COMPARATIVE EFFECT OF SUB-OCCIPITAL MUSCLE INHIBITION TECHNIQUE AND MUSCLE ENERGY TECHNIQUE ON POSTERIOR CHAIN FLEXIBILITY IN YOUNG VOLLEYBALL PLAYERS: A RANDOMIZED CONTROLLED TRIAL

Background:Flexibility of the posterior chain plays a vital role in maintaining efficient movement, athletic performance, andmusculoskeletal health in volleyball players. The repetitive demands of volleyball, including jumping, landing,sprinting, and sudden changes in direction, often lead to increased tension within the posterior myofascialstructures, resulting in reduced flexibility and a higher risk of sports-related injuries. Manual therapy techniquessuch as the Sub-occipital Muscle Inhibition Technique (SMIT) and Muscle Energy Technique (MET) are frequentlyused by physiotherapists to improve flexibility. Although both interventions have shown beneficial effectsindividually, limited evidence is available comparing their influence on posterior chain flexibility in youngvolleyball players.Objective:To compare the effectiveness of the Sub-occipital Muscle Inhibition Technique and Muscle Energy Technique inimproving posterior chain flexibility among young volleyball players.Methods:A randomized controlled trial was carried out on 60 volleyball players aged 15 to 25 years who demonstratedreduced posterior chain flexibility. Participants were randomly assigned into two groups of 30 each. Group Areceived the Sub-occipital Muscle Inhibition Technique, whereas Group B was treated with the Muscle EnergyTechnique. Both groups underwent intervention five days per week for four weeks. Posterior chain flexibility wasevaluated using the Finger Floor Distance (FFD) Test, while hamstring flexibility was assessed with the ActiveKnee Extension (AKE) Test. Statistical analysis was performed using paired and independent t-tests, with the levelof significance set at p < 0.05.Results:A significant improvement in flexibility was observed in both groups following the intervention period (p < 0.001).Participants treated with the Sub-occipital Muscle Inhibition Technique demonstrated greater improvements inFinger Floor Distance and Active Knee Extension scores compared with those who received the Muscle EnergyTechnique. Although both treatment approaches were effective, the magnitude of improvement was higher in theSMIT group, suggesting better enhancement of posterior chain mobility.Conclusion:Both the Sub-occipital Muscle Inhibition Technique and the Muscle Energy Technique are effective interventionsfor improving posterior chain flexibility in young volleyball players. However, the findings of this study indicatethat the Sub-occipital Muscle Inhibition Technique provides greater improvement and may be considered apreferable manual therapy approach for restoring posterior chain mobility, enhancing functional performance, andsupporting injury prevention in volleyball players