Efficacy of Myofascial Release Compared to Isometric Relaxation Combined with Active Stretching for Rhomboid Trigger Points: A Randomized Controlled Pilot Study

Abstract

Background: Myofascial trigger points (MTrPs) in the rhomboid muscles contribute to pain, muscle tightness, and restricted movement, impacting quality of life. Various interventions, including myofascial release (MFR) and isometric relaxation (IR), have been used to alleviate symptoms.

Aim: This pilot study aims to explore the feasibility and preliminary efficacy of MFR combined with active stretching versus IR combined with active stretching in the management of rhomboid MTrPs, with the goal of informing the design of future full-scale studies.

Methods: A randomized controlled trial was conducted with 50 participants diagnosed with rhomboid MTrPs. Participants were assigned to two groups: group A (MFR with active stretching) and group B (IR with active stretching). Interventions were administered for 4 weeks (five sessions per week). Pre- and post-intervention assessments were conducted using the Numerical Pain Rating Scale (NPRS) and goniometric measurements of range of motion (ROM). Statistical analysis was performed using the Wilcoxon method and Mann–Whitney U test via SPSS version 27.

Results: After 4 weeks, group A showed a statistically and clinically significant reduction in NPRS scores from 7.28 ± 0.737 to 5.28 ± 1.061 (p < 0.001, r = 0.59), exceeding the established minimal clinically important difference (MCID) of 2 points for the NPRS. In contrast, group B showed a smaller reduction from 7.16 ± 0.800 to 6.44 ± 1.003 (p < 0.001, r = 0.57), which, although statistically significant, did not meet the MCID threshold, suggesting limited clinical relevance. Similarly, ROM improved in group A from 47.16 ± 1.675 to 52.12 ± 1.616 (p < 0.001, r = 0.63) and in group B from 47.36 ± 1.777 to 48.88 ± 2.147 (p < 0.001, r = 0.56). Group A demonstrated greater improvement in both pain reduction and mobility.

Conclusion: This study concluded that both treatments were successful in addressing rhomboid trigger points. MFR combined with active stretching demonstrated greater pain reduction and improved flexibility. These findings suggest MFR with active stretching may be a valuable addition to clinical health practice guidelines for managing rhomboid trigger points.