Effects of Manual Therapy Techniques on Hamstring

Hamstring muscle strength of the participants was measured with a dynamometer (Microfet 2, Hoggan Health Industries, HHD) with the knee flexed at 90 degrees. After the physiotherapist fixes and positions the dynamometer 5 cm proximal to the calcaneus with a belt, the participant will be asked to accelerate to maximum isometric strength by trying to bring his heel closer to his hip against this resistance. The isometric strength of the hamstring muscle will be measured in Newtons (N) by being asked to wait at maximum force level for three seconds. Measurements were made in 2 repetitions and the highest value was noted. There will be a 30-second rest period between attempts.

The Sit and Reach Test will be administered to evaluate flexibility. Measurements will be made with a test stand with a length of 35 cm, a width of 45 cm and a height of 32 cm. The measurement of the participant who cannot reach the zero point of the sole of the foot on this tripod will be recorded as minus (-), while the measurement of the participant who can pass the zero point will be recorded as plus (+). Participants will be seated in a long sitting position with the soles of their feet resting on the testing apparatus, and the measurement will begin with their knee joints fully extended. While leaning his body forward, he will be asked to lie forward as far as he can, with his hands in front of his body, without bending his knees. The test will be repeated 2 times and the best value will be recorded in cm.

Joint range of motion measurement of the participants was made with a universal goniometer. Degree was used as the measurement unit. The measurement was made in the prone position. The pivot point of the goniometer is placed on the lateral epicondyle of the femur, and the fixed arm is kept parallel to the lateral midline of the femur, while the movable arm will follow the fibula. The joint range of motion of the participants was measured before and after manual therapy. AAOS (American of Orthopedic Surgeons) was taken as the reference value.

A percussion massage device was used in the study. Massage application was applied to the Hamstring muscle, adhering to optimal standards. During the application, a wide round head, which is the most preferred by clinical professionals, was used and 30 Hz, which is considered as the average application speed, was used. The application was applied for a total of 6 minutes, 2 minutes for each part of the muscle. Applications have been made many times on every part of the muscle, from the starting point to the ending point.

Anterior and posterior innominate muscle energy techniques were performed on patients. In the anterior technique, the patient lay on their back with their leg on the diagonal shoulder. The clinician flexed the hip and knee, placed their hand on the back thigh, and instructed the patient to push, resulting in hip extension. After eight seconds, the patient inhaled and exhaled. The clinician then increased hip flexion and applied pressure against a new barrier. In the posterior technique, the patient lay on their side in the modified sims position. The clinician held the leg with their caudal hand and placed the hypothenar edge of their cranial hand on the right SIPS. The patient then pulled the leg towards themselves, applying equal counterforce for eight seconds before inhaling and exhaling. Finally, the clinician extended the leg and pushed it against a new barrier.