Thesis (M.Thec.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 110 leaves ; ill. ; 30 cm / According to Wood (1998), patellofemoral pain syndrome (PFPS) refers to a syndrome that comprises of the following signs and symptoms: anterior knee pain, inflammation, imbalance, instability, or any combination thereof. Prevailing literature suggests that the presence of myofascial trigger points (MFTP’s) in quadriceps femoris (QF) muscle could result in a combination of the following signs and symptoms: - Retro- or peripatella pain, - Weakness of the quadriceps muscle (Chaitow and DeLany, 2002) - Loss of full lengthening (Travell and Simons, 1983:248-250) The aetiology of PFPS is poorly understood (Kannus et al. 1999). The current trend in literature suggests an extensor mechanism dysfunction as the most probable aetiology (Galantly et al., 1994; Juhn, 1999). There appears to be a clinical overlap between the two syndromes, in terms of an extensor mechanism dysfunction and of signs and symptoms. The aim of this investigation was to evaluate the role of active myofascial trigger points in the vastus lateralis (VL) muscle as perpetuating, causative or concomitant factors in the alteration of VL/VM Total Work (TW) in PFPS in distance runners.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 x, 80 leaves / The aim of this study was to evaluate the Myofascial Diagnostic Scale, for its inter-examiner reliability and to assess its reliability and validity as an assessment tool in the diagnosis and treatment of Myofascial Pain Syndrome.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2007 121 leaves / Ankle sprains account for 85% of all injuries to the ankle (Garrick, 1997). Inversion sprains result from a twisting of a weight-bearing foot into a plantarflexed and inverted position leading to lateral ankle ligament injury. Louwerens and Snijders (1999) state that there are multiple factors involved in ankle sprains or lateral ankle instability. These include injury to the lateral ankle ligaments, proprioceptive dysfunction and decrease of central motor control. Other factors that still need further research include the role of the fibularis muscles, the influence of foot geometry and the role of subtalar instability in ankle sprains (Louwerens and Snijders, 1999). This study focused on the fibularis muscles. Fibularis longus and brevis muscles are found in the lateral compartment of the leg and function to evert/pronate the foot and plantarflex the ankle. Fibularis tertius is found in the anterior compartment and its function is to evert and dorsiflex the foot. Myofascial trigger points in these three muscles refer pain primarily over the lateral malleolus of the ankle, above, behind and below it (Travell and Simons, 1993 2: 371). This is the exact area where ankle sprain patients experience pain. Travel and Simons (1993 2:110) state that a once off traumatic occurrence can activate myofascial trigger points. When considering the mechanism of injury of a lateral ankle sprain, the importance of the fibularis muscles becomes obvious. When the ankle inverts during a lateral ankle sprain, these muscles are forcefully stretched whilst trying to contract to bring about their normal action. Therefore these muscles are often injured from traction when the foot inverts (Karageanes, 2004). It stands to reason that as a result of this mechanism of injury myofascial trigger points may develop in the fibularis muscles. It was hypothesised that fibularis muscle trigger points would prove to be more prevalent in the injured leg when compared to the uninjured leg. To further investigate this hypothesis, an analytical, cross sectional study (phase 1) was done on 44 participants between the ages of 15 and 50. Consecutive convenience sampling was used and participants were screened according to phase 1’s inclusion and exclusion criteria. According to Travel et al. (1999 1: 19) myofascial trigger points (whether active or latent) can cause significant motor dysfunction. Trevino, et al. (1994) stated that fibularis muscle weakness is thought to be a source of symptoms after an inversion sprain. Treatment for ankle sprains involves minimising swelling and bruising and encouraging adequate ankle protection in the acute phase. The patient is advised to rest for up to 72 hours to allow the ligaments to heal (Ivins, 2006). After the acute phase has passed, rehabilitation is focused on. This includes improving the ankle range of motion and proprioception. Attention is also given to strengthen the muscles, ligaments and tendons around the ankle joint. In the recommended treatment protocol however, no mention is made of evaluating the musculature around the ankle joint for myofascial trigger points and or treating these points. McGrew and Schenck (2003) noted that if the musculature and neural structures surrounding the ankle joint were affected during an ankle sprain injury, and were left unresolved, they would lead to chronic instability. It was hypothesised that lateral ankle pain due to inversion ankle sprain injuries may be due to referred pain from the fibularis muscle trigger points. Patients treated with dry needling of the fibularis muscle trigger points would therefore show a greater improvement in terms of subjective and objective clinical findings when compared to a placebo treatment (detuned ultrasound) applied to the fibularis muscle trigger points.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic,Durban Institute of Technology, 2005 xxi, 132, 34 leaves ; ill. ; 30 cm / To assess and quantify the number, severity and specific location of myofascial trigger points within the shoulder rotator muscle group. To assess the internal/external ratio of the dominant shoulder in throwing athletes using a Cybex 700 dynamometer, after intervention and to establish a comparable clinical profile of the participants.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xv, 81 leaves ; 30 cm / The purpose of this study was to investigate the association between active Myofascial Trigger Points in the dominant shoulder external rotator muscle group in overhead throwing athletes and an altered internal/external rotation peak torque and single repetition work ratio of the involved shoulder.

Thesis (M.Tech,: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 62, 19 leaves :|bill. ;|c30 cm / To document the relationship between total work and myofascial trigger points in the vastus lateralis and vastus medialis portion of the quadriceps femoris muscle, whilst providing baseline graphs of these muscles with the use of a Cybex 700 Isokinetic Dynanometer in long distance runners both with and without patellofemoral pain syndrome. Methods: A quantitative, non-intervention clinical exploratory study. Fifty participants were divided into two groups, Group A (40 symptomatics) and Group B (10 asymptomatics). Both groups were screened for vastus lateralis and vastus medialis trigger points. Subjective data was obtained from Group A only, using the Numerical Pain Rating Scale and the Patient Specific Functional Scale. Objective data was obtained from both groups using the algometer, Myofascial Diagnostic Scale, and the Cybex 700 Isokinetic Dynanometer. For descriptive analysis frequency tabulations, box and whisker plots were used to display distributions graphically. Comparisons of categorical and quantitative variables between independent groups were run using chi square and Mann-Whitney testing consecutively. Finally Spearman’s correlation, multivariate generalized linear modelling and repeated measures ANOVA were also used. All statistical analysis was completed at the 95% (p<0.05) level of confidence.

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2003 1 v. (various pagings) / This study was a prospective, randomised, double blinded, placebo controlled, comparative clinical trial to establish the efficacy of therapeutic ultrasound and compare the effectiveness of the two waveforms of ultrasound in the treatment of myofascial pain syndrome.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2006. 88 leaves. / Myofascial pain syndrome is the second most common reason patients seek the help of health care workers. It costs billions of dollars each year in lost revenue due to loss of productivity and other costs. The treatment of myofascial pain syndrome has been extensively researched and it appears that dry needling and medicinal injections of trigger points are some of the most effective modalities. However, an unwanted side effect common to both these therapies is post-needling soreness. Despite being mentioned in passing by many authors, very little detail is available regarding post-needling soreness. It is unclear whether post-needling soreness arises from the trigger point itself, or whether the tissue damage caused by the needle insertion is responsible. Therefore, this study was aimed at investigating whether dry needling muscle tissue in asymptomatic subjects (i.e. subjects not suffering from myofascial pain syndrome) resulted in post-needling soreness. Two different dry needling techniques were also compared with a placebo group in order to determine which technique resulted in the least post-needling soreness. This study was designed as a prospective, randomised, placebo controlled experimental investigation. Sixty subjects were randomly allocated into three equal groups. Group one received the single needle insertion technique and the second group received the fanning dry needling technique. The last group formed the control group and the subjects were treated using the Park Sham Device (placebo needles). All the subjects were between the ages of 18 and 50 and were required to be asymptomatic in the low back region.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2007. / Background: Myofascial pain is the most common cause of persistent regional pain such as back pain, shoulder pain, tension-type headaches and facial pain. A variety of therapeutic modalities are proposed in the treatment of myofascial pain including massage. A variety of massage oils are available on the market, each claiming therapeutic efficacy. Most of these claims, however, have not been verified through clinical trials. Methods: A double-blinded placebo controlled study in which 80 subjects were randomly divided into 4 groups of twenty. Subjects in Group 1 received unscented mineral oil, those in Group 2 received scented mineral oil. Subjects in Group 4 received Arnica Massage oil while those in Group 4 received Blue Steel Arnica Massage oil. Results and Conclusions: The use of Arnica Massage oil or Blue Steel Arnica Massage oil resulted in almost 50 % pain reduction in the subjects after five days of self-administered treatment. Both these products can be recommended for the treatment of myofascial pain syndromes but one cannot be placed in preference to the other, as the results were similar with regards to their effectiveness.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2011. / Dry needling (DN) fanning technique is an effective treatment for myofascial trigger points (MTP), however, it causes swelling and intramuscular haemorrhage which results in post-needling soreness (PNS). Kinesio ® taping space-correction-technique (KTSCT) is claimed to aid in reducing pain by decreasing inflammation, increasing circulation and lymphatic drainage. This in theory indicates that Kinesio ® taping could reduce/alleviate PNS pain after DN. Objective: The purpose of this study was to determine the effectiveness of KTSCT utilizing Kinesio ® Tex Gold tape in reducing the level of PNS associated with DN a trapezius muscle trigger point two. Method: Forty five patients with active trapezius muscle MTP two were randomly allocated into one of three treatment groups. All groups received a standardized DN treatment. Thereafter, group one received no further treatment and acted as the control group, group two received an application of KTSCT utilizing Kinesio ® Tex Gold tape, while group three received a non-proprioceptive hypoallergenic tape application. Assessments were made pre-, post-treatment and at a follow-up consultation on the following day once the taping application was removed. Assessments included numerical pain rating scale-101 (NRS-101), a pain diary and algometer readings. Results: Group three showed an improvement over the control group, however, it was not a statistically significant improvement in any of the assessments. Group two showed statistically significant improvement over the control in the pain diary and algometer readings overall. Results from the NRS-101, showed that group two had a statistically significant improvement when compared to the control group over the time interval when the Kinesio ® Tex Gold tape was applied to the patient. Conclusion: KTSCT utilizing Kinesio ® Tex Gold tape had a greater effect in reducing the level of PNS associated with DN a trapezius muscle trigger point two, when compared with either a non-proprioceptive hypoallergenic tape application or a control group.