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Rajdeep Das1, Birendra Jhajharia1, Durgesh Shukla2, Vangie Boto-Montillano3, Dinesh Kumar4

1Department of Exercise Physiology, Lakshmibai National Institute of Physical Education, Deemed University Gwalior, Madhya Pradesh, India
2Department of Community Medicine, Gajra Raja Medical College, Madhya Pradesh, India
3Faculty Physical Education Department, De La Salle University-Dasmarinas Cavite, Philippines
4Department of Physical Education and Sports Science, University of Delhi, India

Determine the Occurrence of Latent Myofascial Trigger Points Through Binary Logistic Regression Model in Sportsmen

Sport Mont 2023, 21(3), 93-100 | DOI: 10.26773/smj.231015


This study aimed to ascertain the prevalence of latent myofascial trigger points (L-MTrPs) among male athletes. Ninety participants were randomly included in the study. The presence of L-MTrPs was identified based on Simon’s criteria, leading to the categorization of participants into two groups: L-MTrPs (n=45) and non-myofascial trigger points (N-MTrPs) (n=45). Pain pressure thresholds (PPT) of muscles were quantified using a pressure algometer, while force production was measured with HUMAC NORM isokinetic. The range of motion (ROM) for knee flexors and extensors was determined using Kinovea software. These parameters were treated as independent variables, whereas L-MTrPs and N-TrPs were considered dependent variables. Binary Logistic Regression (Enter Method) was employed for data analysis. Model fitness was evaluated through standard error computation, Wald’s χ2, and odds ratios with a 95% confidence interval. Model adequacy was assessed via the likelihood ratio, Cox & Snell (R2), Nagelkerke (R2), and Hosmer and Lemeshow tests. The results effectively predicted L-MTrPs and N-MTrPs, revealing that force production, PPT, and ROM were the most significant predictive variables for L-MTrPs. In conclusion, reduced force production, lower PPT, and restricted ROM were indicative of L-MTrPs. Consequently, regular evaluation of muscular strength, PPT, and ROM are recommended for athletes to prevent the development of L-MTrPs.


binary logistic, myofascial pain syndrome, peak torque, range of motion, regression model, athletes

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Bagcier, F., Yurdakul, O. V., Üşen, A., & Bozdag, M. (2022). The relationship between gluteus medius latent trigger point and muscle strength in healthy subjects. Journal of Bodywork and Movement Therapies, 29, 140–145. https://doi.org/10.1016/j.jbmt.2021.10.001

Barbero, M., Schneebeli, A., Koetsier, E., & Maino, P. (2019). Myofascial pain syndrome and trigger points: Evaluation and treatment in patients with musculoskeletal pain. Current Opinion in Supportive & Palliative Care, 13(3), 270–276. https://doi.org/10.1097/SPC.0000000000000445

Benito-de-Pedro, M., Becerro-de-Bengoa-Vallejo, R., Elena Losa-Iglesias, M., Rodríguez-Sanz, D., López-López, D., Palomo-López, P., … & Calvo-Lobo, and C. (2020). Effectiveness of Deep Dry Needling vs Ischemic Compression in the Latent Myofascial Trigger Points of the Shortened Triceps Surae from Triathletes on Ankle Dorsiflexion, Dynamic, and Static Plantar Pressure Distribution: A Clinical Trial. Pain Medicine, 21(2), e172–e181. https://doi.org/10.1093/pm/pnz222

Bethers, A. H., Swanson, D. C., Sponbeck, J. K., Mitchell, U. H., Draper, D. O., Feland, J. B., & Johnson, A. W. (2021). Positional release therapy and therapeutic massage reduce muscle trigger and tender points. Journal of Bodywork and Movement Therapies, 28, 264–270. https://doi.org/10.1016/j.jbmt.2021.07.005

Cao, Q.-W., Peng, B.-G., Wang, L., Huang, Y.-Q., Jia, D.-L., Jiang, H., Lv, Y., … & Huang, D. (2021). Expert consensus on the diagnosis and treatment of myofascial pain syndrome. World Journal of Clinical Cases, 9(9), 2077–2089. https://doi.org/10.12998/wjcc.v9.i9.2077

Castien, R. F., Coppieters, M. W., Durge, T. S. C., & Scholten-Peeters, G. G. M. (2021). High concurrent validity between digital and analogue algometers to measure pressure pain thresholds in healthy participants and people with migraine: A cross-sectional study. The Journal of Headache and Pain, 22(1), 69. https://doi.org/10.1186/s10194-021-01278-8

Celik, D., & Mutlu, E. K. (2013). Clinical Implication of Latent Myofascial Trigger Point. Current Pain and Headache Reports, 17(8), 353. https://doi.org/10.1007/s11916-013-0353-8

Charles, D., Hudgins, T., MacNaughton, J., Newman, E., Tan, J., & Wigger, M. (2019). A systematic review of manual therapy techniques, dry cupping, and dry needling in the reduction of myofascial pain and myofascial trigger points. Journal of Bodywork and Movement Therapies, 23(3), 539–546. https://doi.org/10.1016/j.jbmt.2019.04.001

Chattrattrai, T., Janal, M. N., Lobbezoo, F., & Raphael, K. G. (2023). The association between sleep bruxism and awake bruxism: Polysomnographic and electromyographic recordings in women with and without myofascial pain. Journal of Oral Rehabilitation, 50(9), 822–829. https://doi.org/10.1111/joor.13468

Chesterton, L. S., Sim, J., Wright, C. C., & Foster, N. E. (2007). Interrater Reliability of Algometry in Measuring Pressure Pain Thresholds in Healthy Humans, Using Multiple Raters. The Clinical Journal of Pain, 23(9), 760–766. https://doi.org/10.1097/AJP.0b013e318154b6ae

Cordeiro, M. A., dos Santos, M. B. R., Zotz, T. G. G., & de Macedo, A. C. B. (2021). The influence of sex and level of physical activity on maximum tolerance to mechanical pain. Brazilian Journal of Anesthesiology (English Edition), S010400142100378X. https://doi.org/10.1016/j.bjane.2021.09.019

Cygańska, A. K., Tomaszewski, P., & Cabak, A. (2022). Pain threshold in selected trigger points of superficial muscles of the back in young adults. PeerJ, 10, e12780. https://doi.org/10.7717/peerj.12780

Das, R., & Jhajharia, B. (2022a). Fascia and Myofascial Pain Syndrome - An Overview. Asian Pacific Journal of Health Sciences, 9(4s), 228–232. https://doi.org/10.21276/apjhs.2022.9.4S.44

Das, R., & Jhajharia, B. (2022b). Original Article Correlation between latent myofascial trigger point and peak torque production of lower limb muscles on sports person. Journal of Physical Education and Sport, 22, 2224–2230. https://doi.org/10.7752/jpes.2022.09283

Das, R., Jhajharia, B., Ciocan, V. C., Majumdar, I., & Sharma, A. (2023). The Relationship Between Latent Myofascial Trigger Point and Range of Motion of Knee Flexor and Extensor Muscles. Physical Education Theory and Methodology, 23(2), 192–198. https://doi.org/10.17309/tmfv.2023.2.06

Das, R., Jhajharia, B., Ciocan, V., Sharma, A., & Majumdar, I. (2022). Myofascial Trigger Points and its Influence on Athletic performance- A Review. NeuroQuantology, 20, 467–483. https://doi.org/10.48047/nq.2022.20.19.NQ99043

Do, T. P., Heldarskard, G. F., Kolding, L. T., Hvedstrup, J., & Schytz, H. W. (2018). Myofascial trigger points in migraine and tension-type headache. The Journal of Headache and Pain, 19(1), 84. https://doi.org/10.1186/s10194-018-0913-8

Donnelly, J. M., & Simons, D. G. (Eds.). (2019). Travell, Simons & Simons’ myofascial pain and dysfunction: The trigger point manual (Third edition). Wolters Kluwer Health.

Doraisamy, M. A. & Anshul. (2011). Effect of Latent Myofascial Trigger Points on Strength Measurements of the Upper Trapezius: A Case-Controlled Trial. Physiotherapy Canada, 63(4), 405–409. https://doi.org/10.3138/ptc.2010-27

Duarte, F. C. K., Chien, R., Ghazinour, G., Murnaghan, K., West, D. W. D., & Kumbhare, D. A. (2023). Myofascial Pain as an Unseen Comorbidity in Osteoarthritis: A Scoping Review. The Clinical Journal of Pain, 39(4), 188–201. https://doi.org/10.1097/AJP.0000000000001102

Duarte, F. C. K., West, D. W. D., Linde, L. D., Hassan, S., & Kumbhare, D. A. (2021). Re-Examining Myofascial Pain Syndrome: Toward Biomarker Development and Mechanism-Based Diagnostic Criteria. Current Rheumatology Reports, 23(8), 69. https://doi.org/10.1007/s11926-2021-01024-8

E Silva, D. C. C. M., de Andrade Alexandre, D. J., & Silva, J. G. (2018). Immediate effect of myofascial release on range of motion, pain, and biceps and rectus femoris muscle activity after total knee replacement. Journal of Bodywork and Movement Therapies, 22(4), 930–936. https://doi.org/10.1016/j.jbmt.2017.12.003

Elbarbary, M., Goldberg, M., Tenenbaum, H. C., Lam, D. K., Freeman, B. V., Pustaka, D. J., … & Azarpazhooh, A. (2023). Assessment of Concordance between Chairside Ultrasonography and Digital Palpation in Detecting Myofascial Trigger Points in Masticatory Myofascial Pain Syndrome. Journal of Endodontics, 49(2), 129–136. https://doi.org/10.1016/j.joen.2022.11.013

Escalona-Marfil, C., Coda, A., Ruiz-Moreno, J., Riu-Gispert, L. M., & Gironès, X. (2020). Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study. Journal of Medical Internet Research, 22(2), e13468. https://doi.org/10.2196/13468

Fernández-González, P., Koutsou, A., Cuesta-Gómez, A., Carratalá-Tejada, M., Miangolarra-Page, J. C., & Molina-Rueda, F. (2020). Reliability of Kinovea® Software and Agreement with a Three-Dimensional Motion System for Gait Analysis in Healthy Subjects. Sensors, 20(11), 3154. https://doi.org/10.3390/s20113154

Fousekis, K., & Kounavi, E. (2016). The Effectiveness of Instrument-assisted Soft Tissue Mobilization Technique (Ergon© Technique), Cupping, and Ischaemic Pressure Techniques in the Treatment of Amateur Athletesi, Myofascial Trigger Points. Journal of Novel Physiotherapies, s3. https://doi.org/10.4172/2165-7025.S3-009

Ge, H.-Y., & Arendt-Nielsen, L. (2011). Latent Myofascial Trigger Points. Current Pain and Headache Reports, 15(5), 386–392. https://doi.org/10.1007/s11916-011-0210-6

Girasol, C. E., Dibai-Filho, A. V., de Oliveira, A. K., & de Jesus Guirro, R. R. (2018). Correlation Between Skin Temperature Over Myofascial Trigger Points in the Upper Trapezius Muscle and Range of Motion, Electromyographic Activity, and Pain in Chronic Neck Pain Patients. Journal of Manipulative and Physiological Therapeutics, 41(4), 350–357. https://doi.org/10.1016/j.jmpt.2017.10.009

Habets, B., Staal, J. B., Tijssen, M., & van Cingel, R. (2018). Intrarater reliability of the Humac NORM isokinetic dynamometer for strength measurements of the knee and shoulder muscles. BMC Research Notes, 11(1), 15. https://doi.org/10.1186/s13104-018-3128-9

Haser, C., Stöggl, T., Kriner, M., Mikoleit, J., Wolfahrt, B., Scherr, J., … & Pfab, F. (2017). Effect of Dry Needling on Thigh Muscle Strength and Hip Flexion in Elite Soccer Players. Medicine & Science in Sports & Exercise, 49(2), 378–383. https://doi.org/10.1249/MSS.0000000000001111

Ibrahim, N. A., Abdel Raoof, N. A., Mosaad, D. M., & Abu el kasem, S. T. (2021). Effect of magnesium sulfate iontophoresis on myofascial trigger points in the upper fibres of the trapezius. Journal of Taibah University Medical Sciences, 16(3), 369–378. https://doi.org/10.1016/j.jtumed.2020.12.015

Jiménez-Sánchez, C., Gómez-Soriano, J., Bravo-Esteban, E., Mayoral-del Moral, O., Herrero-Gállego, P., Serrano-Muñoz, D., & Ortiz-Lucas, M. (2021). Effects of Dry Needling on Biomechanical Properties of the Myofascial Trigger Points Measured by Myotonometry: A Randomized Controlled Trial. Journal of Manipulative and Physiological Therapeutics, 44(6), 467–474. https://doi.org/10.1016/j.jmpt.2021.06.002

Karpuz, S., Yılmaz, R., & Yılmaz, H. (2023). Evaluation of temporomandibular joint dysfunction in traumatic brain injury patients. Journal of Oral Rehabilitation, 50(6), 476–481. https://doi.org/10.1111/joor.13445

Kim, H. A., Hwang, U. J., Jung, S. H., Ahn, S. H., Kim, J. H., & Kwon, O. Y. (2017). Comparison of shoulder strength in males with and without myofascial trigger points in the upper trapezius. Clinical Biomechanics, 49, 134–138. https://doi.org/10.1016/j.clinbiomech.2017.09.001

Kisilewicz, A., Janusiak, M., Szafraniec, R., Smoter, M., Ciszek, B., Madeleine, P., … & Kawczyński, A. (2018). Changes in Muscle Stiffness of the Trapezius Muscle after Application of Ischemic Compression into Myofascial Trigger Points in Professional Basketball Players. Journal of Human Kinetics, 64(1), 35–45. https://doi.org/10.2478/hukin-2018-0043

Lee, J.-W., Lee, J.-H., & Kim, S.-Y. (2020). Use of Acupuncture for the Treatment of Sports-Related Injuries in Athletes: A Systematic Review of Case Reports. International Journal of Environmental Research and Public Health, 17(21), 8226. https://doi.org/10.3390/ijerph17218226

Li, L., Stoop, R., Clijsen, R., Hohenauer, E., Fernández-de-las-Peñas, C., Huang, Q., & Barbero, M. (2020). Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review. The Clinical Journal of Pain, 36(12), 955–967. https://doi.org/10.1097/AJP.0000000000000875

Ortega-Santiago, R., González-Aguado, Á. J., Fernández-de-las-Peñas, C., Cleland, J. A., de-la-Llave-Rincón, A. I., … & Plaza-Manzano, G. (2020). Pressure pain hypersensitivity and referred pain from muscle trigger points in elite male wheelchair basketball players. Brazilian Journal of Physical Therapy, 24(4), 333–341. https://doi.org/10.1016/j.bjpt.2018.10.004

Ortega-Santiago, R., de-la-Llave-Rincón, A. I., Salom-Moreno, J., Maciá-Tomás, L. M., Fernández-de-las-Peñas, C., & Cleland, J. A. (2017). Neurophysiological effects of dry needling and electrical stimulation in the myofascial trigger points of the upper trapezius muscle: A randomized controlled trial. Clinical Rehabilitation, 31(7), 960–971. https://doi.org/10.1177/0269215516651150

Pena, R. D. S., Machado, L., & Barbirato, D. (2019). Manual Therapy and Therapeutic Exercise in the Treatment of Chronic Nonspecific Neck Pain: A Systematic Review. Journal of Manipulative and Physiological Therapeutics, 42(8), 575–585. https://doi.org/10.1016/j.jmpt.2018.06.004

Prats, S., Ruiz-Párraga, G. T., Valencia, C., & de Andrés, J. (2019). The efficacy of manual therapy in the management of musculoskeletal myofascial pain: A systematic review. Medicine, 98(20), e15585. https://doi.org/10.1097/MD.0000000000015585

Qin, Z., Zeng, Z., Li, Q., Chen, R., Li, L., & Liu, X. (2019). Evaluation of differential diagnosis of 5 fasciae surrounding myofascial trigger points by ultrasound. Journal of Musculoskeletal & Neuronal Interactions, 19(2), 198–205.

Rey-Matías, A., Corral-Bergantiños, Y., Pérez-González, A., Rodríguez-Torres, J., López-de-Celis, C., & Sánchez-Durán, J. (2019). Use of Spinal Manipulative Therapy in Management of an Adult with Concussion-related Neck Pain and Headache. J Can Chiropr Assoc, 63(2), 89–99.

Salles, A. A., de Resende, M. A., Dias Dantas Maia, F., Calábria, L. K., Riechelmann, R., de Castro, R., … & Efficacy, and Tolerability, and Safety of Baclofen, and Escitalopram in Patients With Myofascial Pain Syndrome: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. (2019). Efficacy, and Tolerability, and Safety of Baclofen, and Escitalopram in Patients With Myofascial Pain Syndrome: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. Frontiers in Pharmacology, 10. https://doi.org/10.3389/fphar.2019.01032

Simons, D. G., Travell, J. G., Simons, L. S., & Cummings, B. D. (1999). Myofascial pain and dysfunction: The trigger point manual (2nd ed.). Williams & Wilkins.

Suh, Y., Kim, S. Y., Yang, H., & Kim, J. K. (2018). Comparison of the Clinical Effects of Ozone and Botulinum Toxin A in the Treatment of Myofascial Pain Syndrome. Pain Research and Management, 2018, 1–7. https://doi.org/10.1155/2018/3459610

Travell, J., & Simons, D. (1992). Myofascial Pain and Dysfunction: The Trigger Point Manual, Volume 1. Lippincott Williams & Wilkins.

Vaillant, J., Vuistiner, P., Favre, J., Léger, B., Frémion, B., Coudeyre, E., & Toulotte, C. (2022). Trigger point dry needling and neuromuscular release for management of temporomandibular joint disorders in young adults: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 103(3), 365–375. https://doi.org/10.1016/j.apmr.2021.07.422

Wu, F., Tang, Y., & Wang, T. (2019). Injection of the gluteus minimus trigger points as a treatment for chronic nonspecific low back pain: A randomized controlled trial. Pain Medicine, 20(11), 2278–2286. https://doi.org/10.1093/pm/pnz157

Zhang, Y., Fu, Z., & Deng, L. (2015). Pathology characteristics and biophysical evaluation of the myofascial trigger points in rats. Acupuncture in Medicine, 33(3), 213–220. https://doi.org/10.1136/acupmed-2014-010611