Diagnosis of trigger points typically takes into account symptoms, pain patterns, and manual palpation. When palpating the therapist will feel for a taut band of muscle with a hard nodule within it. Often a local twitch response will be elicited by running a finger perpendicular to the muscle fibres direction. Pressure applied to the trigger point will often reproduce the pain complaint of the patient and the referral pattern of the trigger point. Often there is a heat differential in the local area of the trigger point. 
Trigger Points
Trigger points in the biceps Brachii muscle.
The Bicep Brachii is perhaps the most recognizable muscle in the body. It’s the muscle that is most often flexed when someone says ” show me your muscles”. It is composed of two heads, the long head and the short head. The short head originates on the coracoid process of the scapula, and the long head on the supraglenoid tubercle. Both heads merge to insert on the radial tuberosity and bicipital aponeurosis into the deep fascia on the medial part of the forearm. The main actions of this muscle are elbow flexion and forearm supination(rotation with the palm of the hand going upward). This muscle also assists shoulder flexion. Trigger points in this muscle mainly refer pain into the shoulder, with spillover into the posterior aspect above the scapula. A less common referral is into the anterior elbow and forearm. 
What is a trigger point
Dr Janet travel coined the term trigger point in 1942 to describe clinical findings with characteristics of pain related a discrete irritable point in muscle or fascia that was not caused by acute trauma, inflammation, degeneration, neoplasm or infection. The painful point can be palpated as a nodule or tight band in the muscle that can produce a local twitch response when stimulated. Palpation of the trigger point reproduces the pain and symptoms of the patient and the pain radiates in a predictable referral pattern specific to the muscle harbouring the trigger point.
What to expect with a trigger point massage.
A treatment with Bryan is very user friendly. And, no, you don’t have to remove any clothing. However, bringing a t-shirt and a pair of shorts or sweats is recommended.
The first time you come for a treatment you will be asked to fill out a Client History form. Bryan will go over the information you provide, asking for more detail and discussing the type of pain you are having and its location.
The treatment itself involves locating the Trigger Points in the muscle or soft tissue and applying a deep focused pressure to the Point. This will reproduce the pain and the referral pattern that is characteristic of that pain.
The treatment will be uncomfortable at first, but as the Trigger Points release, the pain will decrease. The pressure will always be adjusted to your tolerance level. If, at any time, you feel too uncomfortable you can ask Bryan to ease off a bit.
Depending on your specific problem, Bryan may also use some stretching and / or range-of-motion techniques, as needed.
After treatment, it is usually recommended that the client apply moist heat to the area treated.
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. 
Another tunnel injury? Seriously?
Your radial nerve begins in your neck and travels past your elbow en route to its final destination in your hand. Just beyond your elbow, this nerve passes through a 2-inch area on the back of your forearm called the “Radial tunnel”. “Radial tunnel syndrome” means that your radial nerve has been compressed or irritated within this space-leading to forearm pain or hand weakness.
Radial tunnel syndrome is thought to result from muscular overuse, especially prolonged or excessive wrist extension or rotation. The most common cause of compression comes from excessive tightness in a muscle called the “Supinator”. Workers whose jobs require heavy or repetitive wrist movements are at an increased risk for this disorder. Occasionally, the radial nerve can become irritated from direct compression by a tight band or brace. The condition may be more common in those who have diabetes or thyroid problems.
Symptoms from irritation of the radial nerve depend upon which specific nerve fibers are irritated. The most common symptoms include pain, numbness, tingling or decreased sensitivity along the top of your forearm radiating toward your hand and thumb. The symptoms often mimic those of “tennis elbow.” When the nerve fibers that control muscle function become compressed, you may experience weakness when trying to extend your fingers, hand or wrist. Seventy percent of radial tunnel patients also have problems in their neck or upper back.
Conservative treatment of radial tunnel syndrome is generally successful. Fixing the problem means limiting excessive or repetitive wrist movements, especially extension and rotation. In severe cases, a splint may be necessary to limit your motion. Try to avoid compression of your forearm, particularly from tight bands or braces. Use of a tennis elbow brace will likely aggravate your symptoms. You may find relief by applying ice or ice massage to the area for 10-15 minutes at a time.
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. 
Have you Been Told You Have TMJ Disorder?
Temporomandibular Disorder (TMD) is a term used to describe a group problems that cause pain in the temporomandibular joint, also called the TMJ. These problems can arise from the muscles around the joint, the disc within the joint or the bony portion of the joint itself. Imbalances between the muscles that open and close your jaw are the most common culprit.
Up to 25% of the population will suffer with TMD symptoms. Most patients are 20-50 years old and the condition is 2-3 times more common in females. Typical symptoms include: jaw clicking, limited mouth opening, possible jaw locking and pain. Chewing and eating usually make your symptoms more noticeable. TMD pain is generally described as an “ache” located in front of your ear canal but may also refer to other areas of your face, head, neck and shoulders. TMD patients often suffer from headaches.
TMD is more common in people who clench their jaw or grind their teeth, especially at night. Bad posture and emotional stress are contributors to this problem. You are three times more likely to suffer with TMD if you have been involved in a “whiplash” accident.
Conservative treatments, like those provided by our office, have been shown to be as effective as any surgery for most patients with TMD. Treatment is simple, focusing on “massaging” tightness out of the jaw muscles, restoring movement to any restricted joints (including your neck and upper back), and prescribing exercises to improve flexibility.
You should avoid aggravating activities like chewing gum or eating “rubbery” foods. Limit excessive talking. A custom fitted mouth guard may be prescribed to help minimize grinding & clenching and promote relaxation of your jaw muscles at night. Patients with night-time symptoms should avoid stressful activity before bedtime and try to sleep in a “neutral” position. In some cases, stress management techniques, like biofeedback, can assist you in learning how to relax your jaw muscles.
Cubital Tunnel Syndrome…. Ever heard of it?
Your cubital tunnel is the groove on the inside of your elbow, also called the “funny bone.” The funny part about the funny bone is that it is not actually a bone but rather a nerve, called the ulnar nerve. Your ulnar nerve begins in your neck and passes through the cubital tunnel on its way to your hand.
When you flex your elbow, the ulnar nerve is required to both stretch and slide through your cubital tunnel. If your ulnar nerve is “stuck” in the tunnel and does not glide when you flex your elbow, this leads to traction and irritation of the nerve. This is called “cubital tunnel syndrome.” The nerve may also be irritated from direct compression, like leaning your elbow on the edge of a desk or from arthritic spurs. Cubital tunnel syndrome is the second most common nerve compression problem in the arm, behind carpal tunnel syndrome.
Irritation of the ulnar nerve in the cubital tunnel causes pain, numbness or tingling that radiates from your elbow into your fourth and fifth fingers. Your symptoms can vary from a vague increased sensitivity to pain. The symptoms are common at night and are often progressive over time. In severe cases, you may begin to lose grip strength and fine muscle control.
Cubital tunnel syndrome is commonly seen in baseball, tennis and racquetball players. Workers who keep their elbows flexed such as holding a tool or telephone, or those who press the ulnar nerve against a hard surface like a desk, are at an increased risk for this disorder. Cubital tunnel syndrome affects men three to eight times as often as women and is more common in those who have diabetes or are overweight.
You should try to avoid prolonged elbow flexion or direct pressure over your elbow. Our office may prescribe a nighttime elbow splint that limits flexion.
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.
Aberdeen Chiropractic 