Comparative effectiveness of myofascial release versus conventional physiotherapy in bicipital tendinopathy: A randomized controlled trial

Objectives Bicipital tendinopathy (BT) is considered one of the major differential diagnoses of anterior shoulder pain, often accompanied by a restricted or painful range of motion (ROM). Our objective was to assess the effectiveness of myofascial release (MFR) in alleviating pain and improving ROM in patients with BT. Materials and Methods Sixty participants were randomly assigned into two equal groups: A control group and an experimental/test group. The control group (30) received a pre-determined physiotherapy (PT) session. The test group (30) underwent three manual MFR therapy sessions every fifth day starting from day one. Pain during maximum ROM, by visual analog score, and degree of maximum ROM by a digital inclinometer were assessed 2 min before and 2 min after each intervention. Repeated-measures analysis of variance subsequently, the Bonferroni post hoc test was used to measure the statistical significance. Results Pain during ROM was measured on first day pre- and post-intervention, fifth day pre- and post-intervention, and on the tenth day pre- and post-intervention and as follows: 7.8 ± 0.4, 6.7 ± 0.4, 6.6 ± 0.4, 5.9 ± 0.4, 5.7 ± 0.4, and 5.4 ± 0.4, respectively. In the experimental group, the corresponding values were 7.6 ± 0.4, 5.3 ± 0.4, 4.6 ± 0.4, 3.7 ± 0.4, 3.4 ± 0.4, and 2.7 ± 0.4. compared to the baseline, both groups showed a significant improvement in pain scores after each session ( P < 0.001). The baseline pain levels during ROM were similar between the control and experimental groups ( P > 0.999). Those receiving MFR showed a significantly greater reduction in pain soon after each session, starting on day one ( P < 0.001), compared to the conventional PT group. In addition, patients in the control group experienced a significant improvement in ROM, increasing from 169.9° ± 0.2.14° to 176.1° ± 1.15° ( P < 0.01), whereas MFR improved ROM markedly from 150.1° ± 9.58° up to 180.0° ± 0.0° ( P < 0.05). Conclusion MFR is more pronounced than conventional PT in alleviating painful shoulder ROM associated with BT.