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Updated: Apr 10, 2026

Muscle Imbalances: Testing and Training Functional Eccentric Hamstring Strength in Athletic Populations
Published on: May 1, 2018
REACTIVE NEUROMUSCULAR TRAINING RESULTS IN IMMEDIATE AND LONG TERM IMPROVEMENTS IN MEASURES OF HAMSTRING FLEXIBILITY:
Rick A Loutsch1, Russell T Baker2, James M May2
1Northwestern College, Orange City, IA, USA.
Background And Purpose:
Hamstring tightness is a common complaint among active individuals and patients are traditionally classified with tight hamstrings based on commonly accepted clinical exams including the active knee extension, active straight leg raise, and passive straight leg raise tests. Apparent hamstring tightness is a condition that is present in patients who have the perception of hamstring tightness and are classified with a tissue extensibility dysfunction but demonstrate immediate gains in hamstring range of motion following an intervention that does not address a tissue length dysfunction. Reactive neuromuscular training can be used as part of the evaluative process used to classify and treat patients with apparent hamstring tightness. The purpose of this case report was to identify, treat, and report the outcomes experienced when using a reactive neuromuscular training technique on a patient who was classified with hamstring inflexibility based on traditional testing methods.
Case Description:
A 20 year-old female softball player presented with a chief complaint of hamstring tightness of more than four years duration. The patient tested positive for hamstring inflexibility based on traditional testing methods. The patient was then treated using a reactive neuromuscular training technique in which the patient resisted a manual anterior to posterior force at the abdomen, sternum and across the hips while simultaneously bending forward at the hips in an attempt to touch her toes.
Outcomes:
Following one reactive neuromuscular training treatment session the patient tested negative for hamstring inflexibility based on traditional testing methods and maintained those results at a five-week follow-up appointment.
Discussion:
The subject in this case report demonstrated the effectiveness of reactive neuromuscular training in identifying and treating apparent hamstring tightness. Based on these findings, clinicians should consider using reactive neuromuscular training to properly classify and treat patients with a chief complaint of hamstring "tightness."
Level Of Evidence:
4 (single case report).
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