Effect of Stretching Exercises Plus Caflam on Flexibility of Female Athletes

The present study investigated how stretching exercises (Static, Dynamic and Proprioceptive neuromuscular facilitation (PNF)) along with Caflam (diclofenac potassium) affect the flexibility of female athletes at Punjab University Level. It is a controlled experiment with (n=40) female athletes, aged 18-24 years, divided into two groups intervention (N=30) and control group (N=10) randomly. Original Research Article Gill et al.; JPRI, 33(15): 9-15, 2021; Article no.JPRI.66647 10 Stretching exercises were conducted through 6 weeks divided into two sessions that consisted of both static and dynamic exercises in each session. Flexibility was measured with sit and reach test in pre and post evaluation sessions. The study purpose was to identify the effect of stretching exercises on flexibility of female athletes (N=40) by using different stretching exercises techniques (static and dynamic stretching exercises) on female athletes. Paired sample t-test used and found that it showed highly significant results using “Statistical Package for Social Sciences” (SPSS) V.22 utilized. The effect size was also calculated through Cohans’D which was 1.41. The subjects were followed for 4 months to check the recurrence rate of the control & intervention groups and found that 19% having injuries of lower extremity (control group) and 11% having after post-exercise evaluation (intervention group).

Stretching exercises were conducted through 6 weeks divided into two sessions that consisted of both static and dynamic exercises in each session. Flexibility was measured with sit and reach test in pre and post evaluation sessions. The study purpose was to identify the effect of stretching exercises on flexibility of female athletes (N=40) by using different stretching exercises techniques (static and dynamic stretching exercises) on female athletes. Paired sample t-test used and found that it showed highly significant results using "Statistical Package for Social Sciences" (SPSS) V.22 utilized. The effect size was also calculated through Cohans'D which was 1.41. The subjects were followed for 4 months to check the recurrence rate of the control & intervention groups and found that 19% having injuries of lower extremity (control group) and 11% having after post-exercise evaluation (intervention group).
Keywords: Static and dynamic exercises; range of motion (ROM).

INTRODUCTION
Stretching exercises helped to prepare the body for physical activity and athletic events by improving joint range of motion, thus promoting improved performance and reducing the incidence of injury [1,2,3,4]. Consequently, athletes and coaches regularly include stretching exercises in both training programs and in preevent warm-up activities [5]. However, Stretching is the frequently technique used in sport as a prepares the specific muscles during the activity, as well as replenish the muscles through exercise (Anderson, 2010). Upon undertaking a regular stretching program, frequent changes begin to occur within the body and specifically within the muscles itself as other tissues that begin to adapt the stretching process include fascia, tendons, skin and scar tissue (www.stretchcoach.com). Stretching is commonly undertaken in practice and matches as before and after performing in game or it can also be done as part of training session as well which is suppose as a relaxation of muscles, that prepared for a specific training session and helped in reduction of risk in sports injury. With stretching, subsequent gains in muscle lengths will lead to improved performance and decrease in the likelihood of injury. There are several different ways to stretch, easy to complex, simple to hard and single to multi joint not only provide flexibility to the muscles tendons and ligament but also provide strength to the muscles as well. Each type of stretching has its own pros and cons and the key to attaining the most appropriate stretching technique by which our performance purpose and goal is achieved (www.sportscoach.com). For example, static stretching (SS), dynamic stretching (DS), ballistic stretching (BS) and proprioceptive neuromuscular stretching (PNF) etc. This study was primarily based on two main stretching exercises namely static stretching SS and dynamic stretching DS that helped athletes to gain flexibility that lead to improved performance. The injury record of few decades about static stretching become an important part of warm-up (Young and Behm, 2002). An Ancient technique of starting activity (Warm-up) was comprised of an aerobic module whose basic function is to elevate body temperature 1-2°C [6,7]. The elevated temperature enhanced muscle and body amenability, electroneurography nerve which exploits amplification techniques [8].
Furthermore, the still and motionless stretching was isometric stretching [6,7], its motion involved the range of motion which hold up to 10-15 sec [6]. In other words, we can say that the motionless movement which resulted in enhanced the ROM around [9]. The change in ROM which attributed to increase in the extension and decrease in soreness which affected limb musculotendinous unit (MTU) and have been classified as adaptable temporary changes, the enhancement have been mostly ascribed to lessen MTU stiffness [10] as well as amplified in patience to stretch [11].
Furthermore, to enhance in Range of motion, the predictable advantage of stretching were the decrease the risk [1] and protection against injury [4], whose resultant in ensuing muscle fibers relief [12] and upgraded activity level [6,7]. The ultimate functionality was due to the elevated stretching ability or improved ROM around muscle and joint during sports activity [7].
Second, the stretching which control the motion movement Dynamic refers as "stretching which involves skillful movement through the ROM for a certain joint" moreover, facilitate the control, run and explosive jump which resulted no adverse effect on performance [13,14,15,16]. In the perspective of dynamic stretching, the proponent indicated that rapid durations of dynamic stretching did not affect performance, and vice versa [15,16,17]. Flexibility emphasis on the range of motion (ROM) at joint which plays a vital role as health-related fitness component and upkeep of a healthy lifestyle especially for sports performance [18,19]. Flexibility represents the ability to move a joint or a series of joints through a full, unrestricted, pain-free range of motion [20]. Whole body muscles required range of motion to work at its maximum instant [21].
The muscle and their fascia (sheath) should be the main focus while developing flexibility. An individual's performance depends upon number of components namely health related fitness components (Cardiovascular endurance, Muscular strength, Muscular endurance, Flexibility, Body composition) and skill related fitness components (speed, power, agility, coordination, balance, reaction time). Among these components, flexibility is one of the vital part for performance enhancement as it is important to see by the way of only one spoke in the performance wheel. Different fitness components are required according to sports, it is mandatory to perform exercise on regular basis as it contains all ingredients of physical and mental fitness. special requirements when it comes to flexibility. The most common fitness component is flexibility which refers to exploit the range of motion of your joints and muscles. An improvement in the flexibility led to improve your other fitness components (health and skill related components) which can be upgraded with stretching on regular basis and also become the part of our warm-up and cooldown as well in the conditioning periodization. It has been theorized by athletes, coaches, professionals, athletic trainers and physiotherapists that increasing flexibility is an important aspect of physical fitness, leading to upgrade of athletic performance as well as reducing the incidence of injury. One of the most important components of fitness is flexibility as it rated high for the performance of an athlete. The stiff and sore muscles did not perform strength exercises and ROM efficiently, it can be performed as flexible as u are and thus athlete becomes fatigued and weak. If athletes led to reduce speed, movement, decreased strength and power due to fatigue and stiffness which athletes gets more prone to injuries. Regular physical training helps maintain range of motion, strength of muscles and prevent injuries. Therefore, it is important to stretch all major muscle groups regularly before and after workouts or during training session if you're an athlete.

Hypothesis
The study hypothesized that flexibility of female athletes improved through stretching exercises and manage that impact of flexibility on female athlete's performance.

METHODOLOGY
The study consisted of 40 female athletes of Punjab University (New Campus). All the subjects enrolled in research were between the ages of 18 to 24 years and the research carried out on the basis of experimental method with purposive sampling technique procedure. The data was collected mostly from Department of sports sciences and physical education. Preexperimental research design based on control group and intervention groups separately. Pre and post-exercise evaluation conducted for this study to get the baseline results. Pre-exercise values had been taken without warm up through sit and reach test protocols and flexibility measurement had been taken. After pre-exercise evaluation subjects executed warm-up sessions. The stretching exercises included in the warm-up and separately sessions for 6 weeks. The stretching sessions comprised of both static and dynamic stretching exercises and their frequency was three to five times per week along with caflam (as prescribed by the physicians). After completion of 6 weeks stretching exercises program, the subjects passed through again post-exercise evaluation battery process to get the final evaluation values.
Sit and reach test is a valid and reliable test to measure flexibility. A wooden box 30.5 cm x 30.5 cm x 30.5 cm (12 inches) with a fixed 53.34 centimetre (21 inches) ruler on top along with the extended top board of 22.86 cm (9 inches) towards the feet was used in the study. The flexibility was measured both in inches and centimetres. The test was conducted at University of the Punjab, Department of sport sciences and physical education, Lahore. The athletes performed exercises and test on the grass. The attire included T-shirt, mesh trousers and shoes were off during sit and reach test.
In the research design flow chart (Fig. 2), it is shown that subjects were divided into two groups i.e. the control group (n=10) and the experimental group (n=30). Then the pre-test for both the groups (n=40) was conducted through sit and reach box to check their flexibility initially and to know how training sessions and exercises can improve their flexibility. The training session was conducted on female athletes (n=30) and was executed for 6 weeks divided into 2 exercise sessions. Then the postexercise evaluation was conducted from (n=40) subjects including experimental and control group to know the difference in their results. Then analysis was done to compare how stretching exercises influence on flexibility improvement (experimental group) vs. (control group), who did not participate in any training session. At last the study was concluded that stretching exercises has positive effect on flexibility improvement and performance whereas flexibility measurements remained the same with no progress in subjects who did not perform any stretching exercises throughout.

Research Question
 Is stretching exercises effected the flexibility of the female (athletes & nonathletes) and also help down in cut down the injuries rate.

Objectives
 To check the female athlete flexibility affected through stretching exercises  Flexibility cut down the recurrence rate of injuries in both female and male athletes

Data Analysis
The testing instruments that were used in the study are Sit and Reach Test for flexibility measurement, height scale and weighing machine. The Sit-and-Reach Test (SRT) was first described by Wells and Dillon in the 1952 is commonly measure flexibility of the shoulder muscles, lower back, hips, and hamstring. Sit and reach test is a valid and reliable test to measure flexibility. A wooden box 30.5 cm x 30.5 cm x 30.5 cm (12 inches) with a fixed 53.34 centimetre (21 inches) ruler on top along with the extended top board of 22.86 cm (9 inches) towards the feet was used in the study. The flexibility was measured both in inches and centimetres. The test was conducted at University of the Punjab, Department of sport sciences and physical education, Lahore. The athletes performed exercises and test on the grass. The attire included T-shirt, mesh trousers and shoes were off during sit and reach test.
The experimental research descriptive techniques like frequency, mean, median, standard deviation and inferential techniques with paired sample t-test was applied and analyzed through statistical software SPSS) V.22. The effect size was also calculated for the comparison. Paired sample t-test was utilized and it result was founded significant p<0.001. The study also calculated Cohans'D which determined the effort size of the female was 1.41 respectively.
The figure showed the performance of the female athletes after 6 weeks training program and result founded it highly significant as it improved through static and dynamic exercise.
The pre and post exercise values (Female) showed difference of 2.8 along with improvement (%) 6.6 respectively. The result also showed significant improvement (p<0.001) through paired sample t-test.

DISCUSSION
The study emphasis on the static, dynamic and proprioceptive exercises which enhanced flexibility for female athletes. This study was limited to all female athletes at University of the Punjab along with no major injury, Lahore. Main research questions were formulated in relation to purpose of present investigation, which is to identify the upshot of stretching exercises on flexibility of female athletes. The adaptation of stretching resulted in the deduction of risk of injury it was also supported by Unick et al.
[ . Under the shadow of this study it is highly recommended that the training sessions must include stretching for better performance. The recurrence rate was measured and found that control group had 19% after followed the rehab athletes for 4 months of lower extremity injuries and intervention group had 11% after completed the 4 months followed up plan.

CONCLUSION
The aim of the present study was elaborating the "effect of stretching exercises on flexibility of female athletes". After careful handling and supervision of subjects and analysis of pre-test and post-test measurements of flexibility of the female athletes, researcher concluded that the flexibility of female athletes improved by the mean of pre-test 42.38 cm to post-test 45.19 cm after exercises sessions and thus performance definitely was increased. Results reveal that stretching exercises has a positive effect on flexibility of female athletes. Results also reveal that stretching exercises such as static, dynamic and proprioceptive exercises have positive effect on flexibility on players' performance. At the end researcher concluded that female athletes should perform stretching exercises on regular bases to enhance their flexibility and performance.

CONSENT
It's not applicable.