Trigger points in the deltoid muscle.

The deltoid is the the muscle that is most often thought of as the “shoulder.” It is the diamond shaped muscle that caps the shoulder joint. It originates on the clavicle, the acromion, and the spine of the scapula. It inserts on the deltoid tuberosity of the humerus. As a whole unit the deltoid laterally abducts the humerus at the glenohumeral joint. The anterior portion of the delt forward flexes the arm, as well as horizontally flexing the arm across the chest. Since the deltoid is involved in almost all shoulder movements it is especially prone to trigger points. Points in the anterior deltoid refer into the anterior and lateral shoulder. Trigger points in the posterior deltoid refer pain into the posterior shoulder with spillover down the lateral arm.

Trigger points in the pectoralis minor muscle.

The pectoralis minor is a small strap like muscle that is underneath (deep) to the pectoralis major. It originates on the third to fifth rib, near the costal cartilages. It’s insertion is on the coracoid process of the scapula. It acts to draw the scapula forward, downward, and inward at nearly equal angles ( think of rounding or shrugging your shoulders forward). This muscle is very often shortened and tight in people due to the high prevalence of desk jobs. This muscle pulls the shoulder blade forward resulting in the muscles in the back(rhomboid and mid traps) being chronically strained. Trigger points that form in the pec minor primarily refer pain over the anterior chest and shoulder, with spillover down the medial arm. Trigger points in the left side can mimic angina.

Trigger points in the pectoralis Major muscle.

The pectoralis major or “pecs” is commonly thought of as the chest muscle. It originates on the clavicle, sternum, costal cartilage , and the external oblique aponeurosis. It inserts on the intertubercular groove of the humerus. Its main actions are to adduct the shoulder and to internally rotate the humerus. This muscle gets chronically shortened by a rounded shoulder forward posture such as from prolonged sitting. Tightness in this muscle can cause strain in the rhomboids and traps. When trigger points form in this muscle they refer pain into the anterior shoulder, as well as the anterior chest and medial aspect of the arm. Trigger points in the pecs can also cause nipple hypersensitivity. Trigger points in the left pec muscle can mimic heart pain.

Trigger points in the rhomboid muscles.

This is another common muscle to get trigger points. It originates on the spinous processes of the T2-T5 vertebrae. It inserts on the medial border of the scapula. It’s main actions are to adduct the scapula pulling it back toward the spine, and to rotate the glenohumeral joint downward. This muscle also prevents wining of the scapula. This muscle is often overloaded by a sitting posture where the shoulders are rolled forward such as when using a computer. The Rhomboids are often weak and under trained in people. Trigger points in this muscle cause pain and ache in the upper back between the shoulder blade. Strength trading for this muscle is necessary to help prevent postural overload.

Trigger points in the trapezius muscle.

The trapezius muscle is a large diamond shaped muscle in you mid/upper back and neck. This muscle is one of the most common sites where trigger points can form. This muscle originates on the Nuchal ligament and the spinous processes of C6-T12. It inserts on the spine of the scapula, the acromion process, and the distal clavicle. The upper fibres elevate the shoulder and rotate the glenoid fossa (shoulder socket) upward. The lower fibres assist this motion as well as help depress the shoulder. The middle fibres of this muscle strongly adduct the scapula. This muscle is susceptible to postural overload such as sitting at desk all day. Trigger points on the lateral upper edge refer into the lateral neck and temples, causing “tension neck ache”as well as headache pain.Trigger points in the middle and lower fibres refer pain into the posterior neck and shoulder.

Trigger points in the Levator scapula

The Levator scapula is a muscle in your neck that originates on the transverse processes of C1-C4 and inserts on the superior part of the medial border of the scapula. The primary actions of this muscle are to elevate the scapula and rotate the glenoid fossa downward. It also rotates the neck to the same side and assists in extension. When this muscle is tight it restricts neck rotation resulting in the classic “stiff neck”. With a forward head position the Levator is often stretched and over worked. To help combat this you must get the head back by releasing the anterior chest and neck muscles. Trigger points in this muscle refer pain into the angle of the neck and down the shoulder blade.

Trigger points in the masseter muscle

The masseter is the main muscle that moves your jaw. It originates on the zygomatic arch and maxilla, and inserts on the coronoid process and Ramus of the mandible. It’s actions are to elevate the mandible and close the jaw. The deep fibres of this muscle also retrude the mandible. This muscle commonly harbours trigger points as a result of teeth grinding. Trigger points in this muscle are often also associated with tmj dysfunction. Trigger points in the upper part of this muscle will refer pain to the upper molars and maxilla often felt as sinusitis. Trigger points in the lower portion of this muscle refer to the lower molars and temple. All trigger points can cause tooth sensitivity

Trigger points in the suboccipitals.

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The suboccipitals are a group or four muscles that attach to the transverse and spinous process of C1 and C2 and the occipital bone.

These muscles provide extension side bending and rotation movements between the occiput and C1 and C2. These muscles are often overloaded due to postural strain. A classic example being sitting in front of a computer all day.

When these muscles are overloaded trigger points can develop. Pain and symptoms of trigger points in the suboccipitals include head pain that penetrates into the skull but is difficult to localize.

Patients are likely to describe the pain as “all over” including the occiput, eye and forehead, but without any clarity. Trigger points in these muscles are often associated with tension head aches

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Our Exercise Of The Month: ITB Foam Roller

ITB – Foam Roller
  • Lie on your side with your affected thigh over a foam roll.
  • Lift your shoulders off of the floor with your arm and roll the fleshy part your mid & lower thigh back and forth over the foam roller.
  • Avoid rolling over the bony point of your hip unless specifically directed.
  • Perform this exercise for one minute twice per day or as directed.

Trigger points in the sternocleidomastoid muscle. By Bryan Cobb RMT.

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The sternocleidomastoid muscle or “scm” is a strap like muscle located in the front of the neck. It originates on the manubrium of the sternum and the medial clavicle, and inserts on the mastoid process of the temporal bone( the lump or bone behind the ear). When working together the scm flexes the head and neck. The actions of one muscle working by itself is to rotate the face to the opposite side and lift it toward the ceiling.

Trigger points in this muscle usually form due to acute injury or to chronic postural stress. These trigger points can cause a wide variety of symptoms including pain felt in the cheek, temple, forehead, top of the head, and base of the skull. Trigger points in these muscles can also refer deep into the ear and cause postural dizziness.