PainSci summary of Grieve 2013?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★☆☆☆2-star ratings are for studies with flaws, bias, and/or conflict of interest; published in lesser journals. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
Can trigger point therapy help immediately to improve a restricted ankle joint? The answer is a highly qualified yes: “This study identified an immediate significant improvement in ankle range of motion after a single intervention of trigger point pressure release on latent soleus trigger points. These findings are clinically relevant, although the treatment effect on ankle ROM is smaller than a clinically significant ROM (5°).”
Statistically but not clinically significant means “the increase was real but small.” In many cases, the effect on ankle ROM was so small that it probably made no noticeable difference to the patient. But Rob Grieve, the author, pointed out in an email to me that “some of the individual scores post intervention were considerably higher than 5˚,” which patients probably did notice. The real story, though, is that any positive result from such a quick, simple treatment is noteworthy and promising. If an isolated trigger point treatment makes a difference in the extensibility, that certainly bodes well for more thorough treatment.
See my trigger points tutorial for a detailed analysis.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVES: To investigate the immediate effect on restricted active ankle joint dorsiflexion range of motion (ROM), after a single intervention of myofascial trigger point (MTrP) therapy on latent triceps surae MTrPs in recreational runners.
DESIGN: A crossover randomised controlled trial.
PARTICIPANTS: Twenty-two recreational runners (11 men and 11 women; mean age 24.57; ±8.7 years) with a restricted active ankle joint dorsiflexion and presence of latent MTrPs.
INTERVENTION: Participants were screened for a restriction in active ankle dorsiflexion in either knee flexion (soleus) or knee extension (gastrocnemius) and the presence of latent MTrPs. Participants were randomly allocated a week apart to both the intervention (combined pressure release and 10 s passive stretch) and the control condition.
RESULTS: A clinically meaningful (large effect size) and statistically significant increase in ankle ROM in the intervention compared to the control group was achieved, for the soleus (p = 0.004) and the gastrocnemius (p = 0.026).
CONCLUSION: Apart from the statistical significance (p < 0.05), these results are clinically relevant due to the immediate increase in ankle dorsiflexion. These results must be viewed in caution due to the carry-over effect in the RCT crossover design and the combined MTrP therapy approach.
These two articles on PainScience.com cite Grieve 2013 as a source:
- PS Trigger Points & Myofascial Pain Syndrome — A guide to the unfinished science of muscle pain, with reviews of every theory and self-treatment and therapy option
- PS Trigger Points on Trial — A summary of the kerfuffle over Quintner et al., a key 2014 scientific paper criticizing the conventional wisdom about trigger points and myofascial pain syndrome
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.