Comparison Between Mulligan Traction Straight Leg Raise Technique Versus Post Isometric Relaxation on Hamstring Tightness in Asymptomatic Patients

Hamstring is the common muscle which undergoes adaptive shortening when compared with other group of muscles. Hamstrings refer to the three posterior thigh muscles and its action includes hip extension and knee flexion. Limited muscle extensibility is a common problem that affects various patient populations as well as healthy individuals. The ability of an individual to move smoothly depends on his flexibility, an attribute that enhances both safety and optimal physical activities. Flexibility is an important physiological component of physical fitness, and reduced flexibility can cause inefficiency in the workplace and is also a risk factor for low back pain. Muscle extensibility is an essential element of biomechanical function. Flexibility has been defined as the ability of a muscle to lengthen and allows one joint (or more than one joint in a series) to move through a range of motion and is an essential component of normal biomechanical functioning.

The flexibility of hamstring muscle is important for general and athletic population and of almost importance for health care professionals, to achieve this goal one needs to know the most effective and efficient technique to gain hamstring flexibility. Lack of hamstring muscles extensibility conditions decrease the pelvic mobility. This invariably leads to biomechanical changes in the pressure distribution of the spine and consequent spinal disorders. Therefore, poor hamstring extensibility has been associated with thoracic hyper kyphosis , spondylolysis , disc herniation changes in lumbopelvic rhythm and low back pain. Hamstring tightness is also associated with low back and lower extremity musculoskeletal disorders leading to biomechanical changes of the pelvis and low back. The literature reports a number of associated benefits of flexibility including improved athletic performance, reduced injury risk, prevention or reduction of post-exercise soreness, and improved coordination.

Stretching techniques are the treatments used to improve muscular extensibility to improve range of motion (ROM), and can help prevent damage in daily life or sports, reduce muscle pain, and improve muscle capability. There are various treatment for the hamstring stretching like active release technique, passive stretching, static stretching, Proprioceptive neuromuscular facilitation Stretching Techniques, eccentric stretching exercises for improving hamstring flexibility.

Mulligan performs mobilization procedures while patients were moving, either actively or passively, or while they were performing a resisted muscle contraction .Indications for use of Mulligan's Traction Straight Leg Raise (TSLR) technique are limited range of motion of hip flexion together with low back pain with or without referred leg pain. The intention of this technique is to restore normal mobility. It stretches the lower extremity muscles in combination of hamstring, adductors and rotators. The Traction Straight Leg Raise technique is painless intervention that is said to have immediate benefits.

Muscle energy technique (MET) is a procedure that involves voluntary contraction of a patient's muscle in a precisely controlled direction, at varying levels of intensity. It is unique in its application as the patient provides the initial effort while the practitioner facilitates the process. The benefits of muscle energy techniques (MET) include: Restoring normal tone in hypertonic muscles, strengthening weak muscles, preparing the muscle for subsequent stretching, improved joint mobility. It includes two techniques post isometric relaxation technique and reciprocal inhibition.