39
flex the hip until the thigh touched the horizontal bar
Female 22.16 ±1.29 20.9 ±4.03
While maintaining the contact between the thigh and
horizontal bar, the participants were asked to extend
Data was presented as Mean ±SD
the leg as much as possible while keeping their foot
relaxed and to hold the position for about 5 seconds. A Using the height and weight, BMI was calculated. It was
standard universal goniometer was placed over the found that 38% of the participants had high value BMI
previously marked joint axis, and the goniometer arms and 24% of participant were underweight and 38% of
were aligned along the femur and fibula *5, 7+. the participants had BMI under normal range. The data
is represented in figure 3
The AKE measurement was defined as the degree of
knee flexion from terminal knee extension. Each knee
was measured thrice, and the mean angle of the AKE
test was used for analysis. *5+
Fig 3. BMI distribution
Mean hamstring tightness in male when calculated side
wise, it was found that right side is more affected than
left. Graphical representation can be seen in figure 4
Fig 1. Starting position of AKE
Fig 4. Hamstring tightness difference in males
Fig 2. End position of AKE RLE: right lower extremity; LLE: Left lower extremity
Int. j. clin. biomed. res. 2018;4(2):65-68. 66
Bhagyashree et al. Prevalence and severity of hamstring tightness among college student: A cross sectional study.
Mean hamstring tightness in male when calculated side lence of hamstring tightness among the male athletes
wise, it was found that right side is more affected than of university of peradeniya in 2010, Srilanka prevalence
left. Graphical representation can be seen in figure 4 of hamstring tightness was present at significantly high-
er rates among athletes who are engaged in contact
sport among other measured category of sports in the
study. Within the con nes of this study it was found
that there is no significant association between ham-
string tightness and body height, femoral length, dura-
tion of warm- up and cool-down periods. Therefore
precautions to prevent hamstring tightness should be a
major concern of the athletes who are playing contact
sport *2+.
Dipesh Thakur et al conducted a study to find out the
correlation between the right and left hamstring length
in both gender to determine the prevalence of ham-
string tightness among college students. All subjects
had hamstring tightness. The result of the study con-
Fig 5. Hamstring tightness difference in females clude that there was a significant correlation between
the right and left hamstring muscle in both the group
Mean hamstring tightness in female when calculated but there was no correlation of hamstring length when
side wise, it was found that right side is more affected compared with right hamstring length between group
than left. Graphical representation can be seen in fig- and left hamstring length between group. Male subject
ure 5 had comparatively more tightness in left and in female
had in right. The linear prevalence of hamstring tight-
ness was greater in female subject when compared
with male subject *4+.
Sheetal Mahadik conducted a study prevalence of ham-
string tightness in youngster 18-25 years age– a cross
sectional study. In this study they conclude that preva-
lence of hamstring tightness in youngsters is 82% when
assessed by using active knee extension test & preva-
lence of hamstring tightness is more in female than
male *6+.
Akinpelu conducted study on influence of age on ham-
string tightness in apparently healthy Nigerian, sub-
jects' mean age was 29.63 ± 16.72 years. All subjects
had hamstring tightness (absolute extension lag) and
this increased with age up to age group 40-49 years.
The male subjects had significantly higher hamstring
tightness than the females in all the age group *5+.
Fig 6. Severity of hamstring tightness
Severity of hamstring tightness was found higher in
angle between 30O-45o. Graphical representation can National Academy of Sport Medicine said that mechan-
be seen in figure 6 ical tightness of constantly shortened or contracted
DISCUSSION state over the time muscle will adopt by becoming
physically shortened and tighter.
Lack of literature on hamstring tightness in Indian pop-
ulation made us to think about this research. The ob- Cinar suggested patella femoral pain syndrome due to
jective is to find out the Prevalence and severity of lack of hamstring flexibility. Fitzgerald result edweak
hamstring tightness among college going student. and unstable lower abdominals and spinal erectors
result in hamstring tightness *8+
From our study over all prevalence tightness is higher,
prevalence in male 4% and in female prevalence is 96% Eric Cressey June 12, 2012 concluded that anterior pel-
the large difference could be because of more female vic tilt puts a more pressure on hamstrings and this tilt
then males in our study. result in hamstring tightness in individual *9+.
Shanka weerasekara et al conducted study the preva- Result analysis shows that severity of tightness in active
Int. j. clin. biomed. res. 2018;4(2):65-68. 67
Bhagyashree et al. Prevalence and severity of hamstring tightness among college student: A cross sectional study.
knee extension test between 310- 450 68% of peoples 3)Kotteeswaran, Josyula Snigdha, Jagatheesan
are affected. Hence majority of participants were Alagesan, effect of proprioceptive neuromuscular
affected with sever tightness of hamstring. facilitation stretching and dynamic soft tissue mobili-
zation on hamstring flexibility in participants with low
Limitation of our study: Participants was not distribut- back ache - single blinded randomised controlled
ed equally according to gender, participants were only study. International journal pharmaceutics and bio
from one occupation and activity level of participants science. 2014;5(3b):228 – 233.
not assessed. Hence we recommend that further study 4)Dipesh Thakur, Sumi Rose. A study to find out the
can done with inclusion of equal number of male and correlation between the right and left hamstring
female with consideration of level of activity. length in both gender to determine the prevalence of
CONCLUSION hamstring tightness among college students. Nitte
university journal of health science. 2016; 6(4):46-52.
The prevalence of hamstring tightness is very high in 5)Akinpelu AO, Bakareu Adegokeboa Influence tight-
college going student of age group 18-25. Hence ness Nigerians of age on hamstring in apparently
awareness of hamstring stretching is important to pre- healthy - Journal of The Nigerian Society of Physio-
vent musculoskeletal problem of lower quadrant. therapy 2005;15:35 -41.
6)Sheetal Mahadik submitted a dissertation prevalence
Conflict of interest: Nil of hamstring tightness in youngster 18-25 years age–
Acknowledgment: Author are thankful to the partici- a cross sectional study to the MUHS university.
pants of study, Co-PG and supporting staff 7)Oduniaya NA, Hamzat TK, Ajai OF. The effects of
static stretch duration on the excibility of hamstring
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How to Cite this article: Bhagyashree K. Koli, Deepak B. Anap. Prevalence and severity of hamstring tightness among college
student: A cross sectional study. Int. j. clin. biomed. res. 2018;4(2): 65-68.
Int. j. clin. biomed. res. 2018;4(2):65-68. 68
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