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The human physiological function and the anatomical composure purely rely on the flexibility of the muscles. With limited flexibility, the body experiences a lot of overuse on the muscles, including the tendons and even the blood vessels. This may lead to very serious complications. Thus, the core principle of this study is to research the effectiveness of the practice of restructuring the muscles after the hamstring incidence, especially in the sports field.

This factor is very important in the development and functioning of the human health, both physically and emotionally. Muscular tightness is a predisposing factor in the development of the muscle injury. It acts as an intrinsic stage to the development of such problems in the muscles of an individual or personality sportsman. It, therefore, calls for the proper physical activities that will help the muscles to adapt accurately to the eventual overuse in the field of sport. In the health sector and sports field, muscles tendinous strains are very common among people.

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Hamstring injuries are common to the sporting arena and are very frequent in activities that involve issues like running, kicking, jumping, or sprinting. The incidences of hamstring strains range from between 8 percent and 34 percent with very high recurrent rates. It is indeed the most common injury in athletes, especially the sprinters. Inadequate flexibility in the training sessions has been seen as the predisposing factor to the development of hamstring in most athletes in the current society.

Worrell and Perrin (1992) have proposed a very workable theoretical model used in hamstring strains. They suggest that these stains result from the complex interaction of the four etiologic factors. These factors are as follows.

1. Warm up;

2. Fatigue;

3. Strength; and

4. Flexibility.

It is vital for the athletes to perform some stretching exercises before the actual sporting activity begins. This is because the stretching activities will greatly increase the flexibility of the muscles and at the same time reduces the stiffness of the muscles in the long run. The maintenance of the normal muscle length requires a very regular stretching in order to prevent the stiffness of the muscles during the strenuous exercise or the actual practice in the field. The individual will then benefit from the decreased risk of musculoskeletal injuries and, thus, enhance the major physical performance.

Muscular flexibility is an essential aspect of normal human function. Limited flexibility has been proven to predispose a person to several musculoskeletal overuse injuries and, as a result, may affect a function level of a person. Muscular tightness is considered to be an intrinsic risk factor for the muscle injury development. Musculo tendinous strains are the most frustrating and prevalent injuries that occur among health care professionals and athletes.

Hamstring strain injuries are common in the sporting arena and frequently occur in activities, such as running, sprinting, jumping or kicking. As documented in several studies, the incidence rates of hamstring strains range between 7.7% and 30%, with relatively high recurrence rates between 18% and 34%. Injury surveillances have found hamstring injuries to be the most common injury in athletics (especially in sprinters), soccer, Australian Rules football, cricket, touch football, hurling (Watson, 1996), the rugby. Using an injury definition as that preventing player participation in a match, as a percentage of total injuries occurring, prevalence has been measured between 11% (Stretch, 2003) and 15% in cricket, 11% , 12% †in soccer, and 16% in Australian Rules football.

The lack of flexibility has been suggested as a predisposing factor to hamstring strains. Worrell and Perrin (1992) proposed a theoretical model for hamstring strains. Scholars consider that they result from a complex interaction of four etiologic factors: warm-up, strength, fatigue, and flexibility. To prevent muscle injuries, stretching exercises before sports activities are usually recommended. Reasons for stretching relate to beliefs that stretching exercises will increase flexibility and decrease muscle stiffness.

In order to maintain normal muscle length, r regular stretching is required to prevent muscle stiffness, to benefit from the decreased risk of musculoskeletal injuries, and to enhance physical performance. Previous studies concerning muscle stiffness suggest that, at a given muscle length, cyclic stretching will reduce the force that is placed upon the muscle and associated connective tissue. Theoretically, less tension will be applied within the musculo tendinous tissue when it is subjected to the changes in the joint motion that accompany sport or recreational activity. Thus, the potential for musculo tendinous strain throughout the normal range of motion will be reduced by elongation of the musculo tendinous unit.

Considering the importance of hamstring flexibility in general and athletic population, maintaining the flexibility of hamstring muscle is of utmost importance for health care professionals, and to achieve this goal, one needs to know the most effective and efficient technique to gain hamstring flexibility. Numerous investigations establish PNF techniques as more effective than traditional stretching exercises suggested for flexibility enhancement or a range of motion.

The significant improvements have been noted in the hamstring flexibility when PNF stretching techniques are incorporated in comparison to slow stretch, ballistic stretch, and static stretch. The study done by Etnyre et al (1988) has compared the two PNF techniques viz. contract relax & contract relax antagonist contract PNF stretching techniques. It is worth noting that no study has compared the effectiveness of hold relax and contract relax antagonist contract PNF techniques. So, the purpose of this experimental study is to compare the effectiveness of two PNF stretching techniques viz. hold relax & contract relax antagonist contract techniques in improving the hamstring flexibility.

Introduction to the Chapter

It is documented in several studies that, at a specific muscle length, cyclic stretching reduces the force placed on the muscle and associated connective tissue. Theoretically, there will be less tension applied within the musculo tendinous tissue when subjected to the transformations in joint motion that accompany sport or recreational activities. Therefore, the potentiality for musculo tendinous strain all through the normal range of motion will be decreased by the elongation of the musculo tendinous unit.

Stretching Methods

Several techniques of stretching have been applied by the coaches, athletic trainers, and physical therapists in creating a good arena for the athletes to practice. Three methods have been documented for the process of stretching. It is according to the following.

Ballistic Stretching (BS)

This uses a momentum developed through the bouncing of several movements in order to increase the tensile force to the tendons supporting the muscles as it approaches its maximum length. It is the most likely mode to cause injury to the athletes in a broader sense. This is because it can exceed the extensibility limits of the muscle tendon unit in a destructive and uncontrolled manner. These rapid movements will probably invoke a strong myotactic stretch reflex in the muscle that is stretched. This resulting in the sudden increase in the muscle tension will reduce the extent to which the muscle will be lengthened and, thus, increase the chance of injury to both the tendon and the muscle. Ballistic stretching does not allow for neurological adaptations to take place. It implies that this method has not been fully advocated for use in the contemporary society.

Static Stretching

It is the stationery stretching that is held for a specific period of time. The specific joints are locked at positions that place the connective tissues and muscles at their greatest possible length. This takes advantage of the inverse myotactic reflex. This, in turn, promotes muscle relaxation and, thus, leads to further stretch and range of motion (ROM). The controlled and slow movement allows the act of stretching to be performed safely and with reduced risk to injury in comparison to other forms of stretching.

†Proprioceptive Neuromuscular Facilitation (PNF)

It is an advanced form of flexibility training which involves both the stretching and contraction of the muscle group being targeted. It was originally developed as a form of rehabilitation. As some variations of PNF stretching are distinguished, there is one thing in common; they all facilitate muscular inhibition. Various PNF techniques based on Kabatís concept are: Contract Relax (CR), Contract Relax Antagonist Contract (CRAC), and Hold Relax (HR).

Hold Relax (HR) technique is an isometric contraction to the shortened muscle against the maximum resistance followed by a relaxation phase. The contract relax technique includes the concentric contraction of the shortened muscle and then relaxation phase while in Contract Relax - Agonist Contract (CRAC) technique - isometric contraction of the shortened muscle followed by relaxation and later concentric contraction of the opposing muscle or muscle group.

Mechanics of Stretching

Stretching is very important in the training of exercise and the therapeutic regiment to most illnesses in the human body. It increases the joint range of motion. The improvements in the imaging of the soft tissue, as well as the measurement of force technology have been at the forefront of allowing the biomechanical studies to try and explain the effect of stretch on the tendon of the muscles in the body. This will, in turn, affect the muscle performance at greater heights. These insights would be very useful in the management of several conditions in the world. It will boost the confidence of the health professionals at combating problems related to exercise.

Muscle Tension Biomechanics

The tension at the skeletal muscles originates from two mechanical sources. These are the active source and the passive source. The active source simply comes from the contractile effects of the force generated from the interaction from both the actin and myosin fibres. On the other hand, the passive source arises from the connective tissue parts of the skeletal muscles, especially when elongated beyond the resting length. The two sources are, however, inseparable because the connective tissue matrix of the muscle is very complex in nature. This is because of the anatomical positions of the human body. The actin components have some elastic components that make it difficult to categorize what type exactly causes the tension or stretching in the muscle fiber.

Most people are knowledgeable about the electro mechanical and hyperbolic force velocity properties of the muscle that also complicate the production of the muscle forces in the physical activities. Most biochemical models of the muscle use the technique developed by Hill that includes a series of several components of the elastic forces to account for the confusing passive sources of the tensional intrigues. This will help in the evaluation of the interaction of the active and passive sources of the tensional torso. It dwells on the muscle length dependent properties since this gives a clear picture of the mechanical property that is related to the stretching exercises. This force and moment of the force at the axis of the joint is created by the specific muscle or the muscle group. It is the best example and experiment to investigate both the active and passive forces.

Biomechanics has been used in the description of the active and passive components of the muscle as being the length tension relationship of the very muscle. The active tension of the skeletal muscle has about tree limbs or regions. These are the ascending, the descending, and the plateau. The passive source, on the other hand, increases in an exponential fashion as illustrated in Figure 1. These studies were developed using tissue preparations from animal specimens but can be very instrumental to the human physical health. A number of in-vivo studies of the human muscle groups have been documented, especially with the flexor muscles. There is a connection between the data on the issues bordering the passive and the active sources of tension on the human body.

When the connective tissue like the ligaments and the tendon samples are stretched to total failure in machines and materials, then a variety of several variables can be deduced from such experiments, due to the response in a mechanical manner. These variables include issues like peak forces, elongation, stiffness, elasticity, and energy. Cadavers have been used to show the viability of such studies in the contemporary laboratories. The reaction between these two forces of tension is very complex and, thus, can lead to several different and complicated situations when a lot of stretching is propagated upon the muscle ligaments.

Effects of Stretching

When a muscle is stretched using any of the techniques like static, dynamic, or the PNF, some short term effects could arise from the same muscle. Acute or short term effects on the muscle relate to the changes in the performance of the muscle within the first few hours of exercise. This section will look at the factors that affect the acute response of the muscle to the stretching effect. It goes further to depend purely on the biomechanical performance of variance of the interest. Some biomechanical variables, like range of motion, have also been shown to improve as a result of the stretching effect. Some also appear to be unaffected by the same effect.

The passive tension purely depends on the rate of stretch where this dependency implies that the tensile strength resistance in a muscle depends wholly on the timing on the stretch. This is referred to as the viscoelasticity. This is shown in Figure 2. Stiffness is the measure of elasticity of a material and is defined as the slope to the stress and strain load deformation curve just as illustrated in Figure 2. The load slope curves to the viscoelastic materials are very complex within several regions. The region called the toe region is considered the initial quick elongation with very minimal rise in the force applied to the very muscle. This is followed by the non-linear region and, finally, the elastic region where the curve begins to approximate a straight line. If the tissues under this effect were pulled to failure, the curve would show a plastic region where the curves would eventually flatten to a permanent damage to the tissue.

At moments of normal activities, most ligament and tendon strain are typically between 2 and 5 percent strain in that they occur in the toe and simply before the elastic regions of the curve. The viscoelastic response to the muscles, ligaments, and tendons means that a slow stretch will create less passive tension than a very fast stretch to the same length. Stretching creates a very acute increase in the joint range of motion that tends to persist for more than 60 to 90 minutes. This short term increase in the static flexibility is related to the increase in stretch tolerance. It means that the increased motion range may be related with an analgesic effect that will allow an individual to tolerate higher levels of passive tension needed for the elongation of the stretch further.

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