Myotonometric Evaluation of Latent Myofascial Trigger Points and Taut Band in Elite Athletes

Abstract

Purpose: Our aim was to identify the mechanical properties of the latent myofascial trigger points (MTrPs), the taut band and the non-taut band (surrounding muscle) within the gastrocnemius muscle using the myotonometric evaluation method. Methods: Thirty-one asymptomatic elite rugby players (23.0±4.16 y, 97.5±22.1 kg, 183.5±7.6 cm) with a latent MTrP in lateral gastrocnemius muscle included in this study. Muscle stiffness, decrement and muscle tone of latent MTrPs, taut band and the non-taut band were measured using a myotonometer (MyotonPRO, Myoton AS, Tallinn, Estonia). One-way ANOVA was conducted to determine the differences between the three measurement points. After pairwise comparisons, Cohen’s d effect sizes were calculated to determine the magnitude of differences between the measurement points. Results: Although the stiffness of the MTrPs was lower than its taut band, one-way ANOVA revealed that there was no difference between the MTrPs vs the taut band and the non-taut band for frequency, stiffness and decrement parameters (p>0.05). However, there is a difference between the taut band non-taut band for muscle tone (P= 0.016), for stiffness (P=0.035) and for decrement (P=0.012) and effect sizes are as d=0.64, d=0.69 and d=0.62 for stiffness, muscle tone and decrement respectively. Conclusion: The MTrPs and the taut bands showed an increase in muscle stiffness and muscle tone compared to the surrounding muscle. The taut band could be easily identified from the surrounding muscle using the myotonometer. Therefore, myotonometric measurement is a potentially valuable method for the identification of the taut band in elite athletes.

Keywords

• trigger point
• muscle tone
• taut band
• stiffness

Elit Atletlerde Latent Myofasyal Tetik Noktaların ve Gergin Bandın Myotonometrik Ölçümlerle Değerlendirilmesi

Abstract

Keywords

• tetik nokta
• kas tonusu
• kas kompliyansı
• gergin bant

References

1. 1. Thomas K and Shankar H. Targeting myofascial taut bands by ultrasound. Current pain and headache reports 2013; 17: 349.
2. 2. Ibarra JM, Ge H-Y, Wang C, et al. Latent myofascial trigger points are associated with an increased antagonistic muscle activity during agonist muscle contraction. The Journal of Pain 2011; 12: 1282-1288.
3. 3. Devereux F, O'Rourke B, Byrne PJ, et al. Effects of Myofascial Trigger Point Release on Power and Force Production in the Lower Limb Kinetic Chain. The Journal of Strength & Conditioning Research 2019; 33: 2453-2463.
4. 4. Adigozali H, Shadmehr A, Ebrahimi E, et al. Reliability of assessment of upper trapezius morphology, its mechanical properties and blood flow in female patients with myofascial pain syndrome using ultrasonography. Journal of bodywork and movement therapies 2017; 21: 35-40.
5. 5. Celik D and Mutlu EK. Clinical implication of latent myofascial trigger point. Current pain and headache reports 2013; 17: 353.
6. 6. Simons DG. New views of myofascial trigger points: etiology and diagnosis. Archives of physical medicine and rehabilitation 2008; 89: 157-159.
7. 7. Barbero M, Cescon C, Tettamanti A, et al. Myofascial trigger points and innervation zone locations in upper trapezius muscles. BMC musculoskeletal disorders 2013; 14: 179.
8. 8. Chen Q, Basford J and An K-N. Ability of magnetic resonance elastography to assess taut bands. Clinical Biomechanics 2008; 23: 623-629.

9. 9. Werner BC, Belkin NS, Kennelly S, et al. Acute gastrocnemius-soleus complex injuries in National Football League Athletes. Orthopaedic journal of sports medicine 2017; 5: 2325967116680344.
10. 10. Cerrah A, Güngör EO, Soylu A, et al. Muscular activation differences between professional and amateur soccer players during countermovement jump. Türk Spor ve Egzersiz Dergisi 2014; 16: 51-58.
11. 11. Lohr C, Braumann K-M, Reer R, et al. Reliability of tensiomyography and myotonometry in detecting mechanical and contractile characteristics of the lumbar erector spinae in healthy volunteers. European journal of applied physiology 2018; 118: 1349-1359.
12. 12. Chuang L-L, Lin K-C, Wu C-Y, et al. Relative and absolute reliabilities of the myotonometric measurements of hemiparetic arms in patients with stroke. Archives of physical medicine and rehabilitation 2013; 94: 459-466.
13. 13. Mullix J, Warner M and Stokes M. Testing muscle tone and mechanical properties of rectus femoris and biceps femoris using a novel hand held MyotonPRO device: relative ratios and reliability. Working Papers in the Health Sciences 2012; 1: 1-8.
14. 14. Huang J, Qin K, Tang C, et al. Assessment of passive stiffness of medial and lateral heads of gastrocnemius muscle, achilles tendon, and plantar fascia at different ankle and knee positions using the MyotonPRO. Medical science monitor: international medical journal of experimental and clinical research 2018; 24: 7570.
15. 15. Morgan GE, Martin R, Williams L, et al. Objective assessment of stiffness in Achilles tendinopathy: a novel approach using the MyotonPRO. BMJ open sport & exercise medicine 2018; 4.
16. 16. Jiménez-Sánchez C, Ortiz-Lucas M, Bravo-Esteban E, et al. Myotonometry as a measure to detect myofascial trigger points: an inter-rater reliability study. Physiological measurement 2018; 39: 115004.
17. 17. Sergienko S and Kalichman L. Myofascial origin of shoulder pain: a literature review. Journal of bodywork and movement therapies 2015; 19: 91-101.
18. 18. Bohlooli N, Ahmadi A, Maroufi N, et al. Differential activation of scapular muscles, during arm elevation, with and without trigger points. Journal of bodywork and movement therapies 2016; 20: 26-34.
19. 19. Ballyns JJ, Turo D, Otto P, et al. Office‐based elastographic technique for quantifying mechanical properties of skeletal muscle. Journal of Ultrasound in Medicine 2012; 31: 1209-1219.
20. 20. Roch M, Morin M and Gaudreault N. The MyotonPRO: A reliable tool for quantifying the viscoelastic properties of a trigger point on the infraspinatus in non-traumatic chronic shoulder pain. Journal of Bodywork and Movement Therapies 2020; 24: 379-385.
21. 21. Rathbone AT, Grosman-Rimon L and Kumbhare DA. Interrater agreement of manual palpation for identification of myofascial trigger points. The Clinical journal of pain 2017; 33: 715-729.
22. 22. Albin S, Koppenhaver S, MacDonald C, et al. The effect of dry needling on gastrocnemius muscle stiffness and strength in participants with latent trigger points. Journal of Electromyography and Kinesiology 2020; 55: 102479.
23. 23. Chen Q, Bensamoun S, Basford JR, et al. Identification and quantification of myofascial taut bands with magnetic resonance elastography. Archives of physical medicine and rehabilitation 2007; 88: 1658-1661.
24. 24. Chen Q, Wang H-j, Gay RE, et al. Quantification of myofascial taut bands. Archives of physical medicine and rehabilitation 2016; 97: 67-73.
25. 25. Saldıran TÇ, Atıcı E, Öztürk Ö, et al. Cinsiyet Farklılığının Alt Ekstremite Kas Kuvveti ve Kas Mekanik Özelliklerinde Oluşturduğu Değişiklikler-Bir Pilot Çalışma. Turkiye Klinikleri J Health Sci 2020; 5: 530-537.