Myofascial Trigger Points in Suboccipital Muscles Quiz
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Questions and Answers

Which of the following is NOT a muscle that can develop myofascial trigger points in the suboccipital region?

  • Obliquus Superior
  • Sternocleidomastoid (correct)
  • Obliquus Inferior
  • Rectus Capitis Posterior Major

    • Which of the following is a common symptom of myofascial trigger points in the suboccipital muscles?

  • Radiating pain from the occiput to the temple (correct)
  • Sharp, localized pain
  • Numbness and tingling in the hands
  • Difficulty swallowing

    • Which of the following is NOT a potential cause of activation of myofascial trigger points in the suboccipital muscles?

  • Uncorrected nearsightedness
  • Trauma to the back of the neck
  • Prolonged upward gaze
  • Poor posture while sitting (correct)

    • What is the main function of the suboccipital muscles?

    <p>Extension of the neck</p> Signup and view all the answers

    Which of the following is a common referral pattern associated with myofascial trigger points in the sternocleidomastoid muscle?

    <p>Pain in the throat and sternum</p> Signup and view all the answers

    What is the term used to describe the suboccipital muscles as a common source of post-traumatic headache?

    <p>Headache ghosts</p> Signup and view all the answers

    What is the most common symptom associated with myofascial trigger points in the thenar muscles?

    <p>Difficulty with pincer grip movements</p> Signup and view all the answers

    Which of the following can activate and perpetuate myofascial trigger points in the forearm extensor and brachioradialis muscles?

    <p>All of the above</p> Signup and view all the answers

    What is the most common referral pattern associated with myofascial trigger points in the iliocostalis thoracic muscle?

    <p>Pain referred to the shoulder and iliac crest</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the thoracolumbar paraspinal muscles?

    <p>Difficulty rising from a chair</p> Signup and view all the answers

    Which of the following can be a consequence of myofascial trigger points in the thoracolumbar paraspinal muscles?

    <p>Restricted spinal motion</p> Signup and view all the answers

    What is the most common referral pattern associated with myofascial trigger points in the multifidi/rotatores muscles?

    <p>Pain centered on the spinous processes at the segmental level</p> Signup and view all the answers

    Which of the following can be a consequence of myofascial trigger points in the forearm extensor and brachioradialis muscles?

    <p>Weakness with supination and pronation movements</p> Signup and view all the answers

    What is a common misconception associated with myofascial trigger points in the thenar muscles?

    <p>They are a result of carpal tunnel syndrome</p> Signup and view all the answers

    Which of the following can activate myofascial trigger points in the thoracolumbar paraspinal muscles?

    <p>All of the above</p> Signup and view all the answers

    How can myofascial trigger points in the iliocostalis thoracic muscle be differentiated from intercostal nerve pathologies?

    <p>Trigger points can mimic the pain from intercostal nerve pathologies</p> Signup and view all the answers

    Which muscle's myofascial trigger points can cause pain that concentrates deeply in the anterior deltoid region and extends down the front and lateral aspect of the arm and forearm?

    <p>Infraspinatus</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the infraspinatus muscle?

    <p>Inability to internally rotate and adduct the arm</p> Signup and view all the answers

    What is the referral pattern associated with myofascial trigger points in the teres minor muscle?

    <p>Pain is localized at the insertion of the muscle and may spread down the posterior upper arm</p> Signup and view all the answers

    What is the common complaint associated with myofascial trigger points in the teres major muscle?

    <p>Pain with motion when reaching overhead with an outstretched arm</p> Signup and view all the answers

    Which muscle's myofascial trigger points can mimic the symptoms of frozen shoulder, adhesive capsulitis, or pitcher's arm?

    <p>Subscapularis</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the subscapularis muscle?

    <p>Removal of wrist watches due to perceived irritation at the wrist</p> Signup and view all the answers

    Which muscle's myofascial trigger points can cause pain that concentrates along the tendon of the long head and along the common distal tendon?

    <p>Biceps brachii</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the biceps brachii muscle?

    <p>Snapping or grating sounds during movement</p> Signup and view all the answers

    Which muscle's myofascial trigger points are directly associated with trigger points in the infraspinatus muscle?

    <p>Teres minor</p> Signup and view all the answers

    Which muscle's myofascial trigger points are often described as a "painful bursa" about the size of a silver dollar deep in the posterior shoulder area?

    <p>Teres minor</p> Signup and view all the answers

    What symptom is associated with trigger points in the sternal division of the sternocleidomastoid muscle?

    <p>Swollen glands</p> Signup and view all the answers

    Which of the following is NOT a symptom associated with trigger points in the clavicular division of the sternocleidomastoid muscle?

    <p>Facial neuralgia</p> Signup and view all the answers

    What can trigger points in the upper trapezius muscle fibers cause?

    <p>Temporal headaches</p> Signup and view all the answers

    Which of the following is NOT a potential cause of trigger point activation in the trapezius muscle?

    <p>Sleeping on the stomach</p> Signup and view all the answers

    What is the primary symptom associated with trigger points in the splenius capitis and splenius cervicis muscles?

    <p>Stiff neck with limited rotation</p> Signup and view all the answers

    Which of the following is NOT mentioned as a potential cause of trigger point activation in the splenius capitis and splenius cervicis muscles?

    <p>Carrying a heavy backpack</p> Signup and view all the answers

    What is the referral pattern for trigger points in the levator scapulae muscle?

    <p>Concentrates in the angle of the neck and along the vertebral border of the scapula</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with trigger points in the levator scapulae muscle?

    <p>Temporal headaches</p> Signup and view all the answers

    What is NOT mentioned as a potential cause of trigger point activation in the levator scapulae muscle?

    <p>Whiplash injury</p> Signup and view all the answers

    Which muscle's trigger points are said to mimic the symptoms of 'Scapulo-costal Syndrome'?

    <p>Levator scapulae</p> Signup and view all the answers

    What is the primary referral pattern for a trigger point in the pectoralis major muscle?

    <p>Pain over the front of the chest and shoulder, and sometimes down the ulnar side of the arm, forearm and fingers</p> Signup and view all the answers

    What is the primary symptom associated with a trigger point in the serratus anterior muscle?

    <p>Clients complaining of a 'stitch in their side' and difficulty taking a deep breath</p> Signup and view all the answers

    What is the primary referral pattern for a trigger point in the supraspinatus muscle?

    <p>Pain felt as a deep ache in the mid-deltoid region of the shoulder, extending part way down the arm</p> Signup and view all the answers

    What is the primary symptom associated with a trigger point in the deltoid muscle?

    <p>Difficulty raising the arm horizontally, as in bringing the hand to the mouth, and reaching back at the shoulder level</p> Signup and view all the answers

    What is the primary cause of activation for a trigger point in the pectoralis major muscle?

    <p>Trauma, rib fracture, strain through overuse as a shoulder depressor (walking with crutches), strain as an accessory muscle of inspiration, or poor posture</p> Signup and view all the answers

    What is the primary symptom associated with a trigger point in the supraspinatus muscle?

    <p>Pain felt strongly during abduction and a dull ache at rest</p> Signup and view all the answers

    What is the primary referral pattern for a trigger point in the deltoid muscle?

    <p>Pain felt locally over the portion of the deltoid muscle affected</p> Signup and view all the answers

    What is the primary cause of activation for a trigger point in the serratus anterior muscle?

    <p>Strain during excessively fast or prolonged running, push-ups, lifting heavy weights overhead, or severe coughing</p> Signup and view all the answers

    What is the primary symptom associated with a trigger point in the pectoralis major muscle?

    <p>Difficulty reaching forward and up, or reaching backward with the arm at shoulder level</p> Signup and view all the answers

    What is the primary referral pattern for trigger points in the rhomboid muscles?

    <p>Pain refers locally to the rhomboid muscles</p> Signup and view all the answers

    What is a common cause of trigger points in the scalene muscles?

    <p>Overuse of the accessory respiratory muscles in apical (paradoxical) breathing</p> Signup and view all the answers

    Which of the following is a common symptom of trigger points in the pectoralis major and subclavius muscles?

    <p>Sensation of chest constriction, which can be confused with angina pectoris</p> Signup and view all the answers

    Which of the following is a potential consequence of trigger points in the scalene muscles?

    <p>Venous obstruction and compression of the lower trunk of the brachial plexus</p> Signup and view all the answers

    What is a common cause of trigger points in the pectoralis major and subclavius muscles?

    <p>Heavy lifting, especially when reaching out in front</p> Signup and view all the answers

    Which of the following muscles is most likely to have trigger points that refer pain to the upper half of the vertebral border of the scapula and the adjacent interscapular region?

    <p>Scalenes</p> Signup and view all the answers

    Which of the following is a common symptom of trigger points in the rhomboid muscles?

    <p>Superficial achy pain at rest</p> Signup and view all the answers

    What is a potential aggravating factor for thoracic outlet syndrome (TOS) according to the text?

    <p>Trigger points in the scalene muscles</p> Signup and view all the answers

    Which of the following is a common cause of trigger points in the rhomboid muscles?

    <p>Prolonged leaning forward and working with rounded shoulders</p> Signup and view all the answers

    How can trigger points in the pectoralis major and subclavius muscles be differentiated from cardiac-related conditions?

    <p>Cardiac-related conditions should be ruled out</p> Signup and view all the answers

    Which muscle group is referred to as the 'Workhorse Elbow Flexor'?

    <p>Brachialis</p> Signup and view all the answers

    What is a common referral pattern associated with myofascial trigger points in the Triceps Brachii muscle?

    <p>Pain projected up and down the posterior aspect of the arm</p> Signup and view all the answers

    Which activity may contribute to the activation of myofascial trigger points in the Finger Extensors?

    <p>Typing on a keyboard</p> Signup and view all the answers

    Which of the following is a potential symptom associated with myofascial trigger points in the Forearm & Finger Flexors?

    <p>All of the above</p> Signup and view all the answers

    Which activity may contribute to the activation of myofascial trigger points in the Brachialis muscle?

    <p>Carrying a box at arm's length</p> Signup and view all the answers

    Which of the following is NOT a potential cause of activation or perpetuation of myofascial trigger points in the Forearm & Finger Flexors?

    <p>Repetitive finger movements</p> Signup and view all the answers

    Which of the following is a common symptom associated with myofascial trigger points in the Triceps Brachii muscle?

    <p>All of the above</p> Signup and view all the answers

    Which condition can myofascial trigger points in the Finger Extensors mimic or contribute to?

    <p>Tennis elbow</p> Signup and view all the answers

    Which activity may contribute to the activation of myofascial trigger points in the Triceps Brachii muscle?

    <p>Sports activities</p> Signup and view all the answers

    Which muscle group's trigger points can mimic the symptoms and signs of medial epicondylitis, ulnar neuropathy, carpal tunnel syndrome, osteoarthritis, and cervical radiculopathies?

    <p>Forearm &amp; Finger Flexors</p> Signup and view all the answers

    The suboccipital muscles are a common TP source of post-traumatic ______.

    <p>headache</p> Signup and view all the answers

    Activation of these TP's may be caused by a prolonged upward ______.

    <p>gaze</p> Signup and view all the answers

    Trigger points in the suboccipital muscles are commonly referred to as ______.

    <p>Headache Ghosts</p> Signup and view all the answers

    The primary function of the suboccipital muscles is ______.

    <p>head movement</p> Signup and view all the answers

    Myofascial trigger points in the sternocleidomastoid muscle are ______ complex.

    <p>amazingly</p> Signup and view all the answers

    Trigger points in the sternal division of the sternocleidomastoid muscle can refer pain to the ______.

    <p>throat</p> Signup and view all the answers

    The clavicular division of the sternocleidomastoid muscle may cause tension headaches across the forehead, ear aches, tinnitus, dizziness, and nausea. TrP in this division may mimic ____________.

    <p>facial neuralgia</p> Signup and view all the answers

    Myofascial trigger points in the upper fibers of the trapezius muscle are associated with temporal headaches and can limit rotation of the head to the same side. Activation of these trigger points may be caused by trauma such as ____________.

    <p>whiplash</p> Signup and view all the answers

    Splenius Cervicis muscle concentrate pain at the angle of the neck and behind the eye, inside the skull. Clients with trigger points in this muscle may complain of a stiff neck with limited rotation of the head and neck due to the pain. TP's in these muscles can be activated by postural stresses that overload extension or rotation of the head and neck, such as falling asleep with the neck bent in a crooked position, or a ____________.

    <p>cool draft</p> Signup and view all the answers

    Levator Scapulae muscle refers pain to the angle of the neck and along the vertebral border of the scapula. Clients may complain they have trouble looking in their blind spots while driving. TP's in this muscle mimic symptoms of torticollis and scapulo-costal syndrome. Activation of these trigger points are from postural stresses such as walking with a cane, or occupational stresses like improper ergonomics while at a desk, and ____________ to the back of the neck.

    <p>cold draft</p> Signup and view all the answers

    Myofascial trigger points in the splenii muscles may cause a stiff neck with limited rotation of the head and neck due to the pain. These trigger points can be activated by postural stresses that overload extension or rotation of the head and neck, for example, falling asleep with the neck bent in a crooked position, or a ____________.

    <p>cool draft</p> Signup and view all the answers

    Trigger points in the levator scapulae muscle may cause clients to have trouble looking in their blind spots while driving. The activation of these trigger points is from postural stresses such as walking with a cane, or occupational stresses like improper ergonomics while at a desk, and ____________ to the back of the neck.

    <p>cold draft</p> Signup and view all the answers

    Clients with trigger points in the splenius muscles may complain of a stiff neck with limited rotation of the head and neck due to the pain. These trigger points can be activated by postural stresses that overload extension or rotation of the head and neck, such as ergonomically incorrect workstation or falling asleep with the neck bent in a crooked position, or a ____________.

    <p>cool draft</p> Signup and view all the answers

    Myofascial trigger points in the levator scapulae muscle may cause clients to have trouble looking in their blind spots while driving. These trigger points can be activated by postural stresses such as walking with a cane, or occupational stresses like improper ergonomics while at a desk, and a ____________ to the back of the neck.

    <p>cold draft</p> Signup and view all the answers

    The most common myofascial trigger point observed in the body is TP1 in the upper fibers of the trapezius muscle. These trigger points are associated with temporal headaches and can limit rotation of the head to the same side. Activation of these trigger points may be caused by trauma like ____________.

    <p>whiplash</p> Signup and view all the answers

    Trigger points in the upper fibers of the trapezius muscle are associated with temporal headaches and can limit rotation of the head to the same side. Activation of these trigger points may be caused by trauma, overloading by tilting of the shoulder-girdle axis, carrying heavy bags, purse, backpack, heavy winter coats, and bra straps, as well as ____________.

    <p>body asymmetry</p> Signup and view all the answers

    Trigger points in the pectoralis minor muscle can cause distinctive ______ symptoms through entrapment of the brachial plexus.

    <p>neurovascular</p> Signup and view all the answers

    Clients may complain of a ______ in their side and that they can't take a deep breath when they have trigger points in the serratus anterior muscle.

    <p>stitch</p> Signup and view all the answers

    Trigger points in the deltoid muscle can mimic pain arising from the ______ joint.

    <p>glenohumeral</p> Signup and view all the answers

    Trigger points in the supraspinatus muscle can cause a ______ ache in the mid-deltoid region of the shoulder.

    <p>dull</p> Signup and view all the answers

    Trigger points in the pectoralis major muscle can project pain over the ______ of the chest.

    <p>front</p> Signup and view all the answers

    Trigger points in the serratus anterior muscle may be caused by ______ during excessively fast or prolonged running.

    <p>strain</p> Signup and view all the answers

    Trigger points in the deltoid muscle may be activated by ______ to the deltoid muscle during activity.

    <p>impact</p> Signup and view all the answers

    Trigger points in the supraspinatus muscle can cause ______ or snapping sounds around the joint.

    <p>clicking</p> Signup and view all the answers

    Trigger points in the pectoralis minor muscle can cause difficulty ______ forward and up.

    <p>reaching</p> Signup and view all the answers

    Trigger points in the serratus anterior muscle may be associated with high levels of ______ and hysteria.

    <p>anxiety</p> Signup and view all the answers

    Pronator Teres Entrapment of the Median Nerve can present with trigger points in this ______ muscle.

    <p>Teres</p> Signup and view all the answers

    Symptoms of these trigger points include pain complaints when they attempt a firm ______ as with shaking hands to greet someone.

    <p>grip</p> Signup and view all the answers

    Activation and perpetuation are caused by strong or prolonged ______ as when sewing, weeding, writing longhand and opening jars.

    <p>gripping</p> Signup and view all the answers

    A client with TP's in these muscles may often complain of a steady deep ______ in the spine.

    <p>ache</p> Signup and view all the answers

    Active TrPs in Iliocostalis Thoracic can mimic pain from ______ nerve pathologies.

    <p>intercostal</p> Signup and view all the answers

    Activation of these TP's may be caused by sudden ______ (bending and twisting movements), muscle fatigue and/or chill, flat feet, leg and pelvic asymmetry, whiplash type of accidents, and sitting for long hours.

    <p>overload</p> Signup and view all the answers

    Trigger points in the sternal division of the sternocleidomastoid muscle can refer pain to the ______.

    <p>head</p> Signup and view all the answers

    The primary function of the ______ muscles is to stabilize and control head movements.

    <p>suboccipital</p> Signup and view all the answers

    Trigger points in the ______ muscle fibers can cause headaches, neck pain, and restricted neck motion.

    <p>upper trapezius</p> Signup and view all the answers

    Activation of trigger points in the Rhomboids muscle are usually caused by prolonged leaning forward and working with rounded shoulders, such as in activities like writing, sewing, and ____________.

    <p>massage therapy</p> Signup and view all the answers

    Trigger points in the ______ muscle can refer pain to the upper half of the vertebral border of the scapula and the adjacent interscapular region.

    <p>rhomboid</p> Signup and view all the answers

    Trigger points in the Scalenes muscles may be activated by excessive pulling or lifting with the hands at waist level, activities like riding horses or playing ____________.

    <p>tug-of-war</p> Signup and view all the answers

    Pectoralis Major trigger points can mimic the intensity, quality, and distribution of cardiac pain, especially when reaching out in front or with poor ____________.

    <p>ergonomics</p> Signup and view all the answers

    Activation of trigger points in the Subclavius muscle can occur from heavy lifting, overuse of arm adduction, immobilization, poor posture, anxiety, or exposure to cold air/draft; they may project pain over the clavicle and down the anteriolateral arm to the first three ____________.

    <p>digits</p> Signup and view all the answers

    Trigger points in the Rhomboids muscle commonly cause superficial achy pain at rest, not usually influenced by movement, and are often a result of trigger points in neighboring muscles like Levator Scapulae, Trapezius, Infraspinatus, and Serratus Posterior Superior; they are usually caused by prolonged leaning forward and working with rounded shoulders, such as in activities like writing, sewing, or ____________.

    <p>massage therapy</p> Signup and view all the answers

    Excessive coughing due to conditions like a cold virus, pneumonia, bronchitis, asthma, or emphysema can lead to the activation of trigger points in the ____________ muscles.

    <p>Scalenes</p> Signup and view all the answers

    Activation of trigger points in the Pectoralis Major muscle can occur from heavy lifting, especially when reaching out in front, overuse of arm adduction, poor posture, anxiety, working with poor ergonomics, or exposure to cold ____________.

    <p>air/draft</p> Signup and view all the answers

    Trigger points in the Scalenes muscles may cause symptoms like numbness and tingling in the hand, mainly in the ulnar distribution, and unexpected dropping of objects due to compression of the lower trunk of the brachial plexus; this can be exacerbated by excessive pulling or lifting with the hands at waist level, activities like riding horses or engaging in ____________.

    <p>tug-of-war</p> Signup and view all the answers

    Activation of trigger points in the Subclavius muscle can lead to pain projection over the clavicle and down the anteriolateral arm to the first three digits; this can be triggered by heavy lifting, overuse of arm adduction, immobilization, poor posture, anxiety, or exposure to cold ____________.

    <p>air/draft</p> Signup and view all the answers

    Prolonged leaning forward and working with rounded shoulders, such as in activities like writing, sewing, and ____________, can often lead to the development of trigger points in the Rhomboids muscles.

    <p>massage therapy</p> Signup and view all the answers

    Clients may commonly complain "I can't reach into my ______ pocket" or "I can't fasten my bra behind my back" due to trigger points in the infraspinatus muscle.

    <p>back</p> Signup and view all the answers

    Clients may complain of a "PAINFUL ______", about the size of a silver dollar DEEP in the posterior shoulder (Deltoid) area due to trigger points in the teres minor muscle.

    <p>BURSA</p> Signup and view all the answers

    Trigger points in the subscapularis muscle can mimic the symptoms and signs of "______ SHOULDER", "ADHESIVE CAPSULITIS", or "PITCHER'S ARM".

    <p>FROZEN</p> Signup and view all the answers

    The biceps brachii muscle is referred to as "A ______ Joint Motor".

    <p>Three</p> Signup and view all the answers

    Sometimes "______" or "grating" sounds are heard during movement due to trigger points in the biceps brachii muscle.

    <p>snapping</p> Signup and view all the answers

    Clients may complain of pain with ______ when reaching overhead with an outstretched arm due to trigger points in the teres major muscle.

    <p>motion</p> Signup and view all the answers

    Over a period of time, clients may experience a ______ in shoulder range of motion due to trigger points in the subscapularis muscle.

    <p>decrease</p> Signup and view all the answers

    Trigger points in the infraspinatus muscle may limit the ability to ______ rotate and adduct the arm.

    <p>internally</p> Signup and view all the answers

    Trigger points in the teres minor muscle are directly ______ with infraspinatus trigger points.

    <p>associated</p> Signup and view all the answers

    Pain from trigger points in the teres minor muscle may ______ down the posterior upper arm.

    <p>spread</p> Signup and view all the answers

    Activation of myofascial trigger points in the Brachialis muscle can be caused by overloading activities such as holding a power tool or carrying groceries, and may also be an aggravating factor for 'tennis elbow'.

    <p>ironing</p> Signup and view all the answers

    Myofascial trigger points in the Triceps Brachii muscle can mimic and contribute to the signs and symptoms of 'tennis elbow'. Symptoms may include pain or neurological symptoms due to radial nerve entrapment. Activation of these trigger points can be from overloading activities like holding a power tool, carrying groceries, meticulous ___________, or playing guitar or violin.

    <p>holding a power tool</p> Signup and view all the answers

    Myofascial trigger points in the Finger Extensors muscle can be activated by too forceful gripping activities, repetitive finger movements such as typing on a keyboard, or from static muscle contraction for prolonged periods, such as holding the fingers stiffly while ______.

    <p>mousing</p> Signup and view all the answers

    Myofascial trigger points in the Forearm & Finger Flexors muscle, also known as 'Medial Epicondylitis', can be activated or perpetuated from excessive use of the grasping function of the hand or can result from direct trauma such as falling with an outstretched hand. Pain in the finger muscles will often create a sensation of pain that extends beyond the end of the associated fingers. Pain is felt on activities that use the fingers and/or wrist such as use of scissors or when cupping the hand and ______ to receive objects.

    <p>supinating</p> Signup and view all the answers

    What is the term used to describe the suboccipital muscles as a common source of post-traumatic headache?

    <p>Headache Ghosts</p> Signup and view all the answers

    Which muscle's myofascial trigger points can mimic the symptoms of frozen shoulder, adhesive capsulitis, or pitcher's arm?

    <p>Subscapularis</p> Signup and view all the answers

    Which activity may contribute to the activation of myofascial trigger points in the Finger Extensors?

    <p>Excessive pulling or lifting with the hands at waist level</p> Signup and view all the answers

    What is the primary referral pattern for a trigger point in the supraspinatus muscle?

    <p>A dull ache in the mid-deltoid region of the shoulder</p> Signup and view all the answers

    What is the primary cause of activation for a trigger point in the pectoralis major muscle?

    <p>Heavy lifting, overuse of arm adduction, immobilization, poor posture, anxiety, or exposure to cold air/draft</p> Signup and view all the answers

    What is the main function of the suboccipital muscles?

    <p>To stabilize and control head movements</p> Signup and view all the answers

    What is the primary referral pattern associated with myofascial trigger points in the pectoralis major and subclavius muscles?

    <p>Projects pain over the front of the chest, primarily over the front of the shoulder, and sometimes down the ulnar side of the arm, forearm and fingers</p> Signup and view all the answers

    Which of the following is a common symptom associated with myofascial trigger points in the serratus anterior muscle?

    <p>Clients may complain of a stitch in their side and that they can't take a deep breath</p> Signup and view all the answers

    What is a common cause of activation for myofascial trigger points in the serratus anterior muscle?

    <p>All of the above</p> Signup and view all the answers

    What is the primary referral pattern associated with myofascial trigger points in the deltoid muscle?

    <p>Expands pain locally over the portion of the deltoid muscle</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the pectoralis major and subclavius muscles?

    <p>Difficulty reaching forward and up</p> Signup and view all the answers

    What is the primary cause of activation for a myofascial trigger point in the pectoralis major muscle?

    <p>Trauma, rib fracture, or strain through overuse as a shoulder depressor</p> Signup and view all the answers

    What symptoms can the sternal division of the sternocleidomastoid muscle mimic?

    <p>Visual disturbances and tearing</p> Signup and view all the answers

    What might trigger points in the upper trapezius muscle fibers be associated with?

    <p>Tension headaches</p> Signup and view all the answers

    Which of the following is a symptom commonly associated with myofascial trigger points in the splenius capitis muscle?

    <p>Pain behind the eye</p> Signup and view all the answers

    What is a potential consequence of trigger points in the levator scapulae muscle?

    <p>Trouble looking in blind spots while driving</p> Signup and view all the answers

    What might trigger points in the serratus anterior muscle be caused by?

    <p>Excessive fast running</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the teres minor muscle?

    <p>Pain radiating down the arm</p> Signup and view all the answers

    What referral pattern is associated with trigger points in the levator scapulae muscle?

    <p>To the angle of the neck and along the vertebral border of the scapula</p> Signup and view all the answers

    What can trigger points in the pectoralis minor muscle cause difficulty doing?

    <p>Breathing deeply</p> Signup and view all the answers

    What is a potential symptom that might result from trigger points in the triceps brachii muscle?

    <p>Elbow pain and neurological symptoms</p> Signup and view all the answers

    What is a common misconception associated with myofascial trigger points in the infraspinatus muscle?

    <p>They are only triggered by exercise</p> Signup and view all the answers

    Which muscle group's trigger points can mimic the intensity, quality, and distribution of cardiac pain (a heart attack), especially when occurring on the left?

    <p>Pectoralis Major and Subclavius</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the Scalenes muscles?

    <p>Numbness and tingling in the hand, mainly in the ulnar distribution, and unexpected dropping of objects</p> Signup and view all the answers

    What is a common cause of activation for trigger points in the Rhomboids muscle?

    <p>Prolonged leaning forward and working with rounded shoulders, such as in writing, sewing, or massage therapy</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the Pectoralis Major muscle?

    <p>Referral of pain locally to the chest and anterior shoulder, possibly extending down the medial side of the arm to the 4th and 5th digits</p> Signup and view all the answers

    Which activity may contribute to the activation of myofascial trigger points in the Scalenes muscles?

    <p>Overuse of the accessory respiratory muscles in apical (paradoxical) breathing</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the Subclavius muscle?

    <p>Projection of pain over the clavicle and down the anteriolateral arm to the first three digits</p> Signup and view all the answers

    Which activity may contribute to the activation of myofascial trigger points in the Pectoralis Major and Subclavius muscles?

    <p>Heavy lifting, especially when reaching out in front, overuse of arm adduction, immobilization, or poor posture</p> Signup and view all the answers

    Which muscle group's trigger points may be an aggravating factor of Thoracic Outlet Syndrome (TOS)?

    <p>Scalenes</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the Rhomboids muscle?

    <p>Superficial achy pain at rest, not usually influenced by movement</p> Signup and view all the answers

    Clients with trigger points in the Quadratus Lumborum muscle may complain of persistent, deep, aching pain at rest in the __________ area

    <p>low back</p> Signup and view all the answers

    Activation of trigger points in the Quadratus Lumborum muscle can be from coughing, sneezing, chronic overloading, poor posture, trauma, and bending and twisting while lifting, leading to the development of trigger points in its antagonist and usually results in the development of TP's in its ________.

    <p>antagonist</p> Signup and view all the answers

    Trigger points in the Quadratus Lumborum muscle can be activated when putting on pants while standing half stooped and leaning sideways, or after losing balance as the feet become entangled in clothing, causing pain in the low back area and can result in the development of trigger points in its ________.

    <p>antagonist</p> Signup and view all the answers

    Clients may experience sleep disturbances due to the pain in the low back and find it too painful to lie on the affected side (______).

    <p>hip</p> Signup and view all the answers

    The Quadratus Lumborum muscle can be totally immobilizing and can be emotionally depressing, especially when one QL becomes involved, the shortening of that muscle at rest tends to overload its contralateral mate, leading to the development of trigger points in its ________.

    <p>antagonist</p> Signup and view all the answers

    Overloading activities like holding a power tool, carrying groceries, meticulous playing, or playing guitar or violin can lead to the activation of trigger points in the Quadratus Lumborum muscle due to heavy lifting, especially when reaching out in front, overuse of arm adduction, poor posture, anxiety, working with poor ergonomics, or exposure to cold ________.

    <p>temperatures</p> Signup and view all the answers

    Trigger points in the sternocleidomastoid muscle are ______ complex.

    <p>complex</p> Signup and view all the answers

    Trigger points in the suboccipital muscles are commonly referred to as ______.

    <p>headache</p> Signup and view all the answers

    Trigger points in the teres minor muscle are directly ______ with infraspinatus trigger points.

    <p>associated</p> Signup and view all the answers

    Trigger points in the serratus anterior muscle may be associated with high levels of ______ and hysteria.

    <p>anxiety</p> Signup and view all the answers

    Trigger points in the infraspinatus muscle may limit the ability to ______ rotate and adduct the arm.

    <p>externally</p> Signup and view all the answers

    Pectoralis Major trigger points can mimic the intensity, quality, and distribution of cardiac pain, especially when reaching out in front or with poor ____________.

    <p>posture</p> Signup and view all the answers

    Levator Scapulae muscle refers pain to the angle of the neck and along the vertebral border of the scapula. Clients may complain they have trouble looking in their blind spots while driving. TP's in this muscle mimic symptoms of torticollis and scapulo-costal syndrome. Activation of these trigger points are from postural stresses such as walking with a cane, or occupational stresses like improper ergonomics while at a desk, and ____________ to the back of the neck.

    <p>trauma</p> Signup and view all the answers

    Trigger points in the ______ muscle fibers can cause headaches, neck pain, and restricted neck motion.

    <p>upper trapezius</p> Signup and view all the answers

    Trigger points in the supraspinatus muscle can cause ______ or snapping sounds around the joint.

    <p>clicking</p> Signup and view all the answers

    Trigger points in the upper fibers of the trapezius muscle are associated with temporal headaches and can limit rotation of the head to the same side. Activation of these trigger points may be caused by trauma, overloading by tilting of the shoulder-girdle axis, carrying heavy bags, purse, backpack, heavy winter coats, and ____________.

    <p>bra straps</p> Signup and view all the answers

    Myofascial trigger points in the abdominal muscles can mimic the signs and symptoms of ______ and a hiatal hernia.

    <p>heartburn</p> Signup and view all the answers

    Activation of trigger points in the abdominal muscles may be caused by total body fatigue, over-exercise, constipation, poor posture, response to visceral disease, direct trauma, and mechanical, toxic or emotional ______.

    <p>stress</p> Signup and view all the answers

    Pain referred from trigger points in the iliopsoas muscle forms a very distinctive ______ pattern along the lumbar spine, groin, and the upper anteromedial aspect of the thigh.

    <p>vertical</p> Signup and view all the answers

    Clients with tender iliopsoas trigger points may experience referred pain evoked by the passage of a bolus of hard feces that presses against the trigger points due to ______.

    <p>constipation</p> Signup and view all the answers

    Pain from trigger points in the gluteus maximus muscle is felt mostly around the sacroiliac joint and lower buttock region, and swimming the 'crawl' stroke may intensify this pain, especially in ______ water.

    <p>cold</p> Signup and view all the answers

    Trigger points in the tensor fasciae latae muscle are often misdiagnosed as 'Trochanteric Bursitis' and cause pain mostly over the greater trochanter and extending down the lateral ______.

    <p>thigh</p> Signup and view all the answers

    Myofascial trigger points in the gluteus medius muscle refer pain along the posterior iliac crest, to the sacrum, and to the posterior aspect of the buttock, and the pain may extend to the upper ______.

    <p>thigh</p> Signup and view all the answers

    A trigger point in the gluteus medius muscle is a commonly overlooked source of lower back ______.

    <p>pain</p> Signup and view all the answers

    Myofascial trigger points in the tensor fasciae latae muscle may be activated from pelvic asymmetries, sitting for long periods, sudden trauma, chronic overload from jogging uphill and downhill, or running on uneven ______.

    <p>ground</p> Signup and view all the answers

    Activation of trigger points in the gluteus maximus muscle may be caused by acute stress during a fall or near-fall, repetitive strain, direct trauma, postural asymmetries, excessive walking, sitting too long in one position, extreme lower body exercise, sitting on a wallet in the back pocket, and ______ sites.

    <p>injection</p> Signup and view all the answers

    Clients may have discomfort while sitting in a slumped/slouched position potentially compressing the __________.

    <p>TP’s</p> Signup and view all the answers

    Activation of these TP’s may be caused by sudden falls, sports injuries, running, tennis, aerobics, excessive walking, pelvic distortion, Morton’s foot, and injection sites. MYOFASCIAL TRIGGER POINTS GLUTEUS MINIMUS MUSCLE “Pseudo-Sciatica” Referral Pattern: Anterior Fibres - projects to the lower lateral buttock, down the lateral aspect of the thigh, knee and leg to the lateral __________.

    <p>malleolus</p> Signup and view all the answers

    Symptoms: Mimics the signs and symptoms of “Sciatica”. The pain from these TP’s can be persistent and excruciating severe. The pain is so remote from the muscle that the pain’s true origin is easily overlooked. May complain of hip pain that may cause a limp during walking. Lying on the affected side may also be painful. The client will have difficulty rising from a seated position to a standing position out of a __________.

    <p>chair</p> Signup and view all the answers

    Activation of these TP’s can be caused from chronic overload, sporting activities, speed walking, running, SI joint dysfunction, nerve root irritation, sitting for long periods, injection sites, pelvic asymmetries, and a tilting of the pelvis from sitting on a wallet, and __________.

    <p>vertigo</p> Signup and view all the answers

    MYOFASCIAL TRIGGER POINTS PIRIFORMIS MUSCLE “Double Devil” Referral Pattern: Radiates to the sacroiliac region, laterally over the hip region and spillover into the proximal two thirds of the posterior __________.

    <p>thigh</p> Signup and view all the answers

    Symptoms: Called the 'Double Devil' because it causes as much distress by nerve entrapment as it does by referred pain from TrPs. Pain is usually increased by sitting, standing and walking. Activation may result from acute overload, from repetitive, high impact movements such as running, and from sustained overload as when holding the thigh flexed in abduction while __________.

    <p>driving</p> Signup and view all the answers

    MYOFASCIAL TRIGGER POINTS QUADRICEPS FEMORIS MUSCLE “Four Faced Trouble Maker” Referral Pattern: Rectus Femoris - refers to the lower anterior thigh and anterior knee region Vastus Medialis - refers pain to the lower medial thigh and medial knee region Vastus Intermedius - refers to the middle portion of the anterior thigh Vastus Lateralis - has at least 5 TrP sites which refer pain along the lateral thigh from the pelvis and greater trochanter to the lateral side of the __________.

    <p>knee</p> Signup and view all the answers

    Symptoms: Clients might complain of a 'buckling knee' as well as disruption of normal patellar movements leading to excess wear and tear on the internal surfaces of the knee joint. May also cause sleep disturbances. Mimics patellofemoral dysfunction, tendinitis and knee joint pathologies. Activation can occur during a fall, misstep, trauma to the muscle and injections. Perpetuation of these trigger points is often due to tightness in the hamstrings muscle and excessive use of the quads such as with deep knee __________.

    <p>bends</p> Signup and view all the answers

    MYOFASCIAL TRIGGER POINTS ADDUCTOR LONGUS & BREVIS MUSCLES “Obvious Problem-makers” Referral Pattern: Travels upward deep in the groin and downward to the knee and __________.

    <p>shin</p> Signup and view all the answers

    Symptoms: One of the most common causes of groin pain. Pain is often only felt during activity or muscular overload and not at rest. The pain is increased by weight bearing and by sudden twists of the hip. Can mimic pain from trauma to musculoskeletal structures such as avulsion of the pelvic or femoral attachments and stress fractures, articular dysfunction of the acetabulofemoral and pubic symphysis, and nerve entrapment. People with these TrPs should avoid immobility in a shortened position such as crossing the legs when sitting in a chair and they should also incorporate a home care program involving adequate __________.

    <p>stretching</p> Signup and view all the answers

    What is the primary referral pattern associated with myofascial trigger points in the quadratus lumborum muscle?

    <p>Radiates posteriorly to the sacroiliac joint and lower buttock</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the quadratus lumborum muscle?

    <p>Lancinating pain with movement and while standing</p> Signup and view all the answers

    What is a potential cause of activation for myofascial trigger points in the quadratus lumborum muscle?

    <p>Chronic overloading from activities like scrubbing the floor or heavy lifting</p> Signup and view all the answers

    What is a potential consequence of myofascial trigger points in the quadratus lumborum muscle?

    <p>Overloading the contralateral quadratus lumborum muscle</p> Signup and view all the answers

    What is a common client complaint associated with myofascial trigger points in the quadratus lumborum muscle?

    <p>Having to crawl out of bed due to the pain</p> Signup and view all the answers

    Which of the following is NOT a potential cause of trigger point activation in the quadratus lumborum muscle?

    <p>Sudden onset of neck pain</p> Signup and view all the answers

    Which of the following symptoms may be caused by myofascial trigger points in the abdominal muscles?

    <p>All of the above</p> Signup and view all the answers

    What is the distinctive referral pattern associated with trigger points in the iliopsoas muscle?

    <p>Vertical pattern along the lumbar spine, groin, and anteromedial thigh</p> Signup and view all the answers

    What condition is often misdiagnosed when trigger points are present in the tensor fasciae latae muscle?

    <p>Trochanteric bursitis</p> Signup and view all the answers

    Which activity may exacerbate pain from trigger points in the gluteus maximus muscle?

    <p>Swimming the crawl stroke</p> Signup and view all the answers

    Which of the following statements about trigger points in the gluteus medius muscle is true?

    <p>They can refer pain to the posterior iliac crest, sacrum, and posterior buttock.</p> Signup and view all the answers

    Which of the following activities may contribute to the activation of trigger points in the iliopsoas muscle?

    <p>All of the above</p> Signup and view all the answers

    What is a common symptom experienced by clients with trigger points in the tensor fasciae latae muscle?

    <p>All of the above</p> Signup and view all the answers

    Which of the following may contribute to the activation of trigger points in the gluteus maximus muscle?

    <p>All of the above</p> Signup and view all the answers

    What is a potential symptom associated with trigger points in the gluteus maximus muscle?

    <p>All of the above</p> Signup and view all the answers

    Which of the following statements about trigger points in the gluteus medius muscle is false?

    <p>They are often caused by excessive running on flat surfaces.</p> Signup and view all the answers

    What is the primary referral pattern associated with myofascial trigger points in the piriformis muscle?

    <p>Radiates to the sacroiliac region, laterally over the hip region and spillover into the proximal two thirds of the posterior thigh.</p> Signup and view all the answers

    What is a common symptom associated with myofascial trigger points in the quadriceps femoris muscle?

    <p>All of the above.</p> Signup and view all the answers

    What is a potential cause of activation for myofascial trigger points in the adductor longus and brevis muscles?

    <p>All of the above.</p> Signup and view all the answers

    What is a common cause of activation for myofascial trigger points in the gluteus minimus muscle?

    <p>All of the above.</p> Signup and view all the answers

    Which muscle group's trigger points can cause difficulty walking due to weakness in dorsiflexion, leading to dragging of the toes or tripping?

    <p>Tibialis anterior</p> Signup and view all the answers

    Which of the following activities is most likely to activate trigger points in the gastrocnemius muscle?

    <p>All of the above</p> Signup and view all the answers

    Which muscle group's trigger points can cause pain in the lower buttock and upper posterior thigh, extending down the posteromedial aspect of the thigh and upper calf?

    <p>Hamstring muscles (semitendinosus and semimembranosus)</p> Signup and view all the answers

    What is the primary referral pattern associated with trigger points in the soleus muscle?

    <p>All of the above</p> Signup and view all the answers

    Which of the following activities is most likely to perpetuate trigger points in the peroneal muscles?

    <p>All of the above</p> Signup and view all the answers

    Which muscle group's trigger points can cause nocturnal calf cramps, especially when stomach sleeping and with heavy bed coverings?

    <p>Gastrocnemius</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with trigger points in the biceps femoris muscle?

    <p>Pain in the lower back</p> Signup and view all the answers

    Which of the following activities is most likely to activate trigger points in the peroneal muscles?

    <p>Swimming</p> Signup and view all the answers

    Which muscle group's trigger points can mimic the symptoms of lateral compartment syndrome and entrapment of the peroneal nerves?

    <p>Peroneal</p> Signup and view all the answers

    Which of the following is NOT mentioned as a potential cause of trigger point activation in the hamstring muscles?

    <p>Prolonged standing</p> Signup and view all the answers

    Study Notes

    Myofascial Trigger Points: Muscles of the Upper Body

    Rhomboids Muscle

    • Referral pattern: Concentrates locally to the Rhomboids muscle
    • Symptoms: Superficial achy pain at rest, not influenced by movement
    • Activation: Prolonged leaning forward and working with rounded shoulders (e.g., writing, sewing, massage therapy)

    Scalene Muscles

    • Referral pattern: Pain refers in three directions: anteriorly to the pectoral region, laterally to the anterior shoulder region, and posteriorly to the upper half of the vertebral border of the scapula
    • Symptoms: Compression of the lower trunk of the brachial plexus, numbness and tingling in the hand (mainly in the ulnar distribution), and unexpected dropping of objects
    • Activation: Excessive pulling or lifting with the hands at waist level, overuse of accessory respiratory muscles in apical breathing, excessive coughing

    Pectoralis Major & Subclavius Muscles

    • Referral pattern: Pectoralis Major - refers locally to the chest and anterior shoulder, may extend down the medial side of the arm to the 4th and 5th digits; Subclavius - projects pain over the clavicle and down the anteriolateral arm to the first three digits
    • Symptoms: Can strongly mimic cardiac pain, especially on the left; may cause a sensation of chest constriction
    • Activation: Heavy lifting (especially with the hand supinated), overuse of arm adduction, immobilization, poor posture, anxiety, working with poor ergonomics, and cold air/draft

    Brachialis Muscle

    • Referral pattern: Projects to the base of the thumb and often to the anterior shoulder and elbow
    • Symptoms: Pain or neurological symptoms due to radial nerve entrapment
    • Activation: Overloading (e.g., holding a power tool, carrying groceries, meticulous ironing, playing guitar or violin)

    Triceps Brachii Muscle

    • Referral pattern: Pain is mostly projected up and down the posterior aspect of the arm and to the lateral epicondyle
    • Symptoms: Clients may find it hard to localize pain posteriorly in the shoulder and upper arm; may not be aware of any restricted ROM because of the tendency to keep the elbow slightly flexed
    • Activation: Sports, static positions, and repetitive movements

    Finger Extensors

    • Referral pattern: Projects down the dorsum of the forearm to the dorsum of the hand and associated finger
    • Symptoms: Clients are often most aware of pain and stiffness in the fingers and associate it with some local problem such as arthritis
    • Activation: Forceful gripping activities, repetitive finger movements (e.g., typing on a keyboard, mousing)

    Thoracolumbar Paraspinal Muscles

    • Referral pattern: Multifidi/Rotatores - centers on the spinous processes at the segmental level of the TrP; Iliocostalis Thoracic - projects a short distance over the associated rib, may spill over anteriorly into the chest and abdomen
    • Symptoms: The referral pain patterns for these back muscles at specific segmental levels are common examples, but TrPs may develop at any segmental level
    • Activation: Sudden overload (bending and twisting movements), muscle fatigue, and/or chill, flat feet, leg and pelvic asymmetry, whiplash-type accidents, and sitting for long hours

    Suboccipital Muscles

    • Referral pattern: Feels like deep head pain that radiates from the occiput to the temple
    • Symptoms: Pain which seems to penetrate deep inside, but is hard to localize; TrPs in these muscles are aggravating factors to tension headaches
    • Activation: Prolonged upward gaze, inappropriate visual apparatus (maladjusted eyeglasses, uncorrected nearsightedness), work overhead, chilling of the back of the neck (draft), and trauma### Myofascial Trigger Points
    • Sternocleidomastoid Muscle:
      • Referral pattern: Sternal Division - vertex, occiput, cheek, eye, throat, and sternum; Clavicular Division - forehead, ear, and behind the ear
      • Symptoms: Mimics sore throat and swollen glands, visual disturbances, tearing, and inability to raise upper eyelid
    • Trapezius Muscle:
      • Referral pattern: Upper Trapezius - posteriolateral neck, ear, temple region, and angle of the mandible; Middle Trapezius - locally to middle trapezius muscle fibers; Lower Trapezius - entire upper trapezius muscle and may extend to middle and lower fibers
      • Symptoms: Temporal headaches, limited rotation of the head to the same side
    • Splenius Capitis and Splenius Cervicis Muscles:
      • Referral pattern: Splenius Capitis - vertex of the head; Splenius Cervicis - ankle of the neck and behind the eye
      • Symptoms: "Stiff neck" with limited rotation of the head and neck due to pain
    • Levator Scapulae Muscle:
      • Referral pattern: Concentrates in the angle of the neck and along the vertebral border of the scapula, may project to the posterior deltoid region
      • Symptoms: Trouble looking in blind spots while driving, limited ROM of neck rotation on the same side due to pain on movement
    • Pectoralis Minor Muscle:
      • Referral pattern: Projects pain over the front of the chest, primarily over the front of the shoulder, and sometimes down the ulnar side of the arm, forearm, and fingers
      • Symptoms: Difficulty reaching forward and up, or reaching backward with the arm at shoulder level; may mimic cardiac pain
    • Serratus Anterior Muscle:
      • Referral pattern: Expands locally over the side of the ribcage, projects to the inferior portion of the vertebral border of the scapula and may extend down the ulnar aspect of the arm
      • Symptoms: "Stitch-in-the-side" pain, difficulty taking a deep breath, chest pain at rest in severe cases
    • Deltoid Muscle:
      • Referral pattern: Expands pain locally over the portion of the muscle affected
      • Symptoms: Pain arising from the glenohumeral joint, may be misdiagnosed as arthritis; difficulty raising the arm horizontally
    • Supraspinatus Muscle:
      • Referral pattern: Pain is felt as a deep ache in the mid-deltoid region of the shoulder and usually extends part way down the arm
      • Symptoms: Pain during abduction, "dull ache" at rest, clicking or snapping sounds around the joint
    • Thoracolumbar Paraspinal Muscles:
      • Referral pattern: Multifidi/Rotatores - centers on the spinous processes at the segmental level of the TrP; Iliocostalis Thoracic - projects a short distance over the associated rib, may spill up to the shoulder and down to the iliac crest
      • Symptoms: Steady deep ache in the spine, restriction of spinal motion, difficulty rising from a chair and climbing stairs### Myofascial Trigger Points in the Upper Extremities

    Rhomboids Muscle

    • Referral pattern: concentrates locally to the Rhomboids muscle
    • Symptoms: superficial achy pain at rest, not influenced by movement
    • Caused by: TP's in neighboring muscles (Levator Scapulae, Trapezius, Infraspinatus, and Serratus Posterior Superior) and prolonged leaning forward with rounded shoulders (writing, sewing, massage therapy)

    Scalenus Muscles

    • Referral pattern: pain refers in three directions (anteriorly, laterally, and posteriorly)
    • Symptoms: may cause venous obstruction and compression of the lower trunk of the brachial plexus
    • Activation: excessive pulling or lifting with hands at waist level, overuse of accessory respiratory muscles, and excessive coughing due to respiratory diseases

    Pectoralis Major & Subclavius Muscles

    • Referral pattern: Pectoralis Major refers locally to the chest and anterior shoulder; Subclavius projects pain over the clavicle and down the anteriolateral arm
    • Symptoms: can mimic cardiac pain, especially on the left side
    • Activation: heavy lifting, overuse of arm adduction, immobilization, poor posture, anxiety, and cold air/draft

    Infraspinatus Muscle

    • Referral pattern: concentrates deeply in the anterior deltoid region and extends down the front and lateral aspect of the arm and forearm
    • Symptoms: clients may complain of pain with motion when reaching overhead with an outstretched arm

    Teres Minor Muscle

    • Referral pattern: pain is localized at the insertion of the muscle and may spread down the posterior upper arm
    • Symptoms: clients may complain of a "painful bursa" in the posterior shoulder area

    Teres Major Muscle

    • Referral pattern: pain penetrates deeply into the posterior deltoid region and may project to the dorsum of the forearm
    • Symptoms: clients complain of pain with motion when reaching overhead with an outstretched arm

    Subscapularis Muscle

    • Referral pattern: concentrates in the posterior deltoid area and may extend medially over the scapula and down the posterior aspect of the arm
    • Symptoms: can mimic frozen shoulder, adhesive capsulitis, or pitcher's arm

    Biceps Brachii Muscle

    • Referral pattern: pain concentrates along the tendon of the long head and along the common distal tendon
    • Symptoms: clients may complain of superficial pain and possible weakness in the shoulder and anterior arm

    Brachialis Muscle

    • Referral pattern: projects to the base of the thumb and often to the anterior shoulder and elbow
    • Symptoms: pain or neurological symptoms due to radial nerve entrapment

    Triceps Brachii Muscle

    • Referral pattern: pain is mostly projected up and down the posterior aspect of the arm and to the lateral epicondyle
    • Symptoms: clients may find it hard to localize pain posteriorly in the shoulder and upper arm

    Finger Extensors

    • Referral pattern: projects down the dorsum of the forearm to the dorsum of the hand and associated finger
    • Symptoms: clients are often most aware of pain and stiffness in the fingers and associate it with some local problem

    Forearm & Finger Flexors

    • Referral pattern: pain often concentrates at the insertion of these muscles
    • Symptoms: palmaris longus referred pain may present as a prickling, needle-like sensation over the palm

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    Description

    Test your knowledge on myofascial trigger points in the suboccipital muscles, specifically Recti Capitis Posterior Major & Minor, Obliqui Superior & Inferior, known as 'Headache Ghosts'. Explore the referral patterns and symptoms associated with these trigger points and their relation to tension headaches.

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