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J Manipulative Physiol Ther. 2017 Jan;40(1):31-40. doi: 10.1016/j.jmpt.2016.10.007. Epub 2016 Nov 16.

Presence of Latent Myofascial Trigger Points and Determination of Pressure Pain Thresholds of the Shoulder Girdle in Healthy Children and Young Adults: A Cross-sectional Study.

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Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
Department of Nursing and Physical Therapy, University of Salamanca, Salamanca, Spain; Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain. Electronic address:



The primary objective of this study was to compare the number of myofascial trigger points (MTPs) and the pressure pain thresholds (PPTs) in the shoulder girdle, on the dominant and nondominant sides, between healthy children and adults. The secondary aim was to assess the correlations between the number of MTPs and the PPTs in these populations.


A cross-sectional study was performed. Thirty-five children (aged 9.1 ± 1.7 years) and 35 adults (aged 23.4 ± 3.4 years) with no history of shoulder or cervical pathology were included. All participants were examined for MTPs in the shoulder muscles and assessed for PPTs in the neck, shoulder, and tibialis anterior. Parametric and nonparametric tests, effect sizes, and odds ratios were used to determine the differences between groups and sides. Spearman's σ test was used to assess correlations between latent MTPs (LTPs) and PPTs in each group.


Children had fewer LTPs than adults did (P = .03). The upper trapezius was the muscle with the largest number of LTPs, affecting 13 adults on the dominant side. Children had lower PPTs compared with adults (P < .05). Correlations between the number of LTPs (on both sides and in total) and PPTs were observed only in adults.


Healthy children have fewer LTPs and lower PPTs in the shoulder girdle than healthy adults. A relationship was observed between sensitivity to pressure and the presence of LTPs in adults, in whom lower PPT was associated with more LTPs. This relationship was not detected in children.


Musculoskeletal Pain; Pain Threshold; Sensitivity; Trigger Points

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