RESUMEN
STUDY DESIGN: Cross-sectional cohort study. OBJECTIVE: To investigate the differences in the level of activation of neck-shoulder muscles between elite swimmers with and without shoulder pain during a functional upper-limb task. BACKGROUND: Previous studies have reported altered motor control of the neck-shoulder muscles in patients with chronic neck-shoulder pain. Whether the activation of neck-shoulder muscles is altered among elite swimmers who have shoulder pain is unknown. METHODS: Surface electromyography from the sternocleidomastoid, upper trapezius, and anterior scalene (SCL) muscles was recorded bilaterally in 17 elite swimmers (9 men, 8 women; mean ± SD age, 21 ± 3 years) with unilateral shoulder pain, and 17 age- and sex-matched elite swimmers without pain. Root-mean-square values were calculated and normalized to assess the level of muscular activation 5 seconds before, 120 seconds into, 150 seconds into, and 10 seconds after a functional upper-limb task. RESULTS: The data revealed significant differences between groups for the root-mean-square of both SCL muscles (F = 3.733, P = .016) but not for the sternocleidomastoid and upper trapezius muscles. Swimmers with shoulder pain had higher normalized root-mean-square values in both SCL muscles at 120 seconds (78% on average) and 150 seconds (86% on average) into the task and at 10 seconds after the task (40% on average), as compared with swimmers without shoulder pain (P<.05). CONCLUSION: The elite swimmers with shoulder pain demonstrated greater activation of the SCL muscles during a functional task and a lower ability to relax the SCL muscles after completion of the task than elite swimmers without shoulder pain. The present findings suggest an altered pattern of cervical muscle activation in elite swimmers with shoulder pain during performance of a functional task.
Asunto(s)
Trastornos de Traumas Acumulados/epidemiología , Prueba de Esfuerzo/instrumentación , Músculo Esquelético/patología , Cuello/patología , Dolor de Hombro/patología , Natación/lesiones , Adolescente , Adulto , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/etiología , Traumatismos en Atletas/patología , Intervalos de Confianza , Estudios Transversales , Trastornos de Traumas Acumulados/etiología , Electromiografía/instrumentación , Prueba de Esfuerzo/métodos , Femenino , Indicadores de Salud , Humanos , Masculino , Dimensión del Dolor , Factores de Riesgo , Dolor de Hombro/epidemiología , Dolor de Hombro/etiología , Estadística como Asunto , Natación/fisiología , Análisis y Desempeño de Tareas , Extremidad Superior/patología , Adulto JovenRESUMEN
The aim of this case series was to investigate changes in pain and pressure pain sensitivity after manual treatment of active trigger points (TrPs) in the shoulder muscles in individuals with unilateral shoulder impingement. Twelve patients (7 men, 5 women, age: 25 ± 9 years) diagnosed with unilateral shoulder impingement attended 4 sessions for 2 weeks (2 sessions/week). They received TrP pressure release and neuromuscular interventions over each active TrP that was found. The outcome measures were pain during arm elevation (visual analogue scale, VAS) and pressure pain thresholds (PPT) over levator scapulae, supraspinatus infraspinatus, pectoralis major, and tibialis anterior muscles. Pain was captured pre-intervention and at a 1-month follow-up, whereas PPT were assessed pre- and post-treatment, and at a 1-month follow-up. Patients experienced a significant (P < 0.001) reduction in pain after treatment (mean ± SD: 1.3 ± 0.5) with a large effect size (d > 1). In addition, patients also experienced a significant increase in PPT immediate after the treatment (P < 0.05) and one month after discharge (P < 0.01), with effect sizes ranging from moderate (d = 0.4) to large (d > 1).A significant negative association (r(s) = -0.525; P = 0.049) between the increase in PPT over the supraspinatus muscle and the decrease in pain was found: the greater the decrease in pain, the greater the increase in PPT. This case series has shown that manual treatment of active muscle TrPs can help to reduce shoulder pain and pressure sensitivity in shoulder impingement. Current findings suggest that active TrPs in the shoulder musculature may contribute directly to shoulder complaint and sensitization in patients with shoulder impingement syndrome, although future randomized controlled trials are required.
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Osteopatía/métodos , Síndrome de Abducción Dolorosa del Hombro/complicaciones , Dolor de Hombro/etiología , Dolor de Hombro/terapia , Puntos Disparadores , Adulto , Femenino , Humanos , Masculino , Músculo Esquelético/fisiopatología , Dimensión del Dolor , Umbral del DolorRESUMEN
Our aim was to describe the differences in the presence of trigger points (TrPs) in the shoulder muscles and to investigate the presence of mechanical hypersensitivity in patients with unilateral shoulder impingement and healthy controls. Twelve patients with strictly unilateral shoulder impingement and 10 matched controls were recruited. TrPs in the levator scapula, supraspinatus, infraspinatus, subscapularis, pectoralis major, and biceps brachii muscles were explored. TrPs were considered active if the local and referred pain reproduced the pain symptoms and the patient recognized the pain as a familiar pain. Pressure pain thresholds (PPT) were assessed over the levator scapulae, supraspinatus, infraspinatus, pectoralis major, biceps brachii, and tibialis anterior muscles. Both explorations were randomly done by an assessor blinded to the subjects' condition. Patients with shoulder impingement have a greater number of active (mean +/- SD: 2.5 +/- 1; P < 0.001) and latent (mean +/- SD: 2 +/- 1; P = 0.003) TrPs when compared to controls (only latent TrPs, mean +/- SD: 1 +/- 1). Active TrPs in the supraspinatus (67%), infraspinatus (42%), and subscapularis (42%) muscles were the most prevalent in the patient group. Patients showed a significant lower PPT in all muscles when compared to controls (P < 0.001). Within the patient group a significant positive correlation between the number of TrPs and pain intensity (r (s) = 0.578; P = 0.045) was found. Active TrPs in some muscles were associated to greater pain intensity and lower PPTs when compared to those with latent TrPs in the same muscles (P < 0.05). Significant negative correlations between pain intensity and PPT levels were found. Patients with shoulder impingement showed widespread pressure hypersensitivity and active TrPs in the shoulder muscles, which reproduce their clinical pain symptoms. Our results suggest both peripheral and central sensitisation mechanisms in patients with shoulder impingement syndrome.
Asunto(s)
Hiperalgesia/fisiopatología , Músculo Esquelético/fisiopatología , Síndrome de Abducción Dolorosa del Hombro/fisiopatología , Dolor de Hombro/fisiopatología , Hombro/fisiopatología , Adulto , Femenino , Lateralidad Funcional , Humanos , Masculino , Umbral del Dolor , Estimulación Física , Presión , Adulto JovenRESUMEN
OBJECTIVE: The usefulness of massage as a recovery method after high-intensity exercise has yet to be established. We aimed to investigate the effects of whole-body massage on heart rate variability (HRV) and blood pressure (BP) after repeated high-intensity cycling exercise under controlled and standardized pretest conditions. METHODS: The study included 62 healthy active individuals. After baseline measurements, the subjects performed standardized warm-up exercises followed by three 30-second Wingate tests. After completing the exercise protocol, the subjects were randomly assigned to a massage (myofascial release) or placebo (sham treatment with disconnected ultrasound and magnetotherapy equipment) group for a 40-minute recovery period. Holter recording and BP measurements were taken after exercise protocol and after the intervention. RESULTS: After the exercise protocol, both groups showed a significant decrease in normal-to-normal interval, HRV index, diastolic BP (P > .001), and low-frequency domain values (P = .006). After the recovery period, HRV index (P = .42) and high-frequency (HF) (P = .94) values were similar to baseline levels in the massage group, whereas the HRV index tended (P = .05) to be lower and the HF was significantly (P < .01) lower vs baseline values in the placebo group, which also showed a tendency (P = .06) for HF to be lower than after the exercise. Likewise, diastolic BP returned to baseline levels in the massage group (P = .45) but remained lower in the placebo group (P = .02). CONCLUSION: Myofascial release massage favors the recovery of HRV and diastolic BP after high-intensity exercise (3 Wingate tests) to preexercise levels.
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Ciclismo/fisiología , Ejercicio Físico/fisiología , Frecuencia Cardíaca/fisiología , Masaje/métodos , Músculo Esquelético/fisiología , Adulto , Femenino , Humanos , Masculino , Fatiga Muscular/fisiología , Valores de ReferenciaRESUMEN
OBJECTIVE: The aim of this study was to evaluate the effect of massage on neuromuscular recruitment, mood state, and mechanical nociceptive threshold (MNT) after high-intensity exercise. DESIGN: This was a prospective randomized clinical trial using between-groups design. SETTING: The study was conducted at a university-based sports medicine clinic. PARTICIPANTS: Sixty-two (62) healthy active students age 18-26 participated. INTERVENTIONS: Participants, randomized into two groups, performed three 30-second Wingate tests and immediately received whole-body massage-myofascial induction or placebo (sham ultrasound/magnetotherapy) treatment. The duration (40 minutes), position, and therapist were the same for both treatments. MAIN OUTCOME MEASURES: Dependent variables were surface electromyography (sEMG) of quadriceps, profile of mood states (POMS) and mechanical nociceptive threshold (MNT) of trapezius and masseter muscles. These data were assessed at baseline and after exercise and recovery periods. RESULTS: Generalized estimating equations models were performed on dependent variables to assess differences between groups. Significant differences were found in effects of treatment on sEMG of Vastus Medialis (VM) (p = 0.02) and vigor subscale (p = 0.04). After the recovery period, there was a significant decrease in electromyographic (EMG) activity of VM (p = 0.02) in the myofascial-release group versus a nonsignificant increase in the placebo group (p = 0.32), and a decrease in vigor (p < 0.01) in the massage group versus no change in the placebo group (p = 0.86). CONCLUSIONS: Massage reduces EMG amplitude and vigor when applied as a passive recovery technique after a high-intensity exercise protocol. Massage may induce a transient loss of muscle strength or a change in the muscle fiber tension-length relationship, influenced by alterations of muscle function and a psychological state of relaxation.