Date of Award
Master of Science (MS)
School of Kinesiology and Recreation
Background: Non-specific neck pain (NS-NP) is defined as neck pain without a specific diagnosis with varying causes such as poor posture, occupational stressors, and muscular trigger points. Individuals often present with poor posture, including forward head and rounded shoulders. In this position, the upper trapezius muscle becomes tight due to sustained muscle activity leading to trigger points as a result of decreased oxygen to the muscle. Graston Technique® (GT) is a form of manual therapy that uses stainless steel instruments to break down tissue adhesions. GT on trigger points has been presumed to increase local blood flow leading to tissue healing and decreased pain, however, the physiological effects on muscle hemodynamics have yet to be proven.
Objective: To measure active cervical range of motion, neck pain, and subcutaneous hemodynamics of the upper trapezius following a single intervention of GT in patients with neck pain stemming from trigger points.
Participants: Sixty participants between the ages of 18-40 years old with NS-NP and trigger point(s) present in the upper trapezius muscle. Participants were excluded if they had manual therapy treatment within the past 3 months to the neck or shoulder area, history of a diagnosed neck injury, history of spinal or shoulder surgery, cancer, kidney dysfunction, pregnancy, taking an anticoagulant medication, varicose veins, polyneuropathies, diabetes, heart failure, contagious skin conditions, open wounds, thrombophlebitis, and hypertension.
Methods: Participants were allocated into one of the following groups: GT, sham instrument assisted soft tissue mobilization (IASTM), or control. All participants completed the GT protocol which included: a 10-minute arm bike warm, 5-minute treatment based on group allocation, passive lateral flexion stretch, and 3 therapeutic exercises. Treatment area was determined by bilateral palpation of the upper trapezius muscle for the most prominent trigger point.
Results: There were increased levels of oxygenated hemoglobin at superficial and deep depths in the GT and sham groups (p< 0.008) compared to the control group. However, there were no differences found between GT and sham (p>0.555). For ipsilateral lateral flexion, there was no treatment main effect (p=0.126), however GT showed increased ROM compared to control (p=0.043) with post-hoc testing. For contralateral lateral flexion, there was a main effect (p=0.001), where GT and sham showed increased ROM compared to the control, p<0.001 and p=0.019, respectively. There were no differences among groups for PPT (p=.201).
Conclusion: Overall, GT proved to be an effective treatment technique on subcutaneous hemodynamics and ROM in the upper trapezius muscle in patients with neck pain. After a single treatment of GT, participants received increased blood flow to the upper trapezius and increased neck range of motion. Further research is needed to establish GT as a superior treatment to other forms of instrument assisted soft tissue mobilization.
Harris, Hannah, "Hemodynamic Effects Of Graston Technique On Trigger Points In The Upper Trapezius In Patients With Neck Pain" (2020). Theses and Dissertations. 1223.