The Trigger Point Therapy Workbookcista.net/health/TriggerPointTherapyWkbk3_PainGuides_0.pdfThe Trigger Point Therapy Workbook Pain Guide: Head, Face, and Neck 01 Amber avies and Maria

The Trigger Point Therapy Workbook

3rd edition

Clair Davies, MCTMB

Amber Davies, CMTPT, LMT

Pain Guide

© 2013 Amber Davies and Maria Worley / New Harbinger Publications. Permission is granted to the reader to reproduce this form for personal use.

Contents

1. Pain Guide: Head, Face, and Neck 2. Pain Guide: Shoulder, Upper Back, and Upper Arm 3. Pain Guide: Elbow, Forearm, and Hand 4. Pain Guide: Chest, Abdominal, and Genital 5. Pain Guide: Midback, Low Back, and Buttock 6. Pain Guide: Hip, Thigh, and Knee 7. Pain Guide: Lower Leg, Ankle, and Foot

The Trigger Point Therapy Workbook Pain Guide: Head, Face, and Neck

© 2013 Amber Davies and Maria Worley / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.

Back of head pain

Back of neck pain

Crown headache Temple headache Sinus pain Toothache

Tongue pain

Frontal headache

Eye pain

Ear and jaw pain

Throat pain

The Trigger Point Therapy Workbook Pain Guide: Head, Face, and Neck



Pain Guide

Head, Face, and Neck

Boldface type indicates a primary pain pattern. Regular type refers to a less common or satellite trigger point pattern. Muscles are listed in the order of how likely they are to be the problem. Also see Other Symptoms Guide.

Back of Headtrapeziussternocleidomastoidsemispinalissplenius cervicissuboccipitalsoccipitalisdigastrictemporalis

Back of Necktrapeziusmultifidilevator scapulaesplenius cervicisinfraspinatusdigastric

Crown Headachesternocleidomastoidsplenius capitis

Ear and Jawlateral pterygoidmassetermedial pterygoidsternocleidomastoidtrapeziussoleus

Eye and Eyebrowsternocleidomastoidtemporalissplenius cervicismassetersuboccipitalsoccipitalisorbicularis oculitrapezius

Frontal Headachesternocleidomastoidsemispinalis capitisfrontaliszygomaticus major

Sinussternocleidomastoidmasseterlateral pterygoidorbicularis oculizygomaticus major

Temple Headachetrapeziussternocleidomastoidtemporalissplenius cervicissuboccipitalssemispinalis capitis

Throatsternocleidomastoiddigastricmedial pterygoidlongus colliplatysma

Tonguesternocleidomastoidmedial pterygoidmylohyoid

Toothachetemporalismasseterdigastric

The Trigger Point Therapy Workbook Other Symptoms Guide: Head, Face, and Neck



Other Symptoms Guide

Head, Face, and Neck

Blurred Visionsplenius cervicissuboccipitalssternocleidomastoid

Coughsternocleidomastoid

Dizzinesssternocleidomastoid

Ear Itchmasseter

Ear Stuffinessmassetermedial pterygoid

Excess Mucus or Phlegm

sternocleidomastoidlateral pterygoidzygomaticuslevator labii

Eyelid Droopsternocleidomastoidorbicularis oculi

Eye Rednesssternocleidomastoid

Eye Twitchsternocleidomastoidorbicularis oculi

Hearing Losssternocleidomastoid

Imbalancesternocleidomastoid

Malocclusion of Teeth (teeth do not fit together)

temporalislateral pterygoiddigastric

Migraine Headachetrapeziussternocleidomastoidsplenius cervicissuboccipitalstemporalis

Nauseasternocleidomastoid

NumbnessHead

splenius cervicissemispinalis capitis

Pain or Trouble with MotionHead: Lying Down

semispinalis capitisTeeth: Biting Down

medial pterygoidThroat: Swallowing

medial pterygoiddigastricmylohyoid

Reduced Range of MotionJaw

massetertemporalislateral pterygoidmedial pterygoiddigastric

Neck: Flexion/Extensionsemispinalissplenius cervicissuboccipitals

Neck: Rotationlevator scapulaesplenius cervicissuboccipitalssternocleidomastoidtrapezius

Neck: Sideways Flexiontrapeziussternocleidomastoidsplenius cervicisscalenessuboccipitals

Sinus Drainagemasseter

Sore Throatsternocleidomastoidlongus colli

Stiffness, Necktrapeziuslevator scapulaesemispinalissplenius cervicissternocleidomastoidsuboccipitals

Swallowing Difficulty

lateral pterygoidmedial pterygoidlongus colli

Tearingsternocleidomastoid

Temporomandibular Joint (TMJ) Dysfunction

masseterlateral pterygoidmedial pterygoidtemporalissternocleidomastoid

TendernessBack of the Head

semispinalis capitisScalp

sternocleidomastoid

Tinnitus (ringing in the ears)

massetersternocleidomastoidlateral pterygoid

Tooth Sensitivitymassetertemporalisdigastric

Trigeminal Neuralgiasternocleidomastoid

Vertigosternocleidomastoid

Visual Disturbancessternocleidomastoidsplenius cervicissuboccipitals

Vocal Tensionmassetermylohyoidlongus colli

The Trigger Point Therapy Workbook Pain Illustration Guide: Head, Face, and Neck

Sternocleidomastoid, sternal branch: trigger points and referred pain pattern

Sternocleidomastoid, clavicular branch: trigger points and referred pain pattern

Trapezius number 1 trigger point and referred pain pattern: front view

Upper trapezius number 1 trigger point and referred pain pattern: side view

Upper trapezius number 2 trigger points and referred pain pattern

Lower trapezius number 3 trigger points and referred pain pattern

Trapezius number 4 trigger point and referred pain pattern

Middle trapezius number 5 trigger point and referred pain pattern

Upper trapezius number 6 trigger point and referred pain pattern

Levator scapulae trigger points and referred pain pattern

Splenius capitis trigger point and referred pain pattern

Splenius cervicis number 1 trigger point and referred pain pattern

Splenius cervicis number 2 trigger point and referred pain pattern

Caution: Please read the full treatment instructions for each muscle before beginning.

The Trigger Point Therapy Workbook Pain Illustration Guide: Head, Face, and Neck


Sample semispinalis capitis number 1 trigger points and referred pain pattern

Sample semispinalis capitis number 2 trigger point and referred pain pattern

Multifidi and rotatores trigger points and referred pain pattern

sample of rotatores sample of multifidi

Suboccipitals referred pain pattern

Temporalis trigger points and referred pain patterns

Digastric trigger points and referred pain pattern. Pain shown below the lower lip is actually felt in the lower teeth.

Buccinator trigger point and referred pain pattern

Obicularis oculi trigger points and referred pain pattern

Zygomaticus and levator labii trigger points and referred pain pattern

Masseter trigger points and referred pain pattern

Medial pterygoid trigger point and referred pain pattern. (Note that the jawbone is cut away to reveal this muscle deep to the bone.)

Lateral pterygoid trigger points and referred pain pattern

The Trigger Point Therapy Workbook Pain Guide: Shoulder, Upper Back, and Upper Arm



Front of shoulder pain Side of shoulder pain Front of arm pain

Upper back pain Back of shoulder pain Back of arm pain

The Trigger Point Therapy Workbook Pain Guide: Shoulder, Upper Back, and Upper Arm



Pain Guide

Shoulder, Upper Back, and Upper Arm


Back of Armscalenestricepsposterior deltoidsubscapularissupraspinatusteres majorteres minorlatissimus dorsiserratus posterior superiorcoracobrachialis

Back of Shoulderposterior deltoidlevator scapulascalenessupraspinatusteres majorteres minorsubscapularisserratus posterior superiorlatissimus dorsitricepstrapeziussuperficial spinal muscles

Front of Armscalenesinfraspinatusbicepsbrachialistricepssupraspinatusanterior deltoidsubclavius

Front of Shoulderinfraspinatusanterior deltoidscalenessupraspinatuspectoralis majorpectoralis minorbicepscoracobrachialislatissimus dorsisubclavius

Side of Shoulderinfraspinatusscalenesmiddle deltoidsupraspinatus

Upper Backscaleneslevator scapulatrapeziusrhomboidslatissimus dorsideep spinal musclessuperficial spinal musclesserratus posterior superiorinfraspinatusserratus anteriorsplenius cervicissupraspinatusmultifidi and rotatores

The Trigger Point Therapy Workbook Other Symptoms Guide: Shoulder, Upper Back, and Upper Arm





Bursitisscalenessupraspinatusteres majorsubscapularisdeltoidsbicepslatissimus dorsipectoralis major

Crepitus (sounds with movement)Back

rhomboidsShoulder

supraspinatusbiceps

Frozen Shoulder (adhesive capsulitis)

subscapularisinfraspinatussupraspinatuspectoralis majorserratus anteriorlatissimus dorsirhomboidsdeltoids

Impingement Syndromessupraspinatusanterior deltoidsubscapularisbiceps

Musculocutaneous Nerve Entrapment

coracobrachialis

Pain or Stiffness with MovementBreathing

serratus posterior superiorserratus anteriorscalenespectoralis minorlatissimus dorsi

Driving without Power Steeringteres major

Raising Arm Out to the Sidesupraspinatussubscapularisdeltoids

Reaching Back at Shoulder Levelrhomboidspectoralis minor

Reaching Behindsupraspinatusinfraspinatuspectoralis minorcoracobrachialis

Reaching Downrhomboids

Reaching Up and Backteres major

Reaching Up and Forwardlatissimus dorsiteres majorsupraspinatuspectoralis minor

Resting Elbow on a Deskteres major

Sleeping: Side Lyinginfraspinatuslatissimus dorsi

Turning Arm Palm Upsubscapularis

Reduced Range of MotionAbduction (movement toward the outside)

deltoidssubscapularispectoralis majorpectoralis minorteres majortricepssupraspinatus

Adduction (movement toward the body)

infraspinatussupraspinatus

Extension of Upper Armdeltoidsinfraspinatuspectoralis minorsupraspinatusbiceps

External (lateral) Rotationsubscapularisinfraspinatuspectoralis majorpectoralis minor

Flexion of Upper Armdeltoidspectoralis minorsupraspinatusinfraspinatusbicepsteres majorlatissimus dorsipectoralis minor

Internal (medial) rotationinfraspinatusteres minorsubscapularis

The Trigger Point Therapy Workbook Other Symptoms Guide: Shoulder, Upper Back, and Upper Arm

Upward Rotation (movement of arm from 90 degrees abduction to completely overhead)

supraspinatusdeltoidssubscapularisserratus anteriorcoracobrachialisbiceps

Restlessnessscalenes

Tenderness (shoulder)infraspinatussubscapularisbiceps

Tendonitis or Arthritissupraspinatussubscapularisdeltoidsbicepsinfraspinatusteres majorpectoralis major

Thoracic Outlet Syndromescalenespectoralis minorsubclavius

Pseudo– Thoracic Outlet Syndrome

pectoralis majorlatissimus dorsisubscapularisteres major

WeaknessShoulder

deltoidsinfraspinatus

Armbiceps scalenes

The Trigger Point Therapy Workbook Pain Illustration Guide: Shoulder, Upper Back, and Upper Arm



Teres minor trigger point and referred pain pattern

Subscapularis trigger points and referred pain pattern

Posterior deltoid pain pattern

Middle deltoid pain pattern

Scalene referred pain pattern, front view

Scalene referred pain pattern, back view

Rhomboid trigger points and referred pain pattern

Serratus posterior superior referred pain pattern

Infraspinatus medial border trigger point with referred pain pattern

Supraspinatus trigger points and referred pain pattern

Infraspinatus referred pain pattern

Pain Illustrations Guide



The Trigger Point Therapy Workbook Pain Illustration Guide: Shoulder, Upper Back, and Upper Arm

Anterior deltoid pain pattern

Teres major trigger points and referred pain pattern

Latissimus dorsi trigger points and referred pain pattern

Coracobrachialis trigger points and anterior referred pain pattern

Coracobrachialis posterior referred pain pattern

Biceps trigger points and referred pain pattern

Triceps number 1 trigger points and referred pain pattern






The Trigger Point Therapy Workbook Pain Guide: Elbow, Forearm, and Hand



Outer elbow pain

Inner elbow pain

Outer forearm pain

Inner forearm pain

Inner wrist and palm pain

Thumb and web pain

Outer finger pain

Inner finger pain

Outer wrist and hand pain

The Trigger Point Therapy Workbook Pain Guide: Elbow, Forearm, and Hand



Pain Guide

Elbow, Forearm, and Hand


Inner Elbowtricepspectoralis major abductor pollicis brevis pectoralis minorserratus anteriorserratus posterior superiorabductor pollicis brevis

Inner Finger (palm side)flexor digitoruminterosseoustricepslatissimus dorsiserratus anteriorabductor digiti minimi manuspronator quadratussubclavius

Inner Forearmpronator quadratuspalmaris longuspronator teresserratus anteriortricepslatissimus dorsipectoralis majorpectoralis minorserratus posterior superior

Inner Wrist and Palmflexor carpi radialisflexor carpi ulnarisopponens pollicispalmaris longuspronator terespronator quadratusabductor pollicis brevisabductor pollicis longuspectoralis majorpectoralis minorlatissimus dorsiserratus anterior

Outer Finger (dorsal side)extensor digitoruminterosseousscalenesabductor digiti minimi manusabductor pollicis longustricepspectoralis minorlatissimus dorsisubclavius

Outer Forearmbrachioradialistricepsscalenesextensorsinfraspinatusteres majorcoracobrachialissupraspinatussubclavius

Outer Elbowextensorssupinatorbrachioradialistricepssupraspinatusanconeus

Outer Wrist and Handextensorsabductor pollicis longusabductor pollicis brevissubscapulariscoracobrachialisscaleneslatissimus dorsiserratus posterior superiorfirst dorsal interosseous

Thumb and Websupinatorscalenesbrachialisinfraspinatusextensor carpi radialis longusbrachioradialisabductor pollicis brevisopponens pollicisadductor pollicissubclaviusfirst dorsal interosseousflexor pollicis longus

The Trigger Point Therapy Workbook Other Symptoms Guide: Elbow, Forearm, and Hand




Elbow, Forearm, and HandArthritis

extensor digitorum interosseous

Carpal Tunnel SyndromeEntrapment of the Median Nerve in the Forearm

pronator teres flexor carpi radialis

Pseudo– Carpal Tunnel Syndromebrachialis flexor digitorum scalenes palmaris longus opponens pollicis adductor pollicis brachioradialis extensor carpi radialis longusextensor carpi radialis brevissubscapularis

Cubital Tunnel SyndromeEntrapment of the Ulnar Nerve in the Forearm

flexor carpi ulnarisflexor digitorum

Entrapment of the Ulnar Nerve in the Hand

opponens digiti minimi

de Quervain’s Stenosing Tenosynovitis

abductor pollicis longusextensor carpi radialis longusextensor carpi radialis brevisbrachioradialispalmaris longus

Difficulty or Pain with Fine Motor Skills

thenar (thumb muscles)hypothenar (pinky muscles) interosseous

Finger Stiffness, Tenderness, or Weakness

extensor digitorumextensor indicisflexor digitoruminterosseoushypothenar

Golfer’s Elbow (medial epicondylitis)

tricepspectoralis majorforearm flexorsabductor pollicis brevis

Grip (handshake, doorknob, screwdriver, hand tools)Undependable

scalenesextensor carpi radialis longusextensor digitorumsupinator

Weaknessbrachioradialisextensor carpi radialis longusextensor carpi radialis brevisextensor digitorum

Painextensor carpi radialis longusextensor digitorumsupinatorflexor digitorumflexor carpi radialisflexor ulnarisinterosseous

Hand Swellingscalenes

Heberden’s Nodesinterosseousadductor pollicisabductor digiti minimi

Numbness and TinglingForearm

triceps #3pectoralis minorserratus posterior superior

Middle and Ring Fingers (with index or pinky occasionally)

pronator teresflexor digitorum

Pinky, Ring, and Middle Fingersscalenespectoralis minorserratus posterior superiortriceps #3teres minorflexor carpi ulnarisflexor digitorum

Thumb and First Fingerextensor carpi radialis brevisbrachialissupinator

The Trigger Point Therapy Workbook Other Symptoms Guide: Elbow, Forearm, and Hand

Radial Nerve Entrapmenttriceps #3 (extensor carpi radialis brevis supinatorbrachialis

TendernessElbow

tricepsbrachioradialissupinator

Palm (prickling feeling)palmaris longus

Thumb (and web of hand)brachialisscalenessupinatorbrachioradialisextensor carpi radialis longus

Wristflexor carpi radialisflexor ulnaris

Tennis Elbow (lateral epicondylitis)

supinatorbrachioradialisextensor carpi radialis longusextensor digitorumtricepsanconeusbicepsbrachialis

Thoracic Outlet Syndromescalenespectoralis minorsubclavius

Pseudo– Thoracic Outlet Syndrome

pectoralis majorlatissimus dorsisubscapularis teres major

Trigger Fingertendons of the hand and finger

flexors

Trigger Thumbflexor pollicis brevis

Weakness (also see Grip)Arm

biceps scalenes

Handscalenes triceps extensor carpi radialis brevis

The Trigger Point Therapy Workbook Pain Illustrations Guide: Elbow, Forearm, and Hand




Elbow, Forearm, and Hand

Brachialis trigger points and referred pain pattern. The inner 2 trigger points may cause entrapment of the radial nerve.

Extensor carpi radialis longus trigger point and referred pain pattern. The drawings show the outer side of the forearm and hand.

Brachioradialis trigger point and referred pain pattern

Supinator trigger point and referred pain pattern

Extensor carpi radialis brevis trigger point and referred pain pattern

Extensor carpi ulnaris trigger point and referred pain pattern

Anconeus trigger point and referred pain pattern

Extensor digitorum trigger points and referred pain pattern

Extensor indicis trigger point and referred pain pattern

Abductor pollicus longus sample trigger point and referred pain pattern

Flexor carpi radialis trigger point and referred pain pattern

Flexor carpi ulnaris trigger point and referred pain pattern


The Trigger Point Therapy Workbook Pain Illustrations Guide: Elbow, Forearm, and Hand

Adductor pollicis trigger points and referred pain pattern

Flexor pollicis longus trigger point and referred pain pattern

Opponens pollicis trigger points and referred pain pattern

Dorsal interosseous trigger points and referred pain pattern. The abductor digiti minimi manus muscle, trigger point, and referred pain are also included in this drawing.

First dorsal interosseous trigger points and referred pain pattern

Flexor digitorum trigger points and referred pain pattern

Pronator teres and pronator quadratus trigger points, pronator teres referred pain, and pronator quadratus referred pain

Palmaris longus trigger point and referred pain pattern

Abductor pollicis brevis referred pain pattern


The Trigger Point Therapy Workbook Pain Guide: Chest, Abdominal, and Genital



Chest pain Side pain Abdominal pain Genital pain(both genders)

The Trigger Point Therapy Workbook Pain Guide: Chest, Abdominal, and Genital



Pain Guide

Chest, Abdominal, and Genital


Abdominalrectus abdominis abdominal obliques iliocostalis deep spinal muscles quadratus lumborum

Chestpectoralis major pectoralis minor scalenes sternocleidomastoid sternalis intercostals iliocostalis subclavius abdominal obliques diaphragm

Genitalpelvic floor muscles abdominal obliques adductor magnus rectus abdominis gluteus maximus piriformis psoas

Sideserratus anterior abdominal obliques intercostals latissimus dorsi diaphragm

The Trigger Point Therapy Workbook Other Symptoms Guide: Chest, Abdominal, and Genital




Chest, Abdominal, and GenitalBelching

abdominal obliques

Bladder Pain or Frequencyadductor magnus abdominal obliques piriformis (and other deep lateral

rotators) pelvic floor

Breast or Nipple Hypersensitivity

pectoralis major serratus anterior

Cardiac Arrhythmiapectoralis major

Cardiac Ischemia or Angina (false)

pectoralis major pectoralis minor sternalis superficial spinal iliocostalis

Chronic Pelvic Pain, Gynecological or Menstrual Pain

abdominal obliques rectus abdominis adductor magnus pelvic floorpiriformis/deep rotators psoas/iliacus

Coccyx (tailbone) Pain or Tenderness

gluteus maximusmultifidipelvic floor (levator ani,

coccygeus, sphincter ani, and obturator internus)

Colicrectus abdominis

Costochondritispectoralis majorserratus anteriorintercostaldiaphragmabdominal obliquesrectus abdominis

Forward- Head Posture (slouching)

rectus abdominisabdominal obliquespectoralis major pectoralis minorsternalissternocleidomastoidscalenes

Heartburnupper abdominal obliquesrectus abdominis

Impotencepiriformispelvic floor (bulbospongiosus)

Indigestionrectus abdominis

Nausearectus abdominis

Pain or Trouble with MotionBending and Lifting

rectus abdominisBowel Movement

pelvic floor (sphincter ani) Ejaculation

pelvic floor (bulbospongiosus)

Lying Flat on the Backpelvic floor (levator ani)

Reaching Out and Behindpectoralis majorpectoralis minor

Rising from a Chairsuperficial spinal muscles

Side Bendingabdominal obliquessuperficial spinal muscles

Sittingpelvic floor (levator ani and

coccygeus) Twisting

intercostals

Pain with Breathing, Coughing, Sneezing, or Difficulty Taking a Full Breath

scalenesserratus anteriorpectoralis minorpectoralis majordiaphragmintercostalsabdominal obliquesrectus abdominislatissimus dorsi

Penis Painrectus abdominispelvic floor (ischiocavernosus

and bulbospongiosus)

Perineumpiriformispelvic floor (levator ani,

bulbospongiosus, ischiocavenosus)


Pseudo- Appendicitisrectus abdominis

Rectal Pain and Sense of Fullness

adductor magnus pelvic floor (levator ani,

obturator internus, and sphincter ani)

piriformis

Scrotum Painquadratus lumborum psoas/iliacuspelvic floor (bulbospongiosus)

Testicular Painabdominal obliquespelvic floor (bulbospongiosus

and ischiocavernosus)quadratus lumborum

Urinary Frequency or Urgency

abdominal obliques

Urinary Incontinence pelvic floor

Urinary Retentionabdominal obliques

Urinary Sphincter Spasmrectus abdominis

Vaginal Pain or Vulvodyniaabdominal obliquesadductor magnuspelvic floor (levator ani,

bulbospongiosus, ischiocavernosus, and obturator internus)

Vomiting, Projectileabdominal obliques rectus abdominis





Chest, Abdominal, and Genital

Pectoralis major, clavicular section: trigger points and referred pain pattern

Pectoralis major, sternal section: trigger points and referred pain pattern

Pectoralis major, costal section: trigger points and referred pain pattern

Subclavius trigger point and referred pain pattern

Sample sternalis trigger point and referred pain pattern

Pectoralis minor trigger points and referred pain pattern

Serratus anterior referred pain pattern (side stitch)

Serratus anterior referred pain pattern in the back

Upper abdominal trigger points and referred visceral pain pattern

Diaphragm referred pain pattern. Trigger points are hidden behind the lowest ribs.

Midabdominal trigger points and referred visceral pain pattern




Pseudoappendicitis trigger point and referred pain pattern

Lower abdominal trigger points and referred groin and genital pain (both genders)

Abdominal trigger points and referred pain patterns in the back

Psoas and iliacus trigger points and referred pain pattern in the back

Psoas and iliacus trigger points and referred pain pattern in the abdomen, groin, and thigh

The Trigger Point Therapy Workbook Pain Guide: Midback, Low Back, and Buttock



Midback pain

Low back pain

Buttock pain

Hip pain

The Trigger Point Therapy Workbook Pain Guide: Midback, Low Back, and Buttock



Pain Guide

Midback, Low Back, and Buttock


Buttockgluteus mediusquadratus lumborumgluteus maximussuperficial spinal musclessemitendinosussemimembranosuspiriformisgluteus minimusrectus abdominissoleus

Coccyx (tailbone)pelvic floor muscles (levator ani, coccygeus) gluteus maximusdeep spinal muscles

Hipgluteus minimusvastus lateralispiriformisquadratus lumborumtensor fasciae lataeadductor longus and brevisgluteus maximusrectus femoris

Low Backgluteus mediuspsoas/iliacusdeep spinal musclessuperficial spinal musclesquadratus lumborumgluteus maximusrectus abdominissoleuspelvic floor muscles

Midbacksuperficial spinal musclesdeep spinal musclesserratus posterior inferiorrectus abdominisintercostalslatissimus dorsiserratus anterior

Sacrumpelvic floor musclesgluteus mediusquadratus lumborumgluteus maximusdeep spinal musclesrectus abdominissoleus

The Trigger Point Therapy Workbook Other Symptoms Guide: Midback, Low Back, and Buttocks




Midback, Low Back, and Buttocks

Leg- Length Inequality (mechanical, not structural)Anterior Pelvic Tilt

iliacus tensor fasciae latae rectus femoris gluteus medius adductor longus

Pelvic Upslipquadratus lumborum superficial spinal muscles

Posterior Pelvic Tiltsemimembranosus semitendinosus biceps femorisrectus abdominisadductor magnus

Pain or Trouble with MotionCoughing or Sneezing

rectus abdominisquadratus lumborumserratus posterior inferior

Forced to Crawl on All Foursquadratus lumborumpsoas/iliacus

Forward Flexion (bending)superficial spinalquadratus lumborumdeep spinal muscles

Going Down Stairs or Hillssoleus

Going Up Stairs or Hillssuperficial spinal musclesgluteus maximusquadratus lumborum

Hypersensitivity to Touchsuperficial spinal muscles

Liftingquadratus lumborum

Lying Down on Your Backgluteus medius

Lying Down on Your Sidequadratus lumborumgluteus minimusgluteus mediuspiriformis

Rising from a Low Chair or Car Seat

superficial spinal musclesgluteus minimusgluteus maximusquadratus lumborumpsoas/iliacuspiriformissemimembranosussemitendinosus

Side Bendingquadratus lumborumsuperficial spinal musclesabdominal obliquesdeep spinal muscles

Sittingquadratus lumborumpiriformisgluteus maximusgluteus mediussemimembranosussemitendinosuspelvic floorintrapelvic

Sit- Upspsoas/iliacus

Standingpsoas/iliacus quadratus lumborumgluteus minimus piriformis

Standing and Leaning Forwardquadratus lumborumsuperficial spinal muscles

Swayback (exaggerated lumbar curve)

psoasSwimming

gluteus maximusTurning Over in Bed

quadratus lumborumgluteus minimus

Twisting (rotation)quadratus lumborumsuperficial spinal musclesdeep spinal muscles

Upon Rising from Sitting or Lying Down Too Long

psoas/iliacusWalking

quadratus lumborumgluteus mediusgluteus minimuspiriformispsoas/iliacus

Sacroiliac Joint Dysfunction

gluteus minimussuperficial spinal musclesquadratus lumborumpelvic floor (coccygeus) gluteus mediuspiriformispsoas/iliacus

The Trigger Point Therapy Workbook Other Symptoms Guide: Midback, Low Back, and Buttocks

Sciaticapiriformis gluteus minimus vastus lateralis quadratus lumborum semimembranosus semitendinosus

TendernessBack

superficial spinal muscles Buttocks

gluteus maximus gluteus medius gluteus minimus greater trochanter of femur quadratus lumborum

Pelvis (top edge)gluteus medius sacroiliac joint quadratus lumborum sacrum gluteus medius

The Trigger Point Therapy Workbook Pain Illustrations Guide: Midback, Low Back, and Buttocks




Midback, Low Back, and Buttocks

Deep spinal muscles; examples of trigger points and pain patterns. Trigger points can occur anywhere along the spine.

Longissimus trigger points and referred pain pattern. All three points occur on both sides.

Iliocostalis trigger points and referred pain pattern. All three points occur on both sides.

Serratus posterior inferior trigger point and referred pain pattern

Quadratus lumborum superficial trigger points and referred pain pattern

Quadratus lumborum deep trigger points and referred pain pattern. These points are hidden underneath the superficial spinal muscles.

Gluteus maximus number 1 trigger point and referred pain pattern




The Trigger Point Therapy Workbook Pain Illustrations Guide: Midback, Low Back, and Buttocks


Gluteus medius number 1 trigger point and referred pain pattern



Gluteus minimus number 1 trigger point and referred pain pattern

Gluteus minimus number 2 trigger point and referred pain pattern

Piriformis number 1 trigger point and referred pain pattern

Piriformis number 2 trigger point and referred pain pattern

The Trigger Point Therapy Workbook Pain Guide: Hip, Thigh, and Knee



Groin pain

Outer thigh and hip pain

Inner thigh pain

Front of thigh pain

Back of thigh pain

Inner knee pain

Outer knee pain

Front of knee pain

Back of knee pain

The Trigger Point Therapy Workbook Pain Guide: Hip, Thigh, and Knee



Pain Guide

Hip, Thigh, and Knee


Back of Kneegastrocnemius biceps femorispopliteussemitendinosussemimembranosussoleusplantaris

Back of Thighgluteus minimussemitendinosussemimembranosusbiceps femorispiriformispelvic floor muscles (obturator internus)

Front of Kneerectus femorisvastus medialisadductor longus and brevis

Front of Thighadductor longus and brevispsoas/iliacusadductor magnusvastus intermediuspectineussartoriusquadratus lumborumrectus femoris

Groin (also see Genital) Painpectineusadductor longus and brevisabdominal obliquespsoas/iliacusrectus femoristensor fasciae latae

Inner Kneevastus medialisgracilisrectus femorissartoriusadductor longus and brevis

Inner Thighpectineusvastus medialisgracilisadductor magnussartorius

Outer Kneevastus lateralis

Outer Thigh and Hipgluteus minimusvastus lateralispiriformisquadratus lumborumtensor fasciae lataeadductor longus and brevisvastus intermediusgluteus maximus rectus femoris

The Trigger Point Therapy Workbook Other Symptoms Guide: Hip, Thigh, and Knee




Hip, Thigh, and KneeBaker’s Cyst (false)

biceps femoris popliteus plantaris

Numbness or TinglingThigh

piriformis sartorius

Pain or Trouble with MotionBuckling (weak) Knee

vastus medialis vastus intermedius with

gastrocnemius Buckling Hip

rectus femoris vastus intermedius

Crouchingpopliteus

Going Down Stairs or Hillsvastus medialis rectus femoris popliteus

Going Up Stairs or Hillsvastus intermedius vastus lateralis

Inability to Straighten Kneevastus lateralis popliteusvastus intermedius

Kicking toward Opposite Side (hip flexion and adduction)

pectineus

Limpinggluteus minimusvastus lateralisvastus intermediussemimembranosussemitendinosusbiceps femoris

Locking Kneevastus lateralis

Lying on Your Side: Pain in the Top Hip

tensor fasciae lataeLying on Either Side

gluteus minimustensor fasciae lataevastus lateralisadductor magnus

Rising from a Seated Positionpectineuspsoas/iliacusgluteus minimusvastus lateralisvastus intermediussemimembranosussemitendinosusbiceps femoris

Running: Behind the Kneepopliteus

Sharp Pain or Tingling in Thighssartorius

Sleeping: Interrupted by Painrectus femorisvastus medialisbiceps femorisvastus lateralis

Sitting: Hipsemimembranosussemitendinosuspiriformistensor fasciae lataebiceps femoris

Sitting: Lotus Positionpectineus

Standingsartorius

Standing Up Straightgluteus minimus

Stinging Pain: Inner Thighgracilis

Twisting at the Hipadductor longus

Walking: Hipquadratus lumborumtensor fasciae lataesartoriusgluteus minimuspiriformisvastus lateralis

Walking: Hip or Legsemimembranosussemitendinosus

Walking: Back of Kneebiceps femoris

Phantom Limb Pain or Pain with Prosthetic

rectus femorissemimembranosussemitendinosusbiceps femoris

The Trigger Point Therapy Workbook Other Symptoms Guide: Hip, Thigh, and Knee

Pubic Stress Symphysitispectineus

Reduced Range of MotionAbduction of Thigh (opening the legs)

adductor longusadductor magnuspectineus

Crossing Legstensor fasciae lataepiriformis

Extension (taking long strides)tensor fasciae lataepsoas/iliacuspectineus

External Rotation of Thigh (turning the feet and knees out)

tensor fasciae latae gluteus minimusgluteus mediusadductor longus

Inability to Touch Toessemimembranosussemitendinosusbiceps femoris

Knee Flexionvastus intermedius

TendernessHip

tensor fasciae lataeThigh

tensor fasciae lataevastus intermediusvastus lateralis

Trochanteric Bursitis (false)

tensor fasciae lataegluteus minimusvastus lateralis

The Trigger Point Therapy Workbook Pain Illustrations Guide: Hip, Thigh, and Knee




Hip, Thigh, and Knee

Tensor fasciae latae trigger points (in front and on the side) and referred pain pattern

Sartorius trigger points and referred pain pattern

Sartorius referred pain pattern near the knee

Rectus femoris number 1 trigger point and referred pain pattern

Rectus femoris number 2 trigger point and referred pain pattern

Vastus intermedius trigger point and referred pain pattern

Vastus medialis number 1 trigger point and referred pain pattern

Vastus medialis number 2 trigger point and referred pain pattern

Vastus lateralis number 2 trigger points and referred pain pattern

Vastus lateralis number 3 trigger point and referred pain pattern



The Trigger Point Therapy Workbook Pain Illustrations Guide: Hip, Thigh, and Knee


Vastus lateralis number 5 trigger point and referred pain pattern

Pectineus trigger point and referred pain pattern

Adductors longus and brevis trigger points and referred pain pattern

Adductor magnus number 1 trigger points and referred pain pattern

Adductor magnus number 2 trigger points and referred pain pattern

Plantaris trigger point and referred pain pattern

Popliteus trigger point and referred pain pattern

Biceps femoris trigger points and referred pain pattern

Semitendinosus and semimembranosus trigger points and referred pain pattern

Gracilis trigger points and referred pain pattern


The Trigger Point Therapy Workbook Pain Guide: Lower Leg, Ankle, and Foot



Lower Leg and Ankle

Front of leg pain

Front of ankle pain

Inner ankle pain

Back of leg pain Side of leg pain Back of ankle pain

Outer ankle pain




Pain Guide

Lower Leg and Ankle


Back of Anklesoleus tibialis posterior flexor digitorum longus

Back of Legsoleusgluteus minimusgastrocnemiussemitendinosussemimembranosusflexor digitorum longustibialis posteriorplantaris

Front of Ankletibialis anteriorperoneus tertiusextensor digitorum longus extensor hallucis longus

Front of Legtibialis anterior adductor longus

Inner Ankleabductor hallucis flexor digitorum longus soleus

Outer Ankleperoneus longus peroneus brevis abductor digiti minimi peroneus tertius

Side of Leggastrocnemius gluteus minimus peroneus longus peroneus brevis vastus lateralis




Foot Pain

Under big toe pain

Under smaller toes pain

Head of metatarsal pain

Arch and midfoot pain

Heel pain Top of foot pain Top of smaller toes pain

Top of big toe pain




Pain Guide

Foot


Arch and Midfootgastrocnemiusflexor digitorum longusadductor hallucissoleusabductor hallucistibialis posterior

Head of Metatarsalflexor hallucis brevisflexor digitorum brevisadductor hallucisflexor hallucis longusinterosseousabductor digiti minimiflexor digitorum longustibialis posteriorflexor digiti minimi brevis

Heelsoleusquadratus plantaeabductor hallucistibialis posteriorabductor digiti minimigastrocnemius

Top of Big Toetibialis anteriorextensor hallucis longusflexor hallucis brevis

Top of Footextensor digitorum brevisextensor hallucis brevisextensor digitorum longusextensor hallucis longusflexor hallucis brevisinterosseoustibialis anterior

Top of Smaller Toesinterosseousextensor digitorum longus

Under Big Toeflexor hallucis longusflexor hallucis brevistibialis posterior

Under Smaller Toesflexor digitorum longustibialis posterior





Lower Leg, Ankle, and Foot

Achilles Tendonitistibialis posterior soleus gastrocnemius

Ankle Sprainperoneus longusperoneus brevisperoneus tertius

Claw Toesflexor digitorum longus

Calf Crampsgastrocnemiusextensor digitorum longus

Hammertoesflexor digitorum longusextensor digitorum longus

Morton’s Foot Syndromeperoneus longusperoneus brevisperoneus tertiustibialis posteriorflexor digitorum longusflexor hallucis longus

Numbness and TinglingLower Leg and Foot

piriformisBig Toe

first interosseous

Toesflexor digiti minimi brevisflexor hallucis brevisadductor hallucisinterosseous

Top of the Footperoneus longus

Plantar Fasciitissoleusgastrocnemiusquadratus plantaeflexor digitorum brevisabductor hallucisabductor digiti minimi

Pain or Trouble with MovementAching Pain at Rest

abductor hallucisabductor digiti minimiflexor digitorum brevis

Ankletibialis anterior

Back of Knee Pain while Climbing Up Stairs or Hills

gastrocnemiussoleus

Difficulty Picking Things Up off of the Floor

soleusDorsiflexion (flexing foot)

soleustibialis anterior

Foot Droptibialis anteriorperoneus longusextensor digitorum longus

Foot Slaptibialis anteriorextensor digitorum longus

Pain and Swelling of Ankle and Foot

soleusRunning

soleustibialis posterior

Standingflexor digitorum longusflexor digitorum brevisflexor hallucis longus

Standing: Leaning Forwardgastrocnemius

Straightening the Knee with Foot Flexed

gastrocnemiusTripping

tibialis anteriorUnstable Ankle (also see Morton’s Foot)

peroneus longusperoneus brevisperoneus tertius

Walkingtibialis anterior tibialis posteriorgastrocnemius


soleusflexor digitorum longusflexor hallucis longusflexor digitorum brevisflexor hallucis brevis

Walking Down Stairs or Hillssoleus

Walking Fastsoleusgastrocnemius

Walking on Slanted Surfacegastrocnemius

Shin Splinttibialis anterior

TendernessAchilles Tendon

soleusAnkle

tibialis anteriorperoneus tertius

Big Toetibialis anterior

Bottom of Forefootadductor hallucisflexor digitorum longusflexor digitorum brevis

Heelsoleusquadratus plantae

Sides of the Toesinterosseous

Top of Feetextensor digitorum longusextensor hallucis longus

WeaknessAnkle

tibialis anteriorextensor digitorum longusperoneus longusperoneus brevisperoneus tertius

The Trigger Point Therapy Workbook Pain Illustrations Guide: Lower Leg, Ankle, and Foot




Lower Leg, Ankle, and Foot

Tibialis anterior trigger points and referred pain pattern

Extensor digitorum longus trigger point and referred pain pattern

Extensor hallucis longus trigger point and referred pain pattern

Peroneus longus trigger point and referred pain pattern

Peroneus brevis trigger point and referred pain pattern

Peroneus tertius trigger point and referred pain pattern

Gastrocnemius number 1 trigger point and referred pain pattern

Soleus number 2 trigger point and referred pain pattern

Other gastrocnemius trigger points and local pain pattern



Back edge of the tibia

Tibialis posterior trigger point and referred pain pattern


The Trigger Point Therapy Workbook Pain Illustrations Guide: Lower Leg, Ankle, and Foot

Abductor hallucis trigger points and referred pain pattern

Flexor digitorum brevis trigger points and referred pain pattern

Abductor digiti minimi trigger points and referred pain pattern

Flexor hallucis longus trigger point and referred pain pattern

Extensor digitorum brevis and extensor hallucis brevis trigger points and referred pain pattern

Sample interosseous trigger point and referred pain pattern. These muscles lie between each metatarsal.

Flexor digitorum longus trigger point and referred pain pattern

Quadratus plantae trigger point and referred pain pattern

Flexor digiti minimi brevis trigger point and referred pain pattern

Adductor hallucis trigger points and referred pain pattern

Flexor hallucis brevis trigger points and referred pain pattern


Documents

The Trigger Point Therapy Workbookcista.net/health/TriggerPointTherapyWkbk3_PainGuides_0.pdfThe Trigger Point Therapy Workbook Pain Guide: Head, Face, and Neck 01 Amber avies and Maria