Effect of Nitya-Abhyaṅga (self-massage) combined with stretching on hamstring extensibility, muscle stiffness, and stretch tolerance in college students: a randomized controlled trial

INTRODUCTION: Prolonged sitting is increasingly prevalent among young adults and is associated with reduced hamstring extensibility, increased stiffness, and heightened injury risk. Although stretching exercises can improve range of motion, their effects are often transient, with limited effect on muscle stiffness. Nitya‐Abhyaṅga (daily self‐massage) is a traditional Ayurvedic practice indicated for stiffness and restricted movements. However, evidence regarding its effect on hamstring flexibility remains limited. This study evaluated the combined effect of Nitya‐Abhyaṅga and stretching exercises on hamstring extensibility, stiffness, and stretch tolerance in college students. METHOD: In this randomized controlled trial (CTRI/2024/07/070623), 42 male college students aged 18‐25 years with reduced hamstring extensibility (hand‐toe distance >0 cm) were randomly allocated, after obtaining informed consent, to either Group A (Nitya‐Abhyaṅga with stretching) or Group B (stretching alone) for a 4‐week intervention period. Outcomes included the hand‐toe test, knee extension test, hip flexion angle, muscle stiffness assessed using a digital algometer, and stretch tolerance measured using a visual analog scale, measured at baseline and post‐intervention, with compliance monitored through participant diaries. RESULT: Both groups demonstrated significant improvements over time. Two‐way repeated‐measures ANOVA revealed significant group ×  time interactions across all outcome measures (p ≤ 0.001), indicating significant improvement in the Abhyaṅga with stretching group compared with stretching alone, with moderate to large effect sizes. CONCLUSION: Nitya‐Abhyaṅga combined with stretching was more effective than stretching alone in improving hamstring extensibility, reducing algometer‐derived stiffness, and enhancing stretch tolerance. This combined approach may be recommended as a simple, cost‐effective preventive practice to mitigate the adverse effects of prolonged sitting and to maintain musculoskeletal health.Clinical Trial Registration: identifier CTRI/2024/07/070623, https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTExODU3&Enc=&userName=.