Myofascial Release vs. Stretching With Ultrasound for Trapezius Trigger Points in Athletes: A Randomized Clinical Trial

NCT07002593 | Completed DMC

• 1 other identifier: RRC-2022-07
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

This study aimed to compare the efficacy of MFR plus HPPT-US versus stretching plus HPPT-US on pain intensity, cervical range of motion (ROM), muscle length (ML), and neck disability in athletes with active upper trapezius MTrPs. Methods: A randomized clinical trial was conducted on 60 male athletes diagnosed with active upper trapezius MTrPs. Participants were randomly assigned to Group A (MFR + HPPT-US) or Group B (stretching + HPPT-US). Interventions were administered over two weeks. Outcome measures including Visual Analog Scale (VAS), ROM, ML, and Neck Disability Index (NDI) were recorded at baseline, week 1, week 2, and one-week follow-up. Between-group comparisons were analyzed using independent t-tests, and effect sizes were calculated using Cohen's d. For all statistical analyses, the level of significance alpha was set at 95% (p \< .05).

Conditions

Active Trapezius Trigger Point Pain

Keywords

Myofascial Pain Syndromes; Ultrasonic Therapy; Athletes; Trigger Points; Range of Motion

Outcome Measures

Primary Outcomes (4)

• Pain intensity

  Pain intensity was assessed using the visual analog scale (VAS), an imaginary line with either end marked with 0 or 10, indicating no pain or extremely unbearable pain, respectively.

  Once a week for 3 weeks (baseline, week 1 and 2 post-intervention, and follow up at week 3 after one-week completion of intervention.

• Cervical range of motion

  Cervical range of motion (ROM) was assessed with a universal goniometer for flexion, extension, right and left lateral flexion, and rotation.

  Once a week for 3 weeks (baseline, week 1 and 2 post-intervention, and follow up at week 3 after one-week completion of intervention.

• Functional disability

  Neck disability was quantified using the Neck Disability Index (NDI), a 10-item questionnaire with established reliability. The minimum and maximum scores are 0 and 50, indicating no disability to severe disability, respectively.

  Once a week for 3 weeks (baseline, week 1 and 2 post-intervention, and follow up at week 3 after one-week completion of intervention.

• Upper trapezius muscle length

  Upper trapezius muscle length was measured using a vernier calliper with the participants seated in a standardized position. The distance between the mastoid process (posterior to the ear) and the acromioclavicular joint (distal end of the clavicle) was considered.

  Once a week for 3 weeks (baseline, week 1 and 2 post-intervention, and follow-up at week 3 after one-week completion of intervention).

Study Arms (2)

MFR Group

EXPERIMENTAL

MFR Group received a 10-minute manual myofascial release (MFR) technique followed by a 5-minute session of high-powered pulsed therapeutic ultrasound (HPPT-US). It was performed three times per week for two weeks.

Other: Myofascial release (MFR); Other: High-powered pulsed therapeutic ultrasound (HPPT-US)

Stretching Group

ACTIVE COMPARATOR

Stretching Group received three 30-second static stretches for the upper trapezius, involving neck side flexion with contralateral rotation, followed by a 5-minute session of HPPT ultrasound. It was performed three times per week for two weeks.

Other: Muscle Stretching; Other: High-powered pulsed therapeutic ultrasound (HPPT-US)

Interventions

Myofascial release (MFR) OTHER

A 10-minute manual myofascial release (MFR) technique targeting active upper trapezius trigger points (MTrPs), applying sustained pressure until tissue release was achieved.

MFR Group

Muscle Stretching OTHER

Three 30-second static muscle stretches were performed for the upper trapezius by placing neck side flexion with contralateral rotation.

Stretching Group

High-powered pulsed therapeutic ultrasound (HPPT-US) OTHER

A 5-minute high-powered pulsed therapeutic ultrasound (HPPT) was delivered subcutaneously with specific parameters of 1.5 W/cm², 1 MHz, and pulsed mode.

MFR Group; Stretching Group

Eligibility Criteria

• Age: 20 Years - 40 Years
• Gender Eligibility Details: Male
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male athletes
• Aged between 20-40 years
• Active MTrPs in the upper trapezius, confirmed via Travell and Simons' (1999) criteria (palpable taut band, spot tenderness, referred pain, and local twitch response);
• Chronic pain lasting 2-3 months; and
• Willingness to provide informed consent.

You may not qualify if:

• Fibromyalgia (per American College of Rheumatology criteria; Wolfe et al., 1990);
• Recent MTrP injections or physical therapy (within 1 year);
• Acute trauma or systemic conditions (e.g., inflammatory diseases); and
• Neurological deficits.
• Non-willingness to participation or showed non-cooperation.

Sponsors & Collaborators

• King Saud University: lead

Study Sites (1)

King Saud University Hospital

Riyadh, 10219, Saudi Arabia

Location

Related Publications (1)

• Khan N, Ghai T, Kashyap R, Bhat P, Ahmad F, Iqbal A, Alghadir T, Alghadir F, Anwer S, Alghadir AH. Comparative efficacy of myofascial release versus stretching combined with high-powered pulsed therapeutic ultrasound in amateur overhead athletes with active trapezius trigger point pain: a randomized clinical trial. BMC Sports Sci Med Rehabil. 2025 Dec 17. doi: 10.1186/s13102-025-01474-y. Online ahead of print.

  PMID: 41402896 DERIVED

Related Links

• Controlled intervention to compare the efficacies of manual pressure release and the muscle energy technique for treating mechanical neck pain due to upper trapezius trigger points

MeSH Terms

Conditions

Myofascial Pain Syndromes

Interventions

Myofascial Release Therapy; Muscle Stretching Exercises

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Massage; Therapy, Soft Tissue; Musculoskeletal Manipulations; Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation; Exercise Therapy; Aftercare; Continuity of Patient Care; Patient Care; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator

Study Record Dates

• First Submitted: May 25, 2025
• First Posted: June 3, 2025
• Study Start: August 7, 2022
• Primary Completion: January 17, 2023
• Study Completion: April 27, 2023
• Last Updated: August 1, 2025

Record last verified: 2025-07

Locations

SA (1)