March/April 2026 Vol 32.2The Acute Effect of Suboccipital Release Technique on Trapezius Muscle Activation and Pain in Individuals with Anxiety
Authors: Bahriye Bas MSc, Tamer Çankaya PhD, Sezen Tezcan PhD
Abstract:
Objective • Anxiety is an unpleasant emotional and observable response to stressful situations and can adversely affect many systems, including the musculoskeletal system. The study aims to determine the immediate effect of the suboccipital release technique on the trapezius muscle pain threshold, muscle activation, and anxiety level in individuals with anxiety.
Methods • Thirty-six participants with symptoms of anxiety and depression were included in this single-blind, randomized sham-controlled study, with 18 assigned to the control group and 18 to the acute intervention group. Anxiety levels, bilateral upper trapezius muscle pain thresholds, and muscle activation were assessed. The experimental group received a single session of the suboccipital release technique, while the control group received a sham suboccipital release. Evaluations were conducted before and immediately after the intervention.
Results • The mean age of the experimental group was 21.66 ± 2.40 years, and the mean age of the control group was 22.00 ± 2.08 years. There were no statistically significant differences in baseline demographics or most scores before acute
intervention (P > .05), except for cranial rhythmic impulse (P = .000) and surface electromyography right eccentric % maximum voluntary contraction (P = .043). There were also no significant between-group differences in score changes for any outcome measures (all P > .05), except for post-acute intervention cranial rhythmic impulse values (P = .003), favoring the experimental group. Within-group analyses showed significant improvements in trapezius pain thresholds and surface electromyography right concentric % maximum voluntary contraction in both groups (P < .05).
Conclusion • The findings suggest that suboccipital release technique can increase the upper trapezius muscle pain threshold and concentric muscle activation after acute intervention in individuals with anxiety. This technique may be considered a potential approach to reduce the pain of individuals who have pain problems in the upper part of the trapezius muscle due to anxiety.
