7C83 Taping For Trigger Points 1117

Prepared exclusively for jonathandelaorta@yahoo.
com Transaction: 2017-14029

NAT Pro Series:
Taping for Trigger Points

Diploma Course for Manual Therapists
and Exercise Professionals
Stuart Hinds
Published by Niel Asher Education
Copyright 2017, All Rights Reserved
Prepared exclusively for jonathandelaorta@yahoo.com Transaction: 2017-14029

Table of Contents
About Stuart Hinds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
About this course . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
About trigger points. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Deltoids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Teres major / minor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Trapezius . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Infraspinatus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Supraspinatus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Levator scapulae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Forearm extensors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Forearm flexors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Biceps brachii . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Triceps brachii . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Adductor magnus / longus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Gastrocnemius . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Soleus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Gluteus minimus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Gluteus medius . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Tensor Fascia latae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Tibialis anterior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Fibulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Hamstrings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Piriformis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Erector spinae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Exams / Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Stuart Hinds is one of Australia’s leading soft tissue
therapists, with over 25 years of experience as a
practitioner, working with elite sports athletes,
supporting Olympic teams, educating and mentoring
others as well as running a highly successful clinic in
Australia.
Recognised for his expertise in working with elite
athletes, Stuart has played a key role in soft tissue
support with the Australian Olympics Team since 2000 at four separate
Olympics (2012 London Olympics, the 2008 Beijing Olympics, the 2004
Athens Olympics and the 2000 Sydney Olympics).
Stuart also works with athletes at his clinic including elite road cyclists,
adventure racers , swimmers, runners as well as body builders and
worked with the National Premiership winning Geelong Football Club
(Australian Rules Football League) for 8 years.
Stuart has published numerous articles on the subject of trigger point
therapy, pelvic imbalances for cyclists and kinesiology taping for soft
tissue dysfunction.
Recognised for his expertise, he lectures on remedial soft tissue
techniques at Victoria University (Melbourne Australia) and is a regular
keynote speaker at sports medicine events and conferences.
Stuart also has a strong following of practitioners across Australia and
globally who tap in to his expertise as a soft tissue specialist. He delivers
a range of highly sought-after seminars across Australia, supported by
online videos, webinars and one-on-one mentoring to help support his
colleagues to build successful businesses. Stuart is a strong believer
in professional development and he devotes over 100 hours a year to
this ‒ meeting with like-minded professionals and attending specialist
educational workshops across the globe.
Born in Sydney in 1967, Stuart is married to Paula and has three children
Sebastian, Imogen and Edwina.
T a p i n g f o r T r i g g e r P o i n t s 4
Introduction
We all know how effective treating myofascial trigger points can be to
alleviate pain, dysfunction and in helping to improve function, especially
with athletes. This course is designed to offer taping techniques to keep
the treatment process going long after our athletes/clients leave our
clinics.
By following this course and the accompanying video material, you will
learn how to safely and easily apply highly effective taping techniques for
all of the most common muscle trigger point sites.
The techniques covered in this course all utilize kinesiology tape, which
helps provide an accumulated offloading effect by lifting the tissue
around the trigger point sites. This allows an unloading to the vascular,
nerve and the fascia to allow the treatment process to continue.
If you work with athletes whether they are elite or amateur, or simply
‘weekend warriors’, these trigger point taping techniques will add hugely
to your treatment toolbox.
Video Links
The video links in this text have been disabled. Please use the link
below to watch all of the videos relating to this course
https //www.nielasher.com/pages/taping-for-trigger-points-video-
classes-10-2017-update
The History of trigger points
Therapeutic touch has emerged in all cultures in all ages. Massaging

painful muscular spots occurred in Ancient Egypt, India, Japan, Korea,
Rome, Greece and Mesopotamia. In the West, Gowers (as ‘brositis’) and
later Kellgren, Gunn, Travell and Simons all rationalized these hyper-
irritable spots as ‘trigger points’.
Touch isn’t just a human occupation – it’s primal. During his fascinating
work on social grooming amongst primates, Dunbar (2010) suggests that
touch triggers neurobiological mechanisms via slow unmyelinated CT
afferent fibers and a neuroendocrine cascade (oxytocin and endorphins).
Primates, he asserts, spend up to 21% of their waking hours grooming
each other, not for reasons of hygiene but more for social bonding.
Historically, there are two pathways for exploring trigger point

manifestation and treatment. One is the holistic and the other the
orthodox medical.
Trigger points in the Ancient World
Perhaps the most famous book including massage is ‘The Yellow

Emperor’ (2700 BC). This book forms the foundations of Chinese medicine.
The first references to tender/trigger points in Chinese medicine were
around 722-481 BC, when Shiatsu was described in order to treat ‘Ah She’
or painful knots/points. The first school of massage was founded in 581
AD in China within the Office of Imperial Physicians.
In the West, Hippocrates (460 BC) wrote, “The physician must be

experienced in many things, but assuredly in rubbing”. Greco-Roman
medicine including that of Hippocrates advocates “rubbing” the body
with oils to facilitate health. The great ancient physician Avicenna also
advocated ‘pain relieving massage’.
Modern holistic medicine
“The fascia is the place to look for the cause of disease and the place to
consult and begin the action of remedies in all diseases”. - Andrew Taylor-
Still (1828-1917), the founder of osteopathic medicine. His extensive
writing focuses on restrictions, lesions and knots in muscles. Dr. Still
realized that abnormal structures could create the same symptoms
and problems that are associated with other diseases. One of his first
techniques for treating his own recurrent headaches was to tie a rope
between two chair legs and rest his upper neck (sub-occipital muscle) on
the rope.
Orthodox medical history
The first medical doctor to report pain from knotted muscles was
British neurologist Sir William Gowers (1845-1915). He introduced the
term ‘brositis’ for a common but idiopathic, localized form of muscular
rheumatism which he called ‘Lumbago’, now recognized as myofascial
pain syndrome.
However, it was not until Jonas Kellgren (1911-2002) came along that
things really started to “get going”. Kellgren’s seminal work on pain arising
from muscles was first published in the British Medical Journal in 1938.
He was the first to record the pain maps associated with trigger points
when he injected tender/trigger spots. His findings concluded that the
“Referred pain is distant from the stimulated point and may be felt in
joints, teeth or even in the scrotum”. Furthermore, he found that “the pain
follows spinal segmental patterns but that it does not correspond with
sensory segmental patterns”.
Dr. Janet Travell 1901-1997
Dr. Janet Travell, and her partner Dr. David Simons, looked at the work
of Kellgren in a new way. Together they pioneered work in the field of
trigger points and pain medicine. Dr. Travell’s work in pain relief became
legendary and even reached a young man, who was riddled with pain,
called John Kennedy (JFK). He became her most famous case study and
as soon as he became the President of the United States, he appointed
Janet as his “personal physician”, the first woman and one of the few
civilians to hold that post.
Dr. Travell continued to explore and develop her theories and the science
behind trigger points until her death in 1997, at the age of 95. Over time,
her legacy has been extensively researched, expanded and validated.
What is myofascia?
Imagine you are an orange. Your skin is (superficial) fascia embedded

with hairs and receptors; the white tough pith beneath the skin is fascia;
the bags that surround each segment are (deep) fascia; and, if you look
really closely, the juice of the orange is held in even smaller fascial bags.
We are all similar to some extent: our fascia is ubiquitous — it wraps and
supports organs, bones, and tendons. Where it wraps muscles, it is known
as myofascia. Fascia is a living tissue and has memory; it also helps
transport and move chemical and other substances around the body.
When we refer to ‘myofascial trigger points’, we are talking about a trigger
point in a specific muscle and its fascial wrapping.
Myofascia connects many of the areas of the body together, which is why
it is sometimes referred to as connective tissue.
Trigger point definition
We will define a trigger point after Dr’s Janet Travell and David Simons
(1998): “A highly irritable localized spot of exquisite tenderness in a nodule
in a palpable taut band of (skeletal) muscle.”
These hyper-irritable localized spots can vary in size, and have been
described as ‘tiny lumps’, ‘little peas’, and “large lumps”; they can be
felt beneath the surface, embedded within the muscle fibers. If these
spots are tender to pressure, they may well be ‘trigger points’. The size
of a trigger point nodule varies according to the size, shape, and type of
muscle in which it is generated. What is consistent is that they are tender
to pressure. So tender, in fact (hyperalgesia), that when they are pressed,
the patient winces from the pain in which has been called the ‘jump sign.
When pressed and held for six or more seconds this acute pain seems to
melt into a specific and reproducible map of pain.
Myofascial trigger points may well be implicated in all types of

musculoskeletal and mechanical muscular pain. Their presence has
even been demonstrated in children and babies. Pain or symptoms
may be directly due to active trigger points, or pain may ‘build up’ over
time from latent or inactive trigger points. Studies and investigations in
selected patient populations have been carried out on various regions
of the body. There is a growing amount of research evidence directly
linking musculoskeletal pain to trigger points. A high prevalence of trigger
points has been confirmed to be directly associated with myofascial
pain, somatic dysfunction, psychological disturbance, and associated
restricted daily functioning.
Trigger point characteristics
• Pain, often exquisite, is present at a discrete point

• A nodule is embedded within a taut band in the muscle
• Pressure reproduces the pain symptoms, with radiations in a specific
and reproducible distribution (map), often remote from the pressure
point
• Pain cannot be explained by findings from a neurological
examination
• May induce autonomic changes (Simons 1998)
Trigger points 101
• Trigger points develop in the muscle belly so multi-pennate (several

heads) muscles such as the deltoideus or serratus anterior may have
several trigger points at once.
• They are the result of overstimulation of the muscle motor end
plates, which becomes sticky and permanently ‘switched-on’; which
is the lump that we feel.
• They are often embedded in the muscles remotely from where the
pain is felt.
• They make the host muscle shorter and fatter and reduce its
efficiency. This can lead to pressure on nerves and blood vessels.
• They may also cause impaired range of motion, muscle weakness
and loss of coordination
• Reduced efficiency = increased risk of injury
Referred pain patterns
Pain is a complex symptom experienced differently and individually.

However, referred pain is the defining symptom of a myofascial trigger
point.
You may be used to the idea of referred pain of visceral origin: an

example of this is heart pain. A myocardial infarct (heart attack) is not
experienced as crushing chest pain, but as pain in the left arm and hand,
and in the left jaw. This type of pain is well documented, and known to
originate from the embryological dermomyotome (Baron 2006); in this
case, the heart tissue, jaw tissue, and arm tissues all develop from the
same dermomyotome. Referred pain from a myofascial trigger point is
somewhat different. It is a distinct and discrete pattern or map of pain.
This map is consistent, and has no racial or gender differences, because
stimulating an active trigger point generates the pain.
Patients describe referred pain in this map as having a deep and aching
quality; movement may sometimes exacerbate symptoms, making
the pain sharper. An example of this might be a headache. The patient
describes a pattern of pain, or ache, which can sometimes be aggravated
and made sharper by moving the head and neck.
Intensity of pain
The intensity of pain will vary according to the following factors (this list is
not exhaustive):
• Location (attachment points are more sensitive)

• Degree of trigger point irritability
• Active or latent trigger points
• Primary or satellite trigger points
• Site of trigger point (some areas are more sensitive)
• Associated tissue damage
• Location/host tissue stiffness or flexibility
• Aging
• Chronicity of trigger point
How do trigger points develop?
A clear mechanistic description for the initiation of a myofascial trigger

point does not currently exist. Trigger points are thought to occur as a
result of muscle overuse or muscle trauma or even psychological stress.
Examples include trigger points arising secondary to muscle overload
in worksite tasks or activities of daily living such as lifting heavy objects
or sustained repetitive activities (Jafri 2014). In these cases, poor
ergonomics, improper postural positioning, deconditioned muscle,
and fatigue have been associated with the development myofascial
trigger point. There is also increasingly compelling evidence linking
psychological stress to trigger point formation.
Several possible trigger point mechanisms (Dommerholt 2006):
• Low-level muscle contractions

• Uneven intramuscular pressure distribution
• Direct trauma
• Unaccustomed eccentric contractions
• Eccentric contractions in unconditioned muscle
• Maximal or submaximal concentric contractions
Local twitch response (LTR) in a rabbit gastrocnemius tender spot.

LTRs are elicited only when the needle is placed accurately within the
trigger spot. (Adapted from: Hong 1996)
Evidence for Trigger Points -fMRI Scanning
Studies over the past decade have imaged trigger points, showing
that their activation results in CNS activation through fMRI scanning,
demonstrated electrophysiological activity at the trigger point, and
biochemical changes in the trigger point zone. Further studies have
shown that manipulation of the trigger point modulates muscle function
and induces local and referred pain.
Above is a diagram showing the twitch response, stimulated in a rabbit

gastrocnemius muscle. Notice the increase (spike) in electrical activity as
the trigger point is stimulated.
Lifestyle and Diet
Studies have demonstrated that underlying health issues—such as folic

acid, iron, vitamin, and/ or mineral deficiency—may both contribute to
and perpetuate trigger point activity. It is worth noting that tendons do
not repair in the presence of nicotine! Furthermore, recent studies have
indicated that the modern lifestyle tends to ‘underload’ muscles and
tendons, leading to internal fatty changes and increased vulnerability to
damage. Other factors such as fatty foods and exposure to free radicals
may also have a detrimental effect on our soft tissues. Supplements— for
example omega-3, zinc, magnesium, iron, and vitamins K, B12, and C,
as well as folic acid— may speed up recovery. There is also compelling
evidence for using Capsaicin as a therapeutic intervention (Jafri 2014).
Evidence for:
• Allergic hypersensitivity may have a potent effect (Brosto 1992).

• Hormonal estrogen and thyroid deficiency may impact the
endoplasmic environment, leading to increased trigger point
development and/or perpetuation (Lowe & Honeyman-Lowe 1998).
• Chronic viral, yeast and/or parasite infection may increase the
likelihood of trigger point formation (Ferguson & Gerwin 2004).
• Vitamin C deficiency may perpetuate trigger point longevity.
• Iron deficiency (ferritin) 10-15% of people with chronic myofascial
pain syndromes may be iron deficient (Simons et al. 1998).
• Serum levels of 15-20 ng/ml indicate depletion, but even levels below
50ng/ml may be significant (Gerwin et al. 2004).
• Vitamin B1, B6, B12 deficiency may increase tiredness, fatigue, and
chronic trigger point formation.
• Magnesium and zinc deficiency levels in the lower realm of normal
may be low for some people.
• Vitamin D deficiency is implicated in almost 90% of patients with
chronic musculoskeletal pain (Plotniko 2003).
• Cytochrome oxidase lowered levels are common in patients with
myalgia. Associated with tiredness, coldness, extreme fatigue with
exercise, and muscle pain.
• Folic acid may sufficiently change the internal endoplasmic
environment to increase trigger point development and/or
perpetuation (Simons 1999; Gerwin 2004).
Trigger point classification
Trigger points are described according to location, tenderness, and

chronicity: central (or primary), satellite (or secondary), attachment,
diffuse, inactive (or latent), and active.
Central (or primary) trigger points
These are the most well-established and ‘florid’ points when they are
active, and are usually what people refer to when they talk about trigger
points. Central trigger points always exist in the center of the muscle
belly, where the motor endplate enters the muscle.
Note muscle shape and fiber arrangement is of importance in this regard.

For example, in multipennate muscles (such as the deltoid), there may be
several central points. Also, if muscle fibers run diagonally, this may lead
to variations in trigger point location.
Satellite (or secondary) trigger points
Trigger points may be ‘created’ as a response to the central trigger point

in neighboring muscles that lie within the referred pain zone. In such
cases, the primary trigger point is still the key to therapeutic intervention:
the satellite trigger points resolve once the primary point has been
effectively rendered inactive. As a corollary it is also true that satellite
points may prove resilient to treatment until the primary central focus is
weakened such is the case in the paraspinal and/or abdominal muscles.
Attachment trigger points
Myofascia is a continuum. It has been noted that the area where the
tendon inserts into the bone (tendo-osseous junction) is ‘exquisitely’
tender (Simons et al. 1998 Davies 2004).
This may well be the result of the existing forces traveling across these
regions. It has also been suggested by the same authors that this may
result from an associated chronic, active myofascial trigger point. This
is because the tenderness has been demonstrated to reduce once the
primary central trigger point has been treated; in such cases, the point
is described as an attachment trigger point. Furthermore, it has been
suggested that if a chronic situation occurs where the primary and
attachment trigger points remain untreated, ‘degenerative changes’
within the joint may be precipitated and accelerated (Simons et al. 1998).
Diffuse trigger points
Trigger points can sometimes occur where multiple satellite trigger points
exist secondary to multiple central trigger points. This is often the case
when there is a severe postural deformity, such as a scoliosis, and an
entire quadrant of the body is involved. In this scenario, the secondary
points are said to be diffuse. These diffuse trigger points develop along
lines of altered stress and/or strain patterns.
Inactive (or latent) trigger points
This applies to lumps and nodules that feel like trigger points. These can
develop anywhere in the body and are often secondary. However, these
trigger points are not painful, and do not elicit a referred pain pathway.
The presence of inactive trigger points within muscles may lead to

increased muscular stiffness. It has been suggested that these points
are more common in those who live a sedentary lifestyle (Starlanyl &
Copeland 2001). It is worth noting that these points may reactivate if
the central or primary trigger point is (re)stimulated; reactivation may
also occur following trauma and injury. Latent trigger points may have
associated autonomic symptoms with pain and their presence results in
a limited range of motion, muscle fatigability, and muscle weakness as in
the active presentation.
Active trigger points
This can apply to central and satellite trigger points. A variety of

stimulants, such as forcing muscular activity through pain, can activate
an inactive trigger point. This situation is common when activity is
increased after a road traffiic accident (RTA), where multiple and disuse
trigger points may have developed. The term denotes that the trigger
point is both tender to palpation and elicits a referred pain pattern.
Ligamentous Trigger Points
There is some evidence that ligaments may develop trigger points

(Hacket 1958), but the relationships are not clear. The sacrotuberous
and sacrospinous ligaments can refer pain down to the heel and the
iliolumbar ligament can refer pain down to the groin and even into the
testicles or vagina (Hacket 1958). Trigger points in the sacrotuberous
ligaments can have profound effects on the low back, the lumbar erector
spinae and on pelvic pain (Starlanyl and Sharkey 2013) and may also
be associated with backache, neck pain and even vocal dystonia (Lewit
2000).
As well as stabilizing structures, ligaments have strong proprioceptive

functions (Varga et al. 2008). Working on ligament trigger points
therapeutically can be clinically useful as part of the neuroplastic model.
Trigger points may manifest in the Anterior Longitudinal Ligament (ALL)
of the spine (e.g. after whiplash), which may result in neck instability
(Stemper 2006). The bular collateral ligament has a similar referred pain
pattern to the vastus lateralis and trigger points in the ligamentum
patellae are profoundly useful for treating knee pain syndromes.
Smooth muscle trigger points
It has been hypothesized (Simons 1999) that trigger points may develop in
the pericardium of the heart after a massive heart attack. Cysts may form
in the pericardium and cause chest pain, shortness of breath, cough and
maybe even arrhythmia.
It has also been suggested that trigger points may manifest in the gastro-
intestinal system (Starlanyl and Sharkey 2013). Several authorities have
discussed the relationship between the iliocaecal valve (between the
large and the small intestine) and trigger points in the psoas muscle.
Trigger areas that refer pain to the abdomen and multiple sites outside
the abdomen have also been discovered in the esophagus, small intestine
and colon (Moriarty and Dawson 1982). Starlanyl and Simons also
suggested the possibility of trigger points in the interstitial mucosa and
mesentery which, if active, might press on blood or lymph vessels and
cause symptoms.
Hi Guys,
In this course I’ve included the best of those trigger point taping
techniques developed and used by myself and my colleagues. These
techniques have been tried and tested for effect over many years, and
are used at the highest level of international sports and athletics. On the
following pages you’ll find trigger point information including locator
illustrations and common referred pain maps for each muscle presented.
You’ll also find video demonstrations of each technique.
The video links in this text have been disabled. Please use the link below
to watch all of the videos relating to this course;
https //www.nielasher.com/pages/taping-for-trigger-points-video-
classes-10-2017-update
I hope you enjoy!
Deltoids
ORIGIN
Clavicle, acromion
process, and spine of
scapula.
INSERTION
Deltoid tuberosity
situated halfway down
lateral surface of shaft
of humerus.
ACTION TAPING
INSTRUCTIONS
Anterior fibers flex
Stretch - Anterior-
and medially rotate Stretch horizontal
humerous. flexion of shoulder.
Middle fibers abduct Stretch - Posterior
humerus at shoulder shoulder extension
joint (only after with external rotation.
the movement has Tape - from the
been initiated by deltoid origin to just
supraspinatus). pass the AC joint
region along the line
Posterior fibers
of the muscle fibers.
extend and laterally Be sure to measure
rotate humerous. and cut tape the
Antagonist: latissimus correct length.
dorsi. Stabilization - Anchor
at Deltoid tuberosity
REFERRED PAIN with 30-40 % load on
PATTERNS tape.
Generally localized Decompression - at
to trigger point and trigger point sites.
within a 5-10cm zone. Palpation the key.
90% load on tape.
Teres Major / Minor
ORIGIN
Major: Oval area
on lower third of
posterior surface
of lateral border of
scapula.
Minor: Upper two-
thirds of lateral border
of dorsal surface of
scapula.
ACTION
Major: Adducts
humerus. Medially
rotates humerus.
TAPING
Extends humerus
INSTRUCTIONS
from flexed position.
Stretch - horizontal
Minor As a rotator cuff flexion of shoulder.
muscle, helps prevent
upward dislocation Tape - from the
of shoulder joint. lateral border of the
Laterally rotates scapula up towards
humerus. Weakly the insertion to just
adducts humerus. pass the sub acromial
region along the line
REFERRED PAIN
of the muscle fibers.
PATTERNS
Be sure to measure
Deep pain and cut tape to the
into posterior right length.
glenohumeral joint
and an oval zone Stabilization - Anchor
(5–10 cm) of pain in at origin with 30-40 %
posterior deltoid area load on tape.
(can radiate strongly
Decompression - at
to long head of biceps
trigger point sites,
brachii). Diffuse
Palpation the key 90%
pain into dorsum of
load on tape.
forearm.
Trapezius
ORIGIN
Medial third of superior
nuchal line of occipital
bone. External
occipital protuberance.
Ligamentum nuchae.
Spinous processes and
supraspinous ligaments
of 7th cervical vertebra
(C7) and all thoracic
vertebrae (T1–T12).
INSERTION TAPING
Posterior border of INSTRUCTIONS
lateral third of clavicle. Stretch - Stretch
Medial border of lateral flexion
acromion. Upper border
of crest of spine of Tape - from the AC
scapula, and tubercle on joint along the line
this crest. of the trapezius to
ACTION roughly C2 region. Be
Pull shoulder girdle sure to measure and
up. Helps prevent cut tape from the AC
depression of shoulder joint to the nape of
girdle when a weight is the neck.
carried on shoulder or in
hand. Retracts scapula. Stabilization - Anchor
Depresses scapula, at AC joint with
particularly against 30-40 % load on tape.
resistance, as when
using hands to get up Decompression - at
from a chair. Antagonist: trigger point sites,
serratus anterior. Palpation the key 90%
load on tape.
REFERRED PAIN
PATTERNS
Refers pain to scapula
and upper neck area.
Infraspinatus
ORIGIN
Infraspinous fossa of
scapula.
INSERTION
Middle facet on
greater tubercle of
humerus. Capsule of
shoulder joint.
ACTION
TAPING
As a rotator cuff
INSTRUCTIONS
muscle, helps prevent
posterior dislocation Stretch - horizontal
of shoulder joint. flexion of shoulder.
Laterally rotates Tape - from the
humerus. medial border of the
scapula just below
Antagonists:
spine of the scapula
subscapularis,
along the line of the
pectoralis major,
muscle fibers to the
latissimus dorsi.
just past the sub
REFERRED PAIN acromial region. Be
PATTERNS sure to measure and
cut tape from the
Middle/upper cervical
medial border to the
spine: deep anterior
AC joint.
shoulder joint zone
of 3–4 cm in region of Stabilization - anchor
long head of biceps at medial border with
brachii, radiating into 30-40 % load on tape.
biceps belly then into Decompression - at
forearm— diffuse trigger point sites,
symptoms in median Palpation the key.
nerve distribution. 90% load on tape.
Supraspinatus
ORIGIN
Supraspinous fossa of
scapula.
INSERTION
Upper aspect of
greater tubercle of
humerus. Capsule of
shoulder joint.
ACTION
Initiates process of
abduction at shoulder
joint, so that deltoid
can take over at later TAPING
stages of abduction. INSTRUCTIONS
Stretch - horizontal
Antagonists:
flexion of shoulder.
infraspinatus, teres
minor, pectoralis Tape - from the
major, latissimus supraspinatus origin
dorsi. to just past the sub
acromial region along
REFERRED PAIN the line of the muscle
PATTERNS fibers. Be sure to
Belly: deep ache in measure and cut tape
regimental badge from the origin to
area (4–6 cm). Ellipse start of AC joint.
leads to zone of pain
Stabilization - anchor
in lateral epicondyle/
at supraspinatus with
radial head. Diffuse
30-40 % load on tape.
pain into lateral
forearm. Decompression - at
trigger point sites,
Insertion: localized
Palpation the key.
zone of pain 5–8 cm
90% load on tape.
over deltoid.
Levator Scapulae
ORIGIN
Posterior tubercles of
transverse processes
of first three or four
cervical vertebrae
(C1–C4).
INSERTION
Medial (vertebral)
border of scapula
between superior
angle and spine of TAPING
scapula. INSTRUCTIONS
Stretch - lateral
ACTION flexion
Elevates scapula.
Tape - from the
Helps retract scapula.
superior scapular
Helps bend neck
angle along the line
laterally.
of the LS to roughly
REFERRED PAIN C2 region. Be sure to
PATTERNS measure and cut tape
Triangular pattern from the Superior
from top of scapula angle to just above
to nape of neck. the nape of the neck.
Slight overspill to Stabilization - anchor
medial border of at just past the
scapula and posterior superior angle with
glenohumeral joint. 30-40 % load on tape.
Decompression - at
trigger point sites.
palpation the key.
90% load on tape.
Forearm Extensors
ORIGIN
Common extensor
tendon from
lateral epicondyle
of humerus (i.e.
lower lateral end of
humerus).
ACTION
Extends wrist joint
(extensor carpi TAPING
radialis longus/ INSTRUCTIONS
brevis also abduct
Stretch - Flexion
wrist joint; extensor
carpi ulnaris also of wrist-extensors,
adducts wrist joint). extension of wrist-
Antagonists: exor flexors
carpi radialis, exor
carpi ulnaris. Tape - from just above
the crease of the wrist
INSERTION
Dorsal surface of muscle fibers, up over
metacarpal bones.
the greater tuberosity.
REFERRED PAIN Be sure to measure
PATTERNS and cut tape correct
Extensor carpi radialis length.
longus strong 2–3
cm zone over lateral Stabilization - Anchor
epicondyle, diffusely at above the crease of
radiating to dorsum the wrist with 30-40 %
of hand above thumb. load on tape.
Extensor carpi radialis
brevis: strong zone Decompression - at
of pain 3–5 cm over trigger point sites.
dorsum of hand. Palpation the key.
Extensor carpi ulnaris: 90% load on tape.
strong, localized,
specific referral to
dorsal ulnar surface
of hand and bulk of
wrist.
Forearm Flexors
Biceps Brachii
ORIGIN extremity with strong
Long head: zone of pain around
infraglenoid tubercle olecranon process,
of scapula. Lateral and then vaguely into
head: upper half of posterior forearm.
posterior surface
of shaft of humerus
(above and lateral to
radial groove).
Medial head: lower
half of posterior
surface of shaft of
humerus (below
TAPING
and medial to radial
INSTRUCTIONS
groove).
Stretch - from flexion
ACTION of the elbow.
Extends (straightens) Tape - from just above
elbow joint. Long the posterior of the
head can adduct elbow joint along the
humerus and extend line of the muscle
it from flexed position. fibers, up over the
Stabilizes shoulder posterior shoulder.
joint. Be sure to measure
and cut tape correct
INSERTION length.
Posterior part of Stabilization - anchor
olecranon process of at above the crease
ulna. of the elbow with 30-
40 % load on tape.
REFERRED PAIN
PATTERNS Decompression - at
Pain at superolateral trigger point sites.
border of shoulder, Palpation the key.
radiating diffusely 90% load on tape.
down posterior upper
Triceps
ORIGIN epicondyle, radiating
Long head: infraglenoid along medial border
tubercle of scapula. of forearm to 4th & 5th
digits; (c) lateral head:
Lateral head: upper half
strong midline pain
of posterior surface of
into upper extremity,
shaft of humerus (above
radiating vaguely into
and lateral to radial
posterior forearm.
groove).
Medial head: lower half
of posterior surface of
shaft of humerus (below
and medial to radial
groove).
INSERTION
Posterior part of
olecranon process of
ulna.
TAPING
ACTION INSTRUCTIONS
Extends (straightens)
elbow joint. Long Stretch - Elbow flexion
head can adduct to have triceps on
humerus and extend stretch
it from flexed position. Tape - From superior
Stabilizes shoulder elbow joint cut tape
joint. Antagonist: biceps 2/3rd way up the triceps.
brachii. Tape should finish when
on stretch of 30/40%,
REFERRED PAIN
just inferior to the
PATTERNS
scapula insertion.
(a) Long head: pain at
superolateral border Stabilization - Anchor
of shoulder, radiating at superior portion of
diffusely down posterior the triceps insertion to
upper extremity with the elbow joint. 40%
strong zone of pain stretch on tape.
around olecranon Decompression -
process, and vaguely Locate trigger points in
into posterior forearm; either lower or mid belly,
(b) medial head: 5cm palpation is the key.
patch of pain in medial 90% stretch on tape.
Adductor Magnus / Longus
ORIGIN
Anterior part of
pubic bone (ramus).
Adductor magnus
also takes origin from
ischial tuberosity.
TAPING
ACTION INSTRUCTIONS
Adduct and laterally Stretch - Hip in full
rotate hip joint. adduction, knee in
Adductors longus/ flexion, supported on
table.
brevis also ex
extended femur and Stabilization - Anchor
extend flexed femur. the tape just superior
and medial to knee
INSERTION joint, cut the tape to
measure, then finish
Whole length of
with tape on 30-40%
medial side of femur, stretch just inferior to
from hip to knee. the ischial tuberosity.
REFERRED PAIN Decompression -
PATTERNS ADDUCTOR LONGUS
Locate trigger points
There are several
in adductor longus
zones of referred pain: (half way along the
(1) two zones localized belly of the muscle),
around anterior hip palpate trigger point
5–8 cm, and above 80-90% stretch on
knee 5–8 cm; (2) tape.
whole anteromedial ADDUCTOR MAGNUS
thigh from inguinal Magnus (2 trigger
ligament to medial points just below
knee joint (3) medial the attachment to
thigh from hip to knee. the ischial tuberosity
and one in mid belly
of muscle). Palpate
trigger points. Stretch
on the tape 80-90%.
Gastrocnemius
ORIGIN
Medial head: popliteal
surface of femur
above medial condyle.
Lateral head: lateral
condyle and posterior
surface of femur.
ACTION
Plantar exes foot at TAPING
ankle joint. Assists in INSTRUCTIONS
exion of knee joint.
A main propelling Stretch - Plantar
force in walking and flexion.
running. Antagonist: Tape - Tape from
tibialis anterior. under the heel origin
INSERTION
muscle fibers. Be
Posterior surface
sure to measure and
of calcaneus (via
cut tape the correct
tendo calcaneus, a
length.
fusion of tendons of
gastrocnemius and Stabilization - Anchor
soleus). at Heel with 30-40 %
load on tape.
REFERRED PAIN
Several trigger trigger point sites.
points in each Palpation the key.
muscle belly, and 90% load on tape.
attachment trigger
point at ankle. The
four most common
points are indicated
diagrammatically for
medial and lateral
heads.
Soleus
ORIGIN
Posterior surfaces
of head of bula and
upper third of body
of bula. Soleal line
and middle third of
medial border of
tibia. Tendinous arch
between tibia and
bula.
ACTION
TAPING
Plantar exes ankle INSTRUCTIONS
joint. Frequently in
contraction during Stretch - Plantar
standing, to prevent flexion.
body falling forward
at ankle joint, i.e. Tape - Tape from
to offset line of pull under the heel origin
through body’s along the line of the
center of gravity, thus muscle fibers. Be
helping to maintain
sure to measure and
upright posture.
Antagonist: tibialis length.
anterior.
INSERTION Stabilization - Anchor
at Heel with 30-40 %
With tendon of
gastrocnemius into load on tape.
posterior surface of Decompression - at
calcaneus.
REFERRED PAIN Palpation the key.
PATTERNS
90% load on tape.
Pain in distal Achilles
tendon and heel to
posterior half of foot.
Calf pain from knee
to just above Achilles
tendon origin. 4–5
cm zone of pain in
ipsilateral sacroiliac
region (rare).
Gluteus Minimus
ORIGIN TAPING
Outer surface of ilium INSTRUCTIONS
between anterior and Stretch - Hip Flexion/
inferior gluteal lines. adduction
ACTION Tape - from the

Greater trochanter
Abducts, medially
origin along the line of
rotates, and may
the muscle fibers. Be
assist in flexion of hip
sure to measure and
joint. Antagonists:
lateral rotator group.
length.
INSERTION Stabilization - Anchor
Anterior border of at Greater trochanter
greater trochanter. with 30-40 % load on
tape.
REFERRED PAIN
A multipennate trigger point sites.
muscle with multiple Palpation the key.
anterior, middle, 90% load on tape.
and posterior trigger
points referring strong
pain in lower buttock,
hip, and lateral lower
extremity beyond
knee to ankle and calf.
Gluteus Medius
ORIGIN TAPING
Outer surface of ilium INSTRUCTIONS
inferior to iliac crest, Stretch - Hip flexion/
between posterior adduction
gluteal line and
anterior gluteal line. Tape - from the
greater trochanter
ACTION origin along the line of
Abducts hip joint. the muscle fibers. Be
Anterior fibers sure to measure and
medially rotate and cut tape the correct
may assist in flexion length.
of hip joint. Posterior
fibers slightly laterally Stabilization - Anchor
rotate hip joint. at greater trochanter
Antagonists: lateral with 30-40 % load on
rotator group. tape.
INSERTION Decompression - at
Oblique ridge on trigger point sites.
lateral surface of Palpation the key.
greater trochanter of 90% load on tape.
femur.
REFERRED PAIN
PATTERNS
Low back, medial
buttock, and sacral
and lateral hip,
radiating somewhat
into upper thigh.
Tensor Fascia Latae
ORIGIN TAPING
Anterior part of outer INSTRUCTIONS
lip of iliac crest, and Stretch - Hip flexion/
outer surface of ASIS. adduction
ACTION Tape - from the start
Flexes, abducts, and of the medial IT band
medially rotates hip along the line of the
joint. Tenses fascia muscle fibers. Be
lata, thus stabilizing sure to measure and
knee joint. Redirects cut tape the correct
rotational forces length.
produced by gluteus
maximus. Stabilization - Anchor
at IT Band with 30-
INSERTION 40 % load on tape.
Joins IT tract just
Decompression - at
below level of greater
trochanter.
Palpation the key.
REFERRED PAIN 90% load on tape.
PATTERNS
Strong elliptical
zone of pain from
greater trochanter
inferolaterally toward
fibula.
Tibialis Anterior
ORIGIN
Lateral condyle of
tibia. Upper half of
lateral surface of
tibia. Interosseous
membrane.
ACTION
Dorsi flexes ankle
joint. Inverts
foot. Antagonists: TAPING
bularis longus, INSTRUCTIONS
gastrocnemius,
Stretch - Eversion/
soleus, plantaris, dorsi flexion of the
tibialis posterior. foot.
INSERTION Tape - from the below
Medial and plantar the lateral mallelous
surface of medial under the foot side
cuneiform bone. Base of foot along the
of 1st metatarsal. line of the muscle
fibers, tape half
REFERRED PAIN over tibia and other
PATTERNS half covering the
Anteromedial vague musculature. Be sure
pain along shin, with to measure and cut
tape correct length.
zone of pain 3–5 cm in
ankle joint (anterior), Stabilization - Anchor
culminating in great- at inferior to lateral
toe pain (whole toe). malellous lateral foot
with 30-40 % load on
tape.
Decompression - at
alpation the key. 90%
load on tape.
Fibularis
ORIGIN
Longus: upper
two-thirds of lateral
surface of bula.
Lateral condyle
of tibia. Brevis:
lower two-thirds
of lateral surface
of bula. Adjacent
intermuscular septa.
TAPING
Tertius: lower third
INSTRUCTIONS
of anterior surface of
bula and interosseous Stretch - Inversion of
membrane. the foot.
ACTION Tape - from the under

Longus: everts foot. lateral side of foot to
Assists plantar just pass the head of
exion of ankle joint. the fibula along the
Antagonist: tibialis line of the muscle
anterior. fibers. Be sure to
measure and cut tape
Brevis: everts ankle
joint. correct length.
Tertius: dorsi exes Stabilization - Anchor

ankle joint. Everts at underside of the
foot. lateral foot with 30-
40 % load on tape.
REFERRED PAIN
Mainly over lateral trigger point sites.
malleolus, anteriorly Palpation the key.
and posteriorly in a 90% load on tape.
linear distribution.
Laterally along foot,
occasionally vague
pain in middle third of
lateral aspect of lower
leg.
Hamstrings
ORIGIN
Ischial tuberosity
(sitting bone).
Biceps femoris also
originates from back
of femur.
ACTION
Flex knee joint. TAPING
Extend hip joint. INSTRUCTIONS
Semimembranosus Stretch - Hip flexion
and semitendinosus Tape - from the origin
also medially rotate to just up to ischial
(turn in) lower leg tuberosity region
when knee is flexed. along the line of the
Biceps femoris muscle fibers. Be sure
laterally rotates to measure and cut
(turns out) lower tape correct length.
leg when knee is
Stabilization - Anchor
flexed. Antagonists
at origin with 30-40 %
quadriceps.
load on tape.
REFERRED PAIN Decompression - at
PATTERNS trigger point sites.
Semimembranosus Palpation the key.
and semitendinosus: 90% load on tape.
strong 10 cm zone of
pain, inferior gluteal
fold, with diffuse pain
posteromedial legs to
Achilles tendon area.
Biceps femoris diffuse
pain posteromedial
legs, with strong 10
cm zone posterior to
knee joint.
Piriformis
ORIGIN
Internal surface
of sacrum.
Sacrotuberous
ligament.
ACTION
Laterally rotates hip
joint. Abducts thigh
when hip is extended.
TAPING
Helps hold head of
INSTRUCTIONS
femur in acetabulum.
Stretch - Hip flexion /
INSERTION adduction.
Superior border of Tape - from the
greater trochanter of greater trochanter
femur. origin along the line
REFERRED PAIN of the muscle fibers.
PATTERNS Be sure to measure
and cut tape correct
Two strong zones
length.
of pain (1) 3–4
cm zone lateral to Stabilization - Anchor
coccyx; (2) 7–10 cm at greater trochanter
zone posterolateral with 30-40 % load on
buttock/hip joint. tape.
Also broad spillover of Decompression - at
diffuse pain between trigger point sites.
(1) and (2) and down Palpation the key.
thigh to above the 90% load on tape.
knee.
Biceps femoris diffuse
pain posteromedial
legs, with strong
10 cm zone posterior
to knee joint.
Erector Spinae
ORIGIN
Slips of muscle arising
from the sacrum. Iliac
crest. Spinous and
transverse processes
of vertebrae. Ribs.
ACTION
Extends and laterally
exes vertebral column
(i.e. bending backward TAPING
and sideways). Helps INSTRUCTIONS
maintain correct Stretch - Flexion of
curvature of spine in the lumbar spine.
the erect and sitting
positions. Steadies Tape - 2 Strips
the vertebral column placed either side
on the pelvis during of the spine along
walking. Antagonist: the line of the ES
rectus abdominis. muscles, tape past
the thoracolumbar
INSERTION
region, and tape
Ribs. Transverse and
spinous processes of
muscle fibers. Be sure
vertebrae. Occipital
bone. to measure and cut
tape correct length.
REFERRED PAIN
Stabilization - Anchor
PATTERNS
at iliac crest with
Thoracic spine—
30-40 % load on tape.
iliocostalis: medially
toward the spine, and Decompression - at
anteriorly toward the trigger point sites.
abdomen. Lumbar Palpation the key.
spine—iliocostalis: 90% load on tape.
mid buttock. Thoracic
spine— iliocostalis:
buttock and sacroiliac
area.
Exams and Certification
When you have completed this course, you will need to complete and
pass the reflective learning exam in order to certify. Click on the link
below to access the online exam portal. You will be able to create your
own login details so that you can save your answers if you do not wish to
complete the exam in one sitting.
On successful completion of the exam, you will be able to generate your

certificate. If you need any help or assistance, please contact our support
team - support@nielasher.com
CLICK HERE FOR EXAM
» Jamie S. Wyatt Licensed Massage Therapist, Northport, Alabama
Great course and very informative. After reading the Niel Asher Technique, I
love it, and this course information will help me in becoming a better ortho
therapist! Thank you! I look forward to more of your courses.
» Silva Rashida Schuldt Osteopath, Bedfordshire, UK

The NAT shoulder course has revolutionized how I treat my patients - not
only for shoulder problems but also for all other areas of the body. Hands
down the best CPD course I’ve ever done!
» Sean Konrad D.C., Chiropractor, Pennsylvania, USA

NAT has really enhanced my approach to soft tissue treatment. Thank you!
» Tamara Buchanan Massage Therapist, Maricopa, Arizona

I just got this trigger point course in the mail a couple days ago and it is
amazing! Highly recommend!!
» Audrey L Holston Massage Therapist, Crawfordville, FL, USA

I just finished this trigger point course and I love it!
» Dan Stroup Licensed Massage Therapist, NY & CT, USA

This training was valuable for my growth in massage therapy
» Tony Poland, Instructor of Sports & Trigger Point Programs at IPSB,

Los Angeles, California
Of all the trigger point textbooks out there, this is the one I use for my course
at IPSB. It’s the best textbook by far.
» Jules Harper FdSc, MFHT, MNHMA Massage Therapist, Shrewsbury,

UK
My clients have been enjoying relief after having had their trigger points
worked on, what would I do without NAT!
» Michael P. Ganci CNMT, LMT Massage Therapist, St. Petersburg,
Florida
I found the course very informative and well written. I also want to thank you
for responding to my questions and the re-tests for the Master course.
» Alison Angier Sports & Remedial Massage Therapist, Brisbane,

Australia
I bought the frozen shoulder course and found it very informative and useful.
Have had clients for treatment for it. Still treating them and they are getting
better. Very happy with the materials thank you. Have just ordered a bunch
of more NAT courses.
» Mal Williams Sports Massage Therapist, Wales, United Kingdom

Another very useful trigger point course from NAT!
» Tanya Wolf Massage Therapist, St. Coud, Florida, USA

Love the way you all are helping us make the best of our careers with these
trigger point courses! Looking forward to my certification!
» Demelza Ellis Massage Therapist, Cornwall, United Kingdom

I have just joined with Niel Asher to list my practice after purchasing some of
your courses a few months ago. I’m extremely impressed with the results I’m
getting with these trigger point techniques.
» Nicola Johnson Massage Therapist, Berridale, NSW, Australia

Received everything immediately and very impressed with what I received!
» Suzanne Lautz Singh Massage Therapist, Bodyworker, Anderson,

Cincinnati
Neil Asher Technique is a game changer!
Research References:
Kelle, B., Guzel, R., & Sakall, H., (2015). The effect of kinesio taping
application for acute non-specific low back pain A randomised controlled
clinical trial. Clinical Rehabilitation doi 10.1177/0269215515603218
Pamuk, U., & Yucesoy, C.A., (2015) MRI analyses show that kinesio
taping affects much more than just the targeted superficial tissues and
causes heterogenous deformations within the whole limb. Journal of
Biomechanics http //dx.doi.org/10.1016/j.jbiomech.2015.10.036
Ahn, I.K., Kim, Y.L., Bae, Y., & Lee, S.M., (2015). Immediate effects of
kinesiology taping of quadriceps on motor performance after muscle
fatigued induction. Evidence-Based Complementary and Alternative
Medicinehttp // dx.doi.org/10.1155/2015/410526
Zhang, S., Fu, W., Pan, L., Xia, R., & Kiu, Y., (2015). Acute effects of Kinesio
taping on muscle strength and fatigue in the forearm of tennis players.
Journal of Science and Medicine in Sport
doi.org/10.1016/j.jsams.2015.07.012
The effects of taping on scapular kinematics and muscle performancein

baseball players with shoulder impingement syndromeYin-Hsin Hsua,
Wen-Yin Chena,b,1, Hsiu-Chen Linc,1, Wendy T.J. Wanga,b, Yi-Fen Shiha,b
Szczegielniak, J., Luniewski, J., Bogacz, K., & Sliwinski, Z., (2012). The use
of Kinesio Taping for physiotherapy of patients with rheumatoid hand-
pilot study. Ortopaedia, Traumatologica & Rehabilitacja 14, 23-30.
Song, C., Huang, H., Chen, S., Lin, J., & Chang, A.H., (2015). Effects of
femoral rotation taping on pain, lower extremity kinematics, and muscle
activation in female patients with patello-femoral pain. Journal of Science
& Medicine in Sport 18 (4) 388-393
Notes:
Copyright © Niel Asher Healthcare. All rights reserved.
No portion of this book, except for brief review, may be reproduced,

stored in a retrieval system, or transmitted in any form or by any means
- electronic, mechanical, photocopying, scanning, or otherwise - without
the written permission of the publisher.
Niel Asher Education
New York
112 W. 34th Street
18th Floor
New York
NY 10120
London
Belsize Health Clinic
16 England’s Lane
London
NW3 4TG
www.nielasher.com

Stuart Hinds is one of Australia’s leading soft tissue therapists, with over
25 years of experience as a practitioner, working with elite sports athletes,
supporting Olympic teams, educating and mentoring others as well as
running a highly successful clinic Australia.
Recognized for his expertise in working with elite athletes, Stuart has
played a key role in soft tissue support with the Australian Olympics
Team, since 2000, at four separate Olympics (2012 London Olympics, the
2008 Beijing Olympics, the 2004 Athens Olympics and the 2000 Sydney
Olympics).

7C83 Taping For Trigger Points 1117

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Taping for Trigger Points

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Copyright 2017, All Rights Reserved

Prepared exclusively for jonathandelaorta@yahoo.com Transaction: 2017-14029

Prepared exclusively for jonathandelaorta@yahoo.com Transaction: 2017-14029

Therapeutic touch has emerged in all cultures in all ages. Massaging

Historically, there are two pathways for exploring trigger point

Trigger points in the Ancient World

Perhaps the most famous book including massage is ‘The Yellow

In the West, Hippocrates (460 BC) wrote, “The physician must be

Orthodox medical history

Imagine you are an orange. Your skin is (superficial) fascia embedded

Trigger point definition

Myofascial trigger points may well be implicated in all types of

• Pain, often exquisite, is present at a discrete point

• Trigger points develop in the muscle belly so multi-pennate (several

Referred pain patterns

Pain is a complex symptom experienced differently and individually.

You may be used to the idea of referred pain of visceral origin: an

• Location (attachment points are more sensitive)

How do trigger points develop?

A clear mechanistic description for the initiation of a myofascial trigger

Several possible trigger point mechanisms (Dommerholt 2006):

• Low-level muscle contractions

Local twitch response (LTR) in a rabbit gastrocnemius tender spot.

Above is a diagram showing the twitch response, stimulated in a rabbit

Lifestyle and Diet

Studies have demonstrated that underlying health issues—such as folic

• Allergic hypersensitivity may have a potent effect (Brosto 1992).

Trigger point classification

Trigger points are described according to location, tenderness, and

Central (or primary) trigger points

Note muscle shape and fiber arrangement is of importance in this regard.

Satellite (or secondary) trigger points

Trigger points may be ‘created’ as a response to the central trigger point

Attachment trigger points

Inactive (or latent) trigger points

The presence of inactive trigger points within muscles may lead to

Active trigger points

This can apply to central and satellite trigger points. A variety of

There is some evidence that ligaments may develop trigger points

As well as stabilizing structures, ligaments have strong proprioceptive

Smooth muscle trigger points

I hope you enjoy!

ACTION Tape - from the

ACTION Tape - from the under

Tertius: dorsi exes Stabilization - Anchor

On successful completion of the exam, you will be able to generate your

CLICK HERE FOR EXAM

» Silva Rashida Schuldt Osteopath, Bedfordshire, UK

» Sean Konrad D.C., Chiropractor, Pennsylvania, USA

» Tamara Buchanan Massage Therapist, Maricopa, Arizona

» Audrey L Holston Massage Therapist, Crawfordville, FL, USA

» Dan Stroup Licensed Massage Therapist, NY & CT, USA

» Tony Poland, Instructor of Sports & Trigger Point Programs at IPSB,

» Jules Harper FdSc, MFHT, MNHMA Massage Therapist, Shrewsbury,

» Alison Angier Sports & Remedial Massage Therapist, Brisbane,