Trigger points of the Shoulder & Arm Flashcards
What is the possible cause for trigger points found in the Deltoid?
Impact trauma During sports or other activities.
Repudiative strain During prolonged lifting.
What are symptoms of having a trigger point in the Deltoid?
Difficulty abducting the shoulder to a horizontal position.
There will also be pain deep in the deltoid area.
What are the Pain patterns of trigger point in the deltoid?
Anterior, lateral and posterior sides of the shoulder.
Around the Deltoid mm in general.
What are the associated Trigger points?
Pec major, Biceps brachii, Other sections of the Deltoid.
What is a Differential Diagnoses for the Deltoid muscle?
Rotator cuff Tear, Bicipital Tendinosis, Subacromial / Subdeltoid Bursitis, Glenohumeral joint Arthritis.
What are possible Causes for Trapezius Trigger points?
Sudden Trauma, Such as falling, Whiplash injury, Walking with a cane, Arm Rest in high position.
What are the Symptoms of having a Trigger point in the Trapezius Muscle?
Severe neck pain, Headache, “Stiff neck”.
What are the Pain patterns for a Trigger point in the Trapezius muscle?
Angle of the mandible, Temporal Region, Lateral and posterior sides of the neck, Upper back, Medial boarder of the Scapula.
What are the Associated Trigger points for the Trapezius?
Temporalis, Occipitalis, Masseter, Pectoralis +-, Levator Scapula.
What Differential Diagnoses could there be for a Trigger point found in the Trapezius?
Temporomandibular Joint Disorder, TP’s of the Masticatory Mm’s, Fibromyalgia.
What are the possible causes for a Trigger point found in the Latissimus Dorsi?
Repudiative Shoulder Extension, Throwing a baseball, Hanging from a swing or pulling weeds.
What are symptoms of having a Trigger Point in the Latissimus Dorsi?
Pain when Stretching upward or far out in front of the body.
What are the Pain Patterns for a Trigger point found in the Latissimus Dorsi?
Region inferior to the scapula, Radiating and skipping down posterior arm to pinkie and ring finger.
What are associated Trigger points for the Latissimus Dorsi?
Pec major, Teres minor and Subscapularis.
What are Differential Diagnoses for Trigger points found in the Latissimus Dorsi?
Entrapment of Subscapular nerve, Bicipital Tendinosis, ulnar Neuropathy.
What are the Possible causes for having a Trigger point in the Teres Major?
Driving without power steering, Reaching overhead and forward to lifting heavy objects.
What are Symptoms for a Trigger Point found in the Teres Major?
Pain upon muscle activation, Slight restriction in overhead range.
What are pain patterns for a Trigger point found in the trees Major?
Posterior shoulder, Radiates down posterior arm and Forearm.
What are pain patterns for a Trigger point found in the trees Major?
Posterior shoulder, Radiates down posterior arm and Forearm.
What are Associated TP’s for the Teres major?
Latissimus Dorsi, Long head of the Triceps Brachii.
What are Associated TP’s for the Teres major?
Latissimus Dorsi, Long head of the Triceps Brachii.
What are Differential Diagnoses for Trigger points found in the Teres major?
Subacromial / Subdeltoid bursitis, Supraspinatus Tendinosis, TOS.
What are Possible causes for Supraspinatus Trigger points?
Carrying heavy objects that pull inferiorly, Walking a big dog that pulls hard on a leash.
Lifting heavy objects above shoulder height.
What are Symptoms for a Supraspinatus Trigger points?
Pain during shoulder abduction, Severe sleep disturbing pain.
Stiffness of the Shoulder Snapping or clicking sounds at the shoulder.
What are the Pain patterns for a Trigger point found in the Supraspinatus?
Top of the Shoulder and lateral arm to Wrist.
Main points of pain found in lateral deltoid and Lateral epicondyle.
What are the Associated TP’s for the Supraspinatus?
Infrapsinatus, Trap and Deltoid.
What are the Differential Diagnoses for Supraspinatus?
Cervical Arthritis, Spurs with nerve root irritation, Brachial plexus injuries, subacromial and sub deltoid bursitis, RC tear.
What are the possible causes for Trigger points found in the infraspinatus?
Acute stress or multiple overload stress, Reaching arm behind and away, twisting arm during a fall.
What Symptoms are associated with trigger Points found in the Infraspinatus?
Pain when brushing teeth or combing hair, inability to medially rotate and adduct shoulder at the same time.
Inability to sleep on painful side.
What are the Pain patterns associated with Trigger points found in the infraspinatus?
Most intense in shoulder, Lateral arm, forearm and hand.
What are associated TP’s for the Infraspinatus?
Teres minor, Anterior Deltoid, Suprasinatus and Bicep Brachii.
What are the Differential Diagnoses for Trigger points found in the Infraspinatus?
Suprascapular nerve entrapment, Bicepital tendiosis, Scapulohumeral Dysfunction, GH joint arthritis.
What are the Possible Causes for trigger points found in the trees minor?
Reaching behind shoulder in extension, Motor vehicle accident.
Reaching overhead, such as when playing volleyball.
What are symptoms of having a Trigger point in the Teres minor?
Posterior Shoulder pain, local to the Posterior deltoid.
What are Pain patterns for the Teres minor?
Posterior Shoulder and arm.
What are Associated TP’s for the Teres minor?
infraspinatus?
What are Differential Diagnoses for Trigger points in the Teres Minor?
Compression of the Axillary nerve, Subacromial and Subdeltoid bursitis, Ulnar Neuropathy.
Acromioclavicular joint Seperation.
What are the Possible causes for Trigger points found in the Subscapularis?
Repeated forceful medial rotation, Such as swinging or pitching in baseball.
Repeated overhead lifting.
Dislocation of GH joint.
prolonged immobilization of the Shoulder.
What are the Symptoms for trigger points of the Subscapularis?
Pain when arm at rest and in motion.
Restricted Abduction of the Shoulder.
inability to reach across to opposite Armpit.
What are the Pain patterns for a Trigger point found in the Subscapularis?
Posterior shoulder, radiating over scapula.
Mostly in the posterior Deltoid.
Posterior arm and then skipping to the wrist.
What are associated Tp’s for Subscapularis?
Pec major, trees minor, Latissimus Dorsi, Long head of triceps brachii.
What are differential diagnoses for TP’s for subscapularis?
RC tear, Adhesive capsulitis, TOS.
What are the Possible causes for TP’s found in the Rhomboids Major and minor?
Painting overhead, prolonged Leaning forward.
Rounded Shoulder Position, Such as when writing or sewing.
What are Symptoms of TP’s found in the Rhomboid major/minor?
Superficial aching pain at rest, Snapping/crunching noises during movement of the scapula.
What are the Pain patterns for TP’s found in the Rhomboids major minor?
Medial boarder and Superior region of the Scapula.
What are associated TP’s for the Rhomboids?
Scalenes, Lev scapula, Middle Trap and infraspinatus.
What are Differential Diagnoses for Trigger points found in the Rhomboids?
Fibromyalgia and Scapulocostal Dysfunction.
What are then Possible Causes for Trigger points found in the Levator Scapula?
Occupational Stresses, Typing with head and neck turned.
Holding the phone between ear and shoulder.
Sleeping with neck in tilted position.
Walking with cane.
What are Symptoms for TP’s fo the Levator Scapula?
Pain at the angle of the neck “Stiff Neck”.
Torticollis.
Unable to turn head fully to same side or opposite side.
What are the Pain patterns for Trigger points in the Levscapula?
Posterior Shoulder and neck where the Trap runs over the Lev scap.
Medial boarder of Scapula.
What are Differential Diagnoses for TP’s of the Lev scapula?
Splenius cervicis TP’s.
Scapulocostal Dysfunction.
SCM TP’s.
What are the Possible Causes for Trigger points found in the Serratus Anterior?
Excessivly fast or prolonged Running.
Pushups, Lifting heavy weights overhead.
Severe coughing.
What are Symptoms of Trigger points found in the Serratus anterior?
Chest pain, Stiff in side while running, Unable to lie on affected mm.
Shortness of breath.
What are the Pain patterns for TP’s of the Serratus Anterior?
Lateral side of thorax below Axilla.
Radiating down medial side of arm to hand.
What are Associated TP’s for Serratus anterior?
Pec major, SCM, Middle Scalene.
What are Differential Diagnoses for Trigger points of the Serratus Anterior?
Costochondritis.
Intercostal nerve entrapment.
Herpes Zonster.
Broken Rib.
What are possible causes for a Trigger point found in the Sternalis?
Acute Myocardial Infarction
Angina Pectoris
Direct Trauma to the Chest
What are Symptoms of a Trigger point found in the Sternalis?
Intense Deep Substernal pain
Sorness over the Sternum
What are the Pain Patterns for a trigger point of the Sternalis?
It could be heart shaped over the middle of the Chest.
Possible radiating pain down the Anterior shoulder to the medial arm.
What are the Associated trigger points of the Sternalis mm?
Pec major & SCM.
What is the Differential Diagnoses for a trigger point of the Sternalis mm?
Costocondritis / Cardiac Disease.
What are possible causes for a trigger point found in the Pec Major?
Rounded Shoulder posture Chronic Shortening of the mm Heavy lifting Overuses of Shoulder Adduction Immobilization of the Arm
What are Symptoms for a Trigger point of the Pec major?
Activation of SCM Trigger points
Pain in the anterior Shoulder
pain over the pericardium
Limited Abduction at the Shoulder
What are the Pain patterns for a Trigger point of the Pec major?
Anterior Shoulder
Entire Pectoral Region
Medial Side of the arm, down to medial forearm.
What are associated trigger points for the Pec major?
Lat Dorsi
Teres major
Subscapularis
What are the Differential Diagnoses for a trigger point of the Pec major?
Angina pectoris
Tear of the mm
Bicipital / Supraspinatus Tendonitis
What are the Possible causes for a trigger point of the Pec Minor?
Rounded shoulders
Trauma, such as recoil from rifle
Strain from overuse as a shoulder depressor
Strain during inhalation
What are the symptoms of a Trigger point found in the Pec minor?
Major complaint is pain over the Anterior deltoid region
Difficulty reaching forward and up
Neurovascualr Symptoms through entrapment of the neuromuscular bundle.
What are the Pain patterns for a Trigger point of the Pec minor?
Anterior chest
Concentrated in the Anterior shoulder
Radiates down medial side of the arm to fingertips
What are Associated TP’s for pec minor?
Pec Major
Anterior Deltoid
Scalenes
SCM
What are the Differential Diagnoses for a trigger point of the Pec minor?
TOS
C7 - C8 radiculopathy
Bicipital / Supraspinous tendonitis
What are the symptoms of a trigger point found in the Subclavius?
TOS
What are the Pain patterns for a trigger point found int eh Subclavius mm?
Inferior to clavicle
Anterior Arm
Lateral forearm and Hand
What are the Possible causes for a Trigger point found in the Bicep Brachii?
Elevation of Arm above shoulder level.
Overstress during activities such as, backhand tennis, weightlifting with palm supinated.
Repeated Supination.
What are symptoms of a Trigger point in the Bicep Brachii mm?
Superficial, anterior shoulder pain.
Tenderness over bicipital tendon.
Weakness raising hand above head.
What are pain patterns for a Trigger point found in the Bicep Brachii?
Anterior shoulder, down to anterior Elbow.
What are the associated Trigger points for Bicep Brachii?
Brachialis.
Supinator.
Triceps Brachii.
What are the Differential Diagnoses for a trigger point of the Bicep Brachii?
Bicep tendonitis.
Subacromial / Subdeltoid Bursitis.
Bicipital Bursitis.
GH joint Arthritis.
What are the possible causes of a trigger point found in the Tricep Brachii?
Manual Driving.
Overuse / during Exercise.
What are the symptoms of a Trigger point found in the Tricep Brachii?
Difficult to locate Ian in posterior shoulder.
Difficulty or inability to fully Extend shoulder.
What are the pain patterns for a trigger point found in the tricep Brachii?
Posterior Shoulder.
Posterior arm and forearm, down to pinkie and ring finger.
What are the Associated TP’s for the Tricep Brachii?
Lat Dorsi
Teres major / Minor
What are the Differential Diagnoses for a TP of the Tricep Brachii?
Entrapment of the Radial nn.
“Tennis Elbow”
Lateral or medial Epicondylitis.
What are the possible causes for a TP found in the Coracobrachialis?
Active TP’s in the anterior delt, biceps and pec major.
What are the symptoms of TP’s found in the coracobrachialis?
Pain with Shoulder extension and upper limb pain.
What are the Pain patterns for TP’s in the Coracobrachialis?
Anterior shoulder, skipping down to posterior arm, forearm and hand.
What are the possible Differential diagnoses for a TP found in the Coracobrachials?
Subacromial / Deltoid Bursitis, Supraspinitus Tendinitis, AC joint dysfunction and Carpal Tunnel syndrome.
