Superficial Back Line Research Articles

Effects of Sub-Occipital Muscle Inhibition with and Without Hold Relax Agonist Contraction of Hamstrings on Pain, Disability and Craniovertebral Angle in Neck Pain Patients with Hamstring Tightness

Background: Neck pain is a prevalent musculoskeletal disorder with significant impacts on individuals' daily functioning and quality of life. The Superficial Backline (SBL) concept suggests that muscles and fascial structures are interconnected, implying that addressing muscle tightness in one area can influence distant regions. This study explored the effects of sub-occipital muscle inhibition (SMI) with and without hold-relax agonist contraction (HR-AC) of the hamstrings on pain, disability, and craniovertebral angle in patients with neck pain and hamstring tightness. Objective: To determine the efficacy of SMI with and without HR-AC on pain relief, neck disability, and craniovertebral angle in patients suffering from neck pain and hamstring tightness. Methods: This randomized controlled trial included 34 participants aged 20-40 years with neck pain (NPRS ≥ 5) and hamstring tightness (≥ 30° extension lag). Participants were randomly assigned to two groups: Group A (SMI without HR-AC) and Group B (SMI with HR-AC). Interventions were administered three times per week for two weeks. Pain, craniovertebral angle, and neck disability were assessed using the Numeric Pain Rating Scale (NPRS), Bubble Inclinometer, Image J software, and Neck Disability Index (NDI). Data were collected at baseline and post-treatment. Statistical analysis was performed using SPSS version 25, with paired and independent t-tests used to compare outcomes within and between groups. Results: Significant reductions in NPRS scores were observed in both groups: Group A (mean pre-treatment: 6.25 ± 0.85, post-treatment: 3.18 ± 0.98) and Group B (mean pre-treatment: 6.40 ± 0.986, post-treatment: 2.133 ± 0.743). Craniovertebral angle improved significantly in both groups: Group A (mean pre-treatment: 41.25° ± 3.51, post-treatment: 45.48° ± 2.94) and Group B (mean pre-treatment: 40.99° ± 2.70, post-treatment: 49.02° ± 2.868). NDI scores also showed marked improvement: Group A (mean pre-treatment: 32.96 ± 3.04, post-treatment: 15.38 ± 3.39) and Group B (mean pre-treatment: 33.03 ± 2.89, post-treatment: 11.25 ± 3.27). Group B demonstrated more significant improvements in all measured outcomes compared to Group A (p < 0.05). Conclusion: Both interventions, SMI without HR-AC and SMI with HR-AC, significantly reduced pain, improved craniovertebral angle, and decreased neck disability. However, the combination of SMI with HR-AC was more effective, highlighting the importance of addressing both ends of the myofascial chain in managing neck pain and hamstring tightness.

Superficial back line release versus trigger points release in chronic nonspecific low back pain patients

The aim of this study was to investigate the effect of Superficial back line (SBL) release on pain, Pressure Pain Threshold (PPT), lumbar function, lumbar ROM, and balance in chronic nonspecific low back pain (CNSLBP) patients. Additionally, it aims to compare the effect of SBL release versus myofascial trigger points (MTrPs) release on the same variables. This was a Randomized Controlled Trial (RCT) involving forty-eight male and female patients with CNSLBP. They were randomized via an online randomization web service into 3 groups: group A (n=16) received SBL release and exercises, group B (n=16) received MTrPs release and exercises, while group C (n=16) received exercises only. There were statistically significant improvements in all outcomes post-treatment in comparison to pre-treatment within the three groups (p<0.05). After treatment, significant differences emerged between the groups in pain, PPT, lumbar extension ROM, and left anterior balance (p < 0.05). Group A showed the most favorable results in pain reduction, lumbar extension ROM, and left anterior balance compared to groups B and C, while Group B demonstrated the most favorable results in PPT compared to groups A and C. In conclusion, SBL release and MTrPs release are effective in improving pain, lumbar function, MTrPs PPT, lumbar ROM, and balance in patients with CNSLBP. SBL release is particularly effective for pain, lumbar extension ROM, and left anterior balance, while MTrPs release is most effective for improving PPT.

Effect of Superficial Back Line Stretching on Range of Motion and Neck Disability Index in Tension-Type Headache

Effect of Superficial Back Line Stretching on Range of Motion and Neck Disability Index in Tension-Type Headache

Myofascial Release on Pain and Function in Adults with Low Back Pain: A systematic review

Poor posture in sitting and standing exerts stress on the spine muscle leading to non-specific low back pain (LBP). Myofascial release (MFR) on the back and leg muscles may reduce fascial tension in an individual with LBP is unclear. This review describes the effects of MFR on flexibility, pain, disability, and stress level among non-specific LBP individuals. The findings showed that the direct or indirect apply MFR on the back or lower limbs improve flexibility, pain, and disability. However, insufficient information on stress levels. The MFR therapy is recommended to enhance low back pain rehabilitation.

The anatomical myofascial continuum between the neck and eyes.

The posterior myofascial chain (PMC) or superficial back line encompasses a series of muscles interlinked by the deep fascia, extending from the foot to the fascial sheath of the eyeball. The deep cervical fascia of the neck, the epicranial aponeurosis of the head, and the fascial sheath of eyeball, form the proximal PMC. Although the literature has reported an anatomical myofascial continuum between the neck, head, and eyes, the anatomical descriptions vary substantially. Moreover, there is still no plausible functional interrelationship between the proximal structural myofascial links. Chronic neck pain is usually associated with a plethora of symptoms including craniofacial pain and oculomotor disorders. Understanding the anatomy of the proximal myofascial chain could help clinicians improvise treatment strategies for managing such painful head and neck disorders.

Effect of Kinesio Taping with Fascia Manipulation Technique on Superficial Back Line Over Hamstring Fascia to Increase the Range of Motion – An Observational Study

Superficial Back Line is one of the first lines dissected and researched over the fascia as a connective tissue. The Superficial Back Line (SBL) connects and protects the entire posterior surface of the body like a carapace from the bottom of the foot to the top of the head. Strain, tension (good and bad), trauma, and movement tend to be passed through the structure along these fascial lines of transmission leading to soft tissue mal-alignment resulting in somatic and mechanical dysfunction. A forward bend with the knee’s straight links and challenges all the tracks and stations of the Superficial Back Line. Kinesio Taping application with fascia manipulation correction technique helps in the correction and realignment of the collagen fibres found predominantly in the fascia system responsible for tensile strength and force transmission. Observational finding with clinical data collection reveals pre and post KT application over the hamstring fascia suggest its effectiveness in realigning the fascia fibres to increase the range of motion of forwarding bend movement.

Manual therapy on Plantar Fascia affects Superficial Back Line Flexibility: A Randomized Controlled Pilot Study

Background and Aim: Myofascial Release (MFR) is a soft tissue mobilization technique that has been widely researched and supported to increase muscular flexibility and joint range of motion along superficial back line (SBL) structures. The purpose of the present study is to examine and compare the acute effects of MFR and post-isometric relaxation (PIR) applied on plantar fascia, on flexibility of superficial back line (hamstring muscle). Design: This was a pilot single blind randomized control trial (RCT). Participants: Thirty young healthy students (24 boys and 6 girls; mean age 21.46±0.97) Methods: Inclusion and exclusion criteria were followed, and baseline measurements for the Toe-Touch test (TTT) and active straight leg raise test (SLRT) were obtained. Subjects were then randomly assigned to the MFR group and the PIR group. The MFR group received the technique on plantar surface of the feet by applying a gentle and sustained pressure into the myofascial connective tissue. The PIR group received the technique on plantar flexors by placing them in stretched position, performing isometric contraction followed by relaxation and lengthening. Both interventions will be performed for 10 minutes. Afterwards, the Toe Touch Test and straight leg raise test were re-assessed. Results: Before and after intervention SLRT (both right and left) and TTT difference (within group differences) is statistically significant (p<0.05) in both MFR and PIR group. Between-group comparison also shows significant difference in both groups with p<0.05. The MFR group showed a significant difference in the SLR test and Toe Touch test compared to the PIR group (p<0.05). Conclusion: The results of the current study showed that MFR on the planter fascia was immediately effective for improving flexibility of the SBL for the hamstring muscle.

MYOFASCIAL RELEASE AND SUPERFICIAL BACKLINE STRETCHING ON HAMSTRING STRAIN IN CRICKET PLAYERS: AN INTERVENTIONAL STUDY

Background: Hamstring Strain is common among athletes which lead to development of injury. Superficial Backline stretching for improving range of motion and flexibility. Using Tennis ball is a form of self-myofascial release results in increasing range of motion. Literature lacks studies done on self- myofascial release and superficial backline stretching. Hence my intention towards this study in comparison to find out the effect of Self Myofascial Release using tennis ball and superficial backline stretching on hamstring strain in cricket players. Methodology: A total of 24 subjects who were between the age group of 15 -19 years were conveniently allocated based on the inclusion criteria. Subjects received self-myofascial release using tennis ball 60 sec with 3-4 repetitions and 1 min interval of rest between sessions and superficial backline stretching with different poses for 2-3 repetitions and then compared FMS score of all subjects pre and post intervention after giving the superficial backline stretches and myofascial release to all the subjects. Outcome measure: Functional movement screen (FMS) Results: The result shows that there is a significant difference in pre and post Score of FMS, pre-FMS score is 15.9167±2.60295 and post score increased to 19.2500±1.59483which shows thatthere is statistical and clinical difference between the pre and post intervention. Functional movement is measured as the primary outcome measure.There is an average improvement of 3.333 with t value 12.487 and p <0.05. Conclusion: The aim of the study was to compare and find out the effect of Self Myofascial Release using tennis ball and superficial backline stretching on hamstring strain in cricket players., the result showed that there is statistically significant self-myofascial release using tennis ball and superficial backline stretching.

Does Self-Myofascial Release Cause a Remote Hamstring Stretching Effect Based on Myofascial Chains? A Randomized Controlled Trial.

Background: The hamstring muscles are described as forming part of myofascial chains or meridians, and the superficial back line (SBL) is one such chain. Good hamstring flexibility is fundamental to sporting performance and is associated with prevention of injuries of these muscles. The aim of this study was to measure the effect of self-myofascial release (SMR) on hamstring flexibility and determine which segment of the SBL resulted in the greatest increase in flexibility. Methods: 94 volunteers were randomly assigned to a control group or to one of the five intervention groups. In the intervention groups, SMR was applied to one of the five segments of the SBL (plantar fascia, posterior part of the sural fascia, posterior part of the crural fascia, lumbar fascia or epicranial aponeurosis) for 10 min. The analyzed variables were hamstring flexibility at 30 s, 2, 5, and 10 min, and dorsiflexion range of motion before and after the intervention. Results: Hamstring flexibility and ankle dorsiflexion improved when SMR was performed on any of the SBL segments. The segments with the greatest effect were the posterior part of the sural fascia when the intervention was brief (30 s to 2 min) or the posterior part of the crural fascia when the intervention was longer (5 or 10 min). In general, 50% of the flexibility gain was obtained during the first 2 min of SMR. Conclusions: The SBL may be considered a functional structure, and SMR to any of the segments can improve hamstring flexibility and ankle dorsiflexion.

Sub Occipital Muscle Inhibition Technique Verses Cranial Cervical Flexion Exercise for Increasing Hamstring Flexibility in Physiotherapy Students

Background: Variation in flexibility can put an unusual amount of annoyance on the framework of the musculoskeletal system. The hamstring muscles are restricted when they are short, which can interfere with everyday activities and is usually a cause for concern. The flexibility of the hamstrings increases as the suboccipital muscles' tone deteriorates,, which are is single neuronal pathway that goes through the dura mater and connects them and which is called as the superficial back line (SBL). Hence as an intervention suboccipital muscle inhibition technique and cranial cervical technique is less time and energy consuming with efficient amount of results.
 Aim and Objective: The aim of this study is to investigate the effect of suboccipital muscle inhibition technique verses cranial cervical technique for increasing hamstring flexibility.
 Methods: Here we will evaluate hamstring tightness and impact of suboccipital muscle inhibition technique verses cranial cervical technique as an intervention with duration of 2 weeks. As an outcome measure Sit and reach test is given to desired population .This study will be conducted in Ravi Nair Physiotherapy College, Sawangi, Meghe, Wardha. The duration of study will be two week. The study design is pre and post interventional study.
 Results: The data will be analysed using Student paired t test.
 Conclusion: The expected outcome includes detection of hamstring tightness and improvement in hamstring tightness using sit and reach test. Data analysis will be done using students paired t test and conclusion of the study will be published after the results are analysed.

The effect of myofascial self-relase therapy on changes in perficial back line flexibility

Background. The aim of the study was to assess the effect of self myofascial release (SMR) using foam rolling on elasticity of (SMR) using rolling superficial back line (SBL) in young physically active adults. Material and methods. The sample included 40 students (man age 4.91 years). Tissue flexibility was assessed before and after rolling using one of EUROFIT motor ability tests of flexibility. The subjects performed a maximal forward flexion. 9-minute long rolling was performed in the following areas of the body: rear surface of the feet, rear surface of the shanks. rear surface of the thighs. paraspinal muscles of the sacrolumbar spine. The values corresponding to flexion depth prior to and following rolling were compared. Student’s t-test was applied for statistical analysis and significance level was set at p<0.05. Results Depth of flexion significantly increased after rolling (p<0.001). on average by 3.24 cm (31%). It was also found that gender had no effect on the differences in the values corresponding to the depth of superficial back line . In 65 % of the sample improvement of well-being was noted after rolling. Conclusions. The results indicate that the release using a roller is an easy accessible approach to prophylactic measures aimed at improvement of body elasticity.

Effectiveness of Suboccipital Muscle Inhibition Technique versus Muscle Energy Technique on Hamstring Muscle Flexibility in College Going Students

Background: Hamstring is one of the commonest muscle which often gets tight. Suboccipital muscle inhibition technique is a method of relaxing tension in four muscles located between occiput and axis which regulates the upper cervical vertebra. When the tone of suboccipital muscles falls, it has been reported that the tone of knee flexors such as hamstrings also decreases due to relaxation of myofascia. This is because hamstrings and suboccipital muscles are connected by one neural system, which passes through the duramater called the superficial back line. Muscle energy technique is a procedure that involves voluntary contraction of a patient’s muscle in a precisely controlled direction, at varying levels of intensity and has been utilized in lengthening of tight muscles. Method: The study was done after obtaining approval from ethical committee. Subjects having hamstring tightness who fulfilled inclusion criteria were selected from the population. 52 subjects were included and divided into two groups. The study was carried out for 5 days. Subjects in the experimental group were treated with SMIT and Subjects in control group were treated with MET. Outcome measures used were Active Knee extension test and Back Saver Sit and Reach Test. Data was analysed post treatment (Immediate effects) and at the end of 5th session using non- parametric tests at 5% level of significance. Result: Within group analysis at post treatment and at the end of 5th session showed significant improvement in both the outcome measures in experimental and control group. Between group analysis showed no significant effect post treatment whereas after 5 days significant difference was found where more improvement was found in the control group i.e. Muscle energy technique group. Conclusion: Suboccipital Muscle Inhibition Technique and Muscle Energy Technique both were effective in improving hamstring flexibility but Muscle energy technique was found to be more effective. Keywords: Suboccipital Muscle Inhibition Technique, Muscle Energy Technique (MET), Flexibility, Active Knee Extension (AKE), Back Saver Sit and Reach Test (BSRT).

Can Myofascial Interventions Have a Remote Effect on ROM? A Systematic Review and Meta-Analysis.

Anatomical and in vivo studies suggest that muscles function synergistically as part of a myofascial chain. A related theory is that certain myofascial techniques have a remote and clinically important effect on range of motion (ROM). To determine if remote myofascial techniques can effectively increase the range of motion at a distant body segment. In November 2018, the authors searched 3 electronic databases (CENTRAL, MEDLINE, and PEDro) and hand-searched journals and conference proceedings. Inclusion criteria were randomized controlled trials comparing remote myofascial techniques with passive intervention (rest/sham) or local treatment intervention. The primary outcome of interest was ROM. Quality assessment was performed using the PEDro Scale. Three authors independently evaluated study quality and extracted data. RevMan software was used to pool data using a fixed-effect model. Eight randomized controlled trials, comprising N = 354 participants were included (mean age range 22-36y; 50% female). Study quality was low with PEDro scores ranging from 2 to 7 (median scores 4.5/10). None of the studies incorporated adequate allocation concealment and just 2 used blinded assessment of outcomes. In all studies, treatments and outcomes were developed around the same myofascial chain (superficial back line). Five studies included comparisons between remote interventions to sham or inactive controls; pooled results for ROM showed trends in favor of remote interventions (standard mean difference 0.23; 95% confidence intervals; -0.09 to 0.55; 4 studies) at immediate follow-ups. Effects sizes were small, corresponding to mean differences of 9% or 5° in cervical spine ROM, and 1 to 3cm in sit and reach distance. Four studies compared remote interventions to local treatments, but there were few differences between groups. Remote exercise interventions may increase ROM at distant body segments. However, effect sizes are small and the current evidence base is limited by selection and measurement bias.

Self-Myofascial Release of the Superficial Back Line Improves Sit-and-Reach Distance.

Decreased hamstring flexibility can lead to a plethora of musculoskeletal injuries, including low back pain, hamstring strains, and patellofemoral pain. Lack of flexibility may be the result of myofascial adhesions. The fascia connected to the hamstrings is part of the superficial back line that runs from the cranium to the plantar aspect of the foot. Any disruption along this chain may limit the flexibility of the hamstring. To investigate if self-myofascial release (SMR) of the plantar surface of the foot in addition to the hamstring group was more effective at improving the flexibility of the hamstrings when compared with either intervention alone. Cross-over study. Athletic training facility. Fifteen college students (5 males and 10 females; age: 20.9 [1.4]y, height: 173.1 [10.3]cm, mass: 80.0 [24.9]kg) who were not older than 30, with no history of low back pain or injury within the past 6 months, no history of leg pain or injury within the past 6 months, no current signs or symptoms of cervical or lumbar radicular pain, no current complaint of numbness or tingling in the lower-extremity, and no history of surgery in the lower-extremity or legs. Each participant received each intervention separated by at least 96 hours in a randomized order: hamstring foam rolling, lacrosse ball on the plantar surface of the foot, and a combination of both. The sit-and-reach test evaluated hamstring flexibility of each participant before and immediately after each intervention. There were no significant differences found among the SMR techniques on sit-and-reach distance (F2,41 = 2.7, P = .08, ηp2=.12). However, at least 20% of participants in each intervention improved sit-and-reach distance by 2.5cm. SMR may improve sit-and-reach distance, but one technique of SMR does not seem to be superior to another.

Effects of Sling Forearm Plank Exercises on Superficial Back Line Muscle Tone and Stiffness

Background : Although plank exercises is reported to the changes in muscle activity of the deep muscles and superficial muscles among the core muscles. However, no study has examined the effects of forearm plank exercise on tone and stiffness in the superficial back line muscle. Objective: To compare the effects of sling forearm plank exercises and mat forearm plank exercises on the superficial back line muscle tone and stiffness. Design: Randomized controlled clinical trial (single blind) Methods: The subjects were randomized to sling forearm plank exercise group (N = 8) or mat forearm plank exercise group (N = 8). The measurements were taken for each research group following exercises: the muscle tone and stiffness of upper lumbar muscles, lower lumbar muscles, long head of biceps femoris, and medial part of gastrocnemius among the superficial back line muscles. Results: Sling forearm plank exercise group Indicated statistically significant increases in stiffness of medial part of gastrocnemius (p<.05). However, mat forearm plank exercise group reported no statistically significant in muscle tone and stiffness of all measured muscles. No significant differences in measured variables were found between the groups. Conclusions: These results suggest that the forearm plank exercise performed with an unstable surface in the defined sling can increase the stiffness of calf muscle, but it is unlikely to achieve increases in muscle tone and stiffness of the overall superficial back line muscles.

Can the application of the Ergon&lt;sup&gt;®&lt;/sup&gt; IASTM treatment on remote parts of the superficial back myofascial line be equally effective with the local application for the improvement of the hamstrings’ flexibility? A randomized control study

[Purpose] This study was aimed to investigate the effects of Ergon® IASTM applications on the upper or lower part of the Superficial Back Line (SBL) on the hamstring’s flexibility. [Participants and Methods] Sixty University students (age=24.4 ± 4.39; height=176.78 ± 8.31 cm; weight=75.16 ± 11.21 kg) were randomly divided into three sub-groups and received a single 15-minute treatment with Ergon® Technique in a) the upper and b) the lower part of SBL or c) served as control. The participants received one treatment per week for four weeks with a simultaneous pre-and post-therapy assessment of their hamstrings flexibility using the passive Straight Leg Raising (SLR). [Results] Both experimental groups improved SLR performance from pre to post during the four weeks from 4.4% to 9.2% in the trunk group and from 4.9% to 8.0% in the lower body group. These differences were significantly greater from the CTRL group. No differences were observed between the two experimental groups. [Conclusion] In conclusion, application of Ergon Technique of either the upper or lower part of the SBL may lead to a significant increase in the hamstring flexibility irrespective of the site of application.

The effect of one-time task fascial therapy on range of motion during spinal flexion

The latest findings of scientists and literature, pay attention to the important role of fascia in the human body. The fascia is supplied with blood, innervated a n d b e c a u s e o f c h a r a c t e r i s t i c s construction, also very plastic. During d i a g n o s i s o f d y s f u n c t i o n o f m u s c u l o s k e l e t a l s y s t e m , it is important to look at the patient in a holistic way. In practice the fascial dysfunction is far away from the place of issue and is crucial to the impaired function. This thesis is a response for patients and therapists, who have problem with the scope of the traffic and local acting method of relaxing tight muscles does not bring the desired effects. The aim of this work is to evaluate the efficacy of a single therapy fascial method (TASK) to increase the range of motion of flexion during forward bend. The aim of researchers was to carry out the theraphy of the part of superficial back line - sacrolumbar fascia of erector spinae. Before and after therapy has been measured to lumbar flexion range of motion, bend the total spine and Thomayers test. A group of test subjects were 30 students of physiotherapy (18 women and 12 men) from the Academy of Physical Education and Sport in Gdansk. Improving the range of motion was reported in the whole group of patients.The latest findings of scientists and literature, pay attention to the important role of fascia in the human body. The fascia is supplied with blood, innervated a n d b e c a u s e o f c h a r a c t e r i s t i c s construction, also very plastic. During d i a g n o s i s o f d y s f u n c t i o n o f m u s c u l o s k e l e t a l s y s t e m , it is important to look at the patient in a holistic way. In practice the fascial dysfunction is far away from the place of issue and is crucial to the impaired function. This thesis is a response for patients and therapists, who have problem with the scope of the traffic and local acting method of relaxing tight muscles does not bring the desired effects. The aim of this work is to evaluate the efficacy of a single therapy fascial method (TASK) to increase the range of motion of flexion during forward bend. The aim of researchers was to carry out the theraphy of the part of superficial back line - sacrolumbar fascia of erector spinae. Before and after therapy has been measured to lumbar flexion range of motion, bend the total spine and Thomayers test. A group of test subjects were 30 students of physiotherapy (18 women and 12 men) from the Academy of Physical Education and Sport in Gdansk. Improving the range of motion was reported in the whole group of patients.

Decreased amplitude of surface electromyo- graphic recordings of muscle activation along the posterior myofascial kinematic chain in subjects with chronic nonspecific low back pain compared to healthy subjects.

The concept of myofascial continuity suggests that muscles activate along kinematic chains with common fascial coverings. Yet, the literature lacks evidence in regards to the function of anatomical chains in populations suffering from low back pain (LBP). To examine muscle activations along the superficial back line in LBP patients compared to healthy controls. The sample study included 20 males with chronic LBP (mean age 28.7 (± 3.05) years, mean BMI 24.91 (± 2.76)) and 17 healthy controls (mean age 31.06 (± 7.76) years, mean BMI 23.46 (± 3.43)). Muscle activation (gastrocnemius, hamstrings, erector spine, and upper trapezius) along the superficial back line was measured using surface EMG. All subjects underwent five test conditions: Conditions 1-3 involved passive movement, active movement and active movement against maximum isometric resistance of the right gastrocnemius muscle. Conditions 4 and 5 involved neck extension without and with isometric resistance from the prone position. The main outcome was relative muscle activation amplitude between research and control subjects. Muscle activation along the posterior anatomical chain was observed during distal movement (plantar flexion or neck extension). LBP patients showed significant lower muscle activation in the erector spine of lower back region compared with the control group during active plantar flexion and active neck extension (p< 0.05). Lower muscle activation in other regions (gastrocnemius, hamstrings, erector spine level T6) was observed in the research group (although not significant). LBP may cause or result in a lower muscle activation of the posterior kinematic myofascial chain muscles.

Acute effect of self-myofascial release using a foam roller on the plantar fascia on hamstring and lumbar spine superficial back line flexibility

Objective: The purpose of this study was to investigate the immediate effect of applying self-myofascial release (SMR) to the plantar fascia using a foam roller on hamstring and lumbar spine superficial back line (SBL). Design: Randomized controlled trial. Methods: Thirty-one healthy adults agreed to the method and purpose of the study. Selection and exclusion criteria were screened, and baseline measurements for the Toe Touch test and passive straight leg raise (PSLR) test were obtained. The participants were then randomly assigned to the SMR group or the sham group. After group assignment, the SMR group rolled the surface of the foot from the heel to the metatarsal head using a foam roller for 5 minutes. The sham group received passive mobilization of the ankle joint in the supine position. Afterwards, the Toe Touch test and the passive straight leg-raise test were re-assessed. Results: In the SMR group, the Toe Touch test results showed significant improvement (p<0.05). Left and right PSLR test results showed a significant increase (p<0.05). In the sham group, there was no significant difference between pre and post-test results. The SMR group showed a significant difference in the PSLR test and Toe Touch test compared to the sham group (p<0.05). Conclusions: The results of this study showed that SMR on the plantar fascia was immediately effective for improving the flexibility of the SBL of the lumbar spine and hamstring.

Platelet-rich plasma versus dry needling of myofascial meridian trigger points in the treatment of plantar fasciitis

BackgroundPlantar fasciitis (PF) is the most common cause of heel pain, which results from repetitive trauma with degenerative changes in the plantar tissue. Platelet-rich plasma (PRP) and dry needling showed promising results as regards pain resolution and healing effect, and hence our aim was to compare their efficacy in the treatment of chronic PF.Patients and methodsThirty patients diagnosed with unilateral PF were subjected to full clinical assessment for foot function using the foot function index (FFI) and assessment of trigger points along the meridians. Ultrasonographic examination of plantar fascia thickness, echogenicity, and power Doppler was carried out. Patients were divided randomly into two groups of 15 each: group A received a single injection of PRP at the plantar fascia, and group B was treated with dry needling protocol in myofascial meridians trigger points along the superficial back line. Follow-up after 6 and 12 weeks included clinical re-evaluation, FFI determination, and ultrasonography. Our results showed a significant improvement in the clinical outcome of the FFI in group B (P<0.03) and a highly significant improvement in the clinical outcome within the PRP group by the 12th week (P<0.009). A significant decrease in thickness, heterogeneity, and Doppler signals (P<0.04, P<0.003, and P<0.03, respectively) was observed within the PRP group at the 12th week.ConclusionPRP injection is a promising line of treatment for chronic PF with documented ultrasonographic healing effect. Dry needling is a simple and safe technique for treating pain associated with PF, yet it is more invasive and less effective compared with PRP injection.