Document Type : Original Article


1 Department of Physical Therapy, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

3 Baqiyatallah Research Center for gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Department of Epidemiology and Biostatistics, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran

5 Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran



Background: For decades, static stretching has been the standard benchmark for training programs, because it has been shown to increase flexibility compared with other methods of stretching.
Objective: The current study investigated and compared the effects of active dynamic stretching and passive static stretching on hamstring tightness.
Methods: For this experiment, 64 female students were enrolled and randomly assigned to active dynamic or passive static stretching groups (n = 32 each). The first and second experimental groups were trained with repetitive dynamic stretching and static stretching exercises, respectively. Exercises were performed 10 times per limb, 3 times per day, 5 days per week for 4 weeks. Hamstring muscle length measurements were repeated in weeks 2 and 4. Statistical analysis of the results was performed by t-test and repeated measures ANOVA using SPSS 15.
Results: Both experimental groups showed significant improvements in the active knee extension range of motion during the intervention (P < 0.001). However, active stretching showed better results and had a greater effect on range of motion in comparison with static stretching.
Conclusion: Active dynamic training can be considered a suitable method for increasing the flexibility of the hamstring muscle and, consequently, reducing the complications and problems associated with hamstring tightness.


  1. Buckthorpe M, Wright S, Bruce-Low S, et al. Recommendations for hamstring injury prevention in elite football: translating research into practice. Br J Sports Med. 2019;53(7):449-456. doi:10.1136/bjsports-2018-099616.
  2. Levangie PK, Norkin CC. Joint Structure and Function: A Comprehensive Analysis. Philadelphia, PA: FA Davis Co; 2005.
  3. Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. Lippincott Williams & Wilkins; 1983.
  4. Basmajian JV, Wolf SL. Therapeutic Exercise. Baltimore: Williams & Wilkins; 1990.
  5. Lu TW, Chang CF. Biomechanics of human movement and its clinical applications. Kaohsiung J Med Sci. 2012;28(2 Suppl):S13-S25. doi:10.1016/j.kjms.2011.08.004
  6. Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. Lippincott; 1999.
  7. Pooley S, Spendiff O, Allen M, Moir HJ. Static stretching does not enhance recovery in elite youth soccer players. BMJ Open Sport Exerc Med. 2017;3(1):e000202. doi:10.1136/bmjsem-2016-000202.
  8. Ayala F, Sainz de Baranda P, De Ste Croix M, Santonja F. Comparison of active stretching technique in males with normal and limited hamstring flexibility. Phys Ther Sport. 2013;14(2):98-104. doi:10.1016/j.ptsp.2012.03.013.
  9. Rani B, Mohanty PP. A comparison between two active stretching techniques on hamstrings flexibility in asymptomatic individuals. J Dent Med Sci. 2015;14(4):12-16.
  10. Ahmed AR, Samhan AF. Short term effects of neurodynamic stretching and static stretching techniques on hamstring muscle flexibility in healthy male subjects. Int J Med Res Health Sci. 2016;5(5):36-41.
  11. Cochrane DJ, Stannard SR. Acute whole body vibration training increases vertical jump and flexibility performance in elite female field hockey players. Br J Sports Med. 2005;39(11):860- 865. doi:10.1136/bjsm.2005.019950.
  12. Fakhari z, Senobari m, Jalaie s. Prevalence of hamstring and calf mucles shortness. Modern Rehabilitation. 2008;2(1):41- 46. [Persian].
  13. Koli BK, Anap DB. Prevalence and severity of hamstring tightness among college student: a cross sectional study. Int J Clin Biomed Res. 2018;4(2):65-68. doi:10.5455/ijcbr.2018.42.14.
  14. Hamid MS, Ali MR, Yusof A. Interrater and intrarater reliability of the active knee extension (AKE) test among healthy adults. J Phys Ther Sci. 2013;25(8):957-961. doi:10.1589/jpts.25.957.
  15. Gajdosik R, Lusin G. Hamstring muscle tightness: reliability of an active-knee-extension test. Phys Ther. 1983;63(7):1085- 1090. doi:10.1093/ptj/63.7.1085.
  16. Webright WG, Randolph BJ, Perrin DH. Comparison of nonballistic active knee extension in neural slump position and static stretch techniques on hamstring flexibility. J Orthop Sports Phys Ther. 1997;26(1):7-13. doi:10.2519/jospt.1997.26.1.7.
  17. Nelson RT, Bandy WD. Eccentric training and static stretching improve hamstring flexibility of high school males. J Athl Train. 2004;39(3):254-258.
  18. Bandy WD, Irion JM, Briggler M. The effect of static stretch and dynamic range of motion training on the flexibility of the hamstring muscles. J Orthop Sports Phys Ther. 1998;27(4):295- 300. doi:10.2519/jospt.1998.27.4.295.
  19. Coons JM, Gould CE, Kim JK, Farley RS, Caputo JL. Dynamic stretching is effective as static stretching at increasing flexibility. J Hum Sport Exerc. 2017;12(4):1153-1161. doi:10.14198/jhse.2017.124.02.
  20. Shaharuddin SS, Mondam S. The Effectiveness of Static and Dynamic Stretching on Hamstring Flexibility after 4-Weeks Training to Prevent the Risk of Injuries. Malays J Med Biol Res. 2015;2(3):175-181.
  21. Brotzman SB, Manske RC. Clinical Orthopaedic Rehabilitation: An Evidence-Based Approach: Expert Consult. Elsevier Health Sciences; 2011.
  22. Kisner C, Colby LA, Borstad J. Therapeutic Exercise: Foundations and Techniques. FA Davis; 2017.
  23. Youdas JW, Suman VJ, Garrett TR. Reliability of measurements of lumbar spine sagittal mobility obtained with the flexible curve. J Orthop Sports Phys Ther. 1995;21(1):13-20. doi:10.2519/jospt.1995.21.1.13.
  24. Erkula G, Demirkan F, Kiliç BA, Kiter E. Hamstring shortening in healthy adults. J Back Musculoskelet Rehabil. 2002;16(2):77- 81. doi:10.3233/BMR-2002-162-305.
  25. Shakya NR, Manandhar S. Prevalence of hamstring muscle tightness among undergraduate physiotherapy students of Nepal using passive knee extension angle test. Int J Sci Res Pub. 2018;8(1):182-187.
  26. Donatelli RA, Wooden MJ. Orthopaedic Physical Therapy. Elsevier Health Sciences; 2009.
  27. Chan SP, Hong Y, Robinson PD. Flexibility and passive resistance of the hamstrings of young adults using two different static stretching protocols. Scand J Med Sci Sports. 2001;11(2):81-86. doi:10.1034/j.1600-0838.2001.011002081.x.
  28. Funk DC, Swank AM, Mikla BM, Fagan TA, Farr BK. Impact of prior exercise on hamstring flexibility: a comparison of proprioceptive neuromuscular facilitation and static stretching. J Strength Cond Res. 2003;17(3):489-492. doi:10.1519/00124278-200308000-00010.
  29. Shadmehr A, Hadian MR, Naiemi SS, Jalaie S. Hamstring flexibility in young women following passive stretch and muscle energy technique. J Back Musculoskelet Rehabil. 2009;22(3):143-148. doi:10.3233/BMR-2009-0227.
  30. Nishikawa Y, Aizawa J, Kanemura N, et al. Immediate effect of passive and active stretching on hamstrings flexibility: a single-blinded randomized control trial. J Phys Ther Sci. 2015;27(10):3167-3170. doi:10.1589/jpts.27.3167.
  31. Winters MV, Blake CG, Trost JS, et al. Passive versus active stretching of hip flexor muscles in subjects with limited hip extension: a randomized clinical trial. Phys Ther. 2004;84(9):800-807. doi:10.1093/ptj/84.9.800.
  32. Meroni R, Cerri CG, Lanzarini C, et al. Comparison of active stretching technique and static stretching technique on hamstring flexibility. Clin J Sport Med. 2010;20(1):8-14. doi:10.1097/JSM.0b013e3181c96722.