Self-Myofascial Release of the Upper Cervical Muscles

May 5, 2026 updated by: Daniel Cawley, Edward Via Virginia College of Osteopathic Medicine

Exploring the Effect of Self-Myofascial Release of the Upper Cervical Muscles on the Superficial Back Fascial Train

The primary objective is to examine the influence of the suboccipital muscles on the superficial back line. The investigators will measure the following as part of this objective:

  • Changes in biomechanical and viscoelastic properties of points within the superficial back fascial train measured by a handheld myotonometer.
  • Pain pressure threshold measured by algometry.
  • Ankle range of motion.
  • Foot plantar pressure changes.

All participants will have a 5-minute self-myofascial release intervention.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The superficial back line is a network myofascial segments that are connected and extend from the plantar foot up through the posterior lower extremity and back, up to the head. These connective tissue and muscular tracks play a role in supporting upright stance and motion. Dysfunction in one segment of the superficial back line can manifest as pain in a different segment of the fascial system. For example, hamstring and gastrocnemius muscle tightness have been associated with altered foot biomechanics and pain. The suboccipital muscles play an important role in head and body posture; therefore, they can influence eye positioning as it relates to head movements and perturbations. Because of this, the suboccipital muscles may have a hierarchical control over the SBFL. Dysfunction in the suboccipital muscles may exert more widespread effects on muscles and tissues at distant regions of the SBFL. Studies have shown that neck pain and forward head posture are associated with altered gait and ankle posture respectively. In addition, stress, anxiety, and poor sleep quality are associated with increased pain sensitivity and disability. How the interconnectedness of the SBFL responds to treatment is not fully understood. Proper treatment of musculoskeletal pain requires a better understanding of the function of myofascial connections and how dysfunction in one segment affects other regions. Also, enhanced understanding of the influence of stress, anxiety, and low sleep quality on response to treatment is needed. This understanding will better inform clinical practice and support the need for a more holistic approach to treating musculoskeletal pain.

The primary objective is to examine the influence of the suboccipital muscles on the superficial back line. Specifically, investigators will measure the following as part of this objective:

  • Changes in biomechanical and viscoelastic properties of points within the superficial back fascial train measured by a handheld myotonometer.
  • Pain pressure threshold measured by algometry.
  • Ankle range of motion.
  • Foot plantar pressure changes.

A secondary objective is to demonstrate a relationship between changes within the SBFL and stress, anxiety, sleep quality and non-debilitating pain. To achieve this secondary objective, the investigators will use the following:

  • Perceived Stress Scale-10 (PSS-10)
  • General Anxiety Disorder-7 (GAD-7)
  • Pittsburgh Sleep Quality Index (PSQI)
  • Numerical Rating Scale (NRS) will be utilized to record participants' intensity, frequency, and duration of non-debilitating lower extremity pain and back pain.

Study Type

Interventional

Enrollment (Actual)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Alabama
      • Auburn, Alabama, United States, 36832
        • Edward Via College of Osteopathic Medicine-Auburn

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

• Adults 19 years of age and older from VCOM-Auburn and the Auburn area.

Exclusion Criteria:

  • pain that alters gait and/or limits/alters normal daily function
  • currently undergoing treatment by a healthcare provider
  • loss of function
  • use of prescription drugs for muscle or muscle relaxants
  • Pregnancy (hormonal changes affecting tissues could be a confounding variable)
  • inflammatory arthritis and fibromyalgia
  • diabetes or prediabetes
  • lumbar radiculopathy or disc pathology
  • previous surgery of the spine or lower extremity
  • injury to the lower extremity within the past 6 months
  • neurological or musculoskeletal diseases
  • cancer or blood disorder
  • current tobacco use
  • other conditions that alter gait

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Self-Myofascial Release Treatment
Device: Occipivot suboccipital pillow self-myofascial release
Subjects will be instructed in the use of the Occipivot suboccipital pillow and how "it should feel." They will be supervised as it is placed. Once verbal verification is obtained regarding the feel and placement of the wedge, the treatment time will begin and continue for 5 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Muscle Stiffness
Time Frame: Pre-Baseline measurement and immediately after 5-minute self-myofascial release intervention
Using myotonometry to assess muscle stiffness (N/m) in the plantar fascia, gastrocnemius, biceps femoris, semitendinosus, thoracolumbar fascia, and semispinalis.
Pre-Baseline measurement and immediately after 5-minute self-myofascial release intervention
Plantar foot pressure
Time Frame: Pre-Baseline measurement and immediately after 5-minute self-myofascial release intervention
Using Novel EMED plantar pressure platform to assess the distribution of plantar foot pressure (kPa) in different regions of the foot
Pre-Baseline measurement and immediately after 5-minute self-myofascial release intervention
Ankle dorsiflexion
Time Frame: Pre-Baseline measurement and immediately after 5-minute self-myofascial release intervention
Using the weight-bearing lunge test to measure ankle dorsiflexion (degrees). This is a functional test of ankle dorsiflexion range of motion in a loaded position.
Pre-Baseline measurement and immediately after 5-minute self-myofascial release intervention
Pain pressure threshold
Time Frame: Pre-Baseline measurement and immediately after 5-minute self-myofascial release intervention
Using algometry to measure pain pressure threshold (kPa) at the erector spinae, sacrum, posterior leg, plantar fascia, and thenar eminence.
Pre-Baseline measurement and immediately after 5-minute self-myofascial release intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Subjective intensity, frequency, and duration of non-debilitating lower extremity pain and back pain
Time Frame: Prior to 5-minute self-myofascial release intervention
Using Numerical Rating Scale (NRS) to measure. Scales from 0-10 with 0 indicating no pain and 10 indicating severe pain. Scales from 1-5 with 1 indicating no pain ever and 5 indicating pain always.
Prior to 5-minute self-myofascial release intervention
Perceived Stress Scale-10 (PSS-10)
Time Frame: Prior to 5-minute self-myofascial release intervention
Measuring the degree to which situations in one's life are considered stressful. Scales from 0-4 with 0=never and 4=very often.
Prior to 5-minute self-myofascial release intervention
Pittsburgh Sleep Quality Index (PSQI)
Time Frame: Prior to 5-minute self-myofascial release intervention
Used to evaluate overall sleep quality. Each questionnaire's 19 self-reported items belong to one of seven subdomains: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Response scores range from 0-3 with lower scores indicating less disturbances and higher scores indicating more disturbances.
Prior to 5-minute self-myofascial release intervention
General Anxiety Disorder-7 (GAD-7)
Time Frame: Prior to 5-minute self-myofascial release intervention
Used to measure symptoms of anxiety. Scores range from 0-3 with lower scores indicating less anxiety symptoms and higher scores indicating more anxiety symptoms.
Prior to 5-minute self-myofascial release intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Edward Via Virginia College of Osteopathic Medicine

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 26, 2024

Primary Completion (Actual)

March 15, 2026

Study Completion (Actual)

May 5, 2026

Study Registration Dates

First Submitted

July 12, 2024

First Submitted That Met QC Criteria

July 29, 2024

First Posted (Actual)

July 31, 2024

Study Record Updates

Last Update Posted (Actual)

May 8, 2026

Last Update Submitted That Met QC Criteria

May 5, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 2024-048

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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