Isolated Gastrocnemius TightnessNCT06911580
Immediate Effects of Graston Massage on Muscle Properties and Performance in Elite Female Handball Players
A study testing Graston Massage in people with Isolated Gastrocnemius Tightness, run by Giresun University at 1 site in Turkey (Türkiye).
Trial summary
The aim of this study is to investigate the immediate effects of Graston massage on muscle mechanical properties and sports performance in elite handball players with isolated gastrocnemius tightness. Read more about this study
- Who is it for?
- Ages 19 to 27 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Isolated Gastrocnemius Tightness
- What is being tested?
- Graston Massage
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 16 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Nov 2024to 20 Feb 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 19 to 27 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- Participants must have IGT in at least one leg.
- Age range must be between 19-27 years.
- Must have been a licensed handball player for at least the past five years.
- Must not have undergone any surgical operation in the past year.
Who cannot join
- Participants who are in their menstrual period will be excluded from the study.
- Those who have used pharmacological products classified as muscle relaxants or derivatives within the last 24 hours will be excluded.
- Those who do not meet the inclusion criteria will be excluded from the study.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Investigation of the Immediate Effects of Graston Massage on Muscle Mechanical Properties and Sports Performance in Elite Female Handball Players With Isolated Gastrocnemius Tightness
The aim of this study is to investigate the immediate effects of Graston massage on muscle mechanical properties and sports performance in elite handball players with isolated gastrocnemius tightness.
Read the detailed description
Handball is a high-paced competitive sport that requires advanced physical demands. The ability to achieve the desired performance in handball is influenced by the functionality of the lower extremities. One of the key structures responsible for the mobility of the lower extremities is the gastrocnemius muscle. The gastrocnemius is a superficial, two-headed skeletal muscle located in the posterior part of the leg, with its primary function being plantar flexion of the ankle. Due to intense usage, improper training models, or various traumas, structural abnormalities may develop in the gastrocnemius muscle among athletes. One of the most common structural disorders is isolated gastrocnemius tightness (IGT). IGT is considered critical in terms of sports injuries and performance and is also recognized as a prevalent disorder even in the general population.
IGT, which arises as a result of gastrocnemius-soleus contracture, is a muscle dysfunction characterized by increased stiffness of the ankle joint in dorsiflexion. Restrictions in dorsiflexion caused by IGT can increase pressure on soft tissues during changing conditions and sudden movements in training and competitions, leading to a higher risk of injury and potential declines in sports performance. Chronic muscle tightness also affects the viscoelastic properties of the muscle. Mechanical muscle properties such as muscle tone and stiffness are considered fundamental elements for maintaining efficient muscle contractions in terms of both function and energy. A shortened and tight skeletal muscle may hinder potential force production, leading to increased muscle tone and stiffness. Increased tone and stiffness, in turn, can reduce movement efficiency and contribute to a higher risk of injuries.
IGT can be alleviated through various interventions, including exercise models, surgical procedures, and myofascial release techniques. The Graston technique is recommended for restoring optimal length in the myofascial complex, enhancing function, and improving hypomobility caused by skeletal muscle tightness.
Previous studies have emphasized the importance of IGT and its treatment. However, no comprehensive study has been found regarding the effects of preventive measures against IGT on sports performance and muscle properties in athletes. Identifying IGT and implementing effective compensatory mechanisms play a crucial role in maintaining athlete health and sustaining performance, highlighting the significance of this research.
- Conditions
- Isolated Gastrocnemius Tightness
- Being tested
- Graston Massage
- Keywords
- handball, graston, Isolated gastrocnemius tightness, Muscle mechanical properties, Performance
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Graston MassageProcedure or surgery
The participant was positioned prone on the treatment table with the knee slightly flexed. A small amount of lubricating gel was applied to the entire gastrosoleus complex and the calcaneal tendon. For one minute, sweeping strokes were performed downwards on the gastrocnemius heads using the GT-5 tool. From the second to the fourth minute, the GT-5 was used in an upward direction to ensure that both the gastrocnemius and soleus were treated. Afterward, with the GT-2 tool, one minute of downward sweeping and one minute of upward sweeping were performed on the calcaneal tendon. Following the two minutes of sweeping, GT-3 was used to apply short, perpendicular strokes to the medial and lateral sides of the calcaneal tendon, with 30 seconds for each side. The total application lasted approximately 7 minutes (Palmer et al., 2017).
| Study group | Role | What they receive |
|---|---|---|
| Physical Tests and Measurements | Other | Assessment of Muscle Mechanical Properties:The Myoton PRO muscle palpation device was used for the evaluation.
Strength Measurement: Strength measurement was performed on the calf muscle group. The Activforce Digital Dynamometer, which has been reported to have a high level of reliability, was used for this assessment.
Agility Test:Agility values were determined using the Illinois Agility Test, measured with a photocell electronic stopwatch system with a precision of 0.01 seconds. The test was conducted twice, and the best result was recorded.
Vertical Jump Test:Vertical jump values were measured using a Smart Speed electronic jump mat with the hands-free (arm swing) countermovement jump technique. The athlete positioned themselves with their feet shoulder-width apart on the jump mat. Receives: Procedure: Graston Massage |
What is being measured
The primary outcome is the main question the study is designed to answer.
IGT (isolated gastrocnemius tightness) Assessment
The Silfverskiold test was used to identify gastrocnemius tightness, which is characterized by an equinus deformity at the ankle when the knee is extended but disappears when the knee is flexed. In this test, gastrocnemius equinus is determined when passive ankle dorsiflexion is ≤5 degrees with the knee fully extended, but increases to ≥15 degrees when the knee is flexed to 90 degrees. Participants were positioned supine on a treatment table, and goniometric measurements were taken according to the test protocol. Those who met the Silfverskiold criteria in at least one leg were classified as having IGT. (physiological parameter)
Measured: Baseline
Assessment of Muscle Mechanical Properties
The Myoton PRO muscle palpation device was used for the evaluation. Myoton PRO is a portable, non-invasive device with established reliability and objectivity in assessing muscle mechanical properties. The device consists of a body and a probe. The probe applies mechanical pressure to the surface, generating a rapid deformation through a mechanical impulse. This deformation induces damped natural oscillations in the soft tissue, which are recorded by an accelerometer. During the application, the participant was positioned supine on a treatment table. To ensure the most relaxed position of the muscle, a small cushion was placed under the tibia, supporting the ankle. Following the device protocol, three impulses were applied to the reference point of the medial gastrocnemius using the probe. All measurements were performed by the same expert physiotherapist. (physiological parameter)
Measured: Baseline
Measuring Strength
Strength measurement was performed on the calf muscle group. The Activforce Digital Dynamometer, which has been reported to have a high level of reliability, was used for this assessment. The device was fixed to the wall at foot level, and the participant, lying in a supine position, was instructed to apply maximum plantar flexion force against it. To prevent any backward movement that could affect the measurement, support was provided to the participant at the shoulder region during the test. (physiological parameter)
Measured: Baseline
Measuring Agility
Agility values were determined using the Illinois Agility Test, measured with a photocell electronic stopwatch system with a precision of 0.01 seconds. The test was conducted twice, and the best result was recorded. (physiological parameter)
Measured: Baseline
Vertical Jump Test
Vertical jump values were measured using a Smart Speed electronic jump mat with the hands-free (arm swing) countermovement jump technique. The athlete positioned themselves with their feet shoulder-width apart on the jump mat. Once ready, the athlete bent down and jumped vertically to the highest point they could reach, landing back on the mat. Three trials were performed in the correct position, with a 3-second rest between each jump, and the best result was recorded in centimeters. Jumps were repeated with the knees flexed while the athlete was airborne. (physiological parameter)
Measured: Baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Apr 2025
- Study start1 Nov 2024
- Primary completion1 Jan 2025
- Study completion20 Feb 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Isolated Gastrocnemius TightnessStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- The study was designed as a quasi-experimental research.
- Masking
- None (open label)
- Enrolment
- 16 participants (actual)
Sponsor and investigators
- Lead sponsor
- Giresun University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Nihat Sarıalioğlu, Giresun University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06911580
- Sponsor's protocol ID
- GRU-SBF-NS-03
- Status last verified
- Mar 2025
- First submitted
- 24 Mar 2025
- Last updated
- 4 Apr 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: I don't want my data to be shared.
Study at a glance
From the registry record, last updated by the sponsor on 4 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Investigation of the Immediate Effects of Graston Massage on Muscle Mechanical Properties and Sports Performance in Elite Female Handball Players With Isolated Gastrocnemius Tightness
- ClinicalTrials.gov ID
- NCT06911580
- Acronym / sponsor ID
- GRU-SBF-NS-03
- Conditions
- Isolated Gastrocnemius Tightness
- Keywords
- handball, graston, Isolated gastrocnemius tightness, Muscle mechanical properties, Performance
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 16 participants (actual)
- Lead sponsor
- Giresun UniversityUniversity, hospital or other
- Study start
- 1 Nov 2024 (actual)
- Primary completion
- 1 Jan 2025 (actual)
- Study completion
- 20 Feb 2025 (actual)
- First posted
- 4 Apr 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to investigate the immediate effects of Graston massage on muscle mechanical properties and sports performance in elite handball players with isolated gastrocnemius tightness.
Detailed description
Handball is a high-paced competitive sport that requires advanced physical demands. The ability to achieve the desired performance in handball is influenced by the functionality of the lower extremities. One of the key structures responsible for the mobility of the lower extremities is the gastrocnemius muscle. The gastrocnemius is a superficial, two-headed skeletal muscle located in the posterior part of the leg, with its primary function being plantar flexion of the ankle. Due to intense usage, improper training models, or various traumas, structural abnormalities may develop in the gastrocnemius muscle among athletes. One of the most common structural disorders is isolated gastrocnemius tightness (IGT). IGT is considered critical in terms of sports injuries and performance and is also recognized as a prevalent disorder even in the general population.
IGT, which arises as a result of gastrocnemius-soleus contracture, is a muscle dysfunction characterized by increased stiffness of the ankle joint in dorsiflexion. Restrictions in dorsiflexion caused by IGT can increase pressure on soft tissues during changing conditions and sudden movements in training and competitions, leading to a higher risk of injury and potential declines in sports performance. Chronic muscle tightness also affects the viscoelastic properties of the muscle. Mechanical muscle properties such as muscle tone and stiffness are considered fundamental elements for maintaining efficient muscle contractions in terms of both function and energy. A shortened and tight skeletal muscle may hinder potential force production, leading to increased muscle tone and stiffness. Increased tone and stiffness, in turn, can reduce movement efficiency and contribute to a higher risk of injuries.
IGT can be alleviated through various interventions, including exercise models, surgical procedures, and myofascial release techniques. The Graston technique is recommended for restoring optimal length in the myofascial complex, enhancing function, and improving hypomobility caused by skeletal muscle tightness.
Previous studies have emphasized the importance of IGT and its treatment. However, no comprehensive study has been found regarding the effects of preventive measures against IGT on sports performance and muscle properties in athletes. Identifying IGT and implementing effective compensatory mechanisms play a crucial role in maintaining athlete health and sustaining performance, highlighting the significance of this research.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- The study was designed as a quasi-experimental research.
| Arm | Type | Receives |
|---|---|---|
| Physical Tests and Measurements | Other | Procedure: Graston MassageAssessment of Muscle Mechanical Properties:The Myoton PRO muscle palpation device was used for the evaluation. Strength Measurement: Strength measurement was performed on the calf muscle group. The Activforce Digital Dynamometer, which has been reported to have a high level of reliability, was used for this assessment. Agility Test:Agility values were determined using the Illinois Agility Test, measured with a photocell electronic stopwatch system with a precision of 0.01 seconds. The test was conducted twice, and the best result was recorded. Vertical Jump Test:Vertical jump values were measured using a Smart Speed electronic jump mat with the hands-free (arm swing) countermovement jump technique. The athlete positioned themselves with their feet shoulder-width apart on the jump mat. |
Who may qualify
- Ages
- 19 to 27 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Participants must have IGT in at least one leg.
- Age range must be between 19-27 years.
- Must have been a licensed handball player for at least the past five years.
- Must not have undergone any surgical operation in the past year.
Key exclusion criteria (3 listed)
- Participants who are in their menstrual period will be excluded from the study.
- Those who have used pharmacological products classified as muscle relaxants or derivatives within the last 24 hours will be excluded.
- Those who do not meet the inclusion criteria will be excluded from the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Graston MassageThe participant was positioned prone on the treatment table with the knee slightly flexed. A small amount of lubricating gel was applied to the entire gastrosoleus complex and the calcaneal tendon. For one minute, sweeping strokes were performed downwards on the gastrocnemius heads using the GT-5 tool. From the second to the fourth minute, the GT-5 was used in an upward direction to ensure that both the gastrocnemius and soleus were treated. Afterward, with the GT-2 tool, one minute of downward sweeping and one minute of upward sweeping were performed on the calcaneal tendon. Following the two minutes of sweeping, GT-3 was used to apply short, perpendicular strokes to the medial and lateral sides of the calcaneal tendon, with 30 seconds for each side. The total application lasted approximately 7 minutes (Palmer et al., 2017). | Procedure or surgery | Physical Tests and Measurements |
Primary outcome
IGT (isolated gastrocnemius tightness) Assessment
Time frame: Baseline
The Silfverskiold test was used to identify gastrocnemius tightness, which is characterized by an equinus deformity at the ankle when the knee is extended but disappears when the knee is flexed. In this test, gastrocnemius equinus is determined when passive ankle dorsiflexion is ≤5 degrees with the knee fully extended, but increases to ≥15 degrees when the knee is flexed to 90 degrees. Participants were positioned supine on a treatment table, and goniometric measurements were taken according to the test protocol. Those who met the Silfverskiold criteria in at least one leg were classified as having IGT. (physiological parameter)
Assessment of Muscle Mechanical Properties
Time frame: Baseline
The Myoton PRO muscle palpation device was used for the evaluation. Myoton PRO is a portable, non-invasive device with established reliability and objectivity in assessing muscle mechanical properties. The device consists of a body and a probe. The probe applies mechanical pressure to the surface, generating a rapid deformation through a mechanical impulse. This deformation induces damped natural oscillations in the soft tissue, which are recorded by an accelerometer. During the application, the participant was positioned supine on a treatment table. To ensure the most relaxed position of the muscle, a small cushion was placed under the tibia, supporting the ankle. Following the device protocol, three impulses were applied to the reference point of the medial gastrocnemius using the probe. All measurements were performed by the same expert physiotherapist. (physiological parameter)
Measuring Strength
Time frame: Baseline
Strength measurement was performed on the calf muscle group. The Activforce Digital Dynamometer, which has been reported to have a high level of reliability, was used for this assessment. The device was fixed to the wall at foot level, and the participant, lying in a supine position, was instructed to apply maximum plantar flexion force against it. To prevent any backward movement that could affect the measurement, support was provided to the participant at the shoulder region during the test. (physiological parameter)
Measuring Agility
Time frame: Baseline
Agility values were determined using the Illinois Agility Test, measured with a photocell electronic stopwatch system with a precision of 0.01 seconds. The test was conducted twice, and the best result was recorded. (physiological parameter)
Vertical Jump Test
Time frame: Baseline
Vertical jump values were measured using a Smart Speed electronic jump mat with the hands-free (arm swing) countermovement jump technique. The athlete positioned themselves with their feet shoulder-width apart on the jump mat. Once ready, the athlete bent down and jumped vertically to the highest point they could reach, landing back on the mat. Three trials were performed in the correct position, with a 3-second rest between each jump, and the best result was recorded in centimeters. Jumps were repeated with the knees flexed while the athlete was airborne. (physiological parameter)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Apr 2025.
- Individual participant dataSharing planned: No. I don't want my data to be shared.
Related trials for Isolated Gastrocnemius Tightness
RecruitingObservational study
Isolated Gastrocnemius Tightness and Tactile Sensitivity
Isolated Gastrocnemius Tightness, Healthy Adult Participants
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Graston Massage in people with Isolated Gastrocnemius Tightness, run by Giresun University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
IGT (isolated gastrocnemius tightness) Assessment (time frame: Baseline). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Apr 2025.