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Extended sitting can cause hamstring tightness

Article · January 2017

DOI: 10.4103/sjsm.sjsm_5_17


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4 authors, including:

Ghulam Fatima Muhammad Mustafa Qamar

King Edward Medical University University of Sargodha


Ayesha Basharat
University of Sargodha


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Original Article

Extended sitting can cause hamstring tightness

Objective: Sedentary lifestyle has emanated as a new attention for research on exercise and health. The objective of this study was to find
the correlation between prolonged sitting (minimum 6–8 h) and tightness of hamstrings in students.
Materials and Methods: In a cross‑sectional study, 200 students were taken. Probability sampling was used on random basis to assess
the flexibility of hamstring muscles using the straight leg raising (SLR) and active knee extension test. A manual goniometer was used for range
measurement. All information was taken on predesigned pro forma.
Result: The mean age of 200 students was 20.3 ± 1.63 years. The mean value of SLR was found to be 60.97 ± 10.21, and mean value of
popliteal angle was 47.65 ± 8.06. Most of the students, 164 (82%), had tightness according to SLR test. There was a statistically significant
difference between the popliteal angle and chair sitting hours (P = 0.010), and an inverse correlation was found between SLR angle and chair
sitting hours (r = −0.56, P = 0.000).
Conclusion: Tightness of hamstrings is observed in a majority of the students. Long‑duration sitting can be a contributory factor in hamstring

Keywords: Hamstring tightness, popliteal angle, prolonged sitting, straight leg raising

INTRODUCTION and range of motion are affected by hamstring flexibility

in forward bending. Hamstring tightness also influences
Flexibility is a vital component of fitness required for most the lumbar pelvic rhythm.[7] Hamstring tightness is also
desirable musculoskeletal functioning and maximizing the associated with the development of plantar fasciitis[8] as well
performance of physical activities.[1] Flexibility dysfunction as patellar tendinopathy and patellofemoral pain syndrome.[9]
is a widespread problem faced by common as well as An association between hamstring tightness and mechanical
sportspersons, especially in case of hamstring group of low back pain is also found in studies showing a positive
muscles.[2,3] Hamstring tightness is not only a causative correlation between hamstring tightness and severity of
factor for reduced range of motion but it can also lead to low back pain.[10]
various other musculoskeletal problems.[4] Length‑tension
relationship of muscle as well as shock absorbing ability Tight hamstring muscles limit anterior tilt of the pelvis in
of the limb is affected by tightness of muscle. Reduced spinal flexion resulting in aggravated muscle and ligamentous
flexibility generates a vicious circle of range reduction and
Ghulam Fatima, Muhammad Mustafa Qamar1,
resulting increase in postural problems. Tight muscles also
Jawad Ul Hassan2, Ayesha Basharat1
compress the blood vessels and lead to reduced optimal
Department of Physiotherapy, Advance Life College of Medical
performance.[5] Sciences, Lahore, 1Department of Physical Therapy, Sargodha
Medical College, UOS, 2Bhatti International Hospital, Lahore,
Hamstring strain is one of the most commonly suspected Pakistan
complaints resulting from hamstring tightness.[6] According
Address for correspondence: Dr. Muhammad Mustafa Qamar,
to Gajdosik et  al., 2011, pelvic as well as thoracic angle Department of Physical Therapy, Sargodha Medical College,
UOS, Pakistan.

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How to cite this article: Fatima G, Qamar MM, Ul Hassan J, Basharat A.
10.4103/sjsm.sjsm_5_17 Extended sitting can cause hamstring tightness. Saudi J Sports Med

110 © 2017 Saudi Journal of Sports Medicine | Published by Wolters Kluwer - Medknow
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Fatima, et al.: Extended sitting can cause hamstring tightness

tension in the lumbar region which leads to significantly Methodology

higher compressive loads on the lumbar spine.[11] Other Two hundred students fulfilling the inclusion criteria were
postural changes associated with tightness of hamstrings included. After taking consent and necessary personal
can influence stability of sacroiliac joint in an indirect way.[12] data including name, age, sex, weight, and height, sitting
Hence, flexibility of hamstring muscles is crucial for overall hours per day were inquired. Angle of SLR (passive SLR)
well‑being and optimal physical fitness.[13] was measured with the help of a universal goniometer.
After proper positioning on therapeutic couch, the leg was
The main reason of muscular tightness is a reduction raised passively while keeping the knee in extension. The
in ability of muscle to deform, leading to a lower range angle subtended at the hip joint was measured for both
available at concerned joint for motion.[14] Tight hamstrings extremities, and mean was calculated.
are associated with a dysfunctional motor control pattern
leading to a submaximal firing pattern of postural muscles For the measurement of popliteal angle, active knee extension
resulting in function of hamstrings as stabilizers rather test was used. After proper positioning, the hip was flexed at
than their main function of prime movers. This change in an angle of 90°, and the participant was asked to extend his/
primary function leads to the presentation of hamstring her leg at the knee joint. The angle subtended at the knee
tightness.[15] joint was measured. The measurement was taken for both
lower extremities and then mean was recorded.
Many reasons can lead to the development of hamstring
tightness such as genetic predisposition, injury to muscle, Data analysis
and adaptive shortening due to some chronic condition.[16] All data were presented and evaluated using SPSS version 16
Modern sedentary style of living is one of the main reasons (Released 2007. SPSS for Windows, SPSS Inc., Chicago). Mean
for postural abnormalities evident in modern society. The and standard deviation was used for presenting quantitative
prolonged sitting hours required in most of the jobs, and data. Contrarily, percentages and frequency tables were used
educational setups can affect flexibility of soft tissues, for qualitative data.
especially two joint muscles.[5]
Pearson’s correlation analysis was used to see the correlation
The current study is aimed to verify the notion that prolonged between sitting hours and tightness of hamstrings. Chi‑square
sitting can lead to tightness of hamstrings as very rare research analysis was also used to see associations in qualitative
work is available to prove this notion. The study focuses at variables. P < 5% is considered as significant.
young university students who have to attend long sedentary
hours of teaching. This study will help in policy‑making RESULTS
regarding sitting arrangements for students in educational
setups plus need of cocurricular physical activities. This Two hundred healthy university students fulfilling the
study will help to create awareness about the lack of normal inclusion criteria were examined for hamstring tightness.
flexibility maintenance, especially among students. The basic demographic data of participants are shown in
Table 1.
The most number of 44 students had SLR angle at 55.
It was a cross‑sectional study comprised over a period of The mean value of straight raising angle 61 ± 10.22 was
24 weeks. Bliss software was used for calculating sample observed [Figure 1]. The mean value of popliteal angle was
size, with the power of 90 and two‑tailed level of significance observed as 47.7° ± 8.07° [Figure 2].
0.05 based on the mean straight leg raising (SLR) value of
the pilot study. As per sample size calculation, 200 students There were 79 (39.5%) students who had 6–8 chair sitting
were included in this study using probability sampling hours per day while the students with 8–12 chair sitting
for data collection. We had selected only those students hours were 54 (27%). There were 43 (21.5%) students who
who have more than 6 h of sitting and their age range had 10–12 chair sitting hours per day.
between 16 and 30 years. Students with any recent trauma
history (within last 3 months), previous surgery, acute An inverse correlation was found between SLR and chair
spasm of hamstring muscles, any spinal deformity or any sitting hours (r = −0.56, P = 0.000) [Figure 3].
limb length discrepancy, congenital or acquired anomalies,
or neuromuscular disorders of the lower extremity were The mean value of popliteal angle of students with 6–8 h of
excluded from this study. sitting was observed as 45.41° ± 7.79° [Table 2].
Saudi Journal of Sports Medicine / Volume 17 / Issue 2 / May-August 2017 111
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Fatima, et al.: Extended sitting can cause hamstring tightness

DISCUSSION significant moderate and negative correlation between

hamstring tightness and age among males.[19] For females,
This study is one of its own kinds providing basic information value of correlation coefficient was r = 0.219 and P = 0.174
regarding impact of extended sitting on hamstring flexibility. showing weak negative correlation between age and hamstring
To our knowledge, no such study is conducted to observe tightness.[21] Another study claims that maximum flexibility is
the impact of extended sitting on flexibility in educational found in the mid‑twenties for both males and females, and
setups, especially in young and healthy, asymptomatic maximum tightness is observed after the 40s.[22] Contrary to
university students. The important finding was an alarming this claim, we found a significant reduction in flexibility in
high rate of hamstring tightness among most of students, young population in their twenties. One main reason for this
and a significant positive correlation found among extended is prolonged sitting hours and sedentary lifestyle of students.
sitting hours and hamstring tightness.
It was hypothesized in the current study that tightness of
The mean value of straight raising angle 61 ± 10.22 was hamstring is a very common problem in students, especially
observed in the results of the current study which falls below the students having prolonged sitting hours, and in results,
the border line and shows tightness of hamstring while Adar it was seen that majority of the population have hamstring
found the average SLR in the whole research population
to be 65.4°, which is approximately 15° below the normal Table 1: Demographic data of students presented in
standard.[17] There is a difference of 5° on average between mean±standard deviation and range
two studies, but it is consistent with the findings of study Age of the Weight Height BMI
student (years) (kg) (m)
conducted by Adar who claims that hamstring tightness
Mean±SD 20.34±1.63 56.60±10.14 1.65±0.093 20.63±3.01
increases with the increasing age. Adar in his study took
Minimum 16 32 1.25 14.41
data from 303 primary school pupils aged 7–13 years[17] Maximum 27 85 1.89 35.20
while mean age of students in the current study was BMI=Body mass index, SD=Standard deviation
20.3 ± 1.63 years. Same finding was supported by Akinpelu
et al. who claimed in his study that hamstring tightness has a Table 2: Description about chair sitting hours in relation with
tendency to increase with age up to the age of 30–49 years.[18] tightness according to popliteal angle of students
In turn, it can lead to muscle weakness. Different researchers Popliteal angle (h) n Mean±SD P
studied that long‑term strength training can improve muscle 6-8 79 45.41±7.79 0.010
strength in elderly.[19,20] 8-12 54 49.16±7.78
10-12 43 48.40±8.75
In a study conducted by Mistry et al., a correlation coefficient >12 24 50.38±6.78
SD=Standard deviation
of r = −0.526 was observed with P < 0.001, showing a

50 30

44 27

37 23

20 21 21

26 26 25 17
20 15
Std. Dev = 10.22 10
10 13 10
10 11 9
Mean = 61.0 Std. Dev = 8.07

0 N = 200.00 Mean = 47.7

4 4
35.0 45.0 55.0 65.0 75.0 85.0 95.0 N = 200.00
40.0 50.0 60.0 70.0 80.0 90.0
25 .5

35 .5

45 5

55 5

65 5





Straight leg raising angle Popliteal angle

Figure 1: Range of straight leg raising angle Figure 2: Range of popliteal angle

112 Saudi Journal of Sports Medicine / Volume 17 / Issue 2 / May-August 2017

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Fatima, et al.: Extended sitting can cause hamstring tightness

66 hamstring tightness, especially in low back pain patients.[25]

Flexibility of hamstring muscles is not affected by the work
environment or the lifestyle adopted.[25] The difference in
findings with the current study can be due to a larger age
Mean of straight leg raising angle

range of 20–65 years and diverse population working in

62 different work settings.

Uniform age group and same educational setup are the

60 strengths of this study. However, the main limitation is
methodological as the study is a cross‑sectional study, and
it cannot establish extended sitting as a main cause of
hamstring tightness. Many other etiological factors can be
responsible for reduced flexibility. Further research with more
6-8hrs 8-12hrs 10-12hrs more than 12 hrs
vigorous methodology is required to establish a cause‑effect
chair sitting hours per day relationship between sitting hours and hamstring tightness.
We concluded that long sitting hours may be a contributing
Figure 3: Correlation of chair sitting hours per day with mean of straight leg
factor for reduced hamstring flexibility. However, further
raising (r = −0.56, P = 0.000)
studies are required with a large sample size to get deep
tightness. One hundred and sixty‑two (82%) students had insight about cause effect relationship.
tightness according to SLR. Only a minor percentage 18%
of student had range above borderline, and a significant
difference was seen between the popliteal angle and chair
It is concluded that tightness of hamstrings is observed in
sitting hours, i.e., P = 0.010. This trend was also seen in
a majority of the students. Long‑duration sitting can be a
studies conducted by Adar and Akinpelu et al., and they also
contributory factor in hamstring tightness.
documented hamstring tightness to be a common problem
and found all the subgroups to present with hamstring
Financial support and sponsorship
tightness.[17,18] Another study conducted among adolescents
also found hamstring tightness to be a common complaint.[23]
Conflicts of interest
In another study conducted among young military men, 600
There are no conflicts of interest.
men were examined for hamstring tightness, and hamstring
tightness was a very common complaint among this population REFERENCES
too.[24] In SLR testing, only 43% right legs examined and 35%
left legs examined reached the normal SLR range.[22] More 1. Phrompaet S, Paungmali A, Pirunsan U, Sitilertpisan P. Effects of pilates
than half of population showed a reduction in flexibility, and training on lumbo‑pelvic stability and flexibility. Asian J Sports Med
this is in accordance with the findings of the current study.[24] 2011;2:16‑22.
2. Adkitte  R, Rane  SG, Yeole  U, Nandi  B, Gawali  P. Effect of muscle
energy technique on flexibility of hamstring muscle in Indian national
In the current study, it was seen that there is a tendency of football players. Saudi J Sports Med 2016;16:28.
increase in hamstring tightness with increase in the sitting 3. Weerasekara I, Kumari I, Weerarathna N, Withanage C, Wanniarachchi C.
hours. Highly significant difference between mean of SLR The prevalence of hamstring tightness among the male athletes of
University of Peradeniya in 2010, Sri Lanka. Int J Phys Med Rehabil
angle and chair sitting hours per day, i.e., P = 0.000 was 2013;1:2.
seen. Adar also claimed prolonged sitting to be a main 4. Houston  MN, Hodson VE, Adams  KK, Hoch  JM. The effectiveness
danger for the development of hamstring tightness, and of whole‑body‑vibration training in improving hamstring flexibility in
according to the results of his study, a decrease in the range physically active adults. J Sport Rehabil 2015;24:77‑82.
5. Vidhi  S, Anuprita  T, Asmita  K, Twinkle  D, Unnati  P, Sujata  Y.
of hamstrings was seen with increase in the number of Comparison of PNF technique with NDS technique for Hamstrings
sitting hours (P = 0.007), and overall reduction in flexibility tightness in asymptomatic subjects. Indian J Physiother Occup Ther
of the hip and pelvis was seen with increase in sitting 2014;8:158.
hours[17] (P = 0.002). 6. Kage  V, Ratnam  R. Immediate effect of active release technique
versus mulligan bent leg raise in subjects with hamstring tightness:
A randomized clinical trial. Int J Physiother Res 2014;2:301‑4.
On the opposite note, Arab claimed that there is no impact 7. Gajdosik  RL, Hatcher  CK, Whitsell  S. Influence of short hamstring
of work setting and sedentary lifestyle in the development of muscles on the pelvis and lumbar spine in standing and during the

Saudi Journal of Sports Medicine / Volume 17 / Issue 2 / May-August 2017 113

[Downloaded free from on Tuesday, June 6, 2017, IP:]

Fatima, et al.: Extended sitting can cause hamstring tightness

toe‑touch test. Clin Biomech (Bristol, Avon) 1992;7:38‑42. 17. Adar BZ. Risk Factors of Prolonged Sitting and Lack of Physical Activity
8. Labovitz JM, Yu J, Kim C. The role of hamstring tightness in plantar in Relate to Postural Deformities, Muscles Tension and Backache among
fasciitis. Foot Ankle Spec 2011;4:141‑4. Israeli Children. A  Clinical Cross Sectional Research. Semmelweis
9. Hopper D, Deacon S, Das S, Jain A, Riddell D, Hall T, et al. Dynamic University Budapest Doctoral School. 2004. p. 66.
soft tissue mobilisation increases hamstring flexibility in healthy male 18. Akinpelu AO, Bakare U, Adegoke BO. Influence of age on hamstring
subjects. Br J Sports Med 2005;39:594‑8. tightness in apparently healthy Nigerians. J  Niger Soc Physiother
10. Radwan A, Bigney KA, Buonomo HN, Jarmak MW, Moats SM, Ross JK, 2005;115:35‑41.
et al. Evaluation of intra‑subject difference in hamstring flexibility in 19. Qamar MM. Long‑Term Strength Training Reverses the Effects of Aging
patients with low back pain: An exploratory study. J Back Musculoskelet on Skeletal Muscle of Health Elderly Men [D]. School of Health and
Rehabil 2015;28:61‑6. Medical Sciences. Orebro University; 2012.
11. Whitley  CR, Dufek  JS. Effects of backward walking on hamstring 20. Qamar  MM, Qamar  MF. Strength training restores morphological
flexibility and low back range of motion. Int J Exerc Sci 2011;4:4. changes occur during aging. Med Channel 2014;20:79‑82.
12. Massoud Arab  A, Reza Nourbakhsh  M, Mohammadifar  A. The 21. Mistry GS, Vyas NJ, Sheth MS. Correlation of hamstrings flexibility
relationship between hamstring length and gluteal muscle strength with age and gender in subjects having chronic low back pain. Int J Ther
in individuals with sacroiliac joint dysfunction. J  Man Manip Ther Rehabil Res 2014;3:1.
2011;19:5‑10. 22. Muyor  JM, López‑Miñarro PA, Casimiro AJ. Effect of stretching
13. Nishikawa  Y, Aizawa  J, Kanemura  N, Takahashi  T, Hosomi  N, program in an industrial workplace on hamstring flexibility and sagittal
Maruyama H, et al. Immediate effect of passive and active stretching on spinal posture of adult women workers: A randomized controlled trial.
hamstrings flexibility: A single‑blinded randomized control trial. J Phys J Back Musculoskelet Rehabil 2012;25:161‑9.
Ther Sci 2015;27:3167‑70. 23. Harreby M, Nygaard B, Jessen T, Larsen E, Storr‑Paulsen A, Lindahl A,
14. Kaur G, Reza MK. Efficacy of eccentric training and muscle energy et al. Risk factors for low back pain in a cohort of 1389 Danish school
technique on hamstring flexibility in sedentary college students. Indian children: An epidemiologic study. Eur Spine J 1999;8:444‑50.
J Physiother Occup Ther 2013;7:93. 24. Hellsing  AL. Tightness of hamstring‑  and psoas major muscles.
15. Loutsch RA, Baker RT, May JM, Nasypany AM. Reactive neuromuscular A prospective study of back pain in young men during their military
training results in immediate and long term improvements in measures service. Ups J Med Sci 1988;93:267‑76.
of hamstring flexibility: A  case report. Int J Sports Phys Ther 25. Arab AM, Nourbakhsh  MR. Hamstring muscle length and lumbar
2015;10:371‑7. lordosis in subjects with different lifestyle and work setting: Comparison
16. Krohn K, Castro D, Kling J. The effects of kinesio tape on hamstring between individuals with and without chronic low back pain. J Back
flexibility. Logan edu 2011; 1-12. Musculoskelet Rehabil 2014;27:63‑70.

114 Saudi Journal of Sports Medicine / Volume 17 / Issue 2 / May-August 2017

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