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Trigger Point Guide

Trigger Point Guide Theory Karri Koivula PDF created with pdfFactory Pro trial version www.pdffactory.com

Theory

Trigger Point Guide Theory Karri Koivula PDF created with pdfFactory Pro trial version www.pdffactory.com

Karri Koivula

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Legal notices

Disclaimer

Huge effort is made that this book represents generally accepted medical practises and that this information doesn’t pose a risks for anybody who uses it.

But it is very important that you realize that you read this book at your own risk.

All material provided in this e-book is for informational and educational purposes only, and not to be construed as medical advice.

No action should be taken solely based on this e-book

Absolutely consult you physician before you take any actions related to your you health

By downloading/reading this book

You understand and agree that in no event shall the author nor the publisher of this e-book be liable to you or any other user of this e-book for the use of the information.

Statements mentioned within this e-book are not intended to diagnose, treat, cure or prevent any disease.

The statements made within this e-book have not been evaluated by the Food and Drug Administration.

If you don’t understand or agree these terms then please quit reading this book right now and delete this book from your computer.

Thanks.

Copyright notice

It’s illegal to copy any material from this book and distribute it.

I regularly search the internet for illegal copies.

And I will press criminal charges against those who illegally distribute it.

Copyright. 2004 Karri Koivula

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Start here

Foreword

The focus here is in practical advice.

The bottom line,

And all that matters,

Is that trigger points cause referred pain,

And that they “relax” trough massage.

And that the pain symptoms they cause will vanish along them…

Call to action

Read some theory below then go to the pain patterns section and…

Look at the body part pictures and try to pin point your pain, then look at the muscle pain index and see which muscles are generally involved.

Then go to work, use the side menu to easily jump to what ever muscles you need to massage, and use the pictures and written guidelines if any to get the job done.

Theory section starts

Trigger points are hyper contracted bundles of muscle cells. Also because of this contraction there are taut bands of stretched muscle attached to these contraction knots that run to both directions and end up in the muscles attachments points.

Putting pressure on the trigger point will eventually make them relax.

Even pressing at the taut band can make this happen as it forces a stretch to the contracted knots that are in the center.

But for best effect you want to aim center.

you’ll locate the center/trigger point by its pressure tenderness, pressing it moderate/hard force should cause noticeable pain both ate the spot and in the pain referral zone.

You can test this by pressing a spot few centimetres of the spot, and see that you can barely feel the pressing.

Normal muscle tissue can take a lot of force applied to it; until you start to feel even slight discomfort.

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Trigger point identification -important

Pressure tender spot

Spot that hurts to press

Twitch reaction

When you press the spot or taut band you can feel the taut band to twitch violently.

It’s good indicator from trigger points, but it doesn’t happen, or you can’t always feel it.

Reappearing of referred pain symptom

When you press the tp you feel something on the actual pain zone were the symptom that bothers you exists.

Sometimes it’s the exact feeling of the pain but most cases you just feel some weird sensations in the general area of you pain zone.

Brief massage guide lines

Find the spot and the direction of applying pressure massage that hurts the most.

Massage multiple short session though out the day.

As long as it takes for the spots to become none-tender, or as long as it takes to get relief.

This will in most cases take weeks.

Ways to massage

Repetitive stroke massage or continuous pressure

Il like the best from continuous pressure applied by tool and using bodyweight for applying the pressure. It’s the lazy person’s way to do it and works just perfect.

Continuous pressure

Hold 8-15 seconds pressure move to another spot come back later repeat about 2-3 per spot 2-5 times per day

Massage

Massage 10 strokes move to another spot come back repeat 2-3 times per spot 6-10 times per day

There are no rules once you get the hang of it youll make you own system.

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Case example

Acute pain phase

Massages points in many sessions a day for two weeks

Holy smoke I am full of these buggers it seems that every inc of my body is is a tender spot.

Pain symptoms regress backwards old injuries start to feel again maybe resulting in more pain.

My muscles are twitching like there no tomorrow.

Where is this all going to lead

Then every other day for couple of weeks

Things start to normalize

I got to tell everybody about this.

This is pretty cool, why the doctors didn’t tell me about this.

Upkeep/ maintenance

Then once a week, or when needed.

Massage is getting boring but some of the points are still a bit tender, although generally it gets harder and harder to find them

Then once a moth, one session holding for 5 seconds,per spot.

I’m so lazy I should do the massage more often.

Some spots may get tender but they don’t seem to cause those old referred pain symptoms, strange…

Where I ever in pain? It seems so distant…

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Pain shift - important

What you get is a pain shift or the pain gets worse.

You can aggravate the current tp and your pain symptom worsens this is common although it doesn’t seem to postpone the relaxation of the tp.

Which is bit odd, but that’s the practice of things.

And thus some use very rough methods from the beginning to get things handled as quickly as possible and suffer a little extra pain.

Pain shift can be like going back in time.

Pain shift happens when the pull of the muscles changes and it flares old latent trigger points.

For example if you hurt you foot and got longstanding knee pain that eventually settled in you hip.

You can experience the same knee pain again as the trigger point will flare upp again as the balance between the pull of the muscles changes as you massage tps.

But at this point don’t call me and get angry at me but continue to massage the points that are responsible of this newly appeared symptom.

They should vanish eventually.

I don’t know a case where this pain shift or regression back to old symptoms haven’t vanished-

I don’t see any logic reasons for this but realize that there is a risk for this.

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Trigger Point Guide

Trigger Point Guide 1 Pain patterns Karri Koivula PDF created with pdfFactory Pro trial version www.pdffactory.com

1

Pain patterns

Trigger Point Guide 1 Pain patterns Karri Koivula PDF created with pdfFactory Pro trial version www.pdffactory.com

Karri Koivula

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Index

1. Head and neck pain

2. Upper back, shoulder, upper arm pain

3. Middle back, lower back ,hip and buttock pain

4. Chest, abdominal and groin pain ,

5. hip, thigh, knee pain

6. Leg and ankle pain

7. Foot pain

2

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Head and Neck pain

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3

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I pain/muscle index

Top of head

sternocleidomastoid splenius capitis

Back of head pain

Trapezius sternocleidomastoid semispinalis capitis semispinalis cervicis splenius cervicis suboccipital group occipitalis digastric temporalis

Side of head

Trapezius sternocleidomastoid temporalis splenius cervicis suboccipital group semispinalis capitis

Front of head

sternocleidomastoid Frontalis zygomaticus major semispinalis capitis

korva ja leuka nivel särky

lateral pterygoid massater sternocleidomastoid medial pterygoid

Eye area pain

Sternocleidomastoid Temporalis slpenius cervicis massater occipitalis orbicularis oculi suboccipital group trapezius

Ear and chin joint pain

sternocleidomastoid massater lateral pterygoid trapezius buccinator Platysma orbicularis oculi zygomataticus major digastric medial pterygoid

Tooth pain

temporalis

massater

digastric

Back of neck

Trapezius multifidi levator scapulae splenius cervicsis

Front of neck

sternocleidomastoid digastric medial pterygoid

4

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Trapezius

Trapezius Use Stick and tennis ball against the wall. Picture: For trigger points, lower down in
Trapezius Use Stick and tennis ball against the wall. Picture: For trigger points, lower down in

Use Stick and tennis ball against the wall.

Picture:

For trigger points, lower down in the trapezius, lye down in the floor and use tennis ball and use it to apply the pressure and find the right spots.

picture:

5

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Sternocleidomastoid

Sternocleidomastoid Just grab the muscle like in I am doing, bend the head to the side
Sternocleidomastoid Just grab the muscle like in I am doing, bend the head to the side

Just grab the muscle like in I am doing, bend the head to the side you are pinching the muscle to give it some slack and make it easier to grab.

Just go trough the whole muscle pinch gripping it and find the trigger points.

The muscle two branches on top of each others, you can see them divide in the lower attachment point.

But for the most part of the muscle you don’t have to distinguish them.

part of the muscle you don’t have to distinguish them. 6 PDF created with pdfFactory Pro

6

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Temporalis

Temporalis Use your knuckles or some hard tool to locate temporal trigger points. But go easy
Temporalis Use your knuckles or some hard tool to locate temporal trigger points. But go easy

Use your knuckles or some hard tool to locate temporal trigger points.

But go easy on them.

Its really spooky kind of pain that they can make and reappear when pressed.

7

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massater

massater I find it helpful to press little towards ears to hit the muscle in right
massater I find it helpful to press little towards ears to hit the muscle in right

I find it helpful to press little towards ears to hit the muscle in right direction.

Use fingers, knuckles or tool

8

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Splenius Capitis

Splenius Capitis Tool against wall or against floor. Splenius Cervcis 9 PDF created with pdfFactory Pro

Tool against wall or against floor.

Splenius Cervcis

Capitis Tool against wall or against floor. Splenius Cervcis 9 PDF created with pdfFactory Pro trial

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Semispinalis Capitis

Semispinalis Capitis Tool against wall or against floor. 10 PDF created with pdfFactory Pro trial version

Tool against wall or against floor.

10

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multifidi , rotatores

multifidi , rotatores Tennis ball is too big to hit the trigger points but some tool

Tennis ball is too big to hit the trigger points but some tool that is smaller works fine.

Be little extra careful when applying pressure near vertebrae, use common sense.

To be extra cautious use tool with your hands not against floor or wall-

Buccinator

11

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It refers pain to the teeth near the muscle Use your fingers for pressure Lateral

It refers pain to the teeth near the muscle Use your fingers for pressure

Lateral pterygoid

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The x is the trigger point spot and grey areas on both side it the

The x is the trigger point spot and grey areas on both side it the referred pain areas.

use fingers to locate and hit the spot.

Medial pterygoid

use fingers to locate and hit the spot. Medial pterygoid To reach this muscle you need

To reach this muscle you need to press it from below your chin. It is on the x spot

orbicularis oculi

13

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No it’s not the Frankenstein’s bride wearing an eye patch, even thou it kind of

No it’s not the Frankenstein’s bride wearing an eye patch, even thou it kind of a looks like it.

The pain pattern is the grey shadow that seems to sculpt the nose and the trigger point is the small x just in the eye brow line or little below, like it is in this case.

Just track down the bones around the eye looking for tender points.

The black patch describes the muscle.

zygomaticus, levator labii

14

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Indian war painting, or maybe not. Use fingers to locate and aply pressure 15 PDF

Indian war painting, or maybe not.

Use fingers to locate and aply pressure

15

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digastric

digastric Again you need to venture to the underneath of the chin. Use fingers an to
digastric Again you need to venture to the underneath of the chin. Use fingers an to

Again you need to venture to the underneath of the chin.

Use fingers an to search tender spots and referred pain.

16

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frontalis

frontalis occipital Move your eyebrows and try to wiggle your ear can you feel the occipital

occipital

frontalis occipital Move your eyebrows and try to wiggle your ear can you feel the occipital

Move your eyebrows and try to wiggle your ear can you feel the occipital muscle in the back of your head.

Fingers, knuckles or a tool there aren’t any rules.

suboccipitalis

knuckles or a tool there aren’t any rules. suboccipitalis Use a tool to reach the muscle

Use a tool to reach the muscle easily, against wall if necessary.

17

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Upper back, shoulder, upper arm

Upper back, shoulder, upper arm 18 PDF created with pdfFactory Pro trial version www.pdffactory.com

18

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Index II

Upper back pain

Scaleni levatorscapulae trapezius multifidi splenius cervicis supraspinatus rhombodei triceps brachii biceps brachii

Back of shoulder

deltoid

levator scapulae supraspinatus teres major latissimus dorsi

Back of upper arm

scaleni teres major triceps brachii deltoid subscapularis supraspinatus teres minor latissimus dorsi serratus posterior superioir coracobrachialis scalenus minimus

Front of upper arm

teres minor subscapularis serratus posterior superior triceps brachii trapezius scaleni lats erector spinae

Shoulder front

infraspinatus deltoid scaleni supraspinatus pectoralis major pectoralis minor biceps brachii coracobrachialis sternalis subclavius

scaleni biceps brachii triceps brachii

subclavius

supraspinatus

sternalis

infraspinatus

Deltoid

brachialis

latissimus

dorsi

19

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scalanes

scalanes Locate your collar bone use your fingers o pull to the collar bone. . 20

Locate your collar bone use your fingers o pull to the collar bone.

.

20

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trapezius

trapezius Tennis ball or similar tool against the floor is the way to go, just lye
trapezius Tennis ball or similar tool against the floor is the way to go, just lye

Tennis ball or similar tool against the floor is the way to go, just lye on it and move it to the tenderest spots and hold for awhile.

21

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Levator Scapulae

Levator Scapulae Tennis ball or similar tool against the floor is the way to go, just

Tennis ball or similar tool against the floor is the way to go, just lye on it and move it to the tenderest spots and hold for awhile.

22

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Latissimus Dorsi

Latissimus Dorsi Tennis ball or similar tool against the floor is the way to go, just
Latissimus Dorsi Tennis ball or similar tool against the floor is the way to go, just

Tennis ball or similar tool against the floor is the way to go, just lye on it and move it to the tenderest spots and hold for awhile.

23

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Rhomboid

Rhomboid Tennis ball or similar tool against the floor is the way to go, just lye
Rhomboid Tennis ball or similar tool against the floor is the way to go, just lye

Tennis ball or similar tool against the floor is the way to go, just lye on it and move it to the tenderest spots and hold for awhile.

Serratus posterior superior

24

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supraspinatus

supraspinatus Stick as a tool is great to reach this, tennis ball on the floor can

Stick as a tool is great to reach this, tennis ball on the floor can work also.

infraspinatus

this, tennis ball on the floor can work also. infraspinatus Tennis ball or similar tool against
this, tennis ball on the floor can work also. infraspinatus Tennis ball or similar tool against

Tennis ball or similar tool against the floor is the way to go, just lye on it and move it to the tenderest spots and hold for awhile.

25

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Teres Minor

Teres Minor Teres Major 26 PDF created with pdfFactory Pro trial version www.pdffactory.com

Teres Major

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Subscapularis

Subscapularis coracobrachialis 27 PDF created with pdfFactory Pro trial version www.pdffactory.com

coracobrachialis

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deltoid

deltoid 28 PDF created with pdfFactory Pro trial version www.pdffactory.com

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Triceps

Triceps Biceps 29 PDF created with pdfFactory Pro trial version www.pdffactory.com

Biceps

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Middle back, lower back, hip and buttocks/sacral pain

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Index III

Middle back pain

spinae erectors multifidi rotatores rectus abdomis serratus anterior serratus posterior inferior latissimus dorsi intercostals

Lower back pain

gluteus medius gluteus maximus gluteus minimus psoas multifidi rotators (syvät elkälihakset) spinae erectors

pinnalliset selkälihakset) quadratus lumborum rectus abdomis obiliques

(

hamstrings

soleus

Buttock/sacral pain

quadratus lumborum erector spinae gluteus minimus gluteus medius gluteus maximus piriformis hamstring soleus

Hip pain

quadreceps vastus lateralis gluteus minimus gluteus maximus. piriformis quadratus lumborum tensor fasciae latae

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Gluteus maximus 32 PDF created with pdfFactory Pro trial version www.pdffactory.com

Gluteus maximus

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Gluteus medius

Gluteus medius Gluteus minimus 33 PDF created with pdfFactory Pro trial version www.pdffactory.com

Gluteus minimus

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piriformis

piriformis Quadratus lumborum 34 PDF created with pdfFactory Pro trial version www.pdffactory.com
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Quadratus lumborum

piriformis Quadratus lumborum 34 PDF created with pdfFactory Pro trial version www.pdffactory.com

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Spinae erectors

& multifidi ja rotatores

Spinae erectors & multifidi ja rotatores Rectus abdomis 35 PDF created with pdfFactory Pro trial version

Rectus abdomis

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liopsoas

liopsoas obiliques 36 PDF created with pdfFactory Pro trial version www.pdffactory.com

obiliques

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Hamstring

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Chest, abdominal, genital pain

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Index IV

Chest pain pectorals scalenes sternocleidomastoid sternalis intercostals superficial spinal muscles subclavius rectus abdomis diaphgram

Side pain serratus anterior abdominal obiliques intercostals

latissimus dorsidiaphgram

Abdominal pain

rectus abdomis abdominal obliques superficial spinal muscles deep spinal muscles quadratus lumborum

Groin pain

Rectus abdomis Abdominal obiliques intrapelvic muscles adductor magnus psoas piriformis

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Pectorals

Pectorals 40 PDF created with pdfFactory Pro trial version www.pdffactory.com

40

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Serratus anterior

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Latissimus Dorsi

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Rectus abdomis

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Obiliques

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Hip, thigh, knee pain

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Index V

Groin Pain

pectineus abductor longus abductor magnus rectus abdominis abdominal obiliques psoap intrapelvi muscles

Hip pain

gluteus minimus vastus lateralis piriformis qiadratus lumborum tensor fasciae latae vastus intermedialis gluteus maximus

Front thigh pain

Abductor longus psoas abducto magnus vastus intermedialis pectineus sartorius quadratus lumborum rectus abdominis

Front of knee

rectus femoris vastus medialis abductor longus

Inner knee

vastus medialis gracilis rectus femoris sartorius adductor longus

Outer knee

vastus lateralis

Back of thigh

gluteus minimus semitendinosus biceps femoris piriformis intrapelvi muscles

Inner thigh

pectineus vastus medialis grazilis adductor magnus

Back of knee

gastrocnemius biceps femoris popliteus semiteninosus semimembranus soleus plantaris

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Tensor latia fascae

Tensor latia fascae Vastus intermedialis 45 PDF created with pdfFactory Pro trial version www.pdffactory.com

Vastus intermedialis

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Vastus medialis 46 PDF created with pdfFactory Pro trial version www.pdffactory.com

Vastus medialis

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Rectus femoris

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vastus lateralis

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Pectineus 48 PDF created with pdfFactory Pro trial version www.pdffactory.com
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Pectineus

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Abductor brevis Abductor longus 49 PDF created with pdfFactory Pro trial version www.pdffactory.com

Abductor brevis

Abductor longus

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Abductor magnus Gracialis 50 PDF created with pdfFactory Pro trial version www.pdffactory.com

Abductor magnus

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Gracialis

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Hamstrings 51 PDF created with pdfFactory Pro trial version www.pdffactory.com

Hamstrings

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plantaris 52 Popliteus PDF created with pdfFactory Pro trial version www.pdffactory.com

plantaris

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52

Popliteus

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Leg and ankle pain

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Index VI

Front of leg

Tibialis anterior adductor longus

Front of foot

tibialis anterior peroneus tertius extensor digitorum longus

Back of leg

Soleus gluteus minimus gastronomicus semitendinosus semimembranus flexor digitorum longus tibialis posterior Plantaris

Side of leg

Gastrocnemius gluteus minimus peroneus longus peroneus brevis vastus lateralis

inner ankle

Abductor hallucis flexor digitorum lonngus

outer ankle

peroneus longus peroneus brevis peroneus tertius abductoe digiti minimi

back of ankle

soleus tibialis posterior

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tibialis anterior

tibialis anterior extensor hallucis longus & extensor digitorum 55 PDF created with pdfFactory Pro trial version
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extensor hallucis longus

&

extensor digitorum

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peroneus longus peroneus tertius & Peroneus brevis 56 PDF created with pdfFactory Pro trial version
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peroneus longus

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peroneus tertius

&

Peroneus brevis

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gastrocnemius 57 PDF created with pdfFactory Pro trial version www.pdffactory.com
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gastrocnemius

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soleus

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tibialis posterior

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Flexor digitorum longus & flexor hallucis longus

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Foot pain

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Index VII

Top of foot

extensor digitorum brevis extensor hallucis brevis extensor digitorum longus extensor hallucis longus flexor hallucis brevis interosseus tibialis anterior

Big toe

top tibialis anterior extensor hallucis longus flexor hallucis brevis under flexor hallucis longus flexor hallucis brevis tibialis posterior

Other toes

top interosseus extensor digitorum longus under flexor digitorum longus tibialis posterior

Bottom of the foot Front

flexor hallucis brevis flexor digitorum brevis adductor hallucis flexor hallucis longus interosseus abductor digiti minimi flexor digitorum longus tibialis posterior flexor digigti minimi brevis

Bottom of the foot middle

gastrocnemius flexor digitorum longus adductor hallucis soleus interoseus tibislis posterior

Heel pain

soleus quadratus palnatae abductor hallucis tibialis posterior abductor digiti minimi

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Extensor digitorum brevis & extensor hallucis brevis

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introsseus

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Abductor hallucis

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abductor digiti minimi flexor digitorum brevis quadratus plantae 63 PDF created with pdfFactory Pro trial

abductor digiti minimi

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flexor digitorum brevis

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quadratus plantae

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Abductor hallucis & flexor hallucis brevi

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Flexor digiti mininmi brevis

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Elbow, arm, wrist, hand pain

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Index VIII

Elbow

supinator brachioradialis extensor anconeus triceps brachii supraspinatus pectoralis major serratus anterior serratus posterior superior

Outer elbow

trticeps scalanes extensors brachioradialis brachialis flexors infraspinatus teres major cocabrachialis supraspinatus subclavius

Inner elbow pain

palmaris longus pronator teres serratus anterior triceps brachii latissimus dorsi pectoralis major serratus posterioer superior

Wrist outer arm

extensors subsscapulari sascalenes latissimus dorsi serratus posterior superior coracobrachialis

Wrist inner hand pain

flexors palmaris longus pronator teres opopnens pollicis pectorals latissimus dorsi serratus anterior

Inner finger pain

flexores digitorum superficialis and profundus introssei abductor digiti minimi lats serratus subclavius

Top of finger pain

extensor digitorum introssei scalene abductor digiti mininimi pectorals

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lats

subclavius

Thumb pain

supinator scalene brachialis brachioradialis opponenns pollicis abductor pollicis extensor carpi radialis longus first dorsal introsseus flexor pollicis longus subclavius infraspinatus brachialis

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extensor carpi radialis longus

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brachioradialis

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supinator

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extensor carpi radialis brevis

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extensor carpi ulnaris

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anconeus

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extensor digitorum

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Extensor indicis

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flexor carpi radialis

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flexor carpi ulnaris

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palmaris longus

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flexor digitorum

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pronator teres & pronator quadratus

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flexor pollicis longus

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opponens pollicis & abductor pollicis

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introsseus

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