Effect of Active and Positional Release on Hamstring Flexibility in Athletes

Hamstring shortening is common in athletes and often causes pain, limited flexibility, and reduced function, which negatively impact performance. Manual therapy techniques such as Active Release Therapy (ART) and Positional Release Therapy (PRT) are frequently used, but their comparative effectiveness remains unclear. This randomized, single-blinded clinical trial enrolled 74 athletes aged 18-35 years with hamstring shortening at the University of Lahore. Participants were randomly assigned to receive either PRT with conventional physiotherapy (hot pack, TENS, stretching, ankle pumps) or ART with the same physiotherapy protocol. Each group received two supervised sessions per week for four weeks. The primary outcomes were pain (Numeric Pain Rating Scale), range of motion (Popliteal Angle), and functional ability (Lower Extremity Functional Scale). The Active Knee Extension test was used as a secondary outcome. This study seeks to determine which manual therapy approach provides greater improvements in pain, flexibility, and function, with the goal of guiding evidence-based rehabilitation for athletes.