Quick Reference to
Trigger Points
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Revised 5th Edition
Trail Guide
to the Body’s
Quick Reference to
Trigger Points
2nd Edition
DISCOVER
ANDREW BIEL
Trail Guide
to the Body’s
Quick Reference to
Trigger Points
2nd Edition
ANDREW BIEL
Illustrations by
ROBIN DORN
Second Edition
Copyright © 2012, 2019 text, illustrations by Books of Discovery.
All rights reserved. No part of this book may be reproduced in
any form, or by any electronic, mechanical or other means,
without prior permission in writing from the publisher.
Published by Books of Discovery
2539 Spruce Street
Boulder, CO 80302 USA
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800.775.9227
ISBN: 978-0-9987850-8-0
Printed in South Korea by Four Colour Print Group
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Design: Jessica Xavier, Planet X Design
Colorist: Dana Ecklund
Disclaimer
This book does not offer medical advice to the reader and is not
intended as a replacement for appropriate health care and treatment.
For such advice, readers should consult a licensed physician.
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 1
Flexor Carpi Ulnaris . . . . . . . . . . . . . . . . 35
Shoulder & Arm
Flexor Digitorum .
Superficialis and Profundus . . . . . . . 36
3
Deltoid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Trapezius . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Latissimus Dorsi . . . . . . . . . . . . . . . . . . . . 8
Teres Major . . . . . . . . . . . . . . . . . . . . . . . . . 9
Supraspinatus . . . . . . . . . . . . . . . . . . . . . 10
Infraspinatus . . . . . . . . . . . . . . . . . . . . . . . 11
Teres Minor . . . . . . . . . . . . . . . . . . . . . . . . 12
Subscapularis . . . . . . . . . . . . . . . . . . . . . 13
Pronator Teres . . . . . . . . . . . . . . . . . . . . . 37
Supinator . . . . . . . . . . . . . . . . . . . . . . . . . 38
Adductor Pollicis . . . . . . . . . . . . . . . . . . . 39
Flexor Pollicis Longus . . . . . . . . . . . . . . . 41
Dorsal Interossei . . . . . . . . . . . . . . . . . . . 42
Spine & Thorax
43
Iliocostalis . . . . . . . . . . . . . . . . . . . . . . . . . 43
Rhomboid Major and Minor . . . . . . . . . . 14
Longissimus Thoracis . . . . . . . . . . . . . . 44
Levator Scapula . . . . . . . . . . . . . . . . . . . . 15
Multifidi and Rotatores . . . . . . . . . . . . . .46
Serratus Anterior . . . . . . . . . . . . . . . . . . 16
Semispinalis Capitis . . . . . . . . . . . . . . . . 47
Sternalis . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Splenius Capitis . . . . . . . . . . . . . . . . . . . . 48
Pectoralis Major . . . . . . . . . . . . . . . . . . . . 18
Splenius Cervicis . . . . . . . . . . . . . . . . . . . 49
Pectoralis Minor . . . . . . . . . . . . . . . . . . . 20
Suboccipitals . . . . . . . . . . . . . . . . . . . . . . 50
Subclavius . . . . . . . . . . . . . . . . . . . . . . . . 21
Quadratus Lumborum . . . . . . . . . . . . . . 51
Biceps Brachii . . . . . . . . . . . . . . . . . . . . . 22
Rectus Abdominis .
and External Oblique . . . . . . . . . . . . . 53
Triceps Brachii . . . . . . . . . . . . . . . . . . . . . 23
Coracobrachialis . . . . . . . . . . . . . . . . . . . 25
Serratus Posterior Superior . . . . . . . . . 55
Serratus Posterior Inferior . . . . . . . . . . 56
Forearm & Hand
27
Brachialis . . . . . . . . . . . . . . . . . . . . . . . . . 27
Brachioradialis . . . . . . . . . . . . . . . . . . . . . 28
Extensor Carpi Radialis .
Head, Neck & Face
57
Sternocleidomastoid . . . . . . . . . . . . . . . 57
Scalenes . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Longus and Brevis . . . . . . . . . . . . . . . 29
Masseter . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Extensor Carpi Ulnaris . . . . . . . . . . . . . . 30
Temporalis . . . . . . . . . . . . . . . . . . . . . . . . 63
Extensor Digitorum and .
Extensor Indicis . . . . . . . . . . . . . . . . . . 31
Digastric . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Flexor Carpi Radialis . . . . . . . . . . . . . . . . 33
Medial Pterygoid . . . . . . . . . . . . . . . . . . . 66
Palmaris Longus . . . . . . . . . . . . . . . . . . . 34
Lateral Pterygoid . . . . . . . . . . . . . . . . . . . 67
Occipitofrontalis . . . . . . . . . . . . . . . . . . . 65
iii
Pelvis & Thigh
69
Rectus Femoris . . . . . . . . . . . . . . . . . . . . 69
Vastus Medialis . . . . . . . . . . . . . . . . . . . . 70
Vastus Lateralis . . . . . . . . . . . . . . . . . . . . . 71
Vastus Intermedius . . . . . . . . . . . . . . . . . 74
Biceps Femoris . . . . . . . . . . . . . . . . . . . . 75
Semitendinosus .
and Semimembranosus . . . . . . . . . . 76
Gluteus Maximus . . . . . . . . . . . . . . . . . . 77
Gluteus Medius . . . . . . . . . . . . . . . . . . . . 79
Gluteus Minimus . . . . . . . . . . . . . . . . . . . 81
Adductor Magnus . . . . . . . . . . . . . . . . . . 83
Adductor Longus and Brevis . . . . . . . . 84
Pectineus . . . . . . . . . . . . . . . . . . . . . . . . . 85
Tensor Fasciae Latae . . . . . . . . . . . . . . . 86
Sartorius . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Piriformis . . . . . . . . . . . . . . . . . . . . . . . . . 88
Iliopsoas . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Leg & Foot
91
Gastrocnemius . . . . . . . . . . . . . . . . . . . . 91
Soleus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
iv
Contents
Plantaris . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Popliteus . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Fibularis Longus and Brevis . . . . . . . . . 96
Fibularis Tertius . . . . . . . . . . . . . . . . . . . . 97
Tibialis Anterior . . . . . . . . . . . . . . . . . . . . 98
Extensor Digitorum Longus . . . . . . . . . 99
Extensor Hallucis Longus . . . . . . . . . . 100
Tibialis Posterior . . . . . . . . . . . . . . . . . . 101
Flexor Digitorum Longus . . . . . . . . . . . 102
Flexor Hallucis Longus . . . . . . . . . . . . . 103
Extensor Digitorum Brevis . . . . . . . . . 104
Flexor Digitorum Brevis . . . . . . . . . . . . 105
Abductor Hallucis . . . . . . . . . . . . . . . . . 106
Abductor Digiti Minimi . . . . . . . . . . . . . 107
Extensor Hallucis Brevis . . . . . . . . . . . 108
Flexor Hallucis Brevis . . . . . . . . . . . . . . 109
Adductor Hallucis . . . . . . . . . . . . . . . . . 110
Quadratus Plantae . . . . . . . . . . . . . . . . . 111
Recommended Texts . . . . . . . . . . . . . . . 113
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Differential Diagnosis Index . . . . . . . . . . 117
Introduction
Our flagship text, Trail Guide to the Body: A hands-on guide to locating muscles,
bones, and more deals with the subject of palpatory anatomy. The intent of this
Quick Reference is to provide students and practitioners with a quick reference
guide to trigger points. Please see page 112 for a list of recommended texts that cover
trigger points in detail.
A trigger point is a “hyperirritable spot in skeletal muscle.” These sensitive points
of tissue are often associated with palpable nodules in taut muscle fibers and, when
compressed, elicit referred pain, local tenderness, or a twitch response.
An activated trigger point can often radiate a consistent pain pattern, often
referring distally. For example, the trigger points of the pectoralis minor can radiate
pain through the pectoral region and down the medial surfaces of the arm, forearm,
and hand.
Trigger points commonly originate at the midpoint of a muscle’s fibers.
Understanding the design of a muscle’s fibers will help you determine where the
trigger points are located.
Several pieces of information regarding each muscle’s trigger points have been
provided:
• An “X” indicates a common location where
a trigger point can be found in a particular
muscle belly. (An “X” may vary in size and
color to aid with visibility and in proportion
to the image.)
• Possible Causes of trigger points include
postural patterns, traumas, and overuse or
underuse actions.
• Symptoms/Indications cover the types of
pains or discomforts that the patient may be
feeling. For example, the symptoms of the
serratus anterior’s trigger points may include
chest pain and shortness of breath.
• Pain Patterns (also shown in corresponding
images) are the areas where the radiating
pain of a trigger point is felt.
Pectoralis minor trigger
points
• An Associated Trigger Point (TP) is a
trigger point in one muscle that occurs
simultaneously with a trigger point in another
muscle. One point may cause the other, or they both may be induced by the
same neurologic or mechanical origin.
• Differential Diagnoses cover other conditions or dysfunctions that may present
similar signs and symptoms as a trigger point’s referred pain pattern. For example,
pain manifested by trigger points of the masseter could be confused with pain
stemming from a toothache. But please be aware that the pain pattern from an
assumed trigger point could actually be a serious malady, such as a heart attack or
other life-threatening condition.
Introduction
1
Shoulder & Arm
Shoulder & Armx
Deltoid
Possible Causes
Impact trauma during sports or other activities
Repetitive strain during prolonged lifting
Excessive poling while skiing
Symptoms/Indications
Difficulty abducting shoulder to a
horizontal position
Pain deep in the deltoid area
Pain Patterns
Anterior, lateral, and posterior
sides of the shoulder
Lateral views of right shoulder and
arm showing common locations of
trigger points of the deltoid
Shoulder & Arm
3
Deltoid
Associated TPs
Pectoralis major
Biceps brachii
Other sections of the deltoid
Differential Diagnoses
Rotator cuff tear
Bicipital tendinitis
Subacromial/subdeltoid bursitis
Glenohumeral joint arthritis
Lateral view of right
shoulder and arm
Anterior view of right
shoulder and arm
Posterior view of right
shoulder and arm
4
Quick Reference to Trigger Points
Shoulder & Arm
Trapezius
Possible Causes
Sudden trauma, such as falling
Whiplash injury
Walking with cane
Arm rests in high position
Symptoms/Indications
Severe neck pain
Headache
“Stiff neck”
Pain Patterns
Angle of mandible
Temporal region
Lateral and posterior sides of neck
Upper back
Medial border of scapula
Lateral views
Shoulder & Arm
5
Trapezius
Associated TPs
Temporalis
Occipitalis
Masseter
Pectoralis major and minor
Levator scapula
Differential Diagnoses
Temporomandibular joint disorder
TPs of masticatory muscles
Fibromyalgia
Posterior views
6
Quick Reference to Trigger Points
Shoulder & Arm
Posterior views
Shoulder & Arm
7
Latissimus Dorsi
Possible Causes
Associated TPs
Repetitive shoulder extension
Throwing a baseball
Hanging from a swing
Pulling weeds
Symptoms/Indications
Pain when stretching upward
or far out in front of the body
Pectoralis major
Teres major
Subscapularis
Differential Diagnoses
Entrapment of suprascapular nerve
Bicipital tendinitis
Ulnar neuropathy
Pain Patterns
Region inferior to scapula
Radiating and skipping down
posterior arm to pinkie and
ring finger
Posterior views of right
thorax and arm
Anterior view of
right shoulder and
arm
8
Quick Reference to Trigger Points
Possible Causes
Driving without power steering
Reaching overhead and forward
to lift heavy object
Symptoms/Indications
Pain upon muscle activation
Slight restriction in
overhead range
Shoulder & Arm
Teres Major
Associated TPs
Latissimus dorsi
Long head of the triceps brachii
Differential Diagnoses
Subacromial/subdeltoid bursitis
Supraspinatus tendinitis
Thoracic outlet syndrome
Pain Patterns
Posterior shoulder
Radiates down posterior arm
and forearm
Posterior views of right
shoulder and arm
Anterior view
of right side of
shoulder and arm
Shoulder & Arm
9
Supraspinatus
Possible Causes
Carrying heavy objects that pull
inferiorly, such as a suitcase
Walking a big dog that pulls
hard on the leash
Lifting heavy object above
shoulder height
Symptoms/Indications
Pain during shoulder abduction
Severe, sleep-disturbing pain
Stiffness of the shoulder
Snapping or clicking sounds
at the shoulder
Pain Patterns
Top of shoulder
Lateral arm to wrist
Associated TPs
Infraspinatus
Trapezius
Deltoid
Differential Diagnoses
Cervical arthritis
Spurs with nerve root irritation
Brachial plexus injuries
Subacromial/subdeltoid bursitis
Rotator cuff tear
Posterior views of right
shoulder and arm
10
Quick Reference to Trigger Points
Possible Causes
Acute stress or multiple
overload stress
Reaching arm behind and away
Twisting arm during a fall
Symptoms/Indications
Pain when brushing teeth
or combing hair
Inability to medially rotate and
adduct shoulder simultaneously
Inability to sleep on painful side
Shoulder & Arm
Infraspinatus
Pain Patterns
Most intense in shoulder
Lateral arm, forearm, and hand
Associated TPs
Teres minor
Anterior deltoid
Supraspinatus
Biceps brachii
Differential Diagnoses
Suprascapular nerve entrapment
Bicipital tendinitis
Scapulohumeral dysfunction
Glenohumeral joint arthritis
Posterior views
of right shoulder
and arm
Anterior view of
right shoulder and
arm
Shoulder & Arm
11
Teres Minor
Possible Causes
Reaching behind shoulder
in extension
Motor vehicle accident
Reaching overhead, such as
when playing volleyball
Symptoms/Indications
Posterior shoulder pain
Pain Patterns
Posterior shoulder and arm
Associated TPs
Infraspinatus
Differential Diagnoses
Compression of the axillary nerve
Subacromial/subdeltoid bursitis
Ulnar neuropathy
Acromioclavicular joint separation
Posterior views of right
shoulder and arm
12
Quick Reference to Trigger Points
Possible Causes
Repeated, forceful medial rotation,
such as swimming or pitching
Repeated overhead lifting
Dislocation of glenohumeral joint
Prolonged immobilization of shoulder
Symptoms/Indications
Pain when arm at rest and in motion
Restricted abduction of shoulder
Inability to reach across to
opposite armpit
Shoulder & Arm
Subscapularis
Pain Patterns
Posterior shoulder, radiating
over scapula
Posterior arm, skipping to wrist
Associated TPs
Pectoralis major
Teres major
Latissimus dorsi
Long head of the triceps brachii
Differential Diagnoses
Rotator cuff tear
Adhesive capsulitis
Thoracic outlet syndrome
Anterior view of right
shoulder and arm
Posterior view of right
shoulder and arm
Shoulder & Arm
13
Rhomboid Major and Minor
Possible Causes
Painting overhead
Prolonged leaning forward
Rounded shoulder position,
such as when writing or sewing
Symptoms/Indications
Superficial aching pain at rest
Snapping, crunching noises during
movement of the scapula
Associated TPs
Scalenes
Levator scapula
Middle trapezius
Infraspinatus
Differential Diagnoses
Fibromyalgia
Scapulocostal dysfunction
Pain Patterns
Medial border and superior
region of scapula
Posterior views of right
shoulder and arm
14
Quick Reference to Trigger Points
Possible Causes
Occupational stresses
Typing with head and neck turned
Holding the phone between ear
and shoulder
Sleeping with neck in tilted position
Walking with cane
Symptoms/Indications
Pain at the angle of neck
“Stiff neck”
Torticollis
Unable to turn head fully to same
side or opposite side
Shoulder & Arm
Levator Scapula
Pain Patterns
Posterior shoulder and neck
Medial border of scapula
Associated TPs
Trapezius
Rhomboids
Splenius capitis
Differential Diagnoses
Splenius cervicis TPs
Scapulocostal dysfunction
Sternocleidomastoid TPs
Posterior views
Shoulder & Arm
15
Serratus Anterior
Possible Causes
Excessively fast or prolonged running
Push-ups
Lifting heavy weights overhead
Severe coughing
Symptoms/Indications
Chest pain
“Stitch in side” while running
Unable to lie on affected muscle
Shortness of breath
Pain Patterns
Lateral side of thorax, below axilla
Radiating down medial side of arm
to hand
Associated TPs
Pectoralis major
Sternocleidomastoid
Middle scalene
Differential Diagnoses
Costochondritis
Intercostal nerve entrapment
Herpes zoster
Broken rib
Lateral views of right
shoulder and arm
Anterior view of right
shoulder and arm
16
Quick Reference to Trigger Points
Possible Causes
Acute myocardial infarction
Angina pectoris
Direct trauma to chest
Symptoms/Indications
Intense deep substernal pain
Soreness over the sternum
Shoulder & Arm
Sternalis
Associated TPs
Pectoralis major
Sternocleidomastoid
Differential Diagnoses
Costochondritis
Cardiac disease
Pain Patterns
Heart-shaped over center
of chest
Radiates down anterior shoulder to
medial arm
Anterior views of thorax
Shoulder & Arm
17
Pectoralis Major
Possible Causes
Symptoms/Indications
Rounded shoulder posture
Chronic shortening of the muscle
Heavy lifting
Overuse of shoulder adduction
Immobilization of arm
Anterior views of right
shoulder and arm
18
Quick Reference to Trigger Points
Activation of
sternocleidomastoid TPs
Pain in front of shoulder
Pain over the pericardium
Limited abduction at the shoulder
Pain Patterns
Shoulder & Arm
Pectoralis Major
Differential Diagnoses
Anterior shoulder
Entire pectoral region
Medial side of arm, down
to medial forearm
Angina pectoris
Tear of muscle
Bicipital/supraspinatus
tendinitis
Associated TPs
Latissimus dorsi
Teres major
Subscapularis
Anterior views of right
shoulder and arm
Shoulder & Arm
19
Pectoralis Minor
Possible Causes
Pain Patterns
Rounded shoulders
Trauma, such as recoil from rifle
Strain from overuse as a
shoulder depressor
Strain during inhalation
Symptoms/Indications
Major complaint is pain over the
anterior deltoid region
Difficulty reaching forward and up
Neurovascular symptoms through
entrapment of neurovascular
bundle
Anterior chest
Concentrated in anterior shoulder
Radiates down medial side of arm
to fingertips
Associated TPs
Pectoralis major
Anterior deltoid
Scalenes
Sternocleidomastoid
Differential Diagnoses
Anterior views of right
shoulder and arm
20
Quick Reference to Trigger Points
Thoracic outlet syndrome
C-7, C-8 radiculopathy
Bicipital/supraspinatus tendinitis
Shoulder & Arm
Subclavius
Symptoms/Indications
Thoracic outlet syndrome
Pain Patterns
Inferior to clavicle
Anterior arm
Lateral forearm and hand
Anterior views of right
shoulder and arm
Shoulder & Arm
21
Biceps Brachii
Possible Causes
Pain Patterns
Elevation of arm above shoulder level
Overstress during activities, such as
strong tennis backhand or lifting
a heavy object with palm of
hand facing upward
Repeated supination
Symptoms/Indications
Superficial, anterior shoulder pain
Tenderness over bicipital tendon
Weakness raising hand above
the head
Anterior views of right
shoulder and arm
22
Quick Reference to Trigger Points
Anterior shoulder down to anterior
surface of elbow
Associated TPs
Brachialis
Supinator
Triceps brachii
Differential Diagnoses
Bicipital tendinitis
Subacromial/subdeltoid bursitis
Bicipital bursitis
Glenohumeral joint arthritis
Possible Causes
Excessive city driving with
manual transmission
Overenthusiastic exercise
Needlepoint without elbow support
Shoulder & Arm
Triceps Brachii
Pain Patterns
Posterior shoulder
Posterior arm and forearm down to
pinkie and ring finger
Symptoms/Indications
Difficult to locate pain in
posterior shoulder
Inability to fully extend elbow
Posterior views
Shoulder & Arm
23
Triceps Brachii
Associated TPs
Differential Diagnoses
Latissimus dorsi
Teres major
Teres minor
Posterior views
24
Quick Reference to Trigger Points
Entrapment of radial nerve
“Tennis elbow”
Lateral or medial epicondylitis
Shoulder & Arm
Coracobrachialis
Possible Causes
Active trigger points in the anterior
deltoid, biceps brachii, and
pectoralis major
Symptoms/Indications
Pain with shoulder extension
Upper limb pain
Pain Patterns
Anterior shoulder, skipping
down posterior arm, forearm,
and hand
Differential Diagnoses
Subacromial/subdeltoid bursitis
Supraspinatus tendinitis
Acromioclavicular joint dysfunction
Carpal tunnel syndrome
Anterior views of right
shoulder and arm
Posterior view of right
shoulder and arm
Shoulder & Arm
25
Forearm & Handx
Brachialis
Overload of forearm flexion
during heavy lifting
“Tennis elbow”
Symptoms/Indications
Radial nerve entrapment
Soreness of the thumb
Pain over anterior deltoid
Pain Patterns
Associated TPs
Biceps brachii
Brachioradialis
Supinator
Forearm & Hand
Possible Causes
Differential Diagnoses
C-5, C-6 radiculopathy
Bicipital tendinitis
Supraspinatus tendinitis
Carpal tunnel syndrome
Anterior shoulder
Inner elbow
Thenar eminence
Anterior views of right
shoulder and arm
Dorsal view of
right hand
Forearm & Hand
27
Brachioradialis
Possible Causes
Pain Patterns
Repetitive, forceful gripping, such
as weeding with a trowel or
scraping ice off a windshield
Continual re-injury of area
Symptoms/Indications
Pain in lateral epicondyle, spreading
to wrist and hand
“Tennis elbow”
Weakness of grip
Pain and limited movement
Lateral elbow
Lateral forearm to dorsal side
of thenar eminence
Associated TPs
Extensor carpi radialis longus
and brevis
Extensor digitorum
Supinator
Differential Diagnoses
Lateral epicondylitis
C-5, C-6 radiculopathy
Carpal tunnel syndrome
Lateral views .
of right hand
28
Quick Reference to Trigger Points
Extensor Carpi Radialis Longus and Brevis
Possible Causes
Pain Patterns
Repetitive, forceful gripping, such
as weeding with a trowel or
scraping ice off a windshield
Continual re-injury of area
Longus
Posterior elbow, forearm, and hand
Dorsal thenar eminence
Brevis
Dorsal wrist and hand
Symptoms/Indications
Forearm & Hand
Associated TPs
Pain in lateral epicondyle,
spreading to wrist and hand
“Tennis elbow”
Weakness of grip
Pain and limited movement
Extensor digitorum
Supinator
Brachioradialis
Differential Diagnoses
Lateral epicondylitis
C-7, C-8 radiculopathy
Carpal tunnel syndrome
Extensor carpi
radialis longus
Extensor carpi
radialis brevis
Posterior view of right forearm, showing TP
of extensor carpi radialis longus
Posterior view of right forearm, showing TP .
of extensor carpi radialis brevis
Forearm & Hand
29
Extensor Carpi Ulnaris
Possible Causes
Gross trauma, such as fracture of ulna
Prolonged immobilization
Symptoms/Indications
Pain in lateral epicondyle,
spreading to wrist and hand
“Tennis elbow”
Weakness of grip
Pain and limited movement
Pain Patterns
Ulnar surface of wrist
Associated TPs
Extensor digitorum
Differential Diagnoses
C-7, C-8 radiculopathy
Arthritis
Extensor carpi
ulnaris
Posterior view of
right hand
30
Quick Reference to Trigger Points
Extensor Digitorum and Extensor Indicis
Pain Patterns
Forceful or repetitive wrist
or finger extension
Fracture of forearm
Symptoms/Indications
Weakness of grip, accompanied by
pain in the elbow
Pain on lateral elbow
Stiffness and painful cramping
of the fingers
Digitorum
Posterior forearm to middle and ring
fingers
Anterior wrist
Indicis
Dorsal surface of wrist to index
finger
Forearm & Hand
Possible Causes
Extensor
digitorum
Posterior view of right arm and hand (left),
anterior view (right); showing TP and pain
pattern of extensor digitorum
Forearm & Hand
31
Extensor Digitorum and Extensor Indicis
Associated TPs
Extensor carpi ulnaris
Differential Diagnoses
“Tennis elbow”
C-7 radiculopathy
Subluxations of carpal bones
Extensor
digitorum
Extensor
indicis
Posterior view of right arm and
hand, showing TP and pain pattern
of extensor digitorum
Posterior view of right hand, .
showing TP of extensor indicis
32
Quick Reference to Trigger Points
Flexor Carpi Radialis
Possible Causes
Acute or chronic overloading
of the muscle
Excessive gripping movements, such
as gripping steering wheel over
long drives
Forearm & Hand
Symptoms/Indications
Difficulty using scissors
Pain Patterns
Palmar surface of wrist and hand
Associated TPs
Surrounding flexor muscles
Differential Diagnoses
Medial epicondylitis
Ulnar neuropathy
Carpal tunnel syndrome
Arthritis of wrist
Anterior view of right
arm and hand
Forearm & Hand
33
Palmaris Longus
Possible Causes
Pain Patterns
Direct trauma
Fall onto an outstretched hand
Tool pressed into a cupped hand
Leaning on a cane
Anterior forearm
Palm of hand
Associated TPs
Hand and finger flexors
Symptoms/Indications
Difficulty handling tools (pressure
of tool in hand causes pain)
Tenderness in palm
Differential Diagnoses
Carpal tunnel syndrome
Anterior views of right
arm and hand
34
Quick Reference to Trigger Points
Flexor Carpi Ulnaris
Possible Causes
Acute or chronic overloading
of the muscle
Excessive gripping movements,
such as gripping steering wheel
over long drives
Forearm & Hand
Symptoms/Indications
Difficulty using scissors
Pain Patterns
Medial surface of wrist and hand
Associated TPs
Surrounding flexor muscles
Differential Diagnoses
Medial epicondylitis
Ulnar neuropathy
Carpal tunnel syndrome
Arthritis of wrist
Anterior view of right
arm and hand
Forearm & Hand
35
Flexor Digitorum Superficialis and Profundus
Possible Causes
Acute or chronic overloading
of the muscle
Excessive gripping movements,
such as gripping steering wheel
over long drives
Symptoms/Indications
Difficulty using scissors
Pain Patterns
Palmar surface of hand into middle,
ring, and pinkie fingers (and beyond)
Associated TPs
Surrounding flexor muscles
Differential Diagnoses
Medial epicondylitis
Ulnar neuropathy
Carpal tunnel syndrome
Arthritis of wrist
Anterior view of right arm and
hand, showing TPs of flexor
digitorum superficialis
36
Quick Reference to Trigger Points
Flexor
digitorum
superficialis
Pronator Teres
Fracture at the wrist or elbow
Prolonged typing
Symptoms/Indications
Unable to supinate forearm
Pain Patterns
Anterior surface of forearm,
concentrated at wrist
Associated TPs
Finger flexors
Scalenes
Forearm & Hand
Possible Causes
Differential Diagnoses
Carpal tunnel syndrome
Anterior views
of right arm and
hand
Forearm & Hand
37
Supinator
Possible Causes
Pain Patterns
Resisting unexpected pronation
Extremely forceful supination
Forceful and repetitive supination
of the forearm
Carrying heavy suitcase
Symptoms/Indications
Lateral epicondylar pain
Pain in web of thumb
Lateral elbow
Dorsal surface of thenar eminence
Associated TPs
Triceps brachii
Extensors of the fingers
Brachioradialis
Differential Diagnoses
“Tennis elbow”
Entrapment of the posterior
interosseous nerve
Anterior view (left), posterior view
(right) of right arm and hand
38
Quick Reference to Trigger Points
Adductor Pollicis
Pulling weeds
Milking animals
Repetitive fine movements
of thumb
Former bone injury
“Trigger thumb”
Symptoms/Indications
Thumb feels uncoordinated
Poor handwriting
Difficulty with fine movements
for specific tasks
Pain Patterns
All sides of the thumb and
thenar eminence
Forearm & Hand
Possible Causes
Palmar view of right
hand
Forearm & Hand
39
Adductor Pollicis
Associated TPs
First dorsal interossei muscle
Flexor pollicis brevis
Abductor pollicis brevis
Differential Diagnoses
Carpal tunnel syndrome
Carpometacarpal osteoarthritis
Palmar view of right hand
Dorsal view of right hand
40
Quick Reference to Trigger Points
Flexor Pollicis Longus
Possible Causes
Milking animals
Excessive weeding with clippers or other
hand tools
Forceful grasping joined with rocking,
twisting motions
Forearm & Hand
Symptoms/Indications
Difficulty using scissors
Pain in thumb
Pain Patterns
Length of thumb
Differential Diagnoses
Medial epicondylitis
Ulnar neuropathy
Carpal tunnel syndrome
Arthritis of wrist
Anterior view of right .
arm and hand
Forearm & Hand
41
Dorsal Interossei
Possible Causes
Sustained or repetitive
pincer grasping
Playing the piano
Sustained forceful finger
movements
Symptoms/Indications
Arthritis pain in the fingers
Stiffness in the fingers
Sore, swollen joints
Dorsal view of right
hand, showing TP and
pain pattern of first
interossei
Pain Patterns
First interossei
Index and pinkie fingers
Dorsal surface of hand
Second interossei
Middle finger
Associated TPs
Intrinsic thumb muscles
Long extensors and flexors of fingers
Differential Diagnoses
C-6 radiculopathy
Ulnar neuropathy
Nerve entrapment of brachial plexus
Palmar view of
right hand, showing
pain pattern of first
interossei
Dorsal view of right
hand, showing TPs and
pain pattern of second
interossei
42
Quick Reference to Trigger Points
Spine & Thoraxx
Iliocostalis
Possible Causes
Sudden overload or traumatic event
Repeated muscular contraction
Quick bending and twisting
Prolonged immobility, such as sitting
on a plane
Symptoms/Indications
Pain in the back
Restricted spinal movement
Difficulty rising from chair and/or
climbing stairs
Spine & Thorax
Pain Patterns
Entire length of back next to vertebrae,
radiating into the region
of scapula, lower ribs, and buttocks
Posterior view
Spine & Thorax
43
Iliocostalis
Associated TPs
Latissimus dorsi
Quadratus lumborum
Serratus posterior inferior
and superior
Differential Diagnoses
Articular dysfunctions
Fibromyalgia
Visceral disease
Posterior views
44
Quick Reference to Trigger Points
Longissimus Thoracis
Possible Causes
Sudden overload or traumatic event
Repeated muscular contraction
Quick bending and twisting
Prolonged immobility, such as
sitting on a plane
Symptoms/Indications
Restricted spinal movement
Difficulty rising from chair and/or
climbing stairs
Pain Patterns
Buttocks and low back
Associated TPs
Spine & Thorax
Latissimus dorsi
Quadratus lumborum
Serratus posterior inferior
Differential Diagnoses
Articular dysfunctions
Fibromyalgia
Visceral disease
Posterior view
Spine & Thorax
45
Multifidi and Rotatores
Possible Causes
Pain Patterns
Sudden overload or traumatic event
Repeated muscular contraction
Quick bending and twisting
Prolonged immobility, such as
sitting on a plane
Symptoms/Indications
Pain in the back
Restricted spinal movement
Difficulty rising from chair and/or
climbing stairs
Between scapulae
Sacrum
Posterior buttock region
Associated TPs
Latissimus dorsi
Quadratus lumborum
Serratus posterior inferior and superior
Differential Diagnoses
Articular dysfunctions
Fibromyalgia
Visceral disease
Posterior views, .
multifidi shown
46
Quick Reference to Trigger Points
Semispinalis Capitis
Possible Causes
Hitting head
Motor vehicle accident
Acute overload
Postural stress
Symptoms/Indications
Headache
Tenderness over back of
head and neck
Numbness, tingling, or burning
in the scalp
Pain Patterns
Spine & Thorax
Headband pattern
around cranium
Differential Diagnoses
Fibromyalgia
Facet joint osteoarthritis
Posterior view
of neck
Lateral view
Spine & Thorax
47
Splenius Capitis
Possible Causes
Postural stress
Falling asleep with neck in odd
position
Motor vehicle accident
Symptoms/Indications
Pain at top of the head
Associated TPs
Erector spinae muscles
Semispinalis thoracis
Differential Diagnoses
C-2 articular dysfunction
Occipitoatlantal dysfunction
Whiplash syndrome
Pain Patterns
Top of the cranium
Lateral view
48
Quick Reference to Trigger Points
Splenius Cervicis
Possible Causes
Postural stress
Sleeping with neck in odd position
Motor vehicle accident
Excessive rotation or extension of head
Symptoms/Indications
Pain in neck, cranium and eye
“Stiff neck”
Pain Patterns
Lateral eyebrow, radiates to
temporal region
Posterior neck
Associated TPs
Spine & Thorax
Erector spinae
Semispinalis thoracis
Differential Diagnoses
C-2 articular dysfunction
Occipitoatlantal dysfunction
Whiplash syndrome
Posterior
view
Lateral view
Spine & Thorax
49
Suboccipitals
Possible Causes
Forward head posture
Sustained forward flexion
of the head
Symptoms/Indications
Headache
Deep-seated pain in upper neck
Difficulty rotating head
Pain Patterns
Temporal and occipital regions
Differential Diagnoses
Tension-type headache
Cervicogenic headache
Occipital neuralgia
Articular dysfunctions in upper
cervicals
Lateral view
50
Quick Reference to Trigger Points
Quadratus Lumborum
Possible Causes
Sudden trauma
Awkward movements
Motor vehicle accident
Symptoms/Indications
Spine & Thorax
Low back pain
Chronic myofascial pain syndrome
Articular dysfunction
Restricted forward bending
Difficulty leaning to the
opposite side
Difficulty climbing stairs
Posterior view of right
lumbar region
Spine & Thorax
51
Quadratus Lumborum
Pain Patterns
Lateral and posterior hip
Associated TPs
External and internal obliques
Psoas major
Erector spinae
Rectus abdominis
Differential Diagnoses
Sacroiliac joint dysfunction
Lumbar or sacral ligament pain
Bursitis of hip
Posterior view
Anterior/lateral view
52
Quick Reference to Trigger Points
Rectus Abdominis and External Oblique
Possible Causes
Poor posture
Acute or chronic overload
of the abdominals
Direct trauma
Toxic or emotional stress
Symptoms/Indications
Pressure and bloating
Heartburn
Vomiting
Associated TPs
Surrounding abdominal muscles
Hip adductor muscles
Differential Diagnoses
Articular dysfunctions
Fibromyalgia
Appendicitis
Peptic ulcer
Colitis
Pain Patterns
Rectus abdominis
Across midback
Across posterior iliac crests
Spine & Thorax
External oblique
Inferior chest
Superior abdomen
Radiates down to opposite hip
Anterior view, showing TPs of
rectus abdominis
Posterior view, showing pain
patterns of rectus abdominis TPs
Spine & Thorax
53
Rectus Abdominis and External Oblique
Anterior views, showing TPs and pain
patterns for external oblique
54
Quick Reference to Trigger Points
Serratus Posterior Superior
Possible Causes
Excessive coughing (from
pneumonia or asthma)
Poor posture
Quick movements
Sitting for long periods
Symptoms/Indications
Deep ache at rest
Increased pain when lifting
Pain Patterns
Posterior scapula
Posterior shoulder, arm,
and forearm down to hand
Spine & Thorax
Associated TP
Scalenes
Rhomboids
Iliocostalis thoracis
Differential Diagnoses
Thoracic outlet syndrome
Radiculopathy
Olecranon bursitis
Posterior view of right
shoulder and arm
Anterior view of right
shoulder and arm
Spine & Thorax
55
Serratus Posterior Inferior
Possible Causes
Combined movement of lifting,
turning, and reaching
Hyperextension of back
Symptoms/Indications
Nagging ache in lower
thoracic region
Pain Patterns
Directly over muscle
Posterior view
56
Quick Reference to Trigger Points
Associated TPs
Iliocostalis thoracis
Longissimus thoracis
Differential Diagnoses
Renal disease
Lower thoracic radiculopathy
Head, Neck & Face
Sternocleidomastoid
Possible Causes
Symptoms/Indications
Soreness in the neck
“Stiff neck”
Tilting of head to same side
Tension headache
Pain Patterns
Face and cranium
Forehead, ear, and occiput
Strongly around eyebrow
Head, Neck & Face
Poor posture
Excessive forward head posture
Sitting with head turned to side for
long period
Protracted neck extension
Whiplash injury
Superficial head
Anterior, lateral view
Head, Neck & Face
57
Sternocleidomastoid
Associated TPs
Opposite sternocleidomastoid
Scalenes
Levator scapula
Trapezius
Differential Diagnoses
Vascular headache
Atypical facial neuralgia
Trigeminal neuralgia
Ménière’s disease
Deep head
Anterior, lateral view
58
Quick Reference to Trigger Points
Scalenes
Possible Causes
Accidental trauma
Carrying awkward, large objects
Whiplash injury
Symptoms/Indications
Pain Patterns
Lateral shoulder, arm, forearm,
index finger, and thumb
Upper pectoral region
Medial border of scapula
Pain in shoulder, upper limb
Venous obstruction
Pain in upper back
Disturbed sleep
Numbness and tingling in hand
Anterior scalene
Head, Neck & Face
Middle scalene
Posterior scalene
Anterior, lateral view
of neck
Head, Neck & Face
59
Scalenes
Associated TPs
Other scalenes
Sternocleidomastoid
Splenius capitis
Differential Diagnoses
Thoracic outlet syndrome
Carpal tunnel syndrome
C-4 to C-6 articular dysfunction
C-5, C-6 radiculopathy
Anterior view of right
shoulder and arm
Posterior view of right
shoulder and arm
60
Quick Reference to Trigger Points
Masseter
Possible Causes
Sudden, forceful contraction
Repetitive jaw habits
Chronic mouth breathing
Psychological stress
Pain Patterns
Molars
Temporomandibular joint
Mandibular and eyebrow area
Symptoms/Indications
Head, Neck & Face
Temporomandibular joint symptoms
Tension in masseter and temporalis
Restriction of jaw opening and
unilateral tinnitus
Lateral view of
superficial belly
Lateral view of
superficial belly
Head, Neck & Face
61
Masseter
Associated TPs
Temporalis
Medial pterygoid
Sternocleidomastoid
Differential Diagnoses
Tinnitus
Pulpitis
Inflammation of the periodontal
ligament
Tension-type headaches
Earache
Toothache
Lateral view of
superficial belly
Lateral view of deep belly,
superficial belly cut
62
Quick Reference to Trigger Points
Temporalis
Possible Causes
Grinding or clenching of teeth
Direct trauma, such as a fall
Forward head posture
Symptoms/Indications
Head pain
Toothache
Pain Patterns
Upper row of teeth
Temporal region
Over the eyebrow
Associated TPs
Masseter on same side
Temporalis on opposite side
Medial and lateral pterygoids
Differential Diagnoses
Lateral views
Head, Neck & Face
Head, Neck & Face
Temporomandibular
joint disorders
Diseased teeth
Tension-type headaches
Temporal tendinitis
63
Digastric
Possible Causes
Retrusion of mandible
Mouth breathing
Excessive grinding of teeth
Symptoms/Indications
Difficulty swallowing
Sensation of lump in throat
Difficulty turning head
Pain Patterns
Lower front teeth
Upper, lateral neck below ear
Associated TPs
Masseter
Temporalis
Differential Diagnoses
Lateral views
Neighboring muscle TPs
Anterior, inferior view
64
Quick Reference to Trigger Points
Occipitofrontalis
Possible Causes
Frontalis
Sternocleidomastoid TPs
“Stress”
Chronically raised eyebrows
Occipitalis
Decreased visual acuity
Posterior cervical muscles TPs
Symptoms/Indications
Intolerance to pressure on back of head
Pain Patterns
Frontalis
Directly over muscle
Occipitalis
Parietal region and upper eyelid
Differential Diagnoses
Tension-type headache
Frontalis
Neighboring muscle TPs
Occipital neuralgia
Anterior view, highlighting
frontalis TPs and pain patterns
Head, Neck & Face
Sternocleidomastoid TPs
Occipitalis
Lateral view, highlighting
occipitalis TPs and pain patterns
Head, Neck & Face
65
Medial Pterygoid
Possible Causes
Pain Patterns
Forward head posture
Lateral pterygoid TPs
Excessive gum-chewing
Grinding and clenching of teeth
Anxiety
Symptoms/Indications
Refers pain into temporomandibular
joint and side of jaw
Differential Diagnoses
Lateral pterygoid, masseter,
and sternocleidomastoid TPs
Increased pain when opening mouth
wide or chewing food
Clenching teeth
Soreness inside throat
Painful swallowing
Lateral view, mandible cut
66
Quick Reference to Trigger Points
Lateral Pterygoid
Possible Causes
Sternocleidomastoid TPs
Mechanical stress caused
by poor posture
Excessive grinding of teeth
Playing a wind instrument
Symptoms/Indications
Pain Patterns
Temporomandibular joint
Front of face
Differential Diagnoses
Medial pterygoid TPs
Trigeminal neuralgia
Head, Neck & Face
Severe pain in the temporomandibular joint region
Shortening of muscle
Tinnitus
Pain when chewing
Lateral view, mandible cut
Head, Neck & Face
67
Pelvis & Thighx
Rectus Femoris
Possible Causes
Fall or accident that produces
sudden eccentric contraction
Skiing accident
Sitting for long time with heavy
object on lap
Recovery from hip surgery
Symptoms/Indications
Weakness of knee extension
Waking at night with pain in
front of patella
Weakness in knees when
going downstairs
Pain Patterns
Most intense at patellar region
Distal, anterior thigh
Associated TPs
Gluteus minimus and tensor
fasciae latae
Other quadriceps muscles
Biceps femoris
Differential Diagnoses
Pelvis & Thigh
Disease of hip joint
Pain from surgical procedure of hip
Anterior view of right
hip and thigh
Pelvis & Thigh
69
Vastus Medialis
Possible Causes
Pain Patterns
Acute overload from sudden
eccentric contraction
Stumbling or unexpectedly
stepping off a curb
Exercise that includes deep
knee bends
Medial knee and thigh
Associated TPs
Gluteus minimus and tensor
fasciae latae
Other quadriceps muscles
Biceps femoris
Symptoms/Indications
Differential Diagnoses
Weakness of knee extension
Pain deep in knee joint
Buckling of knee
Disease of hip joint
Pain from surgical procedure of hip
Vastus
medialis
Anterior views of right
hip and thigh
70
Quick Reference to Trigger Points
Vastus Lateralis
Possible Causes
Symptoms/Indications
Weakness of knee extension
Hurts to walk, pain on lateral
aspect of knee
Pain Patterns
Lateral hip, thigh, and knee
Pelvis & Thigh
Acute overload from sudden eccentric
contraction
Stumbling or unexpectedly
stepping off a curb
Exercise that includes deep
knee bends
Lateral views of right
hip and thigh
Pelvis & Thigh
71
Vastus Lateralis
Associated TPs
Gluteus minimus and tensor
fasciae latae
Other quadriceps muscles
Biceps femoris
Differential Diagnoses
Disease of hip joint
Pain from surgical procedure of hip
Trochanteric bursitis
Lateral views of right
hip and thigh
72
Quick Reference to Trigger Points
Pelvis & Thigh
Lateral views of right
hip and thigh
Pelvis & Thigh
73
Vastus Intermedius
Possible Causes
Acute overload from sudden
eccentric contraction
Stumbling or unexpectedly
stepping off a curb
Exercise that includes deep
knee bends
Symptoms/Indications
Weakness of knee extension
Difficulty straightening knee
Pain Patterns
Anterior thigh
Associated TPs
Gluteus minimus and tensor
fasciae latae
Other quadriceps muscles
Biceps femoris
Differential Diagnoses
Disease of hip joint
Pain from surgical procedure of hip
Vastus
intermedialis
Anterior views of
right hip and thigh
74
Quick Reference to Trigger Points
Biceps Femoris
Possible Causes
Posterior thigh compression by
ill-fitting chair
Uncomfortable furniture
Prolonged sitting
Pain Patterns
Posterior thigh
Most intense at posterior knee
Associated TPs
Posterior adductor magnus
Vastus lateralis
Gastrocnemius
Symptoms/Indications
Differential Diagnoses
Surrounding muscle TPs
Sciatica/pseudo-sciatica
Biceps
femoris
Pelvis & Thigh
Pain on walking
When sitting, pain in buttock
and upper thigh
Pain when getting up from
a chair
Posterior views of
right hip and thigh
Pelvis & Thigh
75
Semitendinosus and Semimembranosus
Possible Causes
Posterior thigh compression
by ill-fitting chair
Uncomfortable furniture
Prolonged sitting
Symptoms/Indications
Pain on walking
When sitting, pain in buttock
and upper thigh
Pain when getting up from a chair
Pain Patterns
Posterior thigh
Most intense at proximal thigh
Associated TPs
Posterior adductor magnus
Vastus lateralis
Gastrocnemius
Differential Diagnoses
Surrounding muscle TPs
Sciatica/pseudo-sciatica
Both semis
Posterior views of
right hip and thigh
76
Quick Reference to Trigger Points
Gluteus Maximus
Possible Causes
Walking uphill
Vigorous contraction in a shortened
position
Vigorous eccentric contraction
when preventing a fall
Direct blow to buttock
Sleeping on one side with hip flexed
Swimming front crawl
Sitting too long in one position
Repetitious tasks involving
leaning over
Symptoms/Indications
Uncomfortable and restless
when seated
Pain Patterns
Posterior buttock
Posterior surface of sacrum
Pelvis & Thigh
Posterior views
Pelvis & Thigh
77
Gluteus Maximus
Associated TPs
Posterior portion of
gluteus medius
Hamstring muscles
Posterior views
78
Quick Reference to Trigger Points
Differential Diagnoses
Differentiated from the medius and
minimus by topographical location
in the buttock, distribution of pain,
and depth of TP tenderness
Fibrosis of superficial lumbosacral
fascia
Gluteus Medius
Possible Causes
Pain Patterns
Sudden falls
Sports injuries
Running
Long tennis matches
Posterior, lateral buttock
Posterior surface of sacrum
Posterior iliac crest
Symptoms/Indications
Piriformis
Posterior aspect of gluteus
minimus and maximus
Differential Diagnoses
Gluteus maximus TPs
Sacroiliac joint dysfunction
Pain in lumbar facet joints
Low back pain
Pelvis & Thigh
Pain when walking
Difficulty sleeping on affected side
Uncomfortable when sitting in a
slumped position
Associated TPs
Posterior, lateral views of right hip and thigh
Pelvis & Thigh
79
Gluteus Medius
Posterior, lateral views of right hip and thigh
80
Quick Reference to Trigger Points
Gluteus Minimus
Sacroiliac joint dysfunction
Nerve root irritation
Prolonged immobility
Symptoms/Indications
Hip pain that may cause limp
Pain when lying on affected side
Difficulty rising from a chair and
standing up straight
Pelvis & Thigh
Possible Causes
Posterior, lateral views of right
hip, thigh, and leg
Pelvis & Thigh
81
Gluteus Minimus
Pain Patterns
Posterior buttock
Lateral, posterior thigh and leg
Associated TPs
Gluteus medius
Piriformis
Vastus lateralis
Differential Diagnoses
Trochanteric bursitis
Pain from articular dysfunction
Sciatica
Posterior, lateral view .
of right hip, thigh, and leg
82
Quick Reference to Trigger Points
Adductor Magnus
Possible Causes
Sudden overload, such as
slipping on ice
Forcefully resisting hip abduction
Osteoarthritis of the hip
Strenuous horseback riding
Sitting for long periods of time
(driving)
Symptoms/Indications
Groin area
Medial thigh
Rectum
Associated TPs
Other adductors
Vastus medialis
Differential Diagnoses
Groin and medial thigh pain
Trauma to musculoskeletal structures
Articular dysfunction
Pelvis & Thigh
Intra-pelvic pain, specifically localized
to the vagina or rectum during
sexual intercourse
Groin pain
Pain Patterns
Posterior view of right
hip and thigh
Anterior view
Pelvis & Thigh
83
Adductor Longus and Brevis
Possible Causes
Pain Patterns
Sudden overload, such as
slipping on ice
Forcefully resisting hip abduction
Osteoarthritis of the hip
Strenuous horseback riding
Sitting for long periods of time
Symptoms/Indications
Anterior thigh, radiates down
anterior leg
Associated TPs
Other adductors
Vastus medialis
Differential Diagnoses
Pain in the groin during vigorous
activity (not at rest)
Severe restriction of abduction of
thigh
Groin and medial thigh pain
Trauma to musculoskeletal structures
Articular dysfunction
Anterior views
84
Quick Reference to Trigger Points
Pectineus
Possible Causes
Associated TPs
Tripping or falling
Unexpected strong resistance to
adduction of thigh
Horseback riding
Sustained posture that puts muscle
in shortened position
Iliopsoas
Adductors
Gracilis
Differential Diagnoses
Symptoms/Indications
Persistent, deep-seated groin pain
Limited abduction of the hip
Obturator nerve entrapment
Disease of hip joint
Pubic symphysitis
Pain Patterns
Pelvis & Thigh
Proximal, medial thigh and groin
Anterior, medial views of
right hip and thigh
Pelvis & Thigh
85
Tensor Fasciae Latae
Possible Causes
Landing on feet from high jump
Walking or running on sloped surface
Immobilization in shortened position
for long periods
Symptoms/Indications
Referred pain in hip joint
Poor tolerance for prolonged sitting
Inability to lie on side of TP
Pain Patterns
Lateral thigh and hip
Associated TPs
Gluteus minimus
Rectus femoris
Iliopsoas
Sartorius
Differential Diagnoses
Gluteus medius and minimus TPs
L-4 neuropathy
Trochanteric bursitis
Lateral view of right
hip and thigh
86
Quick Reference to Trigger Points
Sartorius
Possible Causes
Secondary TPs of muscle of the thigh
Overload strain in a twisting fall
Symptoms/Indications
Pain along pathway of muscle
Pain Patterns
Following path of muscle down
anterior, medial thigh
Associated TPs
Rectus femoris
Vastus medialis
Differential Diagnoses
Pelvis & Thigh
Vastus medialis TPs
Myogelosis
Disease of knee joint
Anterior, medial view of
right hip and thigh
Pelvis & Thigh
87
Piriformis
Possible Causes
Pain Patterns
Catching oneself in a fall
Twisting sideways while bending
Lifting a heavy load
Direct trauma
Driving a car with foot in same place
over long period
Symptoms/Indications
Pain in low back, groin,
buttock, and hip
Rectal pain during defecation
Posterior views
88
Quick Reference to Trigger Points
Posterior, lateral buttock
Posterior thigh
Associated TPs
Posterior aspect of the
gluteus minimus
Both gemelli
Obturator internus
Differential Diagnoses
Sacroiliac joint dysfunction
Herniated intervertebral disc
Iliopsoas
Surrounding muscle TPs
Prolonged sitting
Sleeping in a fetal position
Vigorous sit-ups
Rectus femoris tightness (which
prevents full hip extension)
Symptoms/Indications
Vertical low back pain
Pain is worse when standing up
Pain in anterior thigh
Pain Patterns
Proximal, anterior thigh
Lumbar region and upper buttock
Pelvis & Thigh
Possible Causes
Anterior view
Pelvis & Thigh
89
Iliopsoas
Associated TPs
Quadratus lumborum
Lower section of rectus abdominis
Longissimus thoracis
Rectus femoris
Tensor fasciae latae
Differential Diagnoses
Quadratus lumborum TPs
Lower section of rectus
abdominis TPs
Longissimus thoracis TPs
Anterior view
Posterior view
90
Quick Reference to Trigger Points
Leg & Footx
Gastrocnemius
Possible Causes
Riding a bike with the seat too low
Walking along slanted surface,
such as a beach
Standing for prolonged
periods, leaning forward
Wearing high socks with a tight
elastic band
Sitting in a reclining chair, compromising circulation to calf muscles
Leg & Foot
Posterior views of right leg, .
foot plantar flexed
Leg & Foot
91
Gastrocnemius
Symptoms/Indications
Associated TPs
Calf cramps
Pain in back of knee when
climbing up steep slope
Soleus and hamstrings
Differential Diagnoses
S-1 radiculopathy
Pain Patterns
Posterior knee
Posterior leg
Arch of foot
Posterior views of right leg, .
foot plantar flexed
92
Quick Reference to Trigger Points
Soleus
Possible Causes
Pain Patterns
Slipping when stepping onto a curb
Overloading the muscle
Direct trauma
High heels
Compromised circulation of calf
Symptoms/Indications
Tenderness in the heel
Unbearable to place weight on heel
Nocturnal calf pain
Edema of foot and ankle
Posterior leg
Heel of foot
Posterior sacrum
Associated TPs
Gastrocnemius
Flexors of the ankles and toes
Differential Diagnoses
Quadratus lumborum TPs
Heel spur
Baker’s cyst
Achilles tendinitis
Leg & Foot
Posterior views of right thigh
and leg, foot plantar flexed
Leg & Foot
93
Plantaris
Possible Causes
Slipping when stepping onto a curb
Overloading the muscle
Direct trauma
High heels
Compromised circulation of calf
Symptoms/Indications
Pain in posterior knee and leg
Pain Patterns
Posterior knee and leg
Associated TPs
Gastrocnemius
Flexors of the ankles and toes
Differential Diagnoses
Quadratus lumborum TPs
Heel spur
Baker’s cyst
Achilles tendinitis
Posterior view of right leg, .
foot plantar flexed
94
Quick Reference to Trigger Points
Popliteus
Possible Causes
Running and twisting knee during
sports, such as football or soccer
Skiing downhill
Quick deceleration from running
Tearing of posterior cruciate ligament
Symptoms/Indications
Pain in posterior knee when
crouching or running,
especially downhill
Associated TPs
Both heads of gastrocnemius
Differential Diagnoses
Popliteus tendinitis
Baker’s cyst
Thrombosis of the popliteal vein
Tear of meniscus
Pain Patterns
Posterior knee
Leg & Foot
Posterior view of
right knee
Leg & Foot
95
Fibularis Longus and Brevis
Possible Causes
Pain Patterns
Fall with twisting
Inversion of the ankle
Prolonged immobilization
by a cast
Gluteus minimus TPs
Symptoms/Indications
Pain and tenderness in the ankle
Foot drop
Pain in feet
Lateral leg and ankle
Associated TPs
Extensors of the ankle
Gluteus minimus
Differential Diagnoses
Neighboring muscle TPs
Entrapment of common
fibular nerve
Ankle sprain
Muscle or tendon rupture
Fibularis longus
Fibularis brevis
Fibularis tertius
96
Quick Reference to Trigger Points
Lateral views of
right leg and foot
Fibularis Tertius
Leg & Foot
Lateral views of right leg and foot
showing trigger points and pain
patterns of Fibularis tertius
Leg & Foot
97
Tibialis Anterior
Possible Causes
Associated TPs
Ankle sprain or fracture
Gross trauma
Walking on rough ground
Fibularis longus
Differential Diagnoses
Symptoms/Indications
Pain in ankle and big toe
Weakness of dorsiflexion
Dragging of foot that causes tripping
Neighboring muscle TPs
L-5 radiculopathy
Anterior compartment syndrome
Pain Patterns
Anterior leg
Dorsal foot
Big toe
Anterior, medial views .
of right leg and foot
98
Quick Reference to Trigger Points
Extensor Digitorum Longus
Possible Causes
Tripping or falling
Gas pedal that puts ankle
at acute dorsiflexion
Excessive jogging or running
Direct gross trauma
Symptoms/Indications
Pain in dorsal foot
Foot drop weakness during walking
Night cramps in foot
Associated TPs
Fibulares
Tibialis anterior
Differential Diagnoses
Pain from synovial joints in tarsal
bones
Neighboring muscle TPs
Hammertoes and claw toes
Tendinitis
Pain Patterns
Dorsal foot into dorsal toes
Extensor digitorum longus
Extensor hallucis longus
Leg & Foot
Anterior, lateral view of right
leg and foot
Leg & Foot
99
Extensor Hallucis Longus
Possible Causes
Tripping or falling
Gas pedal that puts ankle
at acute dorsiflexion
Excessive jogging or running
Direct gross trauma
Symptoms/Indications
Pain in dorsal foot
Foot drop weakness during walking
Night cramps in foot
Associated TPs
Fibulares
Tibialis anterior
Differential Diagnoses
Pain from synovial joints in tarsal
bones
Neighboring muscle TPs
Hammertoes and claw toes
Tendinitis
Pain Patterns
Dorsal foot into dorsal toes
Extensor digitorum longus
Extensor hallucis longus
Anterior, lateral view of right
leg and foot
100
Quick Reference to Trigger Points
Tibialis Posterior
Possible Causes
Associated TPs
Running or jogging
on uneven ground
Ill-fitting footwear
Flexor digitorum longus
Flexor hallucis longus
Fibularis muscles
Symptoms/Indications
Differential Diagnoses
Pain in foot when
running or walking
Pain Patterns
Posterior leg
Most intense in calcaneal tendon area
Sole of foot and heel
Shin splints
Deep posterior compartment
syndrome
Posterior tibial tendon dysfunction
Leg & Foot
Posterior views of right leg,
foot plantar flexed
Leg & Foot
101
Flexor Digitorum Longus
Possible Causes
Running or jogging on uneven ground
Hyperpronation
Impaired mobility of ankle or foot
Inflexible shoe sole
Symptoms/Indications
Foot pain while walking
Pain on plantar surface of
forefoot and toes
Pain Patterns
Posterior leg
Most intense on plantar
surface of foot
Associated TPs
Tibialis posterior
Long and short extensors
of the toes
Differential Diagnoses
Tarsal tunnel syndrome
Hammertoes and claw toes
Neighboring muscle TPs
Hallux valgus
Flexor
digitorum
longus
Flexor
hallucis
longus
Posterior view of right leg,
foot plantar flexed
102
Quick Reference to Trigger Points
Flexor Hallucis Longus
Possible Causes
Running or jogging on uneven ground
Hyperpronation
Impaired mobility of ankle or foot
Inflexible shoe sole
Symptoms/Indications
Foot pain while walking
Pain on plantar surface of
forefoot and toes
Pain Patterns
Plantar surface of big toe
Head of first metatarsal
Associated TPs
Tibialis posterior
Long and short extensors
of the toes
Differential Diagnoses
Tarsal tunnel syndrome
Hammertoes and claw toes
Neighboring muscle TPs
Hallux valgus
Flexor
digitorum
longus
Flexor
hallucis
longus
Leg & Foot
Posterior view of right leg,
foot plantar flexed
Leg & Foot
103
Extensor Digitorum Brevis
Possible Causes
Tight-fitting shoe
Fracture of the ankle
Trauma to the foot
Stubbing of toes
Hyperpronation
Symptoms/Indications
Intolerably sore feet
Fallen arches
Limited walking range
Pain Patterns
Dorsal surface of foot
Associated TPs
Extensor muscles of the toes
Surrounding muscles
Differential Diagnoses
Plantar fasciitis
Bunions
Extensor
hallucis
brevis
Extensor
digitorum
brevis
Dorsal, lateral views
of right foot
104
Quick Reference to Trigger Points
Flexor Digitorum Brevis
Possible Causes
Tight-fitting shoe
Fracture of the ankle
Trauma to the foot
Stubbing of toes
Hyperpronation
Symptoms/Indications
Intolerably sore feet
Fallen arches
Limited walking range
Pain Patterns
Ball of the foot
Associated TPs
Extensor muscles of the toes
Surrounding muscles
Differential Diagnoses
Flexor
digitorum
brevis
Plantar fasciitis
Flat feet
Bunions
Leg & Foot
Plantar views of right foot
Leg & Foot
105
Abductor Hallucis
Possible Causes
Tight-fitting shoe
Fracture of the ankle
Trauma to the foot
Stubbing of toes
Hyperpronation
Symptoms/Indications
Intolerably sore feet
Fallen arches
Limited walking range
Pain Patterns
Medial, plantar surface of foot
Associated TPs
Extensor muscles of the toes
Surrounding muscles
Differential Diagnoses
Abductor
hallucis
Plantar fasciitis
Flat feet
Bunions
Plantar views of right foot
106
Quick Reference to Trigger Points
Abductor Digiti Minimi
Possible Causes
Tight-fitting shoe
Fracture of the ankle
Trauma to the foot
Stubbing of toes
Hyperpronation
Symptoms/Indications
Intolerably sore feet
Fallen arches
Limited walking range
Pain Patterns
Lateral, plantar surface of foot
Associated TPs
Extensor muscles of the toes
Surrounding muscles
Plantar fasciitis
Flat feet
Bunions
Abductor
digiti
minimi
Plantar views of right foot
Leg & Foot
Differential Diagnoses
Leg & Foot
107
Extensor Hallucis Brevis
Possible Causes
Tight-fitting shoe
Fracture of the ankle
Trauma to the foot
Stubbing of toes
Hyperpronation
Symptoms/Indications
Intolerably sore feet
Fallen arches
Limited walking range
Pain Patterns
Dorsal surface of foot
Associated TPs
Extensor muscles of the toes
Surrounding muscles
Differential Diagnoses
Plantar fasciitis
Flat feet
Bunions
Extensor
hallucis
brevis
Dorsal, lateral views
of right foot
108
Quick Reference to Trigger Points
Flexor Hallucis Brevis
Possible Causes
Pain Patterns
Tight-fitting shoe
Fracture of the ankle
Trauma to the foot
Stubbing of toes
Hyperpronation
Medial and plantar surface
of base of big toe
Associated TPs
Neighboring foot muscles
Symptoms/Indications
Differential Diagnoses
Limitation of walking due to pain
Numbness of foot
Feet feel swollen
Muscular imbalance
Articular dysfunction of foot
Hammertoes
TPs of surrounding muscles of foot
Plantar fasciitis
Pain secondary to hallux valgus
Stress fracture of foot
Flexor
hallucis
brevis
Leg & Foot
Plantar views of right foot
Leg & Foot
109
Adductor Hallucis
Possible Causes
Pain Patterns
Tight-fitting shoe
Fracture of the ankle
Trauma to the foot
Stubbing of toes
Hyperpronation
Ball of foot
Associated TPs
Neighboring foot muscles
Differential Diagnoses
Symptoms/Indications
Limitation of walking due to pain
Numbness of foot
Feet feel swollen
Muscular imbalance
Articular dysfunction of foot
Hammertoes
Adductor
hallucis
Plantar views of right foot
110
Quick Reference to Trigger Points
TPs of surrounding muscles of foot
Plantar fasciitis
Pain secondary to hallux valgus
Stress fracture of foot
Quadratus Plantae
Possible Causes
Pain Patterns
Tight-fitting shoe
Fracture of the ankle
Trauma to the foot
Stubbing of toes
Hyperpronation
Heel of foot
Associated TPs
Neighboring foot muscles
Differential Diagnoses
Symptoms/Indications
Limitation of walking due to pain
Numbness of foot
Feet feel swollen
Muscular imbalance
Articular dysfunction of foot
Hammertoes
TPs of surrounding muscles of foot
Plantar fasciitis
Pain secondary to hallux valgus
Stress fracture of foot
Leg & Foot
Quadratus
plantae
Plantar views of right foot
Leg & Foot
111
Recommended Texts
Chaitow, Leon and Judith DeLany, Clinical Application of Neuromuscular Techniques,
Volume 1: The Upper Body, 2nd ed., Churchill Livingstone, Edinburgh, 2008.
Chaitow, Leon and Judith Walker DeLany, Clinical Application of Neuromuscular Techniques,
Volume 2: The Lower Body, Churchill Livingstone, Edinburgh, 2002.
Niel-Asher, Simeon, The Concise Book of Trigger Points, North Atlantic Publishing,
Berkeley, 2005.
Sharkey, John, The Concise Book of Neuromuscular Therapy, North Atlantic Publishing,
Berkeley, 2008.
Simons, David, Janet Travell, and Lois Simons, Myofascial Pain and Dysfunction: The Trigger
Point Manual, Volume 1, 2nd ed., Lippincott Williams & Wilkins, Baltimore, 1999.
Travell, Janet, and David Simons, Myofascial Pain and Dysfunction: The Trigger Point
Manual, Volume 2, Williams & Wilkins, Baltimore, 1992.
Quick Reference to Trigger Points
113
Index
i denotes illustration
A
abductor digiti minimi, 107, 107i
abductor hallucis, 106, 106i
adductor brevis, 84
adductor hallucis, 110, 110i
adductor longus, 84
adductor magnus, 75, 76, 83
adductor pollicis, 39–40
flexor hallucis brevis, 109, 109i
flexor hallucis longus, 101, 102i, 103, 103i
flexor pollicis longus, 41
G
gastrocnemius, 75, 76, 91, 92, 93, 94, 95
gluteus maximus, 77–78, 79
gluteus medius, 78, 79–80, 82
gluteus minimus, 69, 70, 72, 74, 79, 81–82,
86, 88, 96
B
I
biceps brachii, 4, 11, 22, 25, 27
biceps femoris, 69, 70, 72, 74, 75, 75i
brachialis, 22, 27
brachioradialis, 27, 28, 29, 38
iliocostalis, 43–44, 55, 56
iliopsoas, 85, 86, 89–90
infraspinatus, 10, 11, 12, 14
C
lateral pterygoid, 63, 66, 67
latissimus dorsi, 8, 9, 13, 19, 24, 44, 45, 46
levator scapula, 6, 14, 15, 58
longissimus thoracis, 45, 56, 90
coracobrachialis, 25
D
deltoid, 3–4, 10, 11, 20, 25, 27
digastric, 64
dorsal interossei, 40, 42
E
extensor carpi radialis brevis, 28, 29, 29i
extensor carpi radialis longus, 28, 29, 29i
extensor carpi ulnaris, 30, 32
extensor digitorum, 28, 29, 30, 31i, 31–32,
32i, 34
extensor digitorum brevis, 104, 104i
extensor digitorum longus, 99, 99i, 100i
extensor hallucis brevis, 104i, 108, 108i
extensor hallucis longus, 99i, 100, 101i
extensor indicis, 31–32, 32i
external oblique, 53–54, 54i
F
fibularis brevis, 96, 96i
fibularis longus, 96, 96i, 98
fibularis tertius, 96i, 97, 97i
flexor carpi radialis, 33
flexor carpi ulnaris, 35
flexor digitorum brevis, 105, 105i
flexor digitorum longus, 101, 102, 102i, 103i
flexor digitorum profundus, 36
flexor digitorum superficialis, 36, 36i
L
M
masseter, 1, 6, 61–62, 63, 64
medial pterygoid, 62, 66
multifidi, 46, 46i
O
occipitofrontalis, 65
P
palmaris longus, 34
pectineus, 85
pectoralis major, 4, 6, 8, 13, 16, 17, 18–19,
20, 25
pectoralis minor, 1, 1i, 6, 20
piriformis, 79, 82, 88
plantaris, 94
popliteus, 95
pronator teres, 37
psoas major, 52. See also iliopsoas
Q
quadratus lumborum, 44, 45, 46, 51–52, 90
quadratus plantae, 111, 111i
R
rectus abdominis, 52, 53i, 53–54, 55i, 90
rectus femoris, 69, 86, 87, 89, 90
115
rhomboids, 15, 55
rotatores, 46
S
sartorius, 86, 87
scalenes, 14, 20, 37, 55, 58, 59–60
semimembranosus, 76
semispinalis capitis, 47
semitendinosus, 76
serratus anterior, 1, 16
serratus posterior inferior, 44, 45, 46, 56
serratus posterior superior, 44, 46, 55
soleus, 92, 93
splenius capitis, 15, 48, 60
splenius cervicis, 49
sternalis, 17
sternocleidomastoid, 16, 17, 18, 20, 57–58,
60, 62, 65, 67
subclavius, 21
116
Index
suboccipitals, 50
subscapularis, 8, 13, 19
supinator, 22, 27, 29, 38
supraspinatus, 10, 11
T
temporalis, 6, 61, 62, 63, 64
tensor fasciae latae, 69, 70, 72, 74, 86, 90
teres major, 8, 9, 13, 19, 24
teres minor, 11, 12, 24
tibialis anterior, 98, 99, 100
tibialis posterior, 101, 102, 103
trapezius, 5–6, 10, 14, 15, 58
triceps brachii, 9, 13, 22, 23–24, 38
V
vastus intermedius, 74
vastus lateralis, 71–72, 75, 76, 82
vastus medialis, 70, 70i, 83, 84, 87
Trigger Point Differential
Diagnostic Index
A
Achilles tendinitis, 93, 94
acromioclavicular joint dysfunction, 25
acromioclavicular joint separation, 12
adhesive capsulitis, 13
angina pectoris, 19
ankle sprain, 96
anterior compartment syndrome, 98
appendicitis, 53
arthritis
carpometacarpal osteoarthritis, 40
cervical arthritis, 10
facet joint osteoarthritis, 47
glenohumeral joint arthritis, 4, 11, 22
of wrist, 33, 35, 36, 41
articular dysfunctions
C-2 articular dysfunction, 48, 49
C-4 to C-6 articular dysfunction, 60
of foot, 109, 110
in general, 44, 45, 46, 53, 83, 84
pain from, 82
in upper cervicals, 50
atypical facial neuralgia, 58
B
Baker’s cyst, 93, 94, 95
bicipital bursitis, 22
bicipital tendinitis, 4, 8, 11, 22, 27
brachial plexus entrapment, 42
brachial plexus injuries, 10
broken rib, 16
bunions, 104, 105, 106, 107, 108
bursitis
bicipital bursitis, 22
of hip, 52
olecranon bursitis, 55
subacromial/subdeltoid bursitis, 4, 9, 10,
12, 22, 25
trochanteric bursitis, 72, 82, 86
C
C-2 articular dysfunction, 48, 49
C-4 to C-6 articular dysfunction, 60
C-5, C-6 radiculopathy, 27, 28, 60
C-6 radiculopathy, 42. See also C-5, C-6
radiculopathy
C-7, C-8 radiculopathy, 20, 29, 30
C-7radiculopathy, 32
cardiac disease, 17
carpal tunnel syndrome, 25, 27, 28, 29, 33,
34, 35, 36, 37, 40, 41, 60
carpometacarpal osteoarthritis, 40
cervical arthritis, 10
cervicals, articular dysfunctions in upper
cervicals, 50
cervicogenic headache, 50
claw toes, 99, 100, 102, 103
colitis, 53
common fibular nerve entrapment, 96
compression of axillary nerve, 12
costochondritis, 16, 17
cysts, Baker’s cyst, 94, 95, 96
D
deep posterior compartment syndrome, 101
discs, herniated intervertebral disc, 88
diseased teeth, 63
diseases
cardiac disease, 17
of hip joint, 69, 70, 72, 74, 85
of knee joint, 87
Meniere’s disease, 58
renal disease, 56
visceral disease, 44, 45, 46
dysfunctions
acromioclavicular joint dysfunction, 25
articular dysfunctions, in general, 44, 45,
46, 53, 83, 84
articular dysfunctions in upper cervicals,
50
C-2 articular dysfunction, 48, 49
C-4 to C-6 articular dysfunction, 60
occipitoatlantal dysfunction, 48, 49
posterior tibial tendon dysfunction, 101
sacroiliac joint dysfunction, 52, 79, 88
scapulocostal dysfunction, 14, 15
scapulohumeral dysfunction, 11
117
E
earache, 62
elbow, tennis, 24, 32, 38
entrapments
of brachial plexus, 42
of common fibular nerve, 96
intercostal nerve entrapment, 16
obturator nerve entrapment, 85
of posterior interosseous nerve, 38
of radial nerve, 24
of suprascapular nerve, 8, 11
epicondylitis
lateral epicondylitis, 24, 28, 29
medial epicondylitis, 24, 33, 35, 36, 41
F
facet joint osteoarthritis, 47
feet
articular dysfunction of, 109, 110
bunions, 104, 105, 106, 107, 108
claw toes, 99, 100, 102, 103
flat feet, 105, 106, 107, 108
hammertoes, 99, 100, 102, 103
heel spur, 93, 94
stress fracture of, 109, 110, 111
fibromyalgia, 6, 14, 44, 45, 46, 47, 53
fibrosis of superficial lumbosacral fascia, 78
flat feet, 105, 106, 107, 108
G
glenohumeral joint arthritis, 4, 11, 22
gluteus maximus TPs, 79
gluteus medius TPs, 86
gluteus minimus TPs, 86
groin pain, 83, 84
H
hallux valgus, 102, 103, 109, 110, 111
hammertoes, 99, 100, 102, 103
headaches
cervicogenic headache, 50
tension-type headache, 50, 62, 63, 65
vascular headache, 58
heel spur, 93, 94
herniated intervertebral disc, 88
herpes zoster, 16
hip
bursitis of, 52
118
Differential Diagnostic Index
disease of hip joints, 69, 70, 72, 74, 85
pain from surgical procedure of, 69, 70,
72, 74
I
inflammation, of periodontal ligament, 62
intercostal nerve entrapment, 16
J
joints
acromioclavicular joint dysfunction, 25
acromioclavicular joint separation, 12
disease of knee joint, 87
facet joint osteoarthritis, 47
glenohumeral joint arthritis, 4, 11, 22
pain from synovial joints in tarsal bones,
99, 100
pain in lumbar facet joints, 79
sacroiliac joint dysfunction, 52, 79, 88
temporomandibular joint disorder, 6, 63
L
L-4 neuropathy, 86
L-5 radiculopathy, 98
lateral epicondylitis, 24, 28, 29
lateral pterygoid TPs, 66
longissimus thoracis TPs, 90
low back pain, 79
lower thoracic radiculopathy, 56
lumbar facet joints pain, 79
lumbar ligament pain, 52
M
masseter TPs, 66
masticatory muscles TPs, 6
medial epicondylitis, 24, 33, 35, 36, 41
medial pterygoid TPs, 67
medial thigh pain, 83, 84
Meniere’s disease, 58
meniscus, tear of, 95
muscle, tear of, 19
myogelosis, 87
N
nerves
compression of axillary nerve, 12
entrapment of brachial plexus, 42
entrapment of common fibular nerve, 96
entrapment of posterior interosseous
nerve, 38
entrapment of radial nerve, 24
entrapment of suprascapular nerve, 8, 11
intercostal nerve entrapment, 16
obturator nerve entrapment, 85
spurs with nerve root irritation, 10
neuralgia
atypical facial neuralgia, 58
occipital neuralgia, 50, 65
trigeminal neuralgia, 58, 67
neuropathy
L-4, 86
ulnar neuropathy, 8, 12, 33, 35, 36, 41, 42
O
obturator nerve entrapment, 85
occipital neuralgia, 50, 65
occipitoatlantal dysfunction, 48, 49
olecranon bursitis, 55
P
pain
of the groin, 83, 84
low back pain, 79
in lumbar facet joints, 79
lumbar ligament pain, 52
medial thigh pain, 83, 84
sacral ligament pain, 52
secondary to hallux valgus, 109, 110, 111
from surgical procedure of hip, 69, 70,
72, 74
from synovial joints in tarsal bones, 99,
100
peptic ulcer, 53
periodontal ligament, inflammation of, 62
plantar fasciitis, 104, 105, 106, 107, 108, 109,
110, 111
popliteal vein, thrombosis of, 95
popliteus tendinitis, 95
posterior interosseous nerve entrapment,
38
posterior tibial tendon dysfunction, 101
pseudo-sciatica, 75, 76
pubic symphysitis, 85
pulpitis, 62
Q
quadratus lumborum TPs, 90, 93, 94
R
radial nerve entrapment, 24
radiculopathy
C-5, C-6, 27, 28, 60
C-6, 42
C-7, 32
C-7, C-8, 20, 29, 30
in general, 55
L-5, 98
lower thoracic radiculopathy, 56
S-1, 92
rectus abdominis TPs, 90
renal disease, 56
rib, broken, 16
rotator cuff tear, 4, 10, 13
S
S-1 radiculopathy, 92
sacral ligament pain, 52
sacroiliac joint dysfunction, 52, 79, 80
scapulocostal dysfunction, 14, 15
scapulohumeral dysfunction, 11
sciatica/pseudo-sciatica, 75, 76, 82
shin splints, 101
splenius cervicis TPs, 15
sprains, ankle sprain, 96
spurs with nerve root irritation, 10
sternocleidomastoid TPs, 15, 65, 66
stress fracture of foot, 109, 110, 111
subacromial/subdeltoid bursitis, 4, 9, 10,
12, 22, 25
subluxations of carpal bones, 32
suprascapular nerve entrapment, 8, 11
supraspinatus tendinitis, 9, 19, 20, 25, 27
syndromes
anterior compartment syndrome, 98
carpal tunnel syndrome, 25, 27, 28, 29, 33,
34, 35, 36, 37, 40, 41, 60
deep posterior compartment syndrome,
101
tarsal tunnel syndrome, 102, 103
thoracic outlet syndrome, 9, 13, 20, 55, 60
whiplash syndrome, 48, 49
synovial joints in tarsal bones, pain from,
99, 100
Differential Diagnostic Index
119
T
tarsal tunnel syndrome, 102, 103
tears
of meniscus, 95
of muscle, 19
of rotator cuff, 4, 10, 13
teeth, diseased, 63
temporal tendinitis, 63
temporomandibular joint disorder, 6, 63
tendinitis
Achilles tendinitis, 93, 94
bicipital tendinitis, 4, 8, 11, 22, 27
in general, 99, 100
popliteus tendinitis, 95
supraspinatus tendinitis, 9, 19, 20, 25, 27
temporal tendinitis, 63
tennis elbow, 24, 32, 38
tension-type headache, 50, 62, 63, 65
thoracic outlet syndrome, 9, 13, 20, 55, 60
120
Differential Diagnostic Index
thrombosis of popliteal vein, 95
tinnitus, 62
toes
claw toes, 99, 100, 102, 103
hammertoes, 99, 100, 102, 103
toothache, 62
trigeminal neuralgia, 58, 67
trochanteric bursitis, 72, 82, 86
U
ulcer, peptic, 53
ulnar neuropathy, 8, 12, 33, 35, 36, 41, 42
V
vascular headache, 58
vastus medialis TPs, 87
visceral disease, 44, 45, 46
W
whiplash syndrome, 48, 49
wrist, arthritis of, 33, 35, 36, 41
Trail Guide to the Body’s Quick Reference to Trigger Points
Quickly locate common trigger points for practical application. More
than 200 illustrations include detailed drawings showing pain patterns
and point locations of 96 muscles. This guide will help students and practitioners identify the:
• Common location of a trigger point in a particular muscle belly
• Possible causes of trigger points
• Symptoms and indications
• Pain patterns
• Associated trigger points
Check out this other Quick Reference
by Andrew Biel!
Trail Guide to the Body’s Quick Reference
to Stretch & Strengthen
Quick-and-easy guide to 47 strengthening
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at the major joints of the body, making it a
perfect resource for students, practitioners, .
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Trail Guide to the Body product.
ISBN 978-0-9987850-8-0
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