The sternalis muscle is a little known muscle located at the sternum. This muscle seems to be vestigial in that it doesn’t have a known function. In originates on the superior portion of the sternum and the upper part of the pectoralis muscle. It’s insertion is the cartilage of ribs 3-7, or sometimes the sheath of the rectus abdominis, or the lower part of pectoralis major. Even though this muscle doesn’t seem to have a purpose anymore it can still harbour trigger points. These points will cause pain to be felt intensely deep in the sternum, with spillover pain radiating down the inside of the arm.
What is a Trigger Point?
Trigger Points (TP’s) are defined as a “hyper-irritable spot within a taut band of skeletal muscle. The spot is painful on compression and can evoke characteristic referred pain and autonomic phenomena.”1
Put into plain language, a TP is a painful knot in muscle tissue that can refer pain to other areas of the body. You have probably felt the characteristic achy pain and stiffness that TP’s produce at some time in your life.
The rectus femoris muscle is one of your quad muscles. It acts primarily to extend the knee but it also helps to flex the hip. This muscle is often overloaded from athletic activity, but it also can become chronically shortened from prolonged sitting. Trigger points will refer pain deep into the knee producing a deep ache felt into the joint.
Temporomandibular joint dysfunction is a blanket term that refers to pain and dysfunction of the jaw muscles and the tempomandibular joints which connect the mandible to the skull. The most common symptoms are pain and restricted mandibular movement as well as grinding noises coming from the joint. This condition is more common in women then in men, and affects a large portion of patients suffering from fibromyalgia. Trigger points in the muscles of mastication are frequently involved in TMJ dysfunction. Trigger points in the pterygoid and masseter muscles for example will not only refer pain into the tempomandibular joints, but will also cause a dysfunctional movement pattern that can restrict range of motion. Trigger point therapy can be an effective modality to treat TMJ dysfunction.
Your thoracic spine is made up of 12 individual vertebrae stacked on top of each other. To allow for flexibility and movement, there is a cushion or “disc” in between each level. As we age, these discs can wear and become thinner over time. This leads to additional changes, including bone spurs and narrowing of the opening where your nerves exit your spine. This process is called “thoracic spondylosis”, or simply, “arthritis”.
How quickly you develop back arthritis is largely a trait you inherited from your parents. Other factors may play a role, including a history of trauma, smoking, operating motorized vehicles, being overweight and/ or performing repetitive movements (i.e. lifting, twisting, bending or sitting). Men seem to be affected slightly more often than women.
Symptoms often begin as back pain that gradually worsens over time. Stiffness may be present upon arising in the morning. Pain is relieved by rest or light activity and aggravated by strenuous work. Sometimes your nerves can become “pinched” in narrowed openings where they exit your spine. This can cause pain, numbness, or tingling radiating around your trunk along the path of the irritated nerve. Be sure to tell your doctor if you notice any weakness or if you have a rash (running along your rib), fever, abdominal pain, change in bowel or bladder function, or pain in your groin crease.
Arthritic changes can be seen on x-rays, but interestingly, the amount of wearing does not seem to correlate directly with the severity of your symptoms. People with the same degree of arthritis may have symptoms ranging from none to severe. Most researchers believe that the symptoms of osteoarthritis are not the direct result of the disease, but rather, from the conditions that preceded the disease and those that develop after it, like joint restrictions and muscle tightness. Fortunately, those conditions are treatable and our office has a variety of tools to help relieve your pain.
In general, you should avoid repeated lifting and twisting and take frequent breaks from prolonged sitting, especially in motorized vehicles. Avoid any position that causes an increase in radiating pain. Light exercise, like walking, stationary cycling, water aerobics, and yoga may be helpful. Smokers should find a program to help them quit and overweight patients will benefit from a diet and exercise program.