Effects of Positional Release Technique for Myofascial Trigger Points of the Upper Trapezius With Forward Head Posture

Muscular and skeletal structures can change into an incorrect shape due to a reduction in physical activity and inappropriate posture habits in daily living. Kong YS et al defined Forward head posture (FHP) as a posture that adopts upper cervical extension and lower cervical flexion. The center of gravity of the head in this posture is positioned at the front rather than the vertebral body weight.

FHP weakens the deep cervical flexor muscle, the mid thoracic rhomboid muscle for scapular retraction, and the mid and lower trapezius muscles. FHP also shortens the pectoralis major and neck extension muscles. Upper trapezius muscle activity is increased more in FHP than in correct anatomic positions, and most patients complain of pain from muscle overuse.

The craniovertebral angle (CVA) is defined as an angle made by the intersection of a line joining the midpoint of the tragus of ear to the skin overlying the C7 spinous process and a horizontal line passing through the C7 spinous process. There is a correlation between FHP, neck pain, and CVA. One of the studies reported that subjects having smaller CVA had FHP and were prone to have increased severity of neck pain.

D'souza CJ et al stated that positional Release Therapy (PRT) is a noninvasive treatment which can be used in conjunction with several electrical modalities. In this technique, in order to facilitate restoration of normal tissue length and to treat excessive muscle tension or spasm, tissues are placed in a Position of comfort for a brief period (90 sec) to resolve the associated dysfunction.

In 2017 a study conducted which shows that PRT has beneficial effects on myofascial trigger points (MTrPs). In this regard, Kelencz et al. reported that PRT is effective in reducing pain and muscle tension among patients with upper-trapezius MTrPs. Amini A et al studied on 30 female university students, who were identified with latent MTrPs of the upper trapezius, according to the results, both Manual Passive Muscle Shortening (MPMS) and PRT were effective techniques in immediate pain relief of upper-trapezius MTrPs.