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Purslow PP. Muscle fascia and force transmission. Journal of Bodywork and Movement Therapies 2010;14(4):41T7

This paper reviews the major intramuscular extracellular matrix (IM-ECM) structures (endomysium, perimysium and epimysium) and their possible mechanical contributions to muscle functions. The endomysium appears to provide an efficient mechanism for transmission of contractile forces from adjacent muscle fibres within fascicles. This coordinates forces and deformations within the fascicle, protects damaged areas of fibres against over-extension, and provides a mechanism whereby myofibrils can be interrupted to add new sarcomeres during muscle growth without loss of contractile functionality of the whole column. Good experimental evidence shows that perimysium and epimysium are capable in some circumstances to act as pathways for myofascial force transmission. However, an alternative role for perimysium is reviewed, which involves the definition of slip planes between muscle fascicles which can slide past each other to allow large shear displacements due to shape changes in the whole muscle during contraction. As IM-ECM is continually remodelled so as to be mechanically adapted for its roles in developing and growing muscles, control of the processes governing IM-ECM turnover and repair may be an important avenue to explore in the reduction of fibrosis following muscle injury.

Cesar Ferndndez-de-las-Penas PT, Hong-You Ge MD, Cristina Alonso-Blanco PT, Javier Gonzdlez-Iglesias PT and Lars Arendt-Nielsen D. Referredpain areas of active myofascial trigger points in head, neck, and shoulder muscles, in chronic tension type headache. Journal of Bodywork and Movement Therapies 2010; 14(4): 391-396

Our aim was to analyze the differences in the referred pain patterns and size of the areas of those myofascial trigger points (TrPs) involved in chronic tension type headache (CTTH) including a number of muscles not investigated in previous studies. Thirteen right handed women with CTTH (mean age: 38 [+ or -] 6 years) were included. TrPs were bilaterally searched in upper trapezius, sternocleidomastoid, splenius capitis, masseter, levator scapulae, superior oblique (extra-ocular), and suboccipital muscles. TrPs were considered active when both local and referred pain evoked by manual palpation reproduced total or partial pattern similar to a headache attack. The size of the referred pain area of TrPs of each muscle was calculated. The mean number of active TrPs within each CTTH patient was 7 (95% CI 6.2-8.0). A greater number (T = 2.79; p = 0.016) of active TrPs was found at the right side (4.2 [+ or -] 1.5) when compared to the left side (2.9 [+ or -] 1.0). TrPs in the suboccipital muscles were most prevalent (n = 12; 92%), followed by the superior oblique muscle (n = 11/n = 9 right/left side), the upper trapezius muscle (n = 11/n = 6) and the masseter muscle (n = 9/n = 7). The ANOVA showed significant differences in the size of the referred pain area between muscles (F = 4.7, p = 0.001), but not between sides (F = 1.1; p = 0.3): as determined by a Bonferroni post hoc analysis the referred pain area elicited by levator scapulae TrPs was significantly greater than the area from the sternocleidomastoid (p = 0.02), masseter (p = 0.003) and superior oblique (p = 0.001) muscles. Multiple active TrPs exist in head, neck and shoulder muscles in women with CTTH. The referred pain areas of TrPs located in neck muscles were larger than the referred pain areas of head muscles. Spatial summation of nociceptive inputs from multiple active TrPs may contribute to clinical manifestations of CTTH.

Wong CK, Coleman D, Di Persia V, Song J, WrightD. The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. Journal of Bodywork and Movement Therapies 2010;14(4):326-33

A relationship between pectoralis minor muscle tightness and rounded shoulder posture (RSP) has been suggested, but evidence demonstrating that treatment aimed at the pectoralis minor affects posture or muscle function such as lower trapezius strength (LTS) remains lacking. In this randomized, blinded, controlled study of the 56 shoulders of 28 healthy participants, the experimental treatment consisting of pectoralis minor soft tissue mobilization (STM) and self-stretching significantly reduced RSP compared to the pre-treatment baseline (Friedman test, p < .001) and the control treatment of placebo touch and pectoralis major self-stretching (Mann-Whitney U-test, p < .01). RSP remained significantly reduced 2 weeks after the single treatment. Both control and experimental treatments resulted in increased LTS (Friedman test, p < .01) with no significant difference in LTS noted between treatments (p > .05). This study demonstrated that STM and self-stretching of the pectoralis minor can significantly reduce RSP.
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Title Annotation:RECENT RESEARCH
Publication:Journal of the Australian Traditional-Medicine Society
Date:Jun 1, 2011
Words:741
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