Trigger points of the Shoulder & Arm Flashcards

1
Q

What is the possible cause for trigger points found in the Deltoid?

A

Impact trauma During sports or other activities.

Repudiative strain During prolonged lifting.

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2
Q

What are symptoms of having a trigger point in the Deltoid?

A

Difficulty abducting the shoulder to a horizontal position.

There will also be pain deep in the deltoid area.

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3
Q

What are the Pain patterns of trigger point in the deltoid?

A

Anterior, lateral and posterior sides of the shoulder.

Around the Deltoid mm in general.

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4
Q

What are the associated Trigger points?

A

Pec major, Biceps brachii, Other sections of the Deltoid.

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5
Q

What is a Differential Diagnoses for the Deltoid muscle?

A

Rotator cuff Tear, Bicipital Tendinosis, Subacromial / Subdeltoid Bursitis, Glenohumeral joint Arthritis.

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6
Q

What are possible Causes for Trapezius Trigger points?

A

Sudden Trauma, Such as falling, Whiplash injury, Walking with a cane, Arm Rest in high position.

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7
Q

What are the Symptoms of having a Trigger point in the Trapezius Muscle?

A

Severe neck pain, Headache, “Stiff neck”.

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8
Q

What are the Pain patterns for a Trigger point in the Trapezius muscle?

A

Angle of the mandible, Temporal Region, Lateral and posterior sides of the neck, Upper back, Medial boarder of the Scapula.

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9
Q

What are the Associated Trigger points for the Trapezius?

A

Temporalis, Occipitalis, Masseter, Pectoralis +-, Levator Scapula.

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10
Q

What Differential Diagnoses could there be for a Trigger point found in the Trapezius?

A

Temporomandibular Joint Disorder, TP’s of the Masticatory Mm’s, Fibromyalgia.

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11
Q

What are the possible causes for a Trigger point found in the Latissimus Dorsi?

A

Repudiative Shoulder Extension, Throwing a baseball, Hanging from a swing or pulling weeds.

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12
Q

What are symptoms of having a Trigger Point in the Latissimus Dorsi?

A

Pain when Stretching upward or far out in front of the body.

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13
Q

What are the Pain Patterns for a Trigger point found in the Latissimus Dorsi?

A

Region inferior to the scapula, Radiating and skipping down posterior arm to pinkie and ring finger.

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14
Q

What are associated Trigger points for the Latissimus Dorsi?

A

Pec major, Teres minor and Subscapularis.

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15
Q

What are Differential Diagnoses for Trigger points found in the Latissimus Dorsi?

A

Entrapment of Subscapular nerve, Bicipital Tendinosis, ulnar Neuropathy.

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16
Q

What are the Possible causes for having a Trigger point in the Teres Major?

A

Driving without power steering, Reaching overhead and forward to lifting heavy objects.

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17
Q

What are Symptoms for a Trigger Point found in the Teres Major?

A

Pain upon muscle activation, Slight restriction in overhead range.

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18
Q

What are pain patterns for a Trigger point found in the trees Major?

A

Posterior shoulder, Radiates down posterior arm and Forearm.

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18
Q

What are pain patterns for a Trigger point found in the trees Major?

A

Posterior shoulder, Radiates down posterior arm and Forearm.

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19
Q

What are Associated TP’s for the Teres major?

A

Latissimus Dorsi, Long head of the Triceps Brachii.

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19
Q

What are Associated TP’s for the Teres major?

A

Latissimus Dorsi, Long head of the Triceps Brachii.

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20
Q

What are Differential Diagnoses for Trigger points found in the Teres major?

A

Subacromial / Subdeltoid bursitis, Supraspinatus Tendinosis, TOS.

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21
Q

What are Possible causes for Supraspinatus Trigger points?

A

Carrying heavy objects that pull inferiorly, Walking a big dog that pulls hard on a leash.
Lifting heavy objects above shoulder height.

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22
Q

What are Symptoms for a Supraspinatus Trigger points?

A

Pain during shoulder abduction, Severe sleep disturbing pain.
Stiffness of the Shoulder Snapping or clicking sounds at the shoulder.

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23
Q

What are the Pain patterns for a Trigger point found in the Supraspinatus?

A

Top of the Shoulder and lateral arm to Wrist.

Main points of pain found in lateral deltoid and Lateral epicondyle.

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24
Q

What are the Associated TP’s for the Supraspinatus?

A

Infrapsinatus, Trap and Deltoid.

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25
Q

What are the Differential Diagnoses for Supraspinatus?

A

Cervical Arthritis, Spurs with nerve root irritation, Brachial plexus injuries, subacromial and sub deltoid bursitis, RC tear.

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26
Q

What are the possible causes for Trigger points found in the infraspinatus?

A

Acute stress or multiple overload stress, Reaching arm behind and away, twisting arm during a fall.

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27
Q

What Symptoms are associated with trigger Points found in the Infraspinatus?

A

Pain when brushing teeth or combing hair, inability to medially rotate and adduct shoulder at the same time.
Inability to sleep on painful side.

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28
Q

What are the Pain patterns associated with Trigger points found in the infraspinatus?

A

Most intense in shoulder, Lateral arm, forearm and hand.

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29
Q

What are associated TP’s for the Infraspinatus?

A

Teres minor, Anterior Deltoid, Suprasinatus and Bicep Brachii.

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30
Q

What are the Differential Diagnoses for Trigger points found in the Infraspinatus?

A

Suprascapular nerve entrapment, Bicepital tendiosis, Scapulohumeral Dysfunction, GH joint arthritis.

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31
Q

What are the Possible Causes for trigger points found in the trees minor?

A

Reaching behind shoulder in extension, Motor vehicle accident.
Reaching overhead, such as when playing volleyball.

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32
Q

What are symptoms of having a Trigger point in the Teres minor?

A

Posterior Shoulder pain, local to the Posterior deltoid.

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33
Q

What are Pain patterns for the Teres minor?

A

Posterior Shoulder and arm.

34
Q

What are Associated TP’s for the Teres minor?

A

infraspinatus?

35
Q

What are Differential Diagnoses for Trigger points in the Teres Minor?

A

Compression of the Axillary nerve, Subacromial and Subdeltoid bursitis, Ulnar Neuropathy.
Acromioclavicular joint Seperation.

36
Q

What are the Possible causes for Trigger points found in the Subscapularis?

A

Repeated forceful medial rotation, Such as swinging or pitching in baseball.
Repeated overhead lifting.
Dislocation of GH joint.
prolonged immobilization of the Shoulder.

37
Q

What are the Symptoms for trigger points of the Subscapularis?

A

Pain when arm at rest and in motion.
Restricted Abduction of the Shoulder.
inability to reach across to opposite Armpit.

38
Q

What are the Pain patterns for a Trigger point found in the Subscapularis?

A

Posterior shoulder, radiating over scapula.
Mostly in the posterior Deltoid.
Posterior arm and then skipping to the wrist.

39
Q

What are associated Tp’s for Subscapularis?

A

Pec major, trees minor, Latissimus Dorsi, Long head of triceps brachii.

40
Q

What are differential diagnoses for TP’s for subscapularis?

A

RC tear, Adhesive capsulitis, TOS.

41
Q

What are the Possible causes for TP’s found in the Rhomboids Major and minor?

A

Painting overhead, prolonged Leaning forward.

Rounded Shoulder Position, Such as when writing or sewing.

42
Q

What are Symptoms of TP’s found in the Rhomboid major/minor?

A

Superficial aching pain at rest, Snapping/crunching noises during movement of the scapula.

43
Q

What are the Pain patterns for TP’s found in the Rhomboids major minor?

A

Medial boarder and Superior region of the Scapula.

44
Q

What are associated TP’s for the Rhomboids?

A

Scalenes, Lev scapula, Middle Trap and infraspinatus.

45
Q

What are Differential Diagnoses for Trigger points found in the Rhomboids?

A

Fibromyalgia and Scapulocostal Dysfunction.

46
Q

What are then Possible Causes for Trigger points found in the Levator Scapula?

A

Occupational Stresses, Typing with head and neck turned.
Holding the phone between ear and shoulder.
Sleeping with neck in tilted position.
Walking with cane.

47
Q

What are Symptoms for TP’s fo the Levator Scapula?

A

Pain at the angle of the neck “Stiff Neck”.
Torticollis.
Unable to turn head fully to same side or opposite side.

48
Q

What are the Pain patterns for Trigger points in the Levscapula?

A

Posterior Shoulder and neck where the Trap runs over the Lev scap.
Medial boarder of Scapula.

49
Q

What are Differential Diagnoses for TP’s of the Lev scapula?

A

Splenius cervicis TP’s.
Scapulocostal Dysfunction.
SCM TP’s.

50
Q

What are the Possible Causes for Trigger points found in the Serratus Anterior?

A

Excessivly fast or prolonged Running.
Pushups, Lifting heavy weights overhead.
Severe coughing.

51
Q

What are Symptoms of Trigger points found in the Serratus anterior?

A

Chest pain, Stiff in side while running, Unable to lie on affected mm.
Shortness of breath.

52
Q

What are the Pain patterns for TP’s of the Serratus Anterior?

A

Lateral side of thorax below Axilla.

Radiating down medial side of arm to hand.

53
Q

What are Associated TP’s for Serratus anterior?

A

Pec major, SCM, Middle Scalene.

54
Q

What are Differential Diagnoses for Trigger points of the Serratus Anterior?

A

Costochondritis.
Intercostal nerve entrapment.
Herpes Zonster.
Broken Rib.

55
Q

What are possible causes for a Trigger point found in the Sternalis?

A

Acute Myocardial Infarction
Angina Pectoris
Direct Trauma to the Chest

56
Q

What are Symptoms of a Trigger point found in the Sternalis?

A

Intense Deep Substernal pain

Sorness over the Sternum

57
Q

What are the Pain Patterns for a trigger point of the Sternalis?

A

It could be heart shaped over the middle of the Chest.

Possible radiating pain down the Anterior shoulder to the medial arm.

58
Q

What are the Associated trigger points of the Sternalis mm?

A

Pec major & SCM.

59
Q

What is the Differential Diagnoses for a trigger point of the Sternalis mm?

A

Costocondritis / Cardiac Disease.

60
Q

What are possible causes for a trigger point found in the Pec Major?

A
Rounded Shoulder posture
Chronic Shortening of the mm
Heavy lifting 
Overuses of Shoulder Adduction 
Immobilization of the Arm
61
Q

What are Symptoms for a Trigger point of the Pec major?

A

Activation of SCM Trigger points
Pain in the anterior Shoulder
pain over the pericardium
Limited Abduction at the Shoulder

62
Q

What are the Pain patterns for a Trigger point of the Pec major?

A

Anterior Shoulder
Entire Pectoral Region
Medial Side of the arm, down to medial forearm.

63
Q

What are associated trigger points for the Pec major?

A

Lat Dorsi
Teres major
Subscapularis

64
Q

What are the Differential Diagnoses for a trigger point of the Pec major?

A

Angina pectoris
Tear of the mm
Bicipital / Supraspinatus Tendonitis

65
Q

What are the Possible causes for a trigger point of the Pec Minor?

A

Rounded shoulders
Trauma, such as recoil from rifle
Strain from overuse as a shoulder depressor
Strain during inhalation

66
Q

What are the symptoms of a Trigger point found in the Pec minor?

A

Major complaint is pain over the Anterior deltoid region
Difficulty reaching forward and up
Neurovascualr Symptoms through entrapment of the neuromuscular bundle.

67
Q

What are the Pain patterns for a Trigger point of the Pec minor?

A

Anterior chest
Concentrated in the Anterior shoulder
Radiates down medial side of the arm to fingertips

68
Q

What are Associated TP’s for pec minor?

A

Pec Major
Anterior Deltoid
Scalenes
SCM

69
Q

What are the Differential Diagnoses for a trigger point of the Pec minor?

A

TOS
C7 - C8 radiculopathy
Bicipital / Supraspinous tendonitis

70
Q

What are the symptoms of a trigger point found in the Subclavius?

A

TOS

71
Q

What are the Pain patterns for a trigger point found int eh Subclavius mm?

A

Inferior to clavicle
Anterior Arm
Lateral forearm and Hand

72
Q

What are the Possible causes for a Trigger point found in the Bicep Brachii?

A

Elevation of Arm above shoulder level.
Overstress during activities such as, backhand tennis, weightlifting with palm supinated.
Repeated Supination.

73
Q

What are symptoms of a Trigger point in the Bicep Brachii mm?

A

Superficial, anterior shoulder pain.
Tenderness over bicipital tendon.
Weakness raising hand above head.

74
Q

What are pain patterns for a Trigger point found in the Bicep Brachii?

A

Anterior shoulder, down to anterior Elbow.

75
Q

What are the associated Trigger points for Bicep Brachii?

A

Brachialis.
Supinator.
Triceps Brachii.

76
Q

What are the Differential Diagnoses for a trigger point of the Bicep Brachii?

A

Bicep tendonitis.
Subacromial / Subdeltoid Bursitis.
Bicipital Bursitis.
GH joint Arthritis.

77
Q

What are the possible causes of a trigger point found in the Tricep Brachii?

A

Manual Driving.

Overuse / during Exercise.

78
Q

What are the symptoms of a Trigger point found in the Tricep Brachii?

A

Difficult to locate Ian in posterior shoulder.

Difficulty or inability to fully Extend shoulder.

79
Q

What are the pain patterns for a trigger point found in the tricep Brachii?

A

Posterior Shoulder.

Posterior arm and forearm, down to pinkie and ring finger.

80
Q

What are the Associated TP’s for the Tricep Brachii?

A

Lat Dorsi

Teres major / Minor

81
Q

What are the Differential Diagnoses for a TP of the Tricep Brachii?

A

Entrapment of the Radial nn.
“Tennis Elbow”
Lateral or medial Epicondylitis.

82
Q

What are the possible causes for a TP found in the Coracobrachialis?

A

Active TP’s in the anterior delt, biceps and pec major.

83
Q

What are the symptoms of TP’s found in the coracobrachialis?

A

Pain with Shoulder extension and upper limb pain.

84
Q

What are the Pain patterns for TP’s in the Coracobrachialis?

A

Anterior shoulder, skipping down to posterior arm, forearm and hand.

85
Q

What are the possible Differential diagnoses for a TP found in the Coracobrachials?

A

Subacromial / Deltoid Bursitis, Supraspinitus Tendinitis, AC joint dysfunction and Carpal Tunnel syndrome.