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Effects of the addition of neural mobilization to static stretching on nerve conduction and mobility in hamstring-injured soccer players

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Abstract

Background

Hamstring injuries are the most common non-contact injury in male soccer players. Hamstring injuries may cause neuromuscular maladaptation. There are numerous treatment options available for this condition, of which a combination of muscle stretching and nerve slider intervention seems to be a promising one.

Purpose

This study examined the effects of adding sciatic nerve neurodynamic slider (NS) to sustained static stretching (SS) of the hamstring on motor nerve conduction velocity (mNCV) and lower quadrant mobility in soccer players with a previous hamstring injury (PHI).

Methods

Thirty eligible male soccer players were randomly allocated to two groups: NS plus SS and SS alone. mNCV (tibial branch of sciatic nerve) and lower quadrant mobility [passive straight-leg-raise (SLR) test, sit and reach (SR), and, knee extension angle in slump (KEA)] were examined before and after three sessions (on alternate days) of intervention.

Results

Post-intervention, there were significant time and time × group differences in mNCV, passive SLR, KEA, and SR scores for both the groups (p < 0.05), with the descriptives signifying greater improvements in the NS plus SS group.

Conclusions

The addition of NS to SS leads to greater improvements in the mNCV and lower quadrant mobility. The study's findings benefit soccer players with hamstring injuries.

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Data availability

The statistical clinical data used to support the findings of this study are included in the article.

Abbreviations

AIGS:

Abnormal impulse generating site

BMI:

Body mass index

mNCV:

Motor nerve conduction velocity

NS plus SS:

Neurodynamic sliding plus static stretching

SS:

Static stretching

KEA:

Knee extension angle

SLR:

Straight leg raise

SR:

Sit and reach

SEM:

Standard error of measurement

References

  1. Davis DS, Ashby PE, McCale KL, McQuain JA, Wine JM (2005) The effectiveness of 3stretching techniques on hamstring flexibility using consistent stretching parameters. J Strength Condition Res 19(1):27–32

    Google Scholar 

  2. Decoster LC, Cleland J, Altieri C, Russell P (2005) The effects of hamstring stretching on range of motion: a systematic literature review. J Orthop Sports Phys Ther 35(6):377–387

    Article  PubMed  Google Scholar 

  3. Liu H, Garrett WE, Moorman CT, Yu B (2012) Injury rate, mechanism, and risk factors of hamstring strain injuries in sports: A review of the literature. J Sport Health Sci 1(2):92–101

    Article  Google Scholar 

  4. Danielsson A, Horvath A, Senorski C, Alentorn-Geli E, Garrett WE, Cugat R, Samuelsson K, Senorski EH (2020) The mechanism of hamstring injuries–a systematic review. BMC Musculoskelet Disord 21(1):1–21

    Article  Google Scholar 

  5. van Dyk N, Farooq A, Bahr R, Witvrouw E (2018) Hamstring and ankle flexibility deficits are weak risk factors for hamstring injury in professional soccer players: A prospective cohort study of 438 players including 78 injuries. Am J Sports Med 46(9):2203–2210

    Article  PubMed  Google Scholar 

  6. Orchard J, Seward H (2010) Injury Report—Australian Football League. Sport Health 28(2):9–10

    Google Scholar 

  7. Arnason A, Sigurdsson SB, Gudmundsson A, Holme I, Engebretsen L, Bahr R (2004) Risk factors for injuries in football. Am J Sports Med 32(1_suppl):5–16

  8. Opar DA, Williams MD, Shield AJ (2012) Hamstring strain injuries: factors that lead to injury and re-injury. Sports Med 42:209–226

    Article  PubMed  Google Scholar 

  9. Prior M, Guerin M, Grimmer K (2009) An evidence-based approach to hamstring strain injury: a systematic review of the literature. Sports health 1(2):154–164

    Article  PubMed  PubMed Central  Google Scholar 

  10. Safran MR, Garrett JR, Seaber AV, Glisson RR, Ribbeck BM (1988) The role of warmup in muscular injury prevention. Am J Sports Med 16(2):123–129

    Article  CAS  PubMed  Google Scholar 

  11. Croisier J-L (2004) Factors associated with recurrent hamstring injuries. Sports Med 34(10):681–695

    Article  PubMed  Google Scholar 

  12. Croisier J-L, Forthomme B, Namurois M-H, Vanderthommen M, Crielaard J-M (2002) Hamstring muscle strain recurrence and strength performance disorders. Am J Sports Med 30(2):199–203

    Article  PubMed  Google Scholar 

  13. Turl SE, George KP (1998) Adverse neural tension: a factor in repetitive hamstring strain? J Orthop Sports Phys Ther 27(1):16–21

    Article  CAS  PubMed  Google Scholar 

  14. Bennell K, Wajswelner H, Lew P, Schall-Riaucour A, Leslie S, Plant D, Cirone J (1998) Isokinetic strength testing does not predict hamstring injury in Australian Rules footballers. Br J Sports Med 32(4):309–314

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Freckleton G, Pizzari T (2013) Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. Br J Sports Med 47(6):351–358

    Article  PubMed  Google Scholar 

  16. O’Connor S, McCaffrey N, Whyte EF, Fop M, Murphy B, Moran KA (2019) Is poor hamstring flexibility a risk factor for hamstring injury in Gaelic games? J Sport Rehabil 28(7):677–681

    Article  PubMed  Google Scholar 

  17. Fousekis K, Tsepis E, Poulmedis P, Athanasopoulos S, Vagenas G (2011) Intrinsic risk factors of non-contact quadriceps and hamstring strains in soccer: a prospective study of 100 professional players. Br J Sports Med 45(9):709–714

    Article  PubMed  Google Scholar 

  18. Halbertsma JPK, Mulder I, Göeken LNH, Eisma WH (1999) Repeated passive stretching: acute effect on the passive muscle moment and extensibility of short hamstrings. Arch Phys Med Rehabil 80(4):407–414

    Article  CAS  PubMed  Google Scholar 

  19. Green B, Bourne MN, van Dyk N, Pizzari T (2020) Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport. Br J Sports Med 54(18):1081–1088

    Article  PubMed  Google Scholar 

  20. DeWitt J, Vidale T (2014) Recurrent hamstring injury: consideration following operative and non-operative management. Int J Sports Phys Ther 9(6):798

    PubMed  PubMed Central  Google Scholar 

  21. Butler DS (1989) Adverse mechanical tension in the nervous system: a model for assessment and treatment. Australian J Physiothe 35(4):227–238

    Article  CAS  Google Scholar 

  22. Boyd BS, Wanek L, Gray AT, Topp KS (2009) Mechanosensitivity of the lower extremity nervous system during straight-leg raise neurodynamic testing in healthy individuals. J Orthop Sports Phys Ther 39(11):780–790

    Article  PubMed  Google Scholar 

  23. Shacklock M (2005) Improving application of neurodynamic (neural tension) testing and treatments: a message to researchers and clinicians. Man Ther 10(3):175–179

    Article  PubMed  Google Scholar 

  24. Chu SK, Rho ME (2016) Hamstring injuries in the athlete: diagnosis, treatment, and return to play. Curr Sports Med Rep 15(3):184

    Article  PubMed  PubMed Central  Google Scholar 

  25. Gabbe BJ, Finch CF, Bennell KL, Wajswelner H (2005) Risk factors for hamstring injuries in community level Australian football. Br J Sports Med 39(2):106–110

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Afonso J, Olivares-Jabalera J, Andrade R (2021) Time to move from mandatory stretching? We need to differentiate “Can I?” from “Do I have to?” Front Physiol 12:714166

    Article  PubMed  PubMed Central  Google Scholar 

  27. Meroni R, Cerri CG, Lanzarini C, Barindelli G, Della Morte G, Gessaga V, Cesana GC, De Vito G (2010) Comparison of active stretching technique and static stretching technique on hamstring flexibility. Clin J Sport Med 20(1):8–14

    Article  PubMed  Google Scholar 

  28. Balcı A, Ünüvar E, Akınoğlu B, Kocahan T (2020) The effect of different neural mobilization exercises on hamstring flexibility and functional flexibility in wrestlers. J Exerc Rehabil 16(6):503

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kornberg C, Lew P (1989) The effect of stretching neural structures on grade one hamstring injuries. J Orthop Sports Phys Ther 10(12):481–487

    Article  CAS  PubMed  Google Scholar 

  30. Méndez-Sánchez R, Alburquerque-Sendín F, Fernández-de-las-Peñas C, Barbero-Iglesias FJ, Sánchez-Sánchez C, Calvo-Arenillas JI, Huijbregts P (2010) Immediate effects of adding a sciatic nerve slider technique on lumbar and lower quadrant mobility in soccer players: a pilot study. J Altern Complement Med 16(6):669–675

    Article  PubMed  Google Scholar 

  31. Misra UK, Kalita J (2006) Clinical application of EMG and nerve conduction. Clin Neurophysiol 2:80–84

    Google Scholar 

  32. López-Miñarro PA, de Baranda Andújar PS, RodrÑGuez-GarcÑa PL (2009) A comparison of the sit-and-reach test and the back-saver sit-and-reach test in university students. J Sports Sci Med 8(1):116

    PubMed  PubMed Central  Google Scholar 

  33. Ylinen JJ, Kautiainen HJ, Häkkinen AH (2010) Comparison of active, manual, and instrumental straight leg raise in measuring hamstring extensibility. J Strength Condition Res 24(4):972–977

    Article  Google Scholar 

  34. Hengeveld E, Banks K (2013) Maitland’s peripheral manipulation e-book: management of neuromusculoskeletal disorders (Vol. 2). Elsevier Health Sciences

  35. Herrington L, Bendix K, Cornwell C, Fielden N, Hankey K (2008) What is the normal response to structural differentiation within the slump and straight leg raise tests? Man Ther 13(4):289–294

    Article  PubMed  Google Scholar 

  36. Lindell O, Eriksson L, Strender L-E (2007) The reliability of a 10-test package for patients with prolonged back and neck pain: could an examiner without formal medical education be used without loss of quality? A methodological study. BMC Musculoskeletal Disorders 8(1):1–12

    Article  Google Scholar 

  37. Bandy WD, Irion JM, Briggler M (1997) The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Phys Ther 77(10):1090–1096

    Article  CAS  PubMed  Google Scholar 

  38. Castellote-Caballero Y, Valenza MC, Puentedura EJ, Fernández-de-Las-Peñas C, Alburquerque-Sendín F (2014) Immediate effects of neurodynamic sliding versus muscle stretching on hamstring flexibility in subjects with short hamstring syndrome. J Sports Med. https://doi.org/10.1155/2014/127471

    Article  Google Scholar 

  39. Butler, David S (2000) The sensitive nervous system. Noigroup publications

  40. Coppieters MW, Butler DS (2008) Do ‘sliders’ slide and ‘tensioners’ tension? An analysis of neurodynamic techniques and considerations regarding their application. Man Ther 13(3):213–221

    Article  PubMed  Google Scholar 

  41. Nee RJ, Butler D (2006) Management of peripheral neuropathic pain: Integrating neurobiology, neurodynamics, and clinical evidence. Phys Ther Sport 7(1):36–49

    Article  Google Scholar 

  42. Devor M (1999) Pathophysiology of damaged nerves in relation to chronic pain. Textbook Pain 129–164

  43. Gifford L (2001) Acute low cervical nerve root conditions: symptom presentations and pathobiological reasoning. Churchill Livingstone

    Google Scholar 

  44. Vicenzino B, Neal R, Collins D, Wright A (1999) The displacement, velocity and frequency profile of the frontal plane motion produced by the cervical lateral glide treatment technique. Clin Biomech 14(8):515–521

    Article  CAS  Google Scholar 

  45. Vicenzino B, Collins D, Wright A (1996) The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain 68(1):69–74

    Article  PubMed  Google Scholar 

  46. Butler, David S, Jones MA (1991) Mobilisation of the nervous system. Elsevier health sciences

  47. Sunderland S (1991) Neural fibrosis. In Nerve injuries and their repair (p. 213). Churchill Livingstone, Edinburgh

  48. Dye SF (2005) The pathophysiology of patellofemoral pain: a tissue homeostasis perspective. Clin Orthopaed Related Res 436:100–110

    Article  Google Scholar 

  49. Butler DS, Shacklock MO, Slater H (1994) Treatment of altered nervous system mechanics. Grieve’s Modern Manual Therapy: The Vertebral Column. 2nd Ed. Edinburgh, UK: Livingston Churchill, 693–703

  50. LaRoche DP, Connolly DAJ (2006) Effects of stretching on passive muscle tension and response to eccentric exercise. Am J Sports Med 34(6):1000–1007

    Article  PubMed  Google Scholar 

  51. Magnusson SP (1998) Passive properties of human skeletal muscle during stretch maneuvers. Scand J Med Sci Sports 8(2):65–77

    Article  CAS  PubMed  Google Scholar 

  52. Weppler CH, Magnusson SP (2010) Increasing muscle extensibility: a matter of increasing length or modifying sensation? Phys Ther 90(3):438–449

    Article  PubMed  Google Scholar 

  53. Witvrouw E, Mahieu N, Danneels L, McNair P (2004) Stretching and injury prevention. Sports Med 34(7):443–449

    Article  PubMed  Google Scholar 

  54. Goldman EF, Jones DE (2010) Interventions for preventing hamstring injuries. Cochrane Database System Rev. https://doi.org/10.1002/14651858.CD006782.pub2

    Article  Google Scholar 

  55. Castellote-Caballero Y, Valenza MC, Martín-Martín L, Cabrera-Martos I, Puentedura EJ, Fernández-de-Las-Peñas C (2013) Effects of a neurodynamic sliding technique on hamstring flexibility in healthy male soccer players. A pilot study. Phys Ther Sport 14(3):156–162

    Article  PubMed  Google Scholar 

  56. Cleland JA, Childs JD, Palmer JA, Eberhart S (2006) Slump stretching in the management of non-radicular low back pain: a pilot clinical trial. Man Ther 11(4):279–286

    Article  PubMed  Google Scholar 

  57. Ellis RF, Hing WA (2008) Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy. J Man Manipul Ther 16(1):8–22

    Article  Google Scholar 

  58. McHugh MP, Johnson CD, Morrison RH (2012) The role of neural tension in hamstring flexibility. Scand J Med Sci Sports 22(2):164–169

    Article  CAS  PubMed  Google Scholar 

  59. Malik N, Kataria C, Sachdev NB (2012) Comparative effectiveness of straight leg raise and slump stretching in subjects with low back pain with adverse neural tension. Int J Health Rehabil Sci 1(1):2–10

    Article  Google Scholar 

  60. Balster SM, Jull GA (1997) Upper trapezius muscle activity during the brachial plexus tension test in asymptomatic subjects. Man Ther 2(3):144–149

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to admit to sincere thanks to Jamia Millia Islamia for providing logistic help during this study.

Funding

The present study was not funded by any funding agency.

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Authors and Affiliations

  1. Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India

    Saira Parveen, Sumbul Ansari & Saurabh Sharma

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  1. Saira Parveen
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Contributions

SP and SS contributed to the research idea and design. SP was involved in data collection. SP, SS and SA contributed to the data analysis. SA prepared the figures. SP, SS and SA were involved in the main manuscript formatting and drafting. All authors reviewed the manuscript.

Corresponding author

Correspondence to Saurabh Sharma.

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The authors declare that they do not have any conflict of interest pertaining to this article.

Ethical approval

All procedures in the study were carried out in accordance with the institutional/national research committee's ethical standards [Institutional Ethics Committee, Jamia Millia Islamia (4/10/100/JMI/IEC/2016)] as well as the 1964 Helsinki declaration and its subsequent amendments or comparable ethical standards.

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Written informed consent was obtained from all individual players included in the study.

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Parveen, S., Ansari, S. & Sharma, S. Effects of the addition of neural mobilization to static stretching on nerve conduction and mobility in hamstring-injured soccer players. Sport Sci Health 20, 193–201 (2024). https://doi.org/10.1007/s11332-023-01090-8

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