A study to assess the effectiveness of myofascial release technique versus conventional therapy on pain and muscle recruitment pattern at scapulothoracic and glenohumeral joint in subjects with upper trapezius pain – a comparative study.

Upper trapezius (UT) pain is a stress pain and most common type of musculoskeletal pain in clinical practice. As the upper trapezius is a postural muscle it is exceedingly susceptible to overuse.

Neck pain is most frequent in middle-aged women and fluctuates with a mean prevalence of 13%. It often affects the upper trapezius muscle. Mechanical pain in the neck affects 30-50% of the global population during their lifespan.

Neck and Shoulder Musculoskeletal disorders develop due to repetitive monotonous job profile, restricted static postures, desk/study/writing habits, or a combination of all these factors.

Clinical symptoms include tenderness, stiffness at the neck-shoulder complex and occipital heaviness/headache. UT pain hampers the cervical range of motion to a great extent.

UT pain and MTrPs not only alter the movement at the Scapulothoracic joint but also at the Glenohumeral joint.  The UT is responsible for the upward rotation of the Scapula along with other muscles that include – Lower Trapezius (LT)  and Serratus Anterior (SA).

At the Glenohumeral Joint, when abduction is carried out above 30 degrees , UT, LT, and SA must act as a group to produce upward rotation of scapula around the Scapulothoracic joint’s center of motion. This aids in shoulder abduction at the Glenohumeral joint and enhances functional stability.

Myofascial Trigger Points (MTrPs) are commonly associated with UT pain. MTrPs are hyperirritable focuses situated inside a rigid band (Taut Band) of skeletal muscle that causes pain, tenderness and often some anatomical changes.

Myofascial release (MFR) technique is opted for treating trapezius trigger points. It acts by loosening up the contracted muscle and works on the blood circulation and it also has an effect on the lymphatic drainage.

MFR also works by producing changes in the viscoelastic properties of connective tissue and muscle alignment restoration.

MFR is considered to as a treatment option to reduce MTrPs and can be applied over the UT by techniques such as thumb after thumb or by the ulnar border of the hand.

Electromyography (EMG) can be a valuable instrument for the physiotherapist to get data about the timing or magnitude of muscle action while examining muscle action and pattern. Depending on the receiving electrodes EMG are of 2 types : a- Needle Electromyography (NEMG) and b- Surface Electromyography (SEMG).

SEMG technique works with bulk electrical conductivity principle and therefore it eliminates the effect of the distance of the electrode placement from the source of signal. This gives an upside to use surface electrodes on the skin and avoid the discomfort of the procedure being invasive.

SEMG detects and documents the electrical potential created by either neural or electrical stimulation and give the results regarding muscular contraction, muscular tone and muscle fatigue, activation and coordination patterns.