Immediate and short term (24hour) effects of myofascial cupping and therapeutic laser therapy on pain, pressure pain threshold, and range of motion in university students with active hamstring trigger points. A randomized controlled trial

This randomized controlled trial aims to compare the immediate and 24-hour effects of Myofascial Cupping Therapy and Therapeutic Laser Therapy on pain and flexibility in university students with active hamstring trigger points.

Myofascial trigger points in the hamstring muscles are a common cause of musculoskeletal pain and reduced flexibility among university students, often associated with prolonged sitting, poor posture, and decreased physical activity. Active trigger points can lead to localized tenderness, decreased pressure pain threshold, muscle tightness, and restricted range of motion, which may negatively affect functional performance and daily activities trigger points.

Hamstring tightness is a common musculoskeletal condition observed among university students, particularly those leading a sedentary lifestyle. Historically, increased academic demands, prolonged sitting during lectures, extended screen time, and reduced participation in regular physical activity have contributed significantly to decreased hamstring flexibility in young adults. The hamstring muscles, located at the posterior aspect of the thigh, play a vital role in hip extension and knee flexion. When these muscles remain in a shortened position for prolonged periods—such as during sitting—they gradually adaptively shorten, leading to tightness.

In university populations, the prevalence of hamstring tightness has increased over recent decades due to lifestyle changes, including reduced outdoor activities and increased dependence on digital devices. Poor ergonomic posture while studying, lack of structured stretching routines, and sudden engagement in recreational sports without proper warm-up further aggravate the condition. Female students may also exhibit reduced flexibility due to physical inactivity, although tightness affects both genders.

  Myofascial Cupping Therapy

Cupping therapy is a traditional therapeutic technique that has been used for centuries in various medical systems, including traditional Chinese and Middle Eastern medicine. In modern physiotherapy practice, myofascial cupping therapy is used as a non-invasive manual intervention to manage musculoskeletal pain and soft tissue dysfunction. The technique involves placing specially designed cups on the skin and creating negative pressure (suction), which lifts the skin and superficial fascia away from the underlying tissues.This decompressive effect is believed to increase local blood circulation, promote lymphatic drainage, reduce muscle tightness, and improve fascial mobility. In musculoskeletal conditions such as myofascial trigger points, cupping therapy may help decrease pain intensity by stimulating mechanoreceptors and activating pain-modulating pathways. It is commonly applied in cases of back pain, neck pain, sports injuries, and muscle tightness. The therapy is generally safe when performed by trained professionals, though temporary skin discoloration may occur due to capillary dilation.

 Low-Level Laser Therapy (LLLT) or photobiomodulation therapy, is a non-invasive physiotherapy modality used to manage pain, inflammation, and soft tissue injuries. It involves the application of specific wavelengths of light energy to affected tissues using a handheld probe.

The laser light penetrates the skin and interacts with cells to stimulate mitochondrial activity, leading to increased production of adenosine triphosphate (ATP). This process enhances tissue repair, reduces inflammation, improves microcirculation, and modulates pain signals. Laser therapy is widely used in the treatment of musculoskeletal disorders, including tendinitis, ligament sprains, joint pain, and myofascial trigger points.

Participants: 128 eligible participants will be randomly allocated into two groups. Group A (n-64) will receive a single session of Myofascial Cupping Therapy applied directly over the identified hamstring trigger point. This technique uses negative pressure to lift the skin and underlying fascia, potentially improving local blood circulation, reducing muscle stiffness, enhancing tissue mobility, and modulating pain perception through neurophysiological mechanisms.

Group B (n-64) will receive a single session of Therapeutic Laser Therapy applied over the same trigger point region. Laser therapy works through photobiomodulation, which may stimulate cellular metabolism, increase ATP production, reduce inflammation, and decrease pain transmission.

Outcome measures will include pain intensity (measured using a standardized pain scale), pressure pain threshold, and hamstring flexibility or range of motion. Assessments will be conducted at baseline, immediately after treatment, and at 24-hour follow-up to determine short-term effects.

The primary objective of the study is to determine which intervention is more effective in reducing pain and improving flexibility in the short term. The findings may provide evidence-based guidance for physiotherapists in selecting appropriate, non-invasive treatment approaches for managing hamstring trigger points in university student.