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A hyperirritable spot within a taut band of skeletal muscle/ fascia.
Definition of a trigger point
Symptoms of trigger points
- Usually painful upon compression
- Refers pain in predictable pattern
- Causes a shortening of the affected muscle
- Decreases contractile ability (weakens)
- Often produces autonomic phenomena in referral zone (examples: local vasoconstriction, sweating, lacrimation [tearing] runny nose, salivation, piloerections or "goosebumps")
A predictable pattern of pain due to activation/palpation of MTP
- Typically distal to palpated site of MTP
- Reported as dull, achy pain or burning sensation
- Rarely accompanied by radicular numbness/tingling
- Decreases/disappears with reduction/resolve of MTP
- Always tender
- Refers pain on palpation or contraction of the muscle
- Causes a shortening of affected muscle
- Prevents muscle from fully lengthing
- Local twitch response/ jump sign
- Will not likely resolve on its own
What type of MTP is not noticed as painful until activated, but produces pain with palpation?
MTP in agonist muscle/ initial site of trauma
MTP in antagonist or synergist of primary muscle
MTP developed in pain referral zone of either primary of secondary MTP
Focal point of pain upon palpation without referral pain
"Crunchiness" or grainy texture
- Difficult to skin roll
- Often found ofer an aponerosis
- No inflammation
Speed of muscle stripping- location technique
4-6 inches per second
Which fiber direction should muscle stripping be performed?
In the same direction as muscle fibers
How deep should muscle stripping be (locating technique)?
When treating MTP with muscle stripping, what speed is the technique?
1 inch per 2-3 seconds
What pain range should you work in?
After 8-12 seconds of MTP work, what questions should you ask?
- Is the pain better, worse or staying the same?
- Any referral pain?
Where do you go after releasing TP?
Stretch structure then address referral zone.
Steps in lymphatic drainage chain
- Medial, mid then lateral clavicle
- Lateral, mid, then medial back chain (on upper trap)
- Rinse- go back in reverse order to locations just worked.
- Front bottom then front top of neck on SCM
- Side bottom then top of lateral neck
- Waterwheel- just medial to ramus and angle of mandible
- Lateral, mid, then medial clavicle