Muscle activation patterns in the scapular positioning muscles during loaded scapular plane elevation: The effects of Latent Myofascial Trigger Points

Lucas, Karen; Rich, Peter; Polus, Barbara

doi:10.1016/j.clinbiomech.2010.05.006

Cited by 161 publications

(93 citation statements)

References 33 publications

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“…6,36,[112][113][114][115] Lucas and colleagues found altered movement activation patterns in shoulder abduction in subjects with latent trigger points in their shoulder musculature. 8,9 As reviewed previously, latent trigger points do not feature spontaneous pain, but they do provide nociceptive input. In the evaluation of patients with trigger points, clinicians should assess which modifications a particular patient has made, subsequently attempt to determine why the adaptation was made and lastly, why it did not lead to satisfactory resolution of the pain problem.…”

Section: Motor Aspects Of Trigger Pointsmentioning

confidence: 99%

“…2 In 2009, the American Academy of Orthopaedic Manual Physical Therapists adopted a position statement that dry needling is within the scope of manual physical therapy. The advantages of dry needling are increasingly documented 3 and include an immediate reduction in local, referred, and widespread pain, [4][5][6][7] restoration of range of motion and muscle activation patterns, 5,8,9 and a normalization of the immediate chemical environment of active myofascial trigger points. 10,11 Dry needling can reduce peripheral and central sensitization.…”

Section: Introductionmentioning

confidence: 99%

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Dry needling — peripheral and central considerations

Dommerholt¹

2011

Journal of Manual & Manipulative Therapy

220

140

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Dry needling is a common treatment technique in orthopedic manual physical therapy. Although various dry needling approaches exist, the more common and best supported approach targets myofascial trigger points. This article aims to place trigger point dry needling within the context of pain sciences. From a pain science perspective, trigger points are constant sources of peripheral nociceptive input leading to peripheral and central sensitization. Dry needling cannot only reverse some aspects of central sensitization, it reduces local and referred pain, improves range of motion and muscle activation pattern, and alters the chemical environment of trigger points. Trigger point dry needling should be based on a thorough understanding of the scientific background of trigger points, the differences and similarities between active and latent trigger points, motor adaptation, and central sensitize application. Several outcome studies are included, as well as comments on dry needling and acupuncture.

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Section: Motor Aspects Of Trigger Pointsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dry needling — peripheral and central considerations

Dommerholt¹

2011

Journal of Manual & Manipulative Therapy

220

140

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“…(13,22,23) Hand techniques, including manual compression of trigger points, known as ischemic compression or release point is used to inactivate them (18) and retrieve the tissue reperfusion after transient occlusion of the blood flow.…”

Section: Introductionmentioning

confidence: 99%

Effects of ischemic compression of trigger points in painful episodes of patients with chronic shoulder pain. Systematic Review.

Paz¹,

Kerppers²,

Fréz³

2014

mtprehabjournal

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Introduction: Disorders of the shoulder are the major musculoskeletals morbidities, whose pathophysiological mechanisms of pain in the shoulder are poorly understood , myofascial trigger points are presented as alternative diagnosis of these disorders. Objective: To investigate the effectiveness of the release of trigger points on the pain symptoms in patients with chronic shoulder pain. Method: We conducted a descriptive study using a systematic literature review , in consultation with the databases PubMed , EMBASE , CINAHL , PEDro , SportDiscus , and LILACS . Two reviewers assessed the methodological quality of the selected studies , with the help of Quality Scale Jadad and PEDro scale. Results: The initial search resulted in 312 articles . After analyzing the titles and reading the abstracts , 70 studies that appeared repeatedly in more than one database and 214 who did not meet the predefined inclusion criteria , 28 texts were analyzed in their entirety were excluded , considering the inclusion and exclusion criteria defined only 2 articles were selected and subjected to analysis for methodological quality. Conclusion: The results demonstrate the importance of inspection and inactivation of myofascial trigger points in the muscles of the shoulder in patients with chronic pain , as they contribute to decreased overall picture of pain.

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“…As patients with PFP represent a heterogeneous population, future studies should consider the application of manual therapy interventions after a clinical examination of the patients. Clinical reasoning for the application of TrP DN in PFP is based on the hypothesis that TrPs induce motor control disturbances, 26 accelerated muscle fatigability, 12 and increased motor activation 16 in the affected and related muscles. As mechanical (ie, disruption of the contraction knot or increase of sarcomere length) and neurophysiological (ie, decrease of peripheral inputs and activation of central pain pathways) mechanisms are receptive to TrP DN, 3,11 we hypothesized that the mechanical stimulus exerted by the needle into the knee musculature would be able to increase the effectiveness of the strengthening exercise program and that, therefore, patients would potentially achieve better pain and functional outcomes.…”

mentioning

confidence: 99%

Effectiveness of Inclusion of Dry Needling in a Multimodal Therapy Program for Patellofemoral Pain: A Randomized Parallel-Group Trial

Espí-López¹,

Serra-Añó²,

Vicent-Ferrando³

et al. 2017

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Randomized controlled trial. Background Evidence suggests that multimodal interventions that include exercise therapy may be effective for patellofemoral pain (PFP); however, no study has investigated the effects of trigger point (TrP) dry needling (DN) in people with PFP. Objectives To compare the effects of adding TrP DN to a manual therapy and exercise program on pain, function, and disability in individuals with PFP. Methods Individuals with PFP (n = 60) recruited from a public hospital in Valencia, Spain were randomly allocated to manual therapy and exercises (n = 30) or manual therapy and exercise plus TrP DN (n = 30). Both groups received the same manual therapy and strengthening exercise program for 3 sessions (once a week for 3 weeks), and 1 group also received TrP DN to active TrPs within the vastus medialis and vastus lateralis muscles. The pain subscale of the Knee injury and Osteoarthritis Outcome Score (KOOS; 0–100 scale) was used as the primary outcome. Secondary outcomes included other subscales of the KOOS, the Knee Society Score, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), and the numeric pain-rating scale. Patients were assessed at baseline and at 15-day (posttreatment) and 3-month follow-ups. Analysis was conducted with mixed analyses of covariance, adjusted for baseline scores. Results At 3 months, 58 subjects (97%) completed the follow-up. No significant between-group differences (all, P>.391) were observed for any outcome: KOOS pain subscale mean difference, −2.1 (95% confidence interval [CI]: −4.6, 0.4); IKDC mean difference, 2.3 (95% CI: −0.1, 4.7); knee pain intensity mean difference, 0.3 (95% CI: −0.2, 0.8). Both groups experienced similar moderate-to-large within-group improvements in all outcomes (standardized mean differences of 0.6 to 1.1); however, only the KOOS function in sport and recreation subscale surpassed the prespecified minimum important change. Conclusion The current clinical trial suggests that the inclusion of 3 sessions of TrP DN in a manual therapy and exercise program did not result in improved outcomes for pain and disability in individuals with PFP at 3-month follow-up. Level of Evidence Therapy, level 1b. Prospectively registered July 27, 2015 at www.clinicaltrials.gov (NCT02514005). J Orthop Sports Phys Ther 2017;47(6):392–401. doi:10.2519/jospt.2017.7389

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Muscle activation patterns in the scapular positioning muscles during loaded scapular plane elevation: The effects of Latent Myofascial Trigger Points

Cited by 161 publications

References 33 publications

Dry needling — peripheral and central considerations

Dry needling — peripheral and central considerations

Effects of ischemic compression of trigger points in painful episodes of patients with chronic shoulder pain. Systematic Review.

Effectiveness of Inclusion of Dry Needling in a Multimodal Therapy Program for Patellofemoral Pain: A Randomized Parallel-Group Trial

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