74 J Can Chiropr Assoc 2005; 49(2)
CCA Young Investigator Award
Dr. John Z Srbely, BSc, DC, DAc, PhD(student)
Dr. John Srbely is in his 13th year of chiropractic practice
in Toronto following graduation from CMCC in 1992. In
September of 2003, he began post-graduate studies in
Neurophysiology and Biophysics under the guidance of
Dr. Jim Dickey PhD at the University of Guelph and is
currently enrolled in a PhD programme.
His broad interest lies in pain mechanisms with a spe-
cific interest in the neurophysiology of myofascial pain
and trigger points. In addition, “as these neural mecha-
nisms are foundational to the effects of spinal manipula-
tion, I also have a keen interest to concurrently explore
the neurophysiological (somato- somatic, somato-viscer-
al) effects of spinal manipulation and its role in the man-
agement of myofascial pain syndromes”.
Dr. Srbely is currently finishing data collection for his
first study which he presented at the CCCRC Chiroprac-
tic Research Symposium in Montreal in September 2004.
In addition, he and Dr. Dickey are in the midst of collabo-
rating with other labs on the next phase of these studies,
which will investigate these neurophysiological effects in
greater detail via direct nerve fiber recordings.
The Canadian Chiropractic Association Research
Committee met in Vancouver recently and reviewed all of
the abstracts submitted to the Research Symposium that
were eligible for the Young Investigator Award and unan-
imously decided on Dr. John Srbely.
This particular award is given to exceptional chiroprac-
tors to recognize the increasing role that young research-
ers play in the Canadian chiropractic researcher culture.
The Goals of this Award are:
1. to recognize outstanding research on chiropractic topics
2. to attract chiropractors and other scientists to study
chiropractic research topics
3. to advance the discipline of chiropractic
The award is given for original non-published research
and provides a plaque and $1000 prize. The Award is
generally presented at the annual meeting of The CCA.
Congratulations to Dr. Srbely!
CCA Young Investigator Award
J Can Chiropr Assoc 2005; 49(2) 75
John Srbely, James P. Dickey
University of Guelph, Guelph, Ontario, Canada.
Myofascial trigger points (TrP) are discrete palpable hy-
perirritable loci within taut bands of skeletal muscle; pres-
sure application elicits a referral sensation/paresthesiae.1
There is growing body of evidence suggesting that a sub-
stantial proportion of common adult musculoskeletal pain
syndromes are manifestations of myofascial trigger point
activity.2 The possible role of neuroadaptive processes
such as long-term potentiation/central sensitization, and
potential management via modalities such as spinal ma-
nipulative therapy,3 is of special interest to the authors.
This study will explore the neurophysiological interac-
tions of the trigger point complex by evaluating whether
stimulation of one TrP site can influence the pain sensitiv-
ity at another trigger point site innervated by the same neu-
The study involves stimulation of a trigger point locus
within the supraspinatus muscle (via intramuscular dry
needling). The supraspinatus TrP will be confirmed by
the presence of a visible local twitch response within the
muscle, evoked during needle penetration. Raw pain-
pressure threshold values (PPT) will be recorded from a
trigger point site within the ipsilateral infraspinatus mus-
cle at selected time intervals of 1, 2, 5 and 15 minutes. A
baseline (pre-needling) reading will be recorded and the
absolute PPT readings at each time interval (1–15 min)
represented as a ratio of this baseline value.
Figure 1 illustrates representative data for one of the pilot
subjects in our study. PPT readings in the infraspinatus
sharply increase (i.e. decreased trigger point sensitivity)
for the first two minutes post-needling. At the 2 minute
mark, the PPT values tend to stabilize. Interestingly, the
PPT values once again demonstrate a gradual, distinct
rise between the 5 to 15 minute period, suggestive of a
further decline in sensitivity at the infraspinatus site.
Preliminary results suggest that systematic physiological
effects on a trigger point complex may be induced by
stimulation of other trigger point sites specifically inner-
vated by the same neurological level(s). This data may
suggest two distinct processes at play in the neuromodu-
lation effect: an early segmental effect which gives way
to subsequent supraspinal/non-segmental effects.
This project was funded by NSERC.
1 Simons DG. Postgrad Med 1983; 73(2):66, 68–70, 73.
2 Simons DG. J Electromyography and Kinesiology 2004;
3 Boal RW. J Manipulative and Physiol Ther 2004;
Stimulation of myofascial trigger points causes systematic physiological effects
Pressure sensitivity changes at infraspinatus
trigger point site after stimulation of ispsilateral
supraspinatus trigger point
0 5 10 15
Figure 1: representative data of the PPT ratio versus time
for one pilot subject.