Randomized Controlled Trial
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2020; 11(1): 47-56
Published online Jan 18, 2020. doi: 10.5312/wjo.v11.i1.47
Effect of deep transverse friction massage vs stretching on football players’ performance
Mohammed Ali Fakhro, Hussein Chahine, Hassan Srour, Kasim Hijazi
Mohammed Ali Fakhro, Hussein Chahine, Hassan Srour, Kasim Hijazi, Faculty of Public Health, Department of Physical Therapy, Lebanese German University, Sahel Alma, Jounieh 00961, Keserwan, Lebanon
Author contributions: Fakhro MA, Chahine H, Srour H, and Hijazi K contributed to concept and study designing; Srour H, and Hijazi K took part in trial coordination and monitoring; Chahine H, Srour H, and Hijazi K collected the data and their management; Fakhro MA, contributed to the statistical analyses, drafted the manuscript and made the final approval of the version to be published; Fakhro MA, and Chahine H, analyzed and interpreted the data.
Institutional review board statement: The study protocol was approved by the Institutional Review Board (Ref No.:1EC/2017) of the Lebanese German University in Sahel Alma, Jounieh, Keserwan, Lebanon.
Clinical trial registration statement: This trial was registered in ClinicalTrials.gov under the trial registration number (NCT03540888).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mohammed Ali Fakhro, PT, DPT, Coordinator, Department of Physical Therapy, Faculty of Public Health, Lebanese German University, Sahel Alma, P.O Box 206, Jounieh 00961, Keserwan, Lebanon. m.fakhro@lgu.edu.lb
Received: February 3, 2019
Peer-review started: February 11, 2019
First decision: June 7, 2019
Revised: July 4, 2019
Accepted: November 6, 2019
Article in press: November 6, 2019
Published online: January 18, 2020
ARTICLE HIGHLIGHTS
Research background

Flexibility, agility and muscle strength are key factors to either win or lose a game. The high incidence and prevalence of muscular injuries led coaches, medical teams and researchers from around the world to seek modalities to prevent these events from happening. Recently, the effect of a new technique, deep transverse friction massage (DTFM) on muscle extensibility as compared to traditional stretching techniques has been examined.

Research motivation

This study compares the effect of DTFM to that of static and dynamic stretching techniques on the hamstring’s performance amongst Lebanese and Syrian football players. Sports injuries and more precisely muscular injuries can have a serious negative impact on a player’s health, future, and surroundings. Therefore, seeking modalities to prevent these events from happening is needed.

Research objectives

This study primary objective was to compare the effect of DTFM vs static and dynamic stretching techniques on the hamstring’s extensibility, agility, and strength amongst Lebanese and Syrian football players. Recording the incidence of non-contact hamstring muscle injury was a secondary objective. Optimizing the muscle-related parameters is important to decrease the incidence and impact of muscle injuries.

Research methods

A single-blinded prospective longitudinal randomized controlled trial was designed to realize the objectives of this study. The experiment took place over a period of four weeks, where Football players were randomized into three intervention groups (static stretching; dynamic stretching; DTFM). Participants were followed-up carefully three times per week, for a total of 12 sessions. Straight leg raise, and 1 repetition maximum tests were used to measure the dominant leg hamstring muscle extensibility and maximal strength respectively. T-drill test was used to assess the lower extremities agility at (baseline; acute; and chronic) phases.

Research results

Measures of acute strength (P = 0.011) and chronic extensibility (P = 0.000) showed solely a significant difference between the intervention groups, where the static group showed to be the superior. Moreover, no loss to follow-up or protocol violation was recorded. These findings reinforce the effect of static stretching on long-term flexibility and contradict that on strength.

Research conclusions

This study has shown that static stretching technique best outcomes on long-term extensibility and short-term maximal voluntary hamstring muscle strength. Finally, no difference between the interventions was recorded regarding its effects on the rate of muscle injuries occurrence.

Research perspectives

Future studies are required to test the effect of the DTFM as compared to the above-mentioned stretching techniques on muscle performance for a longer period of time. Moreover, the standardization of DTFM testing is needed.