January 3, 2023

Case study: Jason and Upper Trapezius Pain

Jason was experiencing pain and discomfort in his right trapezius muscle. The patient reported that his right upper trap always felt tight with moderate pain or discomfort due to his considerable work sitting and working at a computer. Jason visited a physical therapist to further evaluate the pain. Jason’s PT palpated both the right and left upper trapezius and noted physical tension (muscle firmness) and myofascial trigger points on his right side. Additionally, he noted that Jason had less mobility with left sided bending and rotation. His physical therapist scanned Jason’s upper left and right trapezius muscles with three scans per side. Before treatment, Pact Sense detected significantly higher values in the right trapezius compared to the left, with high asymmetry between sides. 

Treatment plan

Jason’s PT used two treatments on him bilaterally, including sports massage and cupping, for a total of approximately 15 minutes. 

How can the Pact Sense be used in this case?

Upper trapezius pain is very common among adults. Generalized feelings of tightness, discomfort, and pain are all subjective measures based on the individual's perception. This makes it difficult to assess the true properties of the tissue’s quality. Manual palpation is one method to objectively assess the feeling, but again may vary from one practitioner to another. Therefore the Pact Sense can be used to definitively associate a value with the feelings experienced by the patient. Furthermore, tracking these properties after treatment as well can give better insight to the effectiveness of the treatment session. 

What are the muscle properties measured by the Pact Sense?

Pact Sense measures four properties to quantify the state of your muscle; Stiffness, Stiffness Slope, Damping, Damping Slope.

Stiffness: How hard you push the muscle to get it to compress a specific amount

Damping: The “rebound” of tissue following the compression

Stiffness Slope: How hard you push to compress the muscle by different amounts

Damping Slope: The “rebound” of tissue following the compression at different depths

(See in depth descriptions of these parameters here)

What were Jason’s scan results?

Stiffness on the right trap was significantly higher than the left trap before treatment. After treatment, right trap Stiffness decreased, and left trap Stiffness increased, while decreasing the difference between the left and right side. Damping on the right side was significantly higher than the left trap before treatment. After treatment, damping on the right side was slightly lower, while the left trap damping significantly increased to close the difference between the left and right side. Stiffness Slope on the right trap was significantly higher than the left before treatment. After treatment, Stiffness Slope significantly increased on both sides, while decreasing the difference between the left and right side. All of these parameters follow the same pattern before treatment, as there were significant asymmetries in mechanical properties among the contralateral muscles. Post-treatment, these asymmetries resolved in all parameters to improve the overall symmetry score from 41 out of 100 to 91 out of 100.

What does his data mean? 

Jason’s data shows the Pact Sense can detect asymmetries in patients presenting with pain and discomfort. With paired pre-treatment and post-treatment scans, the Pact symmetries can demonstrate the efficacy of PT treatments and provide an objective determination of progress during a therapy session. By monitoring the balance between contralateral muscles, patients can improve symptoms of discomfort caused by strain. Furthermore, practitioners can use this information to evaluate the effectiveness of cupping treatments paired with massage.