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Kinesiology and Recreation


Noelle Selkow

Mentor Department

Kinesiology & Recreation


Justin Stanek

Co-Mentor Department

Kinesiology & Recreation


Context: Non-specific neck pain lacks a specific diagnosis with varying causes such as poor posture and muscular trigger points. Commonly, poor posture causes tightness in the upper trapezius (UT) muscle due to sustained activity. This leads to decreased oxygen to the muscle and trigger point formation. 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, thephysiological effects on subcutaneous hemodynamics have yet to be proven.Objective: To measure active cervical range of motion (ROM), neck pain, and subcutaneoushemodynamics of the UT following a single intervention of GT in patients with neck pain stemming from trigger points.Study Design: Single-blinded randomized controlled laboratory study.Participants: Sixty participants (18-40 yo) experiencing neck pain and trigger point(s) present in the UT muscle volunteered. Participants were excluded if they had manual therapy within the past 3 months to the neck/shoulder, history of diagnosed neck injury, spinal, or shoulder surgery,cancer, kidney dysfunction, pregnancy, anticoagulant medication, varicose veins,polyneuropathies, diabetes, heart failure, contagious skin conditions, open wounds,thrombophlebitis, and hypertension.Interventions: Participants randomly assigned to: GT, sham instrument assisted soft tissue mobilization (IASTM), or control. All participants completed the GT protocol: a 10-minute arm bike warm-up, 5-minute treatment based on group, passive lateral flexion stretch, and 3 therapeutic exercises. Treatment area was determined by bilateral palpation of the UT muscle for the most prominent trigger point.Main Outcome Measure(s): Subcutaneous hemodynamics, neck lateral flexion ROM, and pain pressure threshold.Results: Increased levels of oxygenated hemoglobin (superficial and deep) in GT and sham groups (p< 0.008) compared to control group. However, there were no differences found between GT and sham (p>.555). For right (p=.025) and left (p=.002) lateral flexion, there was a treatment main effect. GT showed increased ROM compared to the sham (p=.019) and control(p=.017) on the right. GT (p=.001) and sham (p=.017) increased ROM compared to control on the left. No differences found among groups for PPT (p=.201).Conclusion: Overall, a single treatment of GT proved to be an effective treatment technique for the UT regarding subcutaneous hemodynamics and ROM in patients with neck pain. Further research is needed to establish if GT as a superior treatment to other forms of IASTM.

Hemodynamic Effects of Graston Technique on Trigger Points in the Upper Trapezius in Patients with Neck Pain

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