Trigger Points/ Tender Points Flashcards by Chris Gothberg

What is a trigger point?

Hyperirritable locus within a taut band of skeletal muscle located in the muscular tissue or its associated fascia

How well did you know this?

Not at all

Perfectly

What are the 2 types of trigger points?

Active (Pain without palpation)

- Latent (Clinically silet, but restricts, weakens muscle, and predisposes it to acute attacks of pain)

How well did you know this?

Not at all

Perfectly

Upon who is trigger point mapping based?

JFK

How well did you know this?

Not at all

Perfectly

Is a Trigger Point a primary or secondary condition?

Can be either

How well did you know this?

Not at all

Perfectly

What are 4 direct causes of trigger points?

Acute overload (a specific event or movement)
Overwork/ overuse fatigue
Direct trauma
Chilling

How well did you know this?

Not at all

Perfectly

What are the 2 causes of overwork fatigue?

Repetitive contractions

- Sustained contractions

How well did you know this?

Not at all

Perfectly

What are 4 indirect causes of trigger points?

Overloaded synergistic muscles from primary muscle dysfunction
Visceral disease
Arthritic joints
Emotional distress

How well did you know this?

Not at all

Perfectly

How much do trigger points vary?

Extremely variable due to activity

- Latent can turn into active

How well did you know this?

Not at all

Perfectly

How do TrPs limit the movement of muscle?

Develop guarding habits that limit movement

How well did you know this?

Not at all

Perfectly

What type of autonomic changes may appear in the presence of Trigger Points?

Diaphoresis
Vascontriction
Changes in proprioception
Hair loss
etc…

How well did you know this?

Not at all

Perfectly

What are the 6 clinical signs used to diagnose a trigger point?

Weakness and restriction in the stretch of an affected muscle
A palpable taut band in the affected muscle
Severe focal tenderness to digital pressure
Twitch response following snapping or dry needling
Reproduction of pain
Elimination of symptoms targeting specific muscle

How well did you know this?

Not at all

Perfectly

What is the goal of trigger point therapy?

Inactivate trigger point decreasing referred pain

How well did you know this?

Not at all

Perfectly

What are 3 methods of trigger point treatment?

Manual technique
Needling w/ or w/o medicaiton
Dry needling

How well did you know this?

Not at all

Perfectly

How much pressure should be applied through digital palpation to assess trigger points?

Approximately 4 kg

How well did you know this?

Not at all

Perfectly

How many tender points need to be present for a diagnosis of fibromyalgia?

11 of 18 sites

How well did you know this?

Not at all

Perfectly

What are the 18 sites of tender points?

Bilateral at suboccipital muscle insertions
Bilateral anterior aspects of the intertransverse spaces at C5 - C7
Bilateral trapezius at midpoints and upper boarders
Bilateral medial supraspinaltus
Bilateral second rib at the 2nd costochondral junctions lateral to junctions of upper surfaces
Bilaterally 2 cm distal to humeral epicondyles
Bilateral outer quadrants of buttocks in anterior fold of muscle
Bilateral greater trochanter near trochanteric prominence
Bilateral medial fat pad proximal to the joint line of knee

How well did you know this?

Not at all

Perfectly

Are tender or trigger points exclusively muscle?

Trigger points

How well did you know this?

Not at all

Perfectly

Who developed the counterstrain/ positional release method?

Jones

How well did you know this?

Not at all

Perfectly

What is the theory behind positional release?

Decreases sensitivity of the muscle spindle to stretch, which decreases the excitability of extrafusal muscle fibers

How well did you know this?

Not at all

Perfectly

Does a trigger point or tender point illicit a local twitch response?

Trigger points

How well did you know this?

Not at all

Perfectly

Does a trigger point or tender point illicit a local tenderness on palpation?

Both

Can a trigger point or tender point be singular?

Only a trigger point

Does a tender point or trigger point occur in specific locations?

Tender point

Does a trigger point or tender point cause a specific referred pain pattern?

Trigger point

Does a trigger point or tender point increase the body's overall sensitivity to pain?

Tender point

What is the referred pain pattern of the SCM?

- Occiput/ occipital headaches - Ear - Eye - Cheek - Frontal area/ frontal headaches - Throat - Sternum

What are 3 autogenic symptoms of the SCM?

- Tinnitus - Blurred vision - Postural dizziness

What type of grip is used when performing TrP therapy on the SCM?

- Pincer

What should be avoided when performing TrP therapy on the SCM?

- The carotid artery and jugular vein

What are the stretch positions that follow TrP therapy of the SCM?

Clavicular head: Neck extension, side bending, and rotation to the opposite side Sternal: Neck extension, side-bending to the opposite side, rotation to the same side of the stretched muscle

What is the positive stretch sign of the SCM?

- Pain at occipital base and upper c-spine of side opposite stretch

What muscle is usually involved in TrPs of the SCM?

- The scalenes

What postural imbalance is typically present if the Scalenes and TrPs develop trigger points?

T-spine/ forward neck posture

Besides posture, what else may lead to TrPs of the SCM?

- Whiplash injury

What occupations may lead to development of SCM trigger points?

- Those that require constant or repetitive forward neck bending

What sleeping modification can be made to prevent SCM TrPs?

- Pillow positioning

What is a common HEP for SCM TrPs?

- Maintain shoulder in depression (hold onto table | - Use MFS positions

What is the referred pain pattern for the Scalenes?

- Neck - Pectoral region - Medial border of scapula - Front and back of arm - Radial surface of the forearm - Index finger and thumb

What grip is used for TrPs in the Scalenes?

- Thumb or four fingesr | - Palpated against transverse processes

What is the stretch for the Scalenes following TrP treatment?

- Neck side-bending with moderate extension | - Stabilize scapula by holding onto chair

What is the positive stretch sign for the scalenes?

- Pain on ipsilateral cervical spine

What are 3 mechanisms of injury for the Scalenes?

- Whiplash - Over respiration - Muscular imbalance between the SCM and scalenes causing forward neck posture

What is the referred pain pattern for the suboccipitals?

- Occipital headaches - Deep headaches - Pain behind the eye

What stretch technique is coupled with TrP of the suboccipitals?

- Suboccipital decompression technique | - Chin tuck with upper cervical traction

What is the positive stretch sign for the suboccipitals?

- There is none

What are 3 mechanisms of injury for the suboccipitals?

- Forward head posture with posterior rotation of the occiput - Prone position for a prolonged period with hands support the head (watching TV or reading a book) - Excessive use of binoculars or eye glasses that require adjustment may cause a short hyperextension of the neck

What is the referred pain pattern of the upper trapezius?

- Posterolateral neck - Behind ear - Temporal area/ temporal headaches - To zygomatic arches

What is the stretch coupled with TrP therapy of the upper trapezius?

- Neck flexion - Side-bending towards opposite side - Slight rotation to ipsilateral side

What is the positive stretch sign of the upper trapezius?

- Pain at the opposite side during a stretch

What is the HEP stretch for the patient for an upper trapezius TrP?

- Pt sitting and holding ipsilateral shoulder in depression by gripping under the table with their hand - Use other hand to flex, contralaterally sidebend, and ipsilaterally rotate the neck to the same side

What are 3 mechanisms of injury of the upper trapezius muscle?

- Stabilizing phone between head and shoulder - Carrying heavy bags with strap over shoulder - Armchairs or wheelchairs with high arm supports or no supports