Comparison of Extracorporeal Shockwave Therapy and Dynamic Soft Tissue Mobilization on Hamstring Tightness in Male Basketball Players: A Randomized Clinical Trial Publisher

Summary: Which therapy helps tight hamstrings? In basketball players, both shockwave therapy and manual treatment helped, with manual treatment performing better. #SportsMedicine #Rehab

Haghighat S ; Behnammanesh S ; Mahmoudzadeh A ; Salehi A ; Taheri P
Source: Middle East Journal of Rehabilitation and Health Studies Published:2026

Abstract

Background: Hamstring tightness is a common musculoskeletal problem among athletes, particularly basketball players, and can negatively affect performance and increase injury risk. Various therapeutic approaches, including electrotherapy and manual therapy, are available; however, their mechanisms and comparative effectiveness are not fully understood. Objectives: This study aimed to evaluate the effects of extracorporeal shockwave therapy (ESWT), an electrotherapy intervention, on hamstring tightness and to compare its effectiveness with that of dynamic soft tissue mobilization (DSTM), a manual therapy technique, in basketball players. Methods: This randomized controlled trial was conducted from January to June 2022 at Amin Hospital, Isfahan, Iran. Forty male basketball players aged 15 - 18 years with hamstring tightness, defined as an active knee extension angle (AKEA) < 170°, were randomly assigned to the ESWT or DSTM groups. Only male participants were included to maintain sample homogeneity and reduce sex-related variability in flexibility outcomes. The ESWT protocol consisted of 4 sessions, with 1 session per week, and the DSTM protocol included 4 sessions over 4 weeks. Outcomes were assessed at baseline, immediately after the final session, and 1 month after the intervention. Outcomes included the Y-Balance Test (YBT), AKEA, passive knee extension angle (PKEA), and finger-to-floor distance. Data were analyzed using the t-test, analysis of covariance (ANCOVA), and one-way repeated-measures analysis of variance in SPSS version 26. Results: Twenty participants in the ESWT group and 20 participants in the DSTM group were evaluated. Between-group comparisons immediately after the intervention and at the 1-month follow-up showed statistically significant differences in all outcome measures (P < 0.001), with greater improvements observed in the DSTM group. Within-group analyses showed significant changes from baseline in both the ESWT (P < 0.05) and DSTM (P < 0.001) groups. Conclusions: Both ESWT and DSTM significantly improved hamstring flexibility; however, DSTM demonstrated superior effectiveness across key flexibility outcomes. These findings provide preliminary evidence supporting the distinct mechanisms of electrotherapy and manual therapy in the treatment of hamstring tightness. Further studies are needed to draw more comprehensive conclusions. Copyright © 2026, Haghighat et al.