Ischemic Pressure vs Postisometric Relaxation for Treatment of Rhomboid Latent Myofascial Trigger Points: A Randomized, Blinded Clinical Trial

J Manipulative Physiol Ther. 2021 Feb;44(2):103-112. doi: 10.1016/j.jmpt.2020.07.005.


Objective: The purpose of this study was to investigate the effects of ischemic pressure (IP) vs postisometric relaxation (PIR) on rhomboid-muscle latent trigger points (LTrPs).

Methods: Forty-five participants with rhomboid-muscle LTrPs were randomly assigned into 3 groups and received 3 weeks of treatment-group A: IP and traditional treatment (infrared radiation, ultrasonic therapy, and transcutaneous electrical nerve stimulation); group B: PIR and traditional treatment; and group C: traditional treatment. Shoulder pain and disability, neck pain and disability, and pressure pain threshold (PPT) of 3 points on each side were measured before and after treatment.

Results: Multivariate analysis of variance indicated a statistically significant Group × Time interaction (P = .005). The PPT for the right lower point was increased in group A more than in groups B or C. Neck pain was reduced in group B more than in group C. Moreover, shoulder and neck disability were reduced in both groups A and B more than in group C. The PPTs of the left lower and middle points were increased in group B compared with groups A and C. The PPT of the left upper point was increased in group A more than in group C. There were significant changes in all outcomes in the 2 experimental groups (P < .05). No changes were found in the control group except in pain intensity, shoulder disability, and PPT of the left lower point.

Conclusion: This study found that IP may be more effective than PIR regarding PPT, but both techniques showed changes in the treatment of rhomboid-muscle LTrPs.

Keywords: Musculoskeletal Manipulations; Physical Therapy Modalities; Superficial Back Muscles; Trigger Points.

MeSH terms

  • Adult
  • Back Muscles / physiology
  • Humans
  • Male
  • Myofascial Pain Syndromes / rehabilitation*
  • Neck Pain / rehabilitation*
  • Pain Measurement
  • Pain Threshold / physiology
  • Shoulder Pain
  • Superficial Back Muscles / physiology*
  • Transcutaneous Electric Nerve Stimulation
  • Trigger Points / physiology*