Effective Physiotherapy Management of Myofascial Pain with Exertion Beyond Fatigue Level in Sportsman: A Case Report

Abstract

Background: Myofascial pain typically represents itself as dull deep aching sensation provoked by excessive or erroneous use of the muscles and psychological stressors causing increased tension in muscle. There is increasing awareness about active myofascial trigger points to have a major role in causing the symptoms of patients with Musculoskeletal pain. Objective: This study aimed to concisely report a case of myofascial pain syndrome associated with exertion beyond fatigue level and managed by myofascial trigger point therapy. Methods: The relevant information about the case was collected prospectively using musculoskeletal assessment form. The patient was diagnosed mainly by detailed history and gold standard palpation method that helps to identify taut muscles, tender myofascial trigger points, and neurodynamic and soft tissue mobilization treatment techniques was used for management. Case description: A 23-yfor male patient attended the physical therapy OPD at Helping hand institute of rehabilitation sciences. Patient was suffering from chronic pain along inferior angle of right scapula and was referred to OPD where he was treated with myofascial massage therapy, with soft tissue mobilization or fascia mobilization technique like friction massage and skin traction techniques over the right medial intra-scapular soft tissues. Moreover, trigger point release techniques for rhomboids and trapezius muscles, muscle stretching for scalene and upper trapezius and strengthening for serratus anterior muscle and thoracic mobilization techniques along with long thoracic nerve mobilization were used in combination. About 20-40 minutes of 1-3 sessions resulted in patient (100%) recovery and remained stable after two-months of follow-up. Conclusion: The maneuvers used for the treatment of myofascial pain in this report provide preliminary evidence of their effectiveness. Furthermore, it gives a background for Musculo-tendinous overuse, lack of warm up and proper biomechanical principles in sports as the sources of intra scapular myofascial pain in players especially those using their upper limb/limbs excessively as demand of their sports. A combination of manual therapy techniques was found reasonably effective with excellent results.