Pennsylvania Physical Therapy Ebook Continuing Education

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Trigger Point Therapy for Headaches, Migraines, and TMJD: Summary

Table 3: Muscle and Trigger Point Chart of Neck and Upper Back (Continued) Muscle & Image # for TP Origin (Lease Moveable) Insertion (Most Moveable) Signs and Symptoms Action

Trigger Point Activation • Forward head posture • Head turned to one side for a prolonged period • Sleeping on two pillows

Sterno- cleidomastoid

• Manubrium of sternum • Clavicle

• Mastoid process • Temporal bone

• Back of head pain • Cheek pain • Dizziness • Double and blurry vision • Earaches/ tinnitus • Frontal HA • Postnasal drip, runny nose • TMJD • Double and blurry vision • HA or Migraines • Pain referred

Unilateral: Lateral flexion Bilateral: Cervical flexion and elevation of rib cage

Splenius Capitis

• Spinous

• Mastoid Process • Superior

• Whiplash • Overlying skin

Unilateral: Cervical Rotation of same side, Lateral flexion Bilateral: Cervical Extension

processes C7-T4 • Ligamentum Nuchae

exposed to cold draft

Nuchal Line

to the top of head (S. Capitis only)

Splenius Cervicis

Spinous Processes T3-T6

Transverse Processes C1-C3

Same as Splenius Capitis

Same as Splenius Capitis Same as Splenius Capitis

Pain and Postural Considerations Neurological Laws: Law of Facilitation : Path of least resistance Chronic Pain Cycle: Muscle tendon → reduced circulation → muscle

Righting Reflex: Corrects the orientation of the body when it is taken out of its normal upright posture Postural Considerations

inflammation->Reduced range of motion → pain → Muscle tendon Arndt-Schultz law :

States that weak stimuli activate physiologic responses whereas very strong stimuli inhibit physiologic responses. That is why it is important to warm up the tissue and work layer by layer with the muscle to keep the client in the relaxation response ○ Avoid the “no pain, no gain” perspective with TP release

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