Comparative Efficacy of Myofascial Release Versus Stretching Combined With High-Powered Pulsed Therapeutic Ultrasound in Athletes With Active Trapezius Trigger Points: A Randomized Comparative Trial

Neck pain caused by active myofascial trigger points (MTrPs) in the upper trapezius is a significant concern for athletes, often leading to decreased mobility, persistent discomfort, and compromised performance. Research indicates that these hyperirritable muscle knots contribute not only to localized pain but also to referred discomfort and motor dysfunction, creating a cycle of chronic impairment (Simons et al., 1999). The underlying mechanisms involve both peripheral factors-such as inflammation and nerve sensitization-and central nervous system adaptations that amplify pain perception (Fernández-de-las-Peñas & Dommerholt, 2018). The resulting limitations extend beyond physical symptoms, affecting training consistency, competition readiness, and long-term athletic careers (Hoy et al., 2014; Elabd et al., 2024).

Athletic Susceptibility to MTrPs Athletes engaged in repetitive or high-load movements are particularly vulnerable to upper trapezius MTrPs. Sports like swimming, tennis, and weightlifting, which demand sustained shoulder and neck exertion, frequently lead to muscle overuse and microtrauma (Page, 2012). Similarly, disciplines requiring prolonged static postures, such as cycling or wrestling, place continuous strain on the cervical musculature, increasing the likelihood of trigger point development (Wiewelhove et al., 2019). Without effective intervention, these issues can evolve into chronic pain syndromes, further hindering athletic output.

Current Therapeutic Approaches

Management of MTrPs typically involves a multimodal approach, including:

Stretching Techniques - Both static and dynamic methods aim to restore muscle pliability and enhance joint mobility (Behm et al., 2021).