scholarly journals Treatment of myofascial trigger points of the infraspinatus is effective in relieving shoulder pain and improving shoulder functions: A randomized clinical trial

2020 ◽  
Author(s):  
Sungeon Park ◽  
Joochul Cho ◽  
Seungwon Lee
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Trigger Points ◽  
Shoulder Abduction ◽  
Dash Score ◽  
Myofascial Trigger Points ◽  
Pressure Threshold ◽  
Shoulder Flexion ◽  
Infraspinatus Muscle ◽  
Pain Pressure Threshold

Abstract Background This study aimed to investigate the effects of ischemic compression treatment (ICT) and low-level laser therapy (LLLT) applied on the trigger points of the infraspinatus muscle on shoulder pain and function in patients with shoulder pain. Methods Thirty patients with shoulder pain were randomly categorized into the ICT group (n = 15) and LLLT groups (n = 15). ICT was performed on three myofascial trigger points (MTrPs) of the infraspinatus muscle twice a week for 4 weeks (eight sessions), with 5 minutes of treatment per trigger point. LLLT was performed similarly. Shoulder pain was assessed using the visual analogue scale (VAS) and pain pressure threshold (PPT), and shoulder function was assessed using the Korean Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, rotator cuff strength, and range of motion (ROM) of shoulder flexion and abduction. Results Significant changes in VAS score and PPT were found after the intervention in both groups (p < 0.05). Significant changes were observed in the Korean DASH score, rotator cuff strength, and ROM of shoulder flexion (p < 0.05) but not in the ROM of shoulder abduction (p < 0.05). There were no significant differences between the two groups. Conclusion This study showed that both ICT and LLLT applied on the MTrPs of the infraspinatus muscle were effective for relieving shoulder pain and improving shoulder functions in patients with shoulder pain.

scholarly journals Dry needling in the deactivation of myofascial trigger points

2021 ◽  
Author(s):  
Elaine Cruz ◽  
Davi Rodrigues Martins ◽  
Richarlison Amaral ◽  
Rodrigo Manhães ◽  
Mairkon Almeida Soares
Keyword(s):  
Clinical Trials ◽  
Range Of Motion ◽  
Randomized Clinical Trials ◽  
Trigger Point ◽  
Pressure Pain Threshold ◽  
Trigger Points ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Pressure Threshold ◽  
Pain Pressure Threshold

Dry Needling (DN) is a technique indicated to treat injuries of muscle origin and widely used in the deactivation of myofascial trigger points (PGMs). Its application almost always produces immediate effect, decreasing pain and increasing range of motion. The main objective of the present study was to verify the effectiveness of Dry Needling in the deactivation of myofascial trigger points. A search was carried out through three distinct databases and 10 articles dating from the last ten years were selected, with a score greater than or equal to six, in the classification of the PEDro platform (Physiotherapy Evidence Database). All selected articles were classified as randomized controlled trials, where eight are blind randomized clinical trials and two double blind randomized clinical trials. Outcomes ranged from decreased trigger points, increased range of motion, pain intensity and pain pressure threshold. The studies included in this review suggest that Dry Needling has a fundamental role in the treatment of PGMs, mainly increasing the pressure pain threshold, thus suggesting trigger point deactivation.

scholarly journals Pain pressure thresholds for evaluating myofascial pain in the equine brachiocephalicus muscle

2019 ◽  
Vol 02 (02) ◽  
pp. 114-114
Author(s):  
Calatayud-Bonilla M. ◽  
Resano-Zuazu M. ◽  
Segura-Ortí E.
Keyword(s):  
Myofascial Pain ◽  
Intraclass Correlation ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Minimum Detectable Change ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Pressure Algometer ◽  
Manual Palpation ◽  
Distal Aspect

Abstract Introduction Myofascial pain is one of the most common musculoskeletal pathologies in humans, with the presence of myofascial trigger points (MTrPs). A MTrP is defined as a hyperirritable nodule in a taut band of musculoskeletal fibers. The pain pressure threshold is a tool for the assessment of pain used in humans with proven reliability, however there is no evidence of the same in the study of MTrPs in horses. Aims The aim of this study was to evaluate the reliability of the measurement of pressure pain sensitivity in horses with MTrPs in the brachiocephalicus muscle. A second aim was to calculate the minimum detectable change (MDC) for this result. Material and Methods Twenty horses were evaluated, aged between five and fifteen years old. All without pathology or previous pharmacological treatment. The cranial angle of the scapula was taken as the anatomic reference. A first evaluator, whose reliability was already confirmed, performed a manual palpation of the distal aspect of the brachiocepalicus muscle. A MTrP was located in all animals included in the study. The anatomic reference and the MTrP were marked. The pain pressure threshold of the MTrP was measured using a pressure algometer (Wagner Instruments, EE.UU., kg/cm2). The same evaluator applied the tip of the algometer parallel to the neck and transversal to the muscle fibers, gradually increasing pressure until the ‘jump sign’ or facial expressions of pain were detected by a second operator who also recorded the measurements. The measurements were repeated consecutively twice in this manner. The first operator was blind to the measurements. The intraclass correlation index (ICC) was calculated to evaluate reliability. Results The mean thresholds of pain pressure sensitivity registered for the first and second measurement were 3.29 (1.0) kg/cm2 and 3.31 (0.9) kg/cm2. The ICC was 0.86 (95% CI: 0.68 to 0.95). The MDC was 0.9 kg/cm2 (95% CI: 0.6 to 1.4). Conclusions Acceptable reliability was found for the measurement of the pain pressure threshold in horses with MTrPs in the brachiocephalicus muscle.

scholarly journals Effect of ice massage with integrated neuromuscular inhibition technique on pain and function in subjects with mechanical neck pain: randomized controlled trial

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Heba Mohammed Moselhy Al-Najjar ◽  
Amal Hassan Mohammed ◽  
Dalia Mohammed Mosaad
Keyword(s):  
Neck Pain ◽  
Trigger Points ◽  
Lateral Side ◽  
Myofascial Trigger Points ◽  
Upper Trapezius ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Significant Difference ◽  
Side Bending ◽  
Inhibition Technique

Abstract Background Myofascial trigger point (MTrP) plays a major role in the genesis of mechanical neck pain, which may lead to chronic disorders. The purpose of the study is to investigate and compare the effect of ice massage plus integrated neuromuscular inhibition technique (INIT) versus INIT alone on active trigger points in the upper trapezius of persons having mechanical neck pain. Forty participants diagnosed as mechanical neck pain with upper trapezius active myofascial trigger points. They were randomized into two equal groups. Group A (experimental) received ice massage for 10 min plus INIT, while group B (control) received INIT alone. The treatment program continued for 2 weeks (3 sessions/week). The outcome measures are the pain intensity, pain pressure threshold, cervical lateral side bending and neck daily functions. Results The results showed that there were significant improvements in VAS at p = .899 and F = .78, PPT at p = .288 and F = .553, cervical side bending at p = .094 and F < 0.00001, and NDI at p = .164 and F = 0.00001 in both groups, while there were no statistically significant differences between both groups as p > 0.05. Conclusion Ice massage and INIT are effective methods in managing active trigger points in the upper trapezius of persons having mechanical neck pain without statistically significant difference.

scholarly journals The Effect of Therapeutic Low-Frequency Ultrasound applied to Myofascial Trigger Points: A Pilot Pre-Post Design Study

2021 ◽  
Vol 3 (3) ◽  
pp. 242-249
Author(s):  
Michal Elboim Gabyzon ◽  
Amit Drat ◽  
Leonid Kalichman
Keyword(s):  
Trigger Point ◽  
Low Frequency ◽  
Trigger Points ◽  
Preliminary Evidence ◽  
Calf Muscle ◽  
Myofascial Trigger Points ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Low Frequency Ultrasound ◽  
Hop Test

Ultrasound at a frequency of 1 or 3 MHz is frequently used to treat various musculoskeletal conditions, but research on ultrasound operating at 38-50 kHz frequencies (US-KHz) is lacking. Study aimed to evaluate the short-term effect of US-KHz on pain pressure threshold (PPT), ankle dorsiflexion range of motion (ROM), and motor performance (the Side Hop Test) in subjects with a myofascial trigger point (TrP) in the calf muscle. US-KHz was applied to the area of the palpable TrP in the calf muscle for 10 minutes (continuous pulse, transducer head size 19.6 cm2, power 0.75-1.25 w/cm2) in twenty volunteers (18-45 years old). Significant improvements (p<0.001) were noted in the Side Hop Test 24 hours after the intervention. ROM improved significantly after 5 minutes with changes maintained 24 hours later. No change was found in the PPT. This pilot study presents preliminary evidence of the efficacy of US-KHz in treating TrPs. Doi: 10.28991/SciMedJ-2021-0303-5 Full Text: PDF

Effects of thoracic spine manipulation on pressure pain sensitivity of rhomboid muscle active trigger points: a randomized control trial

2021 ◽  
pp. 1-12
Author(s):  
Bibi Haleema ◽  
Huma Riaz
Keyword(s):  
Thoracic Spine ◽  
Randomized Control Trial ◽  
Rating Scale ◽  
Trigger Points ◽  
Control Group ◽  
Pressure Sensitivity ◽  
Myofascial Trigger Points ◽  
Pain Pressure Threshold ◽  
Significant Difference ◽  
Randomized Control

Abstract Objective: The objective of study was to determine the effects of thoracic spine manipulation on interscapular pain and pain pressure sensitivity, thoracic mobility and disability due to active myofascial trigger points in rhomboid muscle. Methods: A randomized control trial was conducted at Women Institute of Rehabilitation Sciences Abbottabad, from July to December 2019.Ethical permission was taken fromResearch ethical committee of Riphah international university Islamabad. Participants were selected through non-probability purposive sampling technique as per inclusion criteria. It consisted of 60 participants with forward head posture having active trigger points in rhomboid muscle, with age ranging from 18 to 30 years. The participants were randomly allocated through sealed envelope method into two groups that are experimental and control. Experimental group has received thoracic manipulation along with conventional physical therapy (CPT) whereas control group has only received CPT including manual pressure release and therapeutic exercise. Intervention was applied with 2 sessions / week with 3 weeks in total. Pre and Post assessment was done with outcome measurement tools comprised of Numeric pain rating scale (NPRS) for pain severity, Algometry for pain pressure threshold(PPT), Inclinometer for Range of movement(ROM) and Neck disability index (NDI) for associated disability. Data analysis was done using SPSS-20 version. Results: Between group analysis has shown significant improvement of pain & pain pressure sensitivity with p value <0.01 and <0.05 respectively. All outcome measures have shown significant difference in pre post treatment (p<.000) in both groups. Continuous...

Topographical mapping and mechanical pain sensitivity of myofascial trigger points in the infraspinatus muscle

2008 ◽  
Vol 12 (7) ◽  
pp. 859-865 ◽  
Author(s):  
Hong-You Ge ◽  
César Fernández-de-las-Peñas ◽  
Pascal Madeleine ◽  
Lars Arendt-Nielsen
Keyword(s):  
Pain Sensitivity ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Infraspinatus Muscle ◽  
Topographical Mapping

Trigger Point Dry Needling versus Strain–counterstrain Technique for Upper Trapezius Myofascial Trigger Points: A Randomised Controlled Trial

2016 ◽  
Vol 34 (3) ◽  
pp. 171-177 ◽  
Author(s):  
E Segura-Ortí ◽  
S Prades-Vergara ◽  
L Manzaneda-Piña ◽  
R Valero-Martínez ◽  
JA Polo-Traverso
Keyword(s):  
Randomised Controlled Trial ◽  
Trigger Point ◽  
Controlled Trial ◽  
Trigger Points ◽  
Dry Needling ◽  
Significant Group ◽  
Myofascial Trigger Points ◽  
Upper Trapezius ◽  
Pain Pressure Threshold ◽  
Randomised Controlled

Background Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. Objectives To compare the effects of upper trapezius trigger point dry needling (DN) and strain–counterstrain (SCS) techniques versus sham SCS. Study Design Randomised controlled trial. Method 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects’ own ratings of perceived disability were measured. Results The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI −4.9 to 2.1) or sham SCS (1.8, 95% CI −6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. Conclusions There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. Trial Registration Number NCT01290653.

scholarly journals Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial

BMC Medicine ◽  
2011 ◽  
Vol 9 (1) ◽  
Author(s):  
Carel Bron ◽  
Arthur de Gast ◽  
Jan Dommerholt ◽  
Boudewijn Stegenga ◽  
Michel Wensing ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Shoulder Pain ◽  
Controlled Trial ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Randomized Controlled ◽  
Chronic Shoulder Pain

scholarly journals Arm abduction angle at ball release influences shoulder forces and torques during the windmill softball pitch

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0040
Author(s):  
Donna Scarborough ◽  
Ryan Fallon ◽  
Eric Berkson ◽  
Luke Oh, Shannon Linderman
Keyword(s):  
Shoulder Pain ◽  
Shoulder Joint ◽  
High Speed ◽  
Frontal Plane ◽  
Abduction Angle ◽  
Shoulder Abduction ◽  
Compression Force ◽  
Ball Release ◽  
Shoulder Flexion ◽  
Relationship Of

Objectives: Shoulder pain and ligamentous injury is a common complaint among fast pitch softball pitchers. In addition to extreme shoulder joint motion during pitch delivery, sudden deceleration immediately after ball release places increased stress across the shoulder joint. Some pitchers release the ball with the throwing arm tucked close to the trunk, while others let the arm float outwards in a more abducted position. The position of the arm at ball release (BR) may be key to the mechanism of shoulder pain. Previous work demonstrated that during the change up pitch, softball pitchers with upper extremity pain demonstrated greater shoulder abduction at stride and less trunk lateral flexion at BR compared to athletes without pain (Oliver et al 2018). The purpose of this study was to test the hypothesis that placement of the arm closer to the trunk (shoulder adduction) at ball release will produce less shoulder stress during fastball windmill pitches. Methods: Twenty-six female fast pitch softball pitchers with a mean age of 18 +/- 6 y, including 16 high school, 7 collegiate, and 3 professional athletes, underwent 3D biomechanical pitch analyses using 20 Vicon high-speed motion capture cameras (240 hz). All pitchers threw the standard 13.11 m mound-to-plate distance at a strike zone target while a radar gun collected pitch speeds. The fastest, most accurate fastball pitches for each subject were selected for analyses (average of 5 pitches per subject). A total of 103 pitches were used to calculate: shoulder abduction angle and shoulder compression force during the BR phase (10 frames surrounding BR) and peak shoulder torques. Pearson correlations were performed to determine the relationship of shoulder frontal plane (adduction/abduction) angle during the ball release phase to these biomechanical measures. Results: The smallest abduction shoulder angle reached during the BR phase (avg: 14.06 +/- 6.71 degrees) demonstrated a significant positive correlation with shoulder compression force, p=0.008 and with peak flexion torque, p< 0.001 (Table 1). This shoulder abduction angle during the BR phase demonstrated negative correlations with peak shoulder adduction torque, p<0.001 and shoulder internal rotation torque, p< 0.001. Conclusion: These initial findings support the hypothesis that pitchers who release the ball with their arm close to their trunk demonstrate lower shoulder compression forces and shoulder flexion torques than those with a more abducted arm position. Future studies are needed to explore the interplay of pitching technique mechanics, shoulder joint stresses, and injury history to inform pitching instruction and injury prevention efforts. [Table: see text]

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