Mapping the evidence on neural tissue mobilization for hamstring length and pain outcomes in asymptomatic individuals and individuals with non-specific low back pain: a scoping review.

Journal of Manual & Manipulative Therapy 2026-07-27

Sayani Das, Mandeep Kumar Jangra, Akanksha Saxena

Abstract

Background Sedentary patients to elite athletes alike complain of hamstring tightness and related pain. An abundance of reasons, from decreased sitting time, posture, muscle imbalance, or brain tension, can be the root cause. Tightness of the hamstrings has been treated for many years with manual therapy, eccentric exercise, and static stretching. Neural tissue mobilization (NTM) is used to improve neural mobility and reduce mechanosensitivity. Although several studies have investigated its effects on hamstring length and pain-related outcomes, the available evidence remains heterogeneous regarding participant characteristics, intervention protocols, and outcome measures. Objective of the study To map and summarize the existing literature investigating the effects of neural tissue mobilization on hamstring length and pain-related outcomes in asymptomatic individuals and individuals with nonspecific low back pain. Methods A total of 4,731 articles were identified from PubMed, ScienceDirect, and Scopus between 2015 and 2025. After removing 273 duplicate records. The remaining 4458 articles were screened by titles and abstracts, leading to the removal of 4448 articles. After further analysis based on inclusion criteria, seven articles were selected for review following PRISMA-ScR guidelines. Results Included studies generally reported improvements in hamstring length and pain-related outcomes following neural tissue mobilization; however, considerable variation existed in study populations, intervention protocols, treatment duration, and outcome measures. Conclusion Current evidence suggests that neural tissue mobilization may be associated with improvements in hamstring length and pain-related outcomes; however, the evidence remains heterogeneous and further high-quality studies are required.