Myofascial Release of the Pectoral Fascia

Study Overview
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Brief Summary
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Neck-shoulder pain is among the most common health care problems, especially in office workers and females. Forward shoulder posture (FSP) is a common postural deviation and known risk factor for the development of neck-shoulder pain and pathology. Common approaches for reducing FSP include stretching and performing manual techniques to increase the length and extensibility of the scapular protractors, and strengthening the scapular retractors. Myofascial release (MFR) is a group of manual techniques that elongate and soften restricted fascia, however, the effects of myofascial release to the pectorals on FSP are currently unknown. The objectives of this study are to determine the impact of 4-minutes of MFR on: 1) FSP, 2) pectoral length, 3) muscle activity of the upper, middle, and lower trapezius and pectoralis major, 4) scapular retractor to protractor ratio of activity, and 4) movement performance compared to a soft-touch control. We hypothesize that MFR will: 1) decrease FSP, 2) increase pectoral length, 3) increase upper, middle, and lower trapezius activity and decrease pectorals major activity, 4) increase the scapular retractor to protractor ratio of activity, and 4) improve movement performance.

Official Title
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Myofascial Release of the Pectoral Fascia: Effect on Shoulder Posture, Muscle Length, Muscle Activity, and Movement Performance

Conditions
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Healthy

Intervention / Treatment
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* Other: Myofascial Release
* Other: Soft-touch Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: have 1 cm of anterior deviation of the acromion process (forward shoulder posture) right handed Exclusion Criteria: recent history (<6 months) of neck, shoulder, or upper back pain recent history (<6 months) of neck, shoulder, or upper back injury/pathology history of orthopaedic or neurological disorders

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Single blind between subjects repeated measures crossover design
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Myofascial release (MFR)<br>The pectoral MFR will be completed by an experienced registered massage therapist (RMT). They will stand on the participant's right side slightly rotated to the left facing towards the participant's left hip and apply a cross-hand MFR technique to the superficial pectoral fascia on the right side. The therapist will begin by placing the distal region of the anterior palm of the anchoring hand (therapist's right hand) on the right edge of the anterior sternum at the level of the 3rd to the 6th ribs on the skin and the draping over the pectoral fascia. They will then apply a gentle posterior pressure to hold the fascia in place. The forearm of the mobilizing hand (RMT's left hand) will be directed to the right shoulder wit hate right forearm crossing over the left and the contact of are of the mobilizing hand will be the skin superficial to the pectoral fascia and insertion of pectorals major on the anterior aspect of the humerus. This will be held for four minutes. | Other: Myofascial Release<br>* Moderate pressure manual treatment to the pectoral fascia.<br>|
| Sham Comparator: Soft-touch Control (CON)<br>This control treatment will be set up the same way in regards to the RMT's hand placement, except no pressure will be applied. The RMT's hands will simply be resting over the contact points. This treatment will also be held for four minutes. | Other: Soft-touch Control<br>* No pressure manual treatment to the pectoral fascia.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Forward shoulder posture after intervention | Relative- photographic analysis. Participant stand in a relaxed position and have a photo taken from their side where an online program will be used to quantify their forward shoulder posture | 30-minutes | 
| Change in Forward shoulder posture after intervention | Absolute measurements taken- double square method. Participants will stand with their back against the wall and the tool will measure the distance from the wall to their acromion process. | 30-minutes | 
| Change in Pectoral Length after intervention | Measured passive horizontal abduction of the shoulder | 30-minutes | 
| Change in Muscle Activity- Upper Trapezius after intervention | sEMG during a reaching task | 30-minutes | 
| Change in Muscle Activity- Middle Trapezius after intervention | sEMG during a reaching task | 30-minutes | 
| Change in Muscle Activity- Lower Trapezius after intervention | sEMG during a reaching task | 30-minutes | 
| Change in Muscle Activity- Pectoralis Major after intervention | sEMG during a reaching task | 30-minutes | 
| Change in Movement performance- reaction time after intervention | Participants will complete a reaching task using custom designed software (E-Prime). The reaching task is a modified Fitts' Task where the participant must reach towards one of five randomly appearing targets. | 30-minutes | 
| Change in Movement performance- movement time after intervention | Participants will complete a reaching task using custom designed software (E-Prime). The reaching task is a modified Fitts' Task where the participant must reach towards one of five randomly appearing targets. | 30-minutes | 
| Change in Movement performance- accuracy after intervention | Participants will complete a reaching task using custom designed software (E-Prime). The reaching task is a modified Fitts' Task where the participant must reach towards one of five randomly appearing targets. | 30-minutes |