Short Term Application of the Muscular Inhibition Method of Strain/Counterstrain in the Treatment of Latent Myofascial Trigger Points of the Masticatory Musculature: A Randomized Controlled Trial

  • Juan José González Gerez PT, PhD. Managing Director of Fisiosur I+D. Research & Development Institute of Health Sciences. Garrucha; Almería (SPAIN)
  • María Ángeles Serrera Figallo DDS, PhD. Department of Dentistry, University of Seville Spain. Faculty of Dentistry. Sevilla (SPAIN)
  • Pedro Vicente Munuera Martínez DP, PhD.Department of Podiatry University of Seville, Spain. School of Health Science. Sevilla (SPAIN)
  • Manuel Fernández Rabadán PT. Head of Physiotherapy Service. Prevention & Rehabilitation Fremap Hospital. Sevilla (SPAIN).
  • Miguel Ángel Lérida Ortega PT, PhD. Department of Nursing & Physiotherapy , University of Jaen (SPAIN)
  • José Antonio García Vidal PT, PhD. Department of Physiotherapy , University of Murcia (SPAIN)
  • Manuel Saavedra Hernández PT, PhD. Department of Nursing, Physiotherapy & Medicine, University of Almería (SPAIN)


Background: The aim of the present study was to assess the short-term effects on mandibular dynamics [in terms of mouth opening (MO) and bite force (BF)] of the application of the therapeutic method of muscular inhibition of strain/counterstrain (SCS) on latent myofascial trigger points (MTrPs) of the masseter, temporalis and internal pterygoid muscles.

Methods: Ninety-nine subjects, 47 males and 52 females, aged between 18 and 24 and with at least one MTrP in each pair of muscles, were enrolled in the study. Subjects were randomly allocated to one of two groups: experimental (48 subjects), who received SCS therapy, and control (51 subjects), who received a placebo treatment. As outcome variables, we considered maximum active mouth opening (MO) and maximum bite force (BF), which were evaluated one minute before and five minutes after application of treatment by an external evaluator blinded to the random distribution of subjects to each study group.

Results: The results showed a significant improvement with respect to active MO (controls: 0.03mm ±0.65- experimentals: 1.32mm±1; p< 0.01) and maximum BF (controls: 0.17N ± 1.33- experimentals: 32.25 N ± 22.40; p< 0.001) after treatment of MTrPs with SCS.

Conclusions: Muscular inhibition methods through the application of strain/counterstrain (SCS) could be used in the treatment of the MTrPs of the masseter, temporalis and internal pterygoid muscles in order to improve maximum MO and maximum BF.

Key Words: Myofascial pain syndromes, Mouth Rehabilitation, Bite force, Temporomandibular joint.