Immediate Effects of Strain-Counterstrain Technique on Pressure Pain Threshold and Muscle Activity in Male Adults With Upper Trapezius Latent Trigger Point

  • Jung, Ji-Hee (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University) ;
  • Lee, Nam-Gi (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University) ;
  • You, Sung-Hyun (Dept. of Physical Therapy, College of Health Science, Yonsei University, Dept. of Ergonomic Therapy, The Graduate School of Health and Environment, Yonsei University)
  • Received : 2011.02.24
  • Accepted : 2011.03.31
  • Published : 2011.05.31

Abstract

The aim of this study was to determine the immediate effects of single treatment of strain-counter strain (SCS) on pressure pain threshold (PPT) and muscle activity during scapular plane abduction with 3% body weight load. Fifteen asymptomatic male adults with upper trapezius latent trigger point (LTrP) (PPT<2.9 $kg/cm^2$) participated in this study. Pressure algometer was used to measure PPT and surface electromyography was used to record upper, middle arid lower trapezius, serratus anterior, infraspinatus and middle deltoid muscle activity and relative ratio during scapular plane abduction between pre- and post-intervention. There was a significant increase in upper trapezius PPT after a 90-second SCS (p<.05). The activity of the upper trapezius and middle deltoid was significantly decreased (p=.014, p=.001), coupled with a decreased muscle activity ratio between the upper and lower trapezius (p<.05). These results indicate that the SCS may effectively deactivate upper trapezius activity, thereby alleviating muscle balance and reducing pain sensitivity.

Keywords

References

  1. Cools AM, Declercq GA, Cambier DC, et al. Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. Scand J Med Sci Sports. 2007;17(1):25-33.
  2. Cools AM, Witvrouw EE, Declercq GA, et al. Scapular muscle recruitment patterns: Trapezius muscle latency with and without impingement symptoms, Am J Sport Med. 2003;31(4):542-549.
  3. Criswell E, Cram JR. Cram's Introduction to Surface Electromyography. 2nd ed. Sudbury, MA, Jones and Bartlett Publishers, 2011.
  4. Eisenhart AW, Gaeta TJ, Yens DP. Osteopathic manipulative treatment in the emergency department for patients with acute ankle injuries, J Am Osteopath Assoc. 2003;103(9):417-421.
  5. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain. 1987;30(1):115-126. https://doi.org/10.1016/0304-3959(87)90089-3
  6. Hong CZ, Simons DG. Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points, Arch Phys Med Rehabil. 1998;79(7):863-872. https://doi.org/10.1016/S0003-9993(98)90371-9
  7. Hubbard DR, Berkoff GM. Myofascial trigger points show spontaneous needle EMG activity. Spine. 1993;18(13):1803-1807. https://doi.org/10.1097/00007632-199310000-00015
  8. Huguenin LK. Myofascial trigger points: The current evidence. Phys Ther Sport. 2004;5(1):2-12. https://doi.org/10.1016/j.ptsp.2003.11.002
  9. Jones LH. Strain and counterstrain. Colorado Springs, CO, American Academy of Osteopathy. 1981.
  10. Kendall FP. Muscles: Testing and function with posture and pain. 5th ed. Baltimore, MD, Lippincott Williams & Wilkins, 2005.
  11. Kibler WB, Sciascia A. Current concepts: Scapular dyskinesis. Br J Sports Med. 2010;44(5):300-305. https://doi.org/10.1136/bjsm.2009.058834
  12. Lewis C. The use of strain-counterstrain in the treatment of patients with low back pain. J Man Manip Ther. 2001;9(2):92-98.
  13. Lewis C. A randomised controlled study examining the short-term effects of strain-counterstrain treatment on quantitative sensory measures at digitally tender points in the low back. Man Ther. 2010;15(6):536-541. https://doi.org/10.1016/j.math.2010.05.011
  14. Lieoeison C. Rehabilitation of the Spine: A practitioner's manual. 2nd ed. Philadelphia, PA, Lippincott Williams & Wilkins, 2007.
  15. Lucas KR, Polus BI, Rich PAPA. Latent myofascial trigger points: Their effects on muscle activation and movement efficiency. J Bodyw Mov Ther. 2004;8(3):160-166. https://doi.org/10.1016/j.jbmt.2003.12.002
  16. Lucas KR, Rich PA, Polus BI. Muscle activation patterns in the scapular positioning muscles during loaded scapular plane elevation: The effects of latent myofascial trigger points. Clin Biomech. 2010;25(8):765-770. https://doi.org/10.1016/j.clinbiomech.2010.05.006
  17. Lucas N. Macaskill P, Irwig L, et al. Reliability of physical examination for diagnosis of myofascial trigger points: A systematic review of the literature, Clin J Pain. 2009;25(1):80-89. https://doi.org/10.1097/AJP.0b013e31817e13b6
  18. Meseguer AA, Fernandez-de-las-Penas C, Navarro-Poza JL, et al. Immediate effects of the strain/counter-strain technique in local pain evoked by tender points in the upper trapezius muscle. Clin Chiropr. 2006;9(3):112-118. https://doi.org/10.1016/j.clch.2006.06.003
  19. Nagrale AV, Glynn P, Joshi A, et al. The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigg er points in subjects with non-specific neck pain: A randomized controlled trial. J Man Manip Ther. 2010;18(1):37-43. https://doi.org/10.1179/106698110X12595770849605
  20. Page P, Frank CC, Lardner R. Assessment and Treatment of Muscle Imbalance: The Janda approach. Champaign, IL, Human Kinetics. 2010.
  21. Pedowitz RN. Use of osteopathic manipulative treatment for iliotibial band friction syndrome. J Am Osteopath Assoc. 2005;105(12):563-567.
  22. Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. Mosby, St. Louis, Mo., 2002.
  23. Sciotti VM, Mittak VL, DiMarco L, et al. Clinical precision of myofascial trigger point. location in the trapezius muscle. Pain. 2001;93(3):259-266. https://doi.org/10.1016/S0304-3959(01)00325-6
  24. Simons DG. Understanding effective treatments of myofascial trigger points. J Bodyw Mov Ther. 2002;6(2):81. https://doi.org/10.1054/jbmt.2002.0271
  25. Simons DG, Travell JG, Simons LS. Travell & Simons' Myofascial Pain and Dysfunction: The trigger point manual. 2nd ed. Baltimore, MD, Williams & Wilkins, 1999.
  26. Thigpen CA, Padua DA, Michener LA, et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol. 2010;20(4):701-709. https://doi.org/10.1016/j.jelekin.2009.12.003