Effects of a Structured Sports Massage Program on Hamstring Flexibility Among Male University Football Athletes

Main Article Content

  WHKT Nimesh Weerasinghe
  Pramesh Chathushka Thotawaththa

Abstract

Background: Hamstring tightness is a common issue among football players, increasing the risk of injury and reducing performance. Sports massage is frequently used to enhance flexibility, but limited evidence exists regarding its structured, longitudinal application in university-level athletes.


Aims: This study investigated the effect of a six-week structured sports massage program on hamstring flexibility among male university football players.


Methods: A two-group, pre-test–post-test quasi-experimental design was employed with 20 male football players from Sabaragamuwa University of Sri Lanka. Participants were allocated to a treatment group (n = 10; mean age = 22.7 ± 1.2 years; body mass = 66.4 ± 4.8 kg; height = 1.67 ± 0.04 m) or a control group (n = 10; mean age = 22.8 ± 1.3 years; body mass = 66.9 ± 5.1 kg; height = 1.68 ± 0.05 m). The treatment group received 15-minute effleurage-based sports massage sessions twice weekly for six weeks, while the control group continued regular football training without massage. Flexibility was assessed using seven measures: the Sit-and-Reach Test (SRT), left and right Active Knee Extension Tests (AKET), left and right Passive Knee Extension Tests (PKET), and left and right Straight-Leg Raise tests (SLR). Data were analyzed using 2 × 2 mixed analysis of variance (ANOVA), with Bonferroni-adjusted post-hoc comparisons.


Result: The treatment group demonstrated improvements across all seven flexibility measures, whereas the control group showed small declines in the reported mean scores. The original analysis reported significant Time × Group interactions for all outcomes (p < 0.001), with partial eta-squared values of 0.52–0.61. Reported within-group improvements in the treatment group ranged from 1.77° to 4.11° across the angular measures, while the SRT reportedly increased by 3.56 cm. The reported effect sizes were very large (Cohen’s d = 2.32–3.78). However, these inferential statistics and change scores require verification against the participant-level data and final descriptive tables before publication.


Conclusion: A six-week effleurage-based sports massage program was associated with improvements in hamstring flexibility among male university football players. Sports massage may be a useful supplementary strategy for flexibility management within football training programs. Further research with larger samples and longer follow-up periods is needed to establish the durability of these improvements and determine whether they translate into meaningful performance or injury-prevention benefits.

Article Details

How to Cite
Weerasinghe, W. N., & Thotawaththa, P. C. (2026). Effects of a Structured Sports Massage Program on Hamstring Flexibility Among Male University Football Athletes. Indonesian Journal of Sport, Health and Physical Education Science, 4(3), 120–137. https://doi.org/10.58723/inasport.v4i3.753
Section
Articles

References

Afshar, N. G., Soltani, M., & Naderinasab, H. (2025). Identifying key factors influencing hamstring muscle strains in football players: A narrative review with descriptive analysis. International Journal of Sport Studies for Health, 8(1). https://doi.org/10.5812/intjssh-3608

Behara, B., & Jacobson, B. H. (2017). Acute effects of deep tissue foam rolling and dynamic stretching on muscular strength, power, and flexibility in division I linemen. The Journal of Strength & Conditioning Research, 31(4), 888-892. https://doi.org/10.1519/JSC.0000000000001051

Best, T. M., Hunter, R., Wilcox, A., & Haq, F. (2016). Effectiveness of sports massage for recovery of skeletal muscle from strenuous exercise. Clinical Journal of Sport Medicine, 26(5), 446–460. https://doi.org/10.1097/JSM.0000000000000281

Bramah, C., Mendiguchia, J., Dos’Santos, T. and Morin, J.B. (2024) ‘Exploring the role of sprint biomechanics in hamstring strain injuries: A current opinion on existing concepts and evidence’, Sports Medicine, 54, pp. 783–793. http://doi.org/10.1007/s40279-023-01925-x

Clapis, P., Cottle, J., Conklin, C., Stone, R., & Szymczyk, D. (2024). The combined effect of communication, expectations, and percussive therapy on acute hamstring flexibility in healthy subjects. Medicine & Science in Sports & Exercise, 56(10S), 63–64. https://doi.org/10.1249/01.mss.0001053040.82784.a0

Dakić, M., Toskić, L., Ilić, V., Đurić, S., Dopsaj, M. J., & Šimenko, J. (2023). The effects of massage therapy on sport and exercise performance: A systematic review. Sports, 11(6), 110. https://doi.org/10.3390/sports11060110

Davis, H. L., Alabed, S., & Chico, T. J. A. (2020). Effect of sports massage on performance and recovery: A systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine, 6(1), e000614. https://doi.org/10.1136/bmjsem-2019-000614

Edholm, P., Ørtenblad, N., Holmberg, H. C., & Sperlich, B. (2024). Optimizing recovery strategies for winter athletes: Insights for Milano-Cortina 2026 Olympic Games. Sport Sciences for Health, 20, 1169–1182. https://doi.org/10.1007/s11332-024-01245-1

Ekstrand, J., Waldén, M., & Hägglund, M. (2016). Hamstring injuries have increased by 4% annually in men's professional football since 2001: A 13-year longitudinal analysis of the UEFA Elite Club injury study. British Journal of Sports Medicine, 50(12), 731–737. https://doi.org/10.1136/bjsports-2015-095359

Engebretsen, A. H., Myklebust, G., Holme, I., Engebretsen, L., & Bahr, R. (2016). Intrinsic risk factors for hamstring injuries among male soccer players: A prospective cohort study. American Journal of Sports Medicine, 44(6), 1147–1153. https://doi.org/10.1177/0363546515624614

Fauris, P., Redondo, B., Tarazona-Santabalbina, F.J., López-Pascual, J., Pla, L. and Pérez-Bellmunt, A. (2021) ‘Does self-myofascial release cause a remote hamstring stretching effect based on myofascial chains? A randomized controlled trial’, International Journal of Environmental Research and Public Health, 18(23), 12356. http://doi.org/10.3390/ijerph182312356

Freitas, S.R., Mendes, B., Le Sant, G., Andrade, R.J., Nordez, A. and Milanović, Z. (2018) ‘Can chronic stretching change the muscle-tendon mechanical properties? A review’, Scandinavian Journal of Medicine & Science in Sports, 28(3), pp. 794–806. http://doi.org/10.1111/sms.12957

Hägglund, M., Waldén, M., & Ekstrand, J. (2016). Risk factors for lower extremity muscle injury in professional soccer: The UEFA injury study. American Journal of Sports Medicine, 44(2), 327–335. https://doi.org/10.1177/0363546515610628

Hodgson, D. D., Quigley, P. J., Whitten, J. H., Reid, J. C., & Behm, D. G. (2019). Impact of 10-minute interval roller massage on performance and active range of motion. The Journal of Strength & Conditioning Research, 33(6), 1512-1523. https://doi.org/10.1519/JSC.0000000000002271

Hopper, D., Conneely, M., Chromiak, F., Canini, E., Berggren, J., & Briffa, K. (2021). Evaluation of the effect of two massage techniques on hamstring muscle length in competitive female hockey players. Physical Therapy in Sport, 6(3), 137–145. https://doi.org/10.1016/j.ptsp.2021.03.004

Iguchi, J., Watanabe, Y., Kimura, M., Fujisawa, Y., Hojo, T., Yuasa, Y., Higashi, S., & Kuzuhara, K. (2016). Risk factors for injury among Japanese collegiate players of American football based on performance test results. Journal of Strength and Conditioning Research, 30(12), 3405–3411. https://doi.org/10.1519/JSC.0000000000001429

Kamaruddin, I., Arsyad, A. N., Baharuddin, Firman, M. F. Z., Hasnullah, & Muhabbah, A. I. (2026). Validity of the sit and reach test for hamstring and low back flexibility: A systematic review. Competitor: Journal of Sports Science, 8(1). https://doi.org/10.26858/cpjok.v18i1.468

Kargarfard, M., Lam, E. T. C., Shariat, A., Shaw, I., Shaw, B. S., & Mohd Tamrin, S. B. (2016). Efficacy of massage on muscle soreness, perceived recovery, physiological restoration and physical performance in male bodybuilders. Journal of Sports Sciences, 34(10), 959–965. https://doi.org/10.1080/02640414.2015.1081264

Kaur, K. and Sinha, A.G.K. (2020) ‘Effectiveness of massage on flexibility of hamstring muscle and agility of female players: An experimental randomized controlled trial’, Journal of Bodywork and Movement Therapies, 24(4), pp. 519–526. https://doi.org/10.1016/j.jbmt.2020.06.029

Kellis, E., Kekelekis, A. and Drakonaki, E.E. (2024) ‘Thoracolumbar fascia and lumbar muscle stiffness in athletes with a history of hamstring injury’, Journal of Sports Science and Medicine, 23(2), pp. 436–444. https://doi.org/10.52082/jssm.2024.436

Kim, D., & Lee, M. (2025). Prevention of hamstring injuries in elite football players: Exercise and load management strategies. Korean Journal of Exercise Physiology, 34(1), 10–19. https://doi.org/10.15857/ksep.2025.00024

Krause, F., Wilke, J., Vogt, L. and Banzer, W. (2016) ‘Intermuscular force transmission along myofascial chains: A systematic review’, Journal of Anatomy, 228(6), pp. 910–918. https://doi.org/10.1111/joa.12464

Lestari, W. A., Wardani, R., & Haryono. (2025). The effect of massage therapy on preventing delayed onset muscle soreness (DOMS) in sprinters. Jurnal Kesehatan, 16(2). https://doi.org/10.26630/jk.v16i2.5013

Liyanage, E., Malwanage, K., Senarath, D., Wijayasinghe, H., Liyanage, I., Chellapillai, D., & Nishshanka, S. (2024). Effects of different physical therapy interventions in improving flexibility in university students with hamstring tightness-a systematic review and network meta-analysis. International Journal of Exercise Science, 17(3), 359. https://doi.org/10.70252/ZOLU9336

Lim, W. (2024) ‘Optimal cut-off values of the active knee extension test for diagnosing hamstring tightness’, Journal of Bodywork and Movement Therapies, 40, pp. 1769–1773. https://doi.org/10.1016/j.jbmt.2024.10.042

Liu, H., Shen, Y., Xiong, Y., Zhou, H., Mao, Y., Shen, Q., Hong, W., Liu, M., Liu, Y., Qiu, L., Zhang, Z. and Jia, Y. (2022) ‘Psychometric properties of four common clinical tests for assessing hamstring flexibility in young adults’, Frontiers in Physiology, 13, 911240. https://doi.org/10.3389/fphys.2022.911240

Madoni, S. N., Costa, P. B., Coburn, J. W., & Galpin, A. J. (2018). Effects of foam rolling on range of motion, peak torque, muscle activation, and the hamstrings-to-quadriceps strength ratios. The Journal of Strength & Conditioning Research, 32(7), 1821-1830. https://doi.org/10.1519/JSC.0000000000002468

Mughal, M. Z., Ghafoor, I., Javaid, W., Nawaz, F., Ahmad, Z., & Nawaz, M. A. (2026). Comparative effect of percussive and myofascial release therapy on pain and hamstring flexibility among traffic wardens. RMJ, 51(2), 519–522. https://www.rmj.org.pk/?mno=223791

Martínez-Aranda, L. M., Sanz-Matesanz, M., García-Mantilla, E. D., & González-Fernández, F. T. (2024). Effects of self-myofascial release on athletes’ physical performance: A systematic review. Journal of Functional Morphology and Kinesiology, 9(1), 15. https://doi.org/10.3390/jfmk9010015

Miyamoto, N., Hirata, K., Miyamoto-Mikami, E., Yasuda, O. and Kanehisa, H. (2018) ‘Associations of passive muscle stiffness, muscle stretch tolerance, and muscle slack angle with range of motion: Individual and sex differences’, Scientific Reports, 8, 8274. https://doi.org/10.1038/s41598-018-26574-3

Moraska, A. (2016). Sports massage: A comprehensive review. Journal of Sports Medicine and Physical Fitness, 56(5), 570–580. https://doi.org/10.23736/S0022-4707.19.10237-X

Niewiadomy, P., Szuścik-Niewiadomy, K., Kochan, M., & Kuszewski, M. T. (2021). The relationship between active and passive flexibility of the knee flexors. Muscles, Ligaments and Tendons Journal, 11(2), 265–272. https://doi.org/10.32098/mltj.02.2021.21

Oranchuk, D. J., Flattery, M. R., & Robinson, T. L. (2019). Superficial heat administration and foam rolling increase hamstring flexibility acutely; with amplifying effects. Physical Therapy in Sport, 40, 213-217. https://doi.org/10.1016/j.ptsp.2019.10.004

Pinto, D., Bonaldi, L., Pirri, C., Fontanella, C. G., & Stecco, C. (2024). Lower flexibility and range of motion in prepubertal soccer players: a pilot study. Sport Sciences for Health, 20(3), 843-851. https://doi.org/10.1007/s11332-024-01167-y

Poppendieck, W., Wegmann, M., Ferrauti, A., Kellmann, M., Pfeiffer, M., & Meyer, T. (2016). Massage and performance recovery: a meta-analytical review. Sports medicine, 46(2), 183-204. https://doi.org/10.1007/s40279-015-0420-x

Shepherd, E., Winter, S. and Gordon, S. (2017) ‘Comparing hamstring muscle length measurements of the traditional active knee extension test and a functional hamstring flexibility test’, Journal of Physiotherapy & Physical Rehabilitation, 2(1), 125. https://doi.org/10.4172/2573-0312.1000125

Talu, Y., Tuncer, A., & Talu, B. (2024). A new measuring approach in assessing hamstring flexibility: Reliability, validity, and applicability of isolated hamstring flexibility test. Clinical Journal of Sport Medicine, 34(5), 430–435. https://doi.org/10.1097/JSM.0000000000001235

Thotawaththa, P. C., & Chandana, A. W. S. (2023). The effects of the basic meso-cycle of the general preparation period on the improvement of long jump performance and fitness level. International journal of physical education, sports and health, 10(1), 409-416. https://doi.org/10.22271/kheljournal.2023.v10.i1f.2815

Weerapong, P., Hume, P. A., & Kolt, G. S. (2016). The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Medicine, 46(3), 235–256. https://doi.org/10.1007/s40279-015-0420-5

Whalen, A., Farrell, K., Roberts, S., Smith, H. and Behm, D.G. (2019) ‘Topical analgesic improved or maintained ballistic hip flexion range of motion with treated and untreated legs’, Journal of Sports Science and Medicine, 18(3), pp. 552–558. PMID: 31427878; PMCID: PMC6683618

Witvrouw, E., Danneels, L., Asselman, P., D'Have, T., & Cambier, D. (2016). Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. American Journal of Sports Medicine, 44(1), 41–46. https://doi.org/10.1177/0363546515610626