Podcast
Questions and Answers
What are the aggravating factors of myofascial trigger points?
What are the aggravating factors of myofascial trigger points?
What is a relieving factor for myofascial trigger points?
What is a relieving factor for myofascial trigger points?
What technique should be performed after warm up of effleurage to palpate trigger points?
What technique should be performed after warm up of effleurage to palpate trigger points?
What is a confirmation that a trigger point is present during palpation?
What is a confirmation that a trigger point is present during palpation?
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What does 'effleurage' refer to in the context of palpating trigger points?
What does 'effleurage' refer to in the context of palpating trigger points?
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When should assisted effleurage towards the heart be performed?
When should assisted effleurage towards the heart be performed?
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What is the referral pattern for the rectus femoris muscle?
What is the referral pattern for the rectus femoris muscle?
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What is the stretch position for the vastus lateralis muscle?
What is the stretch position for the vastus lateralis muscle?
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What is the referral pattern for the semimembranosus muscle?
What is the referral pattern for the semimembranosus muscle?
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What is the stretch position for the tibialis anterior muscle?
What is the stretch position for the tibialis anterior muscle?
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What is the referral pattern for the gastrocnemius muscle?
What is the referral pattern for the gastrocnemius muscle?
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Which technique involves applying pressure to a trigger point for 7-10 seconds at a time to create ischemia and then hyperemia?
Which technique involves applying pressure to a trigger point for 7-10 seconds at a time to create ischemia and then hyperemia?
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What is the most clinically significant feature of a myofascial trigger point?
What is the most clinically significant feature of a myofascial trigger point?
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Which muscle group's trigger point referral pattern feels like deep head pain that radiates from occipital to temple, eye, and forehead?
Which muscle group's trigger point referral pattern feels like deep head pain that radiates from occipital to temple, eye, and forehead?
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What is the action of the trapezius muscles associated with?
What is the action of the trapezius muscles associated with?
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Which technique involves using a rubber reflex hammer to tap onto the trigger point 10 times with a force equal to that of eliciting a tendon reflex jerk?
Which technique involves using a rubber reflex hammer to tap onto the trigger point 10 times with a force equal to that of eliciting a tendon reflex jerk?
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Which muscle's trigger point referred pain concentrates at the vertex of the head?
Which muscle's trigger point referred pain concentrates at the vertex of the head?
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What is the primary action associated with the splenius cervicis muscle?
What is the primary action associated with the splenius cervicis muscle?
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What is the purpose of the intermittent cold and stretch technique?
What is the purpose of the intermittent cold and stretch technique?
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Which muscle's trigger point referral pattern feels like an 'all over headache' from occipital to temple, eye, and forehead?
Which muscle's trigger point referral pattern feels like an 'all over headache' from occipital to temple, eye, and forehead?
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What may activate the trapezius muscles' trigger points?
What may activate the trapezius muscles' trigger points?
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What causes pain in clients with trigger points in splenius cervicis muscle?
What causes pain in clients with trigger points in splenius cervicis muscle?
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What is the purpose of applying moderate pressure to a trigger point for 30 seconds?
What is the purpose of applying moderate pressure to a trigger point for 30 seconds?
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Which muscle is responsible for pain concentrated at the inferior angle of the scapula and may extend to the back and down the medial arm and forearm to the ulnar aspect of the hand including 4th & 5th digit?
Which muscle is responsible for pain concentrated at the inferior angle of the scapula and may extend to the back and down the medial arm and forearm to the ulnar aspect of the hand including 4th & 5th digit?
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Which muscle causes pain that is projected up & down the posterior aspect of the arm & to the lateral epicondyle more than medial, with spill over into 4th & 5th digits up to Suprascapular region?
Which muscle causes pain that is projected up & down the posterior aspect of the arm & to the lateral epicondyle more than medial, with spill over into 4th & 5th digits up to Suprascapular region?
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For pain penetrating deeply into the posterior deltoid region and may project to the dorsum of the forearm, which muscle is primarily responsible?
For pain penetrating deeply into the posterior deltoid region and may project to the dorsum of the forearm, which muscle is primarily responsible?
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When a client complains of persistent deep, achy, lower back pain, which muscle is often responsible for this condition?
When a client complains of persistent deep, achy, lower back pain, which muscle is often responsible for this condition?
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Which muscle is activated for swimmers when performing the 'crawl' stroke and can cause pain around the sacroiliac joint & lower buttock region?
Which muscle is activated for swimmers when performing the 'crawl' stroke and can cause pain around the sacroiliac joint & lower buttock region?
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In cases where a client experiences limited movement, weakness & pain from elbow to hand and the lateral epicondyle is tender to touch, which muscle is likely causing this dysfunction?
In cases where a client experiences limited movement, weakness & pain from elbow to hand and the lateral epicondyle is tender to touch, which muscle is likely causing this dysfunction?
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If a client has trouble looking in blind spots while driving and has limited range of motion of neck rotation on the same side, which muscle may be causing these symptoms?
If a client has trouble looking in blind spots while driving and has limited range of motion of neck rotation on the same side, which muscle may be causing these symptoms?
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For pain that refers locally to the chest and anterior shoulder & may extend down medial side of arm to 4th & 5th digit, which muscle should be examined?
For pain that refers locally to the chest and anterior shoulder & may extend down medial side of arm to 4th & 5th digit, which muscle should be examined?
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In cases where the pain is projected over CLAVICAL & down anteriolateral arm to first 3 digits, which muscle is most likely responsible?
In cases where the pain is projected over CLAVICAL & down anteriolateral arm to first 3 digits, which muscle is most likely responsible?
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Which muscle can mimic cardiac pain, especially when it occurs on the left and can cause sensation of chest constriction?
Which muscle can mimic cardiac pain, especially when it occurs on the left and can cause sensation of chest constriction?
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If a client experiences pain that concentrates at the angle of the neck and along the vertebral border of the scapula, and may project to the posterior deltoid region, which muscle should be considered as the source of pain?
If a client experiences pain that concentrates at the angle of the neck and along the vertebral border of the scapula, and may project to the posterior deltoid region, which muscle should be considered as the source of pain?
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A client who complains of pain penetrating deeply into posterior deltoid region and may project to the dorsum of the forearm may have activation in which muscle?
A client who complains of pain penetrating deeply into posterior deltoid region and may project to the dorsum of the forearm may have activation in which muscle?
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Two types of passive stretch techniques are ______ and facilitated.
Two types of passive stretch techniques are ______ and facilitated.
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______ is the ability to yield to a stretch.
______ is the ability to yield to a stretch.
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______ is the ability to return to its resting length after stretch.
______ is the ability to return to its resting length after stretch.
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______ is assuming a new and greater length after a stretch.
______ is assuming a new and greater length after a stretch.
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The ______ causes the muscle to contract in response to a stretch.
The ______ causes the muscle to contract in response to a stretch.
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When the stretch is released, sarcomeres return to their ______ length.
When the stretch is released, sarcomeres return to their ______ length.
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What is the ability of tissue to return to its original shape and size after a stretch?
What is the ability of tissue to return to its original shape and size after a stretch?
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What is the ability of tissue to assume a new, permanent length after a prolonged stretch?
What is the ability of tissue to assume a new, permanent length after a prolonged stretch?
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What is the danger of increasing range of motion (ROM) too quickly during a stretch?
What is the danger of increasing range of motion (ROM) too quickly during a stretch?
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When should stretching be indicated for a client?
When should stretching be indicated for a client?
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What is the ability of tissue to yield to a stretch?
What is the ability of tissue to yield to a stretch?
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What is the primary goal of stretching according to the text?
What is the primary goal of stretching according to the text?
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What is the recommended duration for holding a passive stretch?
What is the recommended duration for holding a passive stretch?
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What should the client feel during a passive stretch?
What should the client feel during a passive stretch?
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What should be done before initiating a passive stretch?
What should be done before initiating a passive stretch?
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What should be done after releasing a passive stretch?
What should be done after releasing a passive stretch?
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What is a contraindication for passive stretching?
What is a contraindication for passive stretching?
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The primary goal of stretching is to ______ normal ROM.
The primary goal of stretching is to ______ normal ROM.
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Prolonged immobilization leads to atrophy and ______ of tissues.
Prolonged immobilization leads to atrophy and ______ of tissues.
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The ______ causes the muscle to contract in response to a stretch.
The ______ causes the muscle to contract in response to a stretch.
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______ is assuming a new and greater length after a stretch.
______ is assuming a new and greater length after a stretch.
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When the stretch is released, sarcomeres return to their ______ length.
When the stretch is released, sarcomeres return to their ______ length.
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______ is the ability of tissue to return to its resting length after stretch.
______ is the ability of tissue to return to its resting length after stretch.
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If the stress is held for prolonged periods of time, the collagen fibers begin to fail and tissue will assume a new lengthened position permanently. This is known as tissue ______.
If the stress is held for prolonged periods of time, the collagen fibers begin to fail and tissue will assume a new lengthened position permanently. This is known as tissue ______.
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When limited ROM interferes with Activities of Daily Living (ADLs) and there is tissue shortened opposed by muscle weakness, it indicates the need for ______.
When limited ROM interferes with Activities of Daily Living (ADLs) and there is tissue shortened opposed by muscle weakness, it indicates the need for ______.
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A significant change to the client's ROM can occur when tissue exhibits plasticity, leading to a new shape and size. However, the tissue may become more fragile and susceptible to rupture, reducing its ______.
A significant change to the client's ROM can occur when tissue exhibits plasticity, leading to a new shape and size. However, the tissue may become more fragile and susceptible to rupture, reducing its ______.
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Overstretching can pose a danger if the ROM is increased too quickly, potentially resulting in the client injuring themselves with simple daily ______.
Overstretching can pose a danger if the ROM is increased too quickly, potentially resulting in the client injuring themselves with simple daily ______.
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Limited ROM restricted by adhesions, contractures, and scar formations are indications for ______.
Limited ROM restricted by adhesions, contractures, and scar formations are indications for ______.
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Prolonged use of steroids can lead to thickening of soft tissues.
Prolonged use of steroids can lead to thickening of soft tissues.
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During passive stretching, the client should feel pain to ensure effectiveness.
During passive stretching, the client should feel pain to ensure effectiveness.
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Overstretching weak postural muscles can improve postural alignment.
Overstretching weak postural muscles can improve postural alignment.
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Edematous tissue is strong and resilient.
Edematous tissue is strong and resilient.
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The primary goal of passive stretching is to strengthen tissues.
The primary goal of passive stretching is to strengthen tissues.
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Stretching exercises should never be combined with strengthening exercises.
Stretching exercises should never be combined with strengthening exercises.
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If the stress on tissue is held for a prolonged period, the tissue will retain its original shape and size.
If the stress on tissue is held for a prolonged period, the tissue will retain its original shape and size.
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Overstretching can significantly reduce the stability of the tissue, making it more susceptible to rupture.
Overstretching can significantly reduce the stability of the tissue, making it more susceptible to rupture.
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$ROM = \frac{1}{2}(\pi r^2)$
$ROM = \frac{1}{2}(\pi r^2)$
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Stretching should be indicated when limited ROM interferes with Activities of Daily Living (ADLs) or when there is tissue shortening opposed by muscle weakness.
Stretching should be indicated when limited ROM interferes with Activities of Daily Living (ADLs) or when there is tissue shortening opposed by muscle weakness.
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Elasticity refers to the ability of tissue to assume a new, permanent length after a prolonged stretch.
Elasticity refers to the ability of tissue to assume a new, permanent length after a prolonged stretch.
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If the stress is held for prolonged periods of time, the collagen fibers begin to fail and tissue will assume a new lengthened position permanently. This is known as tissue ______.
If the stress is held for prolonged periods of time, the collagen fibers begin to fail and tissue will assume a new lengthened position permanently. This is known as tissue ______.
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A significant change to the client's ROM can occur when tissue exhibits ______, leading to a new shape and size.
A significant change to the client's ROM can occur when tissue exhibits ______, leading to a new shape and size.
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When limited ROM interferes with Activities of Daily Living (ADLs) and there is tissue shortened opposed by muscle weakness, it indicates the need for ______.
When limited ROM interferes with Activities of Daily Living (ADLs) and there is tissue shortened opposed by muscle weakness, it indicates the need for ______.
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The ______ causes the muscle to contract in response to a stretch.
The ______ causes the muscle to contract in response to a stretch.
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______ is the ability to yield to a stretch.
______ is the ability to yield to a stretch.
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Prolonged immobilization leads to atrophy and ______ of tissues.
Prolonged immobilization leads to atrophy and ______ of tissues.
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______ is the ability to yield to a stretch.
______ is the ability to yield to a stretch.
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______ is assuming a new and greater length after a stretch.
______ is assuming a new and greater length after a stretch.
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The ______ causes the muscle to contract in response to a stretch.
The ______ causes the muscle to contract in response to a stretch.
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When the stretch is released, sarcomeres return to their ______ length.
When the stretch is released, sarcomeres return to their ______ length.
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Overstretching can pose a danger if the ROM is increased too quickly, potentially resulting in the client injuring themselves with simple daily ______.
Overstretching can pose a danger if the ROM is increased too quickly, potentially resulting in the client injuring themselves with simple daily ______.
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Limited ROM restricted by adhesions, contractures and scar formations are indications for ______.
Limited ROM restricted by adhesions, contractures and scar formations are indications for ______.
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When limited ROM interferes with Activities of Daily Living (ADLs) and there is tissue shortened opposed by muscle weakness, it indicates the need for ______.
When limited ROM interferes with Activities of Daily Living (ADLs) and there is tissue shortened opposed by muscle weakness, it indicates the need for ______.
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Prolonged immobilization leads to atrophy and ______ of tissues.
Prolonged immobilization leads to atrophy and ______ of tissues.
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______ is the ability of tissue to return to its resting length after stretch.
______ is the ability of tissue to return to its resting length after stretch.
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______ is assuming a new and greater length after a stretch.
______ is assuming a new and greater length after a stretch.
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The ______ causes the muscle to contract in response to a stretch.
The ______ causes the muscle to contract in response to a stretch.
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Stretching is indicated when limited range of motion (ROM) interferes with activities of daily living (ADLs).
Stretching is indicated when limited range of motion (ROM) interferes with activities of daily living (ADLs).
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The primary goal of stretching is to increase muscle strength.
The primary goal of stretching is to increase muscle strength.
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Prolonged immobilization leads to tissue atrophy and fragility.
Prolonged immobilization leads to tissue atrophy and fragility.
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Overstretching weak postural muscles can improve muscular imbalances.
Overstretching weak postural muscles can improve muscular imbalances.
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Acute sharp pain with movement is a contraindication for passive stretching.
Acute sharp pain with movement is a contraindication for passive stretching.
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Tissue creep refers to the ability of tissue to return to its resting length after a stretch.
Tissue creep refers to the ability of tissue to return to its resting length after a stretch.
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Prolonged immobilization leads to tissue atrophy and ________.
Prolonged immobilization leads to tissue atrophy and ________.
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A significant change to the client's ROM can occur when tissue exhibits __________, leading to a new shape and size.
A significant change to the client's ROM can occur when tissue exhibits __________, leading to a new shape and size.
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The _________ causes the muscle to contract in response to a stretch.
The _________ causes the muscle to contract in response to a stretch.
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If the stress is held for prolonged periods of time, the collagen fibers begin to fail and tissue will assume a new lengthened position permanently. This is known as tissue __________.
If the stress is held for prolonged periods of time, the collagen fibers begin to fail and tissue will assume a new lengthened position permanently. This is known as tissue __________.
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When the stretch is released, sarcomeres return to their _________ length.
When the stretch is released, sarcomeres return to their _________ length.
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When limited ROM interferes with Activities of Daily Living (ADLs) and there is tissue shortened opposed by muscle weakness, it indicates the need for __________.
When limited ROM interferes with Activities of Daily Living (ADLs) and there is tissue shortened opposed by muscle weakness, it indicates the need for __________.
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Deep moist heat applied for 20 minutes on the site of the treated trigger point is recommended later that day to minimize ______.
Deep moist heat applied for 20 minutes on the site of the treated trigger point is recommended later that day to minimize ______.
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As a general guideline, it can take anywhere from ______ treatments to fully resolve a trigger point.
As a general guideline, it can take anywhere from ______ treatments to fully resolve a trigger point.
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Elimination of trigger points largely depends on the removal of ______ factors.
Elimination of trigger points largely depends on the removal of ______ factors.
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Ice area to create ______ (referral pain pattern) – repeat with movement.
Ice area to create ______ (referral pain pattern) – repeat with movement.
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Using a rubber reflex hammer, slowly direct a ______ onto the trigger point 10x.
Using a rubber reflex hammer, slowly direct a ______ onto the trigger point 10x.
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The patient is urged to restrict any ______ activities after the treatment.
The patient is urged to restrict any ______ activities after the treatment.
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The purpose of performing a Myo-fascial Trigger point technique is to release trigger points and relieve ______.
The purpose of performing a Myo-fascial Trigger point technique is to release trigger points and relieve ______.
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Flat palpation is used for broad, flatter, hard to pick up muscles like ______.
Flat palpation is used for broad, flatter, hard to pick up muscles like ______.
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Local Twitch Response (LTR) is a fasciculation contraction of muscle fibers in the taut band lasting for about ______ seconds.
Local Twitch Response (LTR) is a fasciculation contraction of muscle fibers in the taut band lasting for about ______ seconds.
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The pain felt by the patient associated with the TrP is seemingly unrelated to the location of the TrP, making it ______ and predictable in skeletal muscle.
The pain felt by the patient associated with the TrP is seemingly unrelated to the location of the TrP, making it ______ and predictable in skeletal muscle.
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In trigger point therapy, the client should expect to feel a sensation of ______ when pressure is applied to tender nodules.
In trigger point therapy, the client should expect to feel a sensation of ______ when pressure is applied to tender nodules.
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Referred pain is the most clinically significant feature of a TrP, which can be elicited from both active and latent ______.
Referred pain is the most clinically significant feature of a TrP, which can be elicited from both active and latent ______.
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Trigger point release using Ischemic Compression involves holding pressure on a tender nodule for 30 seconds to 2 minutes, until the muscle fibers ______ under your fingers.
Trigger point release using Ischemic Compression involves holding pressure on a tender nodule for 30 seconds to 2 minutes, until the muscle fibers ______ under your fingers.
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Warm the tissue with effleurage and specific petrissage, and also may warm with ______ heat before trigger point release.
Warm the tissue with effleurage and specific petrissage, and also may warm with ______ heat before trigger point release.
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The jump sign occurs if a body part moves as a result of palpation of the trigger point, such as hip hikes or shoulder ______.
The jump sign occurs if a body part moves as a result of palpation of the trigger point, such as hip hikes or shoulder ______.
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Pincer palpation is used for muscles that are easy to pick up, like the upper trapezius, gastrocnemius, latissimus, sternocleidomastoid, and the lateral border of ______ major.
Pincer palpation is used for muscles that are easy to pick up, like the upper trapezius, gastrocnemius, latissimus, sternocleidomastoid, and the lateral border of ______ major.
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Getting a clear description of where the patient's ______ is felt can be diagnostically significant to identifying which TrP is contributing to their problem.
Getting a clear description of where the patient's ______ is felt can be diagnostically significant to identifying which TrP is contributing to their problem.
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TrP's can produce ______ without producing pain (latent trigger points).
TrP's can produce ______ without producing pain (latent trigger points).
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Decreased range of motion and strength due to muscle fatigue and ______ (Without muscle atrophy or neurological deficit).
Decreased range of motion and strength due to muscle fatigue and ______ (Without muscle atrophy or neurological deficit).
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An initial ______ overloads muscle fibres giving rise to the trigger point.
An initial ______ overloads muscle fibres giving rise to the trigger point.
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Prolonged emotional stress such as ______ can lead to gradual onset of trigger points.
Prolonged emotional stress such as ______ can lead to gradual onset of trigger points.
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Strenuous use of the muscle and ______ on the TrP are aggravating factors for trigger points.
Strenuous use of the muscle and ______ on the TrP are aggravating factors for trigger points.
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Slow steady gentle ______ stretch can provide relief from trigger points.
Slow steady gentle ______ stretch can provide relief from trigger points.
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Limited ROM interferes with ______ and indicates the need for stretching.
Limited ROM interferes with ______ and indicates the need for stretching.
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Prolonged immobilization leads to ______ of tissues.
Prolonged immobilization leads to ______ of tissues.
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Before initiating a passive stretch, ______ of effleurage should be performed to palpate trigger points.
Before initiating a passive stretch, ______ of effleurage should be performed to palpate trigger points.
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What is the main precaution to take when dealing with active trigger points?
What is the main precaution to take when dealing with active trigger points?
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What is a major contraindication for trigger point therapy?
What is a major contraindication for trigger point therapy?
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What are the effects of Trigger Point Therapy?
What are the effects of Trigger Point Therapy?
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How can trigger points be identified based on patient symptoms?
How can trigger points be identified based on patient symptoms?
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What is a key factor in identifying taut band attachments related to trigger points?
What is a key factor in identifying taut band attachments related to trigger points?
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What symptom indicates that a patient may have a trigger point contributing to their problem?
What symptom indicates that a patient may have a trigger point contributing to their problem?
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What is the primary purpose of performing a myofascial trigger point technique?
What is the primary purpose of performing a myofascial trigger point technique?
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What is the recommended duration for holding pressure on a tender trigger point nodule during ischemic compression?
What is the recommended duration for holding pressure on a tender trigger point nodule during ischemic compression?
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Which palpation technique is recommended for broad, flatter muscles that are harder to pick up, such as the supraspinatus and infraspinatus?
Which palpation technique is recommended for broad, flatter muscles that are harder to pick up, such as the supraspinatus and infraspinatus?
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What is the most clinically significant feature of a myofascial trigger point?
What is the most clinically significant feature of a myofascial trigger point?
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Which muscle is likely responsible for a client's pain projected over the clavicle and down the anteriolateral arm to the first 3 digits?
Which muscle is likely responsible for a client's pain projected over the clavicle and down the anteriolateral arm to the first 3 digits?
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What is the purpose of performing a series of effleurage strokes before initiating a passive stretch?
What is the purpose of performing a series of effleurage strokes before initiating a passive stretch?
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What is the danger of increasing range of motion (ROM) too quickly during a stretch?
What is the danger of increasing range of motion (ROM) too quickly during a stretch?
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What is the primary goal of stretching?
What is the primary goal of stretching?
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Which muscle's trigger point referral pattern feels like an 'all over headache' from the occipital to the temple, eye, and forehead?
Which muscle's trigger point referral pattern feels like an 'all over headache' from the occipital to the temple, eye, and forehead?
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What is the ability of tissue to assume a new, permanent length after a prolonged stretch?
What is the ability of tissue to assume a new, permanent length after a prolonged stretch?
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What technique can be used if the client is unable to manage the pain for 2 minutes?
What technique can be used if the client is unable to manage the pain for 2 minutes?
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What should be done after the trigger point treatment to minimize pain?
What should be done after the trigger point treatment to minimize pain?
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How frequently should trigger point treatments be performed as a general guideline?
How frequently should trigger point treatments be performed as a general guideline?
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What is the recommended technique to apply to a trigger point using a rubber reflex hammer?
What is the recommended technique to apply to a trigger point using a rubber reflex hammer?
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What is the primary goal of the exercises that may be given as homecare to the client?
What is the primary goal of the exercises that may be given as homecare to the client?
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What is the relationship between the time since the acute onset of pain and the number of treatments required to fully resolve the trigger point?
What is the relationship between the time since the acute onset of pain and the number of treatments required to fully resolve the trigger point?
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Which of the following is NOT a typical symptom associated with trigger points?
Which of the following is NOT a typical symptom associated with trigger points?
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What is the primary purpose of getting a clear description of the patient's pain pattern?
What is the primary purpose of getting a clear description of the patient's pain pattern?
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Which of the following is NOT a characteristic of trigger point pain?
Which of the following is NOT a characteristic of trigger point pain?
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Which of the following is a common aggravating factor for trigger points?
Which of the following is a common aggravating factor for trigger points?
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What is the primary goal of passive stretching in trigger point therapy?
What is the primary goal of passive stretching in trigger point therapy?
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Which of the following is a common relieving factor for trigger points?
Which of the following is a common relieving factor for trigger points?
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What is the significance of identifying limitations in range of motion?
What is the significance of identifying limitations in range of motion?
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Which of the following is a common cause of sudden onset or acute activation of trigger points?
Which of the following is a common cause of sudden onset or acute activation of trigger points?
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What is the purpose of applying deep moist heat after trigger point therapy?
What is the purpose of applying deep moist heat after trigger point therapy?
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Which of the following is a technique used in trigger point therapy?
Which of the following is a technique used in trigger point therapy?
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If a patient stretches or loads the muscle with a trigger point, they are likely to feel discomfort in the region of the taut band attachments.
If a patient stretches or loads the muscle with a trigger point, they are likely to feel discomfort in the region of the taut band attachments.
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Vigorous ischemic compressions can be safely done on active trigger points without causing any additional pain.
Vigorous ischemic compressions can be safely done on active trigger points without causing any additional pain.
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Heat can be directly applied proximal to an acute injury, such as to the forearm with a wrist sprain.
Heat can be directly applied proximal to an acute injury, such as to the forearm with a wrist sprain.
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The main goal of trigger point therapy is to decrease local circulation in the affected area.
The main goal of trigger point therapy is to decrease local circulation in the affected area.
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A prolonged chilling of muscles, like from a draft window, is considered a precaution in trigger point therapy.
A prolonged chilling of muscles, like from a draft window, is considered a precaution in trigger point therapy.
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Myofascial Trigger Point Techniques can help increase the length of muscles with trigger points.
Myofascial Trigger Point Techniques can help increase the length of muscles with trigger points.
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Flat palpation is used for muscles that are easy to pick up, such as the upper trapezius and sternocleidomastoid.
Flat palpation is used for muscles that are easy to pick up, such as the upper trapezius and sternocleidomastoid.
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The primary goal of stretching is to increase muscle strength.
The primary goal of stretching is to increase muscle strength.
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Edematous tissue is strong and resilient.
Edematous tissue is strong and resilient.
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If a client experiences pain that concentrates at the angle of the neck and along the vertebral border of the scapula, and may project to the posterior deltoid region, the supraspinatus muscle is likely the source of the pain.
If a client experiences pain that concentrates at the angle of the neck and along the vertebral border of the scapula, and may project to the posterior deltoid region, the supraspinatus muscle is likely the source of the pain.
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The primary purpose of performing a myofascial trigger point technique is to increase muscle strength.
The primary purpose of performing a myofascial trigger point technique is to increase muscle strength.
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Deep moist heat applied for 20 minutes on the site of the treated trigger point is recommended later that day to minimize inflammation.
Deep moist heat applied for 20 minutes on the site of the treated trigger point is recommended later that day to minimize inflammation.
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If a client has trouble looking in blind spots while driving and has limited range of motion of neck rotation on the same side, the sternocleidomastoid muscle may be causing these symptoms.
If a client has trouble looking in blind spots while driving and has limited range of motion of neck rotation on the same side, the sternocleidomastoid muscle may be causing these symptoms.
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Acute sharp pain with movement is a contraindication for passive stretching.
Acute sharp pain with movement is a contraindication for passive stretching.
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Tissue creep refers to the ability of tissue to assume a new and greater length after a stretch.
Tissue creep refers to the ability of tissue to assume a new and greater length after a stretch.
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If the stress on tissue is held for a prolonged period, the tissue will retain its original shape and size.
If the stress on tissue is held for a prolonged period, the tissue will retain its original shape and size.
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Intermittent Ischemic Compression involves applying pressure to a trigger point for 20-25 seconds at a time.
Intermittent Ischemic Compression involves applying pressure to a trigger point for 20-25 seconds at a time.
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The patient should engage in aggravating activities after trigger point treatment.
The patient should engage in aggravating activities after trigger point treatment.
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Deep moist heat should be applied for 20 minutes on the site of the treated trigger point to minimize pain later that day.
Deep moist heat should be applied for 20 minutes on the site of the treated trigger point to minimize pain later that day.
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The longer the period between the acute onset of pain and the beginning of treatment, the fewer treatments will be required over a shorter period of time.
The longer the period between the acute onset of pain and the beginning of treatment, the fewer treatments will be required over a shorter period of time.
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It can take anywhere from 5-15 treatments to fully resolve a trigger point.
It can take anywhere from 5-15 treatments to fully resolve a trigger point.
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Elimination of trigger points largely depends on factors other than removing perpetuating factors.
Elimination of trigger points largely depends on factors other than removing perpetuating factors.
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Trigger points rarely produce dysfunction without producing pain.
Trigger points rarely produce dysfunction without producing pain.
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A clear description of the patient's pain pattern is important for identifying the contributing trigger point.
A clear description of the patient's pain pattern is important for identifying the contributing trigger point.
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Passively stretching the muscle is an aggravating factor for trigger points.
Passively stretching the muscle is an aggravating factor for trigger points.
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Trigger point referral patterns are not significant in identifying the contributing muscle.
Trigger point referral patterns are not significant in identifying the contributing muscle.
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Limited range of motion is rarely the chief complaint for trigger points.
Limited range of motion is rarely the chief complaint for trigger points.
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Weakness due to muscle fatigue and hypertonicity is not associated with trigger points.
Weakness due to muscle fatigue and hypertonicity is not associated with trigger points.
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Sudden onset or acute overload can be caused by emotional stress or a death of a loved one.
Sudden onset or acute overload can be caused by emotional stress or a death of a loved one.
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Cold, damp weather is a relieving factor for trigger points.
Cold, damp weather is a relieving factor for trigger points.
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A slow, steady, gentle passive stretch is a relieving factor for trigger points.
A slow, steady, gentle passive stretch is a relieving factor for trigger points.
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Trigger points can cause various non-pain associated symptoms such as excessive lacrimation and nasal secretion.
Trigger points can cause various non-pain associated symptoms such as excessive lacrimation and nasal secretion.
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Study Notes
Here are the study notes:
Trigger Points and Pain Patterns
- Trigger points (TrP's) are areas of hyperirritable muscle tissue that can cause pain and stiffness in various parts of the body
- TrP's can be active or latent, and can cause referred pain, which is pain felt in a different area of the body than the TrP itself
Palpation and Identification of Trigger Points
- Palpation involves feeling for taut bands and tender nodules in the muscle tissue
- A local twitch response (LTR) can occur when a TrP is palpated, which is a rapid contraction of the muscle fibers
- Jump sign: a body part may move or jerk when a TrP is palpated
- Referred pain: pain felt in a different area of the body than the TrP itself
Trigger Point Release Technique
- Identify a TrP and explain the procedure to the client
- Warm the tissue with effleurage and specific petrissage
- Apply ischemic compression to the TrP, holding for 30 seconds to 2 minutes
- Release the pressure and flush the area with petrissage and effleurage
- Passive stretching of the affected muscle
Trigger Point Therapy
- Increase local circulation
- Reduce pain and sympathetic nervous system firing
- Treat TrPs
- Increase length of muscle
- Decrease hypertonicity of muscle
Contraindications and Precautions
- Avoid vigorous techniques on active TrPs
- Avoid full stretch of muscle with TrPs when hypermobility is present
- Avoid prolonged chilling of muscle
- Avoid vigorous ischemic compressions done too quickly
- Avoid heat directly proximal to an acute injury
Alternative Trigger Point Techniques
- Intermittent ischemic compression
- Intermittent cold and stretch
- Percussion and stretch
Post-Treatment and Prognosis
- Restrict aggravating activities after treatment
- Apply deep moist heat to the TrP
- Identify and reduce lifestyle factors contributing to TrP activity
- Exercises may be given as homecare to correct postural imbalances
- Prognosis: number of treatments required depends on the duration of pain and the removal of perpetuating factors### Myofascial Trigger Point Techniques
- Decreased range of motion, pain, and autonomic and proprioceptive symptoms are indications for myofascial trigger point techniques
- Precautions for myofascial trigger point techniques:
- Avoid vigorous techniques on active trigger points to prevent "kick-back" pain
- Avoid full stretch of muscle with trigger points when hypermobility is present
- Prolonged chilling of muscle should be avoided
- Contraindications for myofascial trigger point techniques:
- Vigorous ischemic compressions done too quickly
- Heat directly proximal to an acute injury
- Locally if there is a strain or sprain
- Vigorous ischemic compressions within the same treatment as friction technique
Effects of Trigger Point Therapy
- Increases local circulation
- Reduces pain and sympathetic nervous system firing
- Treats trigger points
- Increases length of muscle
- Decreases hypertonicity of muscle
Trigger Point Technique Procedure
- Identify trigger points through palpation and client history
- Prepare the client by explaining the procedure and goals
- Warm the tissue with effleurage and petrissage
- Apply ischemic compression and hold for 30 seconds to 2 minutes
- Flush out the area with effleurage and petrissage after compression
- Stretch the affected muscle and hold for 30 seconds
Palpation
- Use flat palpation for broad, flatter muscles
- Use pincer palpation for muscles that are easy to pick up
- Identify taut bands and tender nodules to locate trigger points
- Use a local twitch response to confirm the presence of a trigger point
Determining if there is a Trigger Point
- Identify a taut band
- Palpate to localize the tender nodule
- Use a local twitch response to confirm the presence of a trigger point
- Identify the referred pain pattern associated with the trigger point
Passive Stretching Technique Procedure
- Explain the goals and procedure to the client
- Position the client comfortably and in a stable position
- Free the area of restrictions
- Warm structures using petrissage or hydrotherapy
- Stabilize the proximal segment of the joint and move the distal segment
- Move the body segment in a slow, smooth, and gentle manner to the point of tissue resistance
- Remind the client to breathe comfortably
- Hold the stretch for 30 seconds or longer
- Release the stretch slowly to prevent recoil of tissues
- Allow for a rest period before stretching again
- Flush out after stretch with effleurage and petrissage
Precautions and Contraindications for Stretching
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Precautions:
- Do not passively force a joint beyond its normal ROM
- Extra care should be taken with suspected or known osteoporosis
- Prolonged use of steroids causes thinning of soft tissues
- Prolonged immobilization leads to atrophy and tissue fragility
- Strengthening exercises should be coupled with stretching
- Post-stretching, the client should feel muscle soreness lasting no more than 24 hours
- Edematous tissue is fragile
- Overstretching weak postural muscles can increase muscular imbalances
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Contraindications:
- When a bony formation limits ROM
- Recent fracture
- Muscles in spasm
- Acute inflammation or infection
- Acute sharp pain with movement
- Severe contusion or tissue trauma
- Hypermobility
- Paralysis or severe numbness### Drawing the Pain Pattern
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Identifying the location of the patient's pain is crucial in determining which trigger point (TrP) is contributing to their problem.
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Pain often travels to other areas, and understanding the referral patterns of TrPs is essential.
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Pain is typically described as an achiness and stiffness, and it's essential to differentiate it from radiating nerve pain.
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Determining the activities and postures that aggravate and relieve the pain is vital.
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Limited range of motion (ROM) is a fundamental characteristic of TrPs, identified by pain that develops as the muscle approaches full stretch ROM.
Limited Range of Motion
- Observing the patient's posture and examining for limitations in ROM is crucial.
- Watching the patient's spontaneous posture and movements while walking and sitting can provide valuable insights.
- Limited ROM is often worse in the morning and recurs after periods of over-activity of the affected muscle(s).
- This is due to the abnormal tension of the taut band.
Weakness
- Decreased ROM and strength are due to muscle fatigue and hypertonicity, without muscle atrophy or neurological deficit.
Other Non-pain Associated Symptoms
- Excessive lacrimation/tearing
- Nasal secretion/runny nose
- Pilomotor activity/hairs up
- Changes in sweat patterns/sweating
- Postural dizziness
- Spatial disorientation
- Altered perception of the weight of lifted objects
- Sleep disturbances, which can increase pain sensitivity the next day
Motor Function Interruption
- Includes spasm of other muscles, weakness of the involved muscle, loss of coordination, and decreased work tolerance.
Sudden Onset/Acute Overload
- Sudden onset can occur due to an initial trauma that overloads muscle fibers, giving rise to the trigger point.
- Pain develops within 12-24 hours post-trauma of the muscle(s) involved.
- Examples of sudden onset events include wrenching movements, automobile accidents, falls, fractures, joint sprains, dislocations, direct blows to the muscle, episodes of excessive or unusual exercise, and intramuscular injections at the site of a latent TrP.
Gradual Onset/Overload
- Gradual onset can take from hours to days to become a triggering factor in TrP activation.
- Factors contributing to gradual onset include sustained postural overload, repetitive activities at work, prolonged emotional stress, other TrPs, immobilization in the shortened position, joint or nerve damage, and pathology.
Aggravating Factors
- Strenuous use of the muscle
- Passively stretching the muscle
- Pressure on the TrP
- Placing the involved muscle in a shortened position for a prolonged period
- Sustained or repeated contraction of the involved muscle
- Cold, damp weather
- Viral infections
- Periods of marked nervous tension
- Exposure to a cold draft
Relieving Factors
- Slow, steady, gentle passive stretching
- Indications for stretching include limited ROM, restricted by adhesions, contractures, and scar formations, when limited ROM interferes with Activities of Daily Living (ADLs), and when there is tissue shortened opposed by muscle weakness.
Precautions and Contraindications
- Precautions include avoiding passive force beyond normal ROM, taking extra care with suspected or known osteoporosis, and being cautious with prolonged use of steroids and immobilization.
- Contraindications include when a bony formation limits ROM, recent fracture, muscles in spasm, acute inflammation or infection, acute sharp pain with movement, severe contusion, and hypermobility.
Myofascial Trigger Point Technique
- Procedure involves identifying trigger points, treating trigger points, and increasing local circulation.
- Avoid vigorous techniques on active trigger points, and do not use full stretch of muscle with trigger points when hypermobility is present.
- Contraindications include vigorous ischemic compressions done too quickly, heat directly proximal to an acute injury, and locally if there is a strain or sprain.
Effects of Trigger Point Therapy
- Increase local circulation
- Reduce pain and sympathetic nervous system firing
- Treat trigger point
- Increase length of muscle
- Decrease hypertonicity of muscle
Alternate Trigger Point Techniques
- Intermittent ischemic compression
- Intermittent cold and stretch
- Percussion and stretch
Post Treatment
- The patient should restrict any aggravating activities after treatment.
- Deep moist heat applied for 20 minutes on the site of the treated trigger point is recommended later that day to minimize pain.
- Lifestyle factors contributing to the trigger point activity should be identified and reduced if possible.
- Exercises may be given as homecare to correct postural imbalances.
Prognosis
- The longer the period between the acute onset of pain and the beginning of treatment, the greater the number of treatments required over a longer period.
- It can take anywhere from 3-10 treatments to fully resolve a TrP.
- Elimination of trigger points largely depends on the removal of perpetuating factors.
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Description
Test your knowledge of neck muscle stretching techniques and their associated referral patterns. This quiz covers stretches for muscles like Splenius Capitus, Splenius Cervicis, and Levator Scapula, as well as common client complaints and limitations in range of motion.
