Journal of Mazandaran University of Medical Sciences (Oct 2024)
The Effect of Immediate Self-Myofascial Release and Static Stretching of the Gastrocnemius Muscle and Plantar Fascia in the Superficial Back Line on Range of Motion and chronic Neck Pain: A Randomized Clinical Trial
Abstract
Background and purpose: The human body functions as an integrated and coordinated unit, with each part capable of influencing the entire system. Modern science views the body holistically, addressing not only the treatment of symptoms but also the root cause of any disorder, often located far from the apparent site of the issue. This study aims to examine the effect of immediate release and static stretching of the gastrocnemius muscle and plantar fascia within the superficial back line on range of motion and chronic neck pain. Materials and methods: In this randomized clinical trial, 32 subjects with nonspecific chronic neck pain, aged 30-40 years, were recruited. Participants were randomly assigned into two equal groups: a control group (16 participants) and an intervention group (16 participants). The intervention group performed release and stretching exercises using a foam roller and band, respectively, while the control group did not receive any intervention. Neck range of motion in the sagittal plane was measured using a goniometer, and pain levels were assessed using a visual analog scale before and after the protocol. Data were analyzed using paired t-tests and ANCOVA at a significance level of 0.05 with SPSS software. Results: The ANCOVA test revealed a significant difference between the intervention and control groups in terms of neck pain (P=0.001) and neck range of motion in the sagittal plane, including neck flexion (P=0.001) and neck extension (P=0.001) among individuals with chronic neck pain. Paired t-test results showed that, in the intervention group, there were significant differences between pre-test and post-test scores for neck pain, neck flexion, and extension range of motion after participating in the stretching and myofascial release exercises on the gastrocnemius muscle and plantar fascia (P=0.001). However, no significant differences were found in the control group between the pre- and post-test stages (P>0.05). Conclusion: The use of self-release interventions and stretching exercises on the gastrocnemius muscle and plantar fascia appears to increase range of motion and reduce neck pain. These results suggest tension transmission along the superficial back line, which extends from the plantar fascia to the frontal muscles of the skull, meaning intervention at any point in this chain can affect the entire pathway. This method could be beneficial for individuals with acute neck pain or in cases where direct neck intervention is not possible. By targeting other areas along this muscle chain, improvements in neck symptoms may be achieved. Over recent years, this concept has garnered significant research interest, with a proliferation of studies affirming the existence of the posterior superficial back line through laboratory and cadaver research. Clinically, factors such as the tissue's viscoelastic properties, nerve receptors, and changes in the extracellular matrix are proposed to facilitate tension transmission along muscle chains, though the precise mechanism remains a “black box” in fascia tissue research. (Clinical Trials Registry Number: IRCT20200209046422N2)
