A Literature Review on Select Manual Therapies Followed by a Study Design on Comparative Effects of Massage, Blood Flow Restriction, and Dry Needling on Hamstring Injuries in College Athletes




Engman, Timothy

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Background: Manual therapies have become an increasingly popular supplemental therapeutic modality for hamstring injury recovery. Examples of manual therapies include massage, blood flow restriction (BFR), and dry needling. The increasing popularity of these modalities could be due, in part, to that they are often easily accessible and require little or no equipment. As a result, they have been used to aid in the recovery of a wide range of acute and chronic injuries. Massage has been shown to increase blood flow and promote relaxation through the strategic and methodic manipulation of soft tissues. Blood flow restriction can act as an early form of resistance training because it promotes similar muscle fatigue while not exposing weakened tissue to high loads of mechanical stress. Dry needling can provide precise relief of pain and stiffness by breaking apart trigger points in soft muscle tissue. These three manual therapies have gained particular traction in the recovery of hamstring injuries. Purpose: To evaluate the comparative effectiveness of massage, BFR, and dry needling in hamstring injury recovery of college athletes. Hamstring injuries are among the most common in athletics, especially at the college level, and they occur frequently as either acute or chronic. As such, it would be valuable for medical professionals working with college athletes to know whether massage, BFR, and dry needling are equally effective in both circumstances. Methods (proposed): A two-pronged study that incorporates a high volume of post-recovery surveys and a lower volume of mid-recovery randomized controlled trial (RCT). Subjects will be college athletes ages 18 to 25 who have been diagnosed with a hamstring injury within the last 6 months. Participants in the mid-recovery RCT will be randomized into one of four treatment groups, consisting of massage, BFR, dry needling, or control, through block randomization. Participants will undergo treatments three times a week for 10 weeks. Results: There are no results to report. The study was not completed due to time constraints. Conclusion: If the proposed study can be conducted, the data collected should fill gaps in research on the comparative effectiveness of massage, BFR, and dry needling on hamstring injury recovery in college athletes.



manual therapy, hamstring, BFR, blood flow restriction, injury, college athlete, dry needling, massage


Engman, T. (2021). A literature review on select manual therapies followed by a study design on comparative effects of massage, blood flow restriction, and dry needling on hamstring injuries in college athletes (Unpublished thesis). Texas State University, San Marcos, Texas.


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