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What causes trigger points

Specific causes of Trigger Points can include, but are not limited to, trauma, overuse, repetitive straining, or alignment imbalances. There can also be episodes where increased and prolonged muscle tension from an existing injury activates Trigger Points. For example, someone sprains an ankle and then walks with a limp Trigger points develop as a result of muscular injuries, strains, and trauma. When muscle fibers, fascia, ligaments, or tendons become weakened, overstretched, or inflamed, tiny tears in the associated soft tissue can occur. As the tissue heals it contracts, becoming twisted and knotted Sensitive areas of tight muscle fibers can form in your muscles after injuries or overuse. These sensitive areas are called trigger points. A trigger point in a muscle can cause strain and pain throughout the muscle. When this pain persists and worsens, doctors call it myofascial pain syndrome Causes of trigger point formation • Emotional stress will always play a role in muscle function. The trapezius and quadratus lumborum is most susceptible to the effects of emotional stress, although many other muscles can be affected by stress. Tension, anxiety and everyday nervousness can make trigger point therapy ineffective What causes a trigger point? A trigger point may form after muscle injury, overuse, stress, or tension. Muscle stress may be from poor posture or an awkward sleep position. Emotional stress can make you tense certain muscles, such as in your neck

Trigger points (TrPs) or muscle knots are sore spots in soft tissue that cause deep aching. Myofascial pain syndrome (MPS) is a chronic pain disorder of too many trigger points. TrPs are usually described as micro-cramps, but the science is half-baked and their nature is controversial A trigger point is a small knot in your muscle. These muscle knots can cause pain where it originates or further away, in a spot that seems complete unconnected. Trigger points are responsible for a majority of all pain syndromes, especially that caused by myofascial trigger points. This pain is often referred to as a Myofascial Pain Syndrome Causes of Trigger Points When your muscles are injured or stressed they often form trigger points. The damage to the connective and muscle tissue can occur in several ways, including: Repetitive overuse injuries (i.e. typing, gardening, home improvements, certain spots such as tennis and golf, etc. Fibromyalgia causes what's now referred to as regions of pain. Some of these regions overlap with what was previously referred to as areas of tenderness called trigger points or tender..

What Causes Trigger Points?: Quince Orchard Medical Center

  1. You may develop trigger points along the bands of the trapezius. These are raised parts of the muscle that can be painful. Trigger points can develop for many reasons, including from exercise,..
  2. Muscle inflammation can be caused by repetitive strain, lack of muscle activity, or a direct muscle injury. When muscles are stressed or injured, they often form tender trigger points that feel like dense tight knots in the muscle tissue. Pressure on a trigger point causes the muscle fibers to shorten and be painful to the touch
  3. Causes of Trigger Points? Muscular pain without traumatic injury isn't anything new to the medical community. Prior to the 1950s, it was thought to originate from inflammation of the connective tissues, such as bone and fascia. When this was shown to be false through biopsies of tissues, a new culprit was needed to explain the enigmatic pain
  4. Trigger points are classified as being active or latent, depending on their clinical characteristics.5 An active trigger point causes pain at rest
  5. Causes of myofascial trigger points. Charleston says there are several factors that can lead to painful trigger points, including: Injuries from overuse, heavy lifting or repetitive motions. Poor posture, which often results from a sedentary lifestyle and lack of exercise. Tension from mental and emotional stress
  6. Trigger points are an extremely common cause of pain. Myofascial pain often results from muscle trauma, injury or repetitive strain and also from poor posture and stress. The body will naturally try to protect itself when under stress, but this may cause strength and flexibility imbalances in the body
  7. Trigger finger is also known as stenosing tenosynovitis (stuh-NO-sing ten-o-sin-o-VIE-tis). It occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger. If trigger finger is severe, your finger may become locked in a bent position

Trigger Points: How They Develop & How to Relieve Them

Trigger points, on the other hand, are simply tender points on your body that 'trigger' or cause discomfort in a different location. For example, if a therapist presses on a spot on your back, you might feel pain radiating up into your head or down the arm - that's a trigger point The scalene muscles are three muscles that are attached to the cervical spine and can trigger various forms of pain. Among other, it can cause shoulder and upper arm pain or thoracic outlet syndrome A Trigger Point (TrP) is a hyperirritable spot, a palpable nodule in the taut bands of the skeletal muscles' fascia. Direct compression or muscle contraction can elicit jump sign, local tenderness, local twitch response and referred pain which usually responds with a pain pattern distant from the spot Myofascial pain syndrome (MPS) is described as the sensory, motor, and autonomic symptoms caused by myofascial trigger points (TrPs). Knowing the potential causes of TrPs is important to prevent their development and recurrence, but also to inactivate and eliminate existing TrPs. There is general ag For trigger points, arm, shoulder and neck comfort is crucial for proper relief. What causes trigger points when we talk about pillows is this. Having pillows that are too high will tighten certain neck muscles like the scalenes, and can be one of the most overlooked causes of trigger points

Myofascial pain syndrome - Symptoms and causes - Mayo Clini

Activation of trigger points may be caused by a number of factors, including acute or chronic muscle overload, activation by other trigger points (key/satellite, primary/secondary), disease, psychological distress (via systemic inflammation), homeostatic imbalances, direct trauma to the region, collision trauma (such as a car crash which stresses many muscles and causes instant trigger points), radiculopathy, infections and health issues such as smoking Causes Of Trigger Points. Trigger points can often be linked to stress, postural imbalance, repetitive motion, or the lasting effects of an old but healed injury. They can also be caused by muscular atrophy or holding a muscle in an awkward position for repeated or extended periods. Latent trigger points can become active due to overuse. Also called myofascial trigger point, the trigger point is a hyperirritable spot in skeletal muscle. Trigger points are associated with palpable nodules in taut bands of muscle fibers. It is believed that palpable nodules are small contraction knots and a common cause of pain. Myofascial pain syndrome is a common painful muscle disorder. A latent trigger point does not cause spontaneous pain, but may restrict movement or cause muscle weakness.6 The patient presenting with muscle restrictions or weakness may become aware of pain. management of BPPV and other benign causes of dizziness SCM trigger point can be part of this picture—why? Trigger Points. History of Trigger Points. First mention of muscular pain in literature, as listed in Travell's book: called muscle callus, in 184

For instance, a calf muscle with a latent trigger point that gets cold might develop a knot and trigger point pain will occur again, long after the injury is gone. Trigger points are also identified as key and satellite trigger points. A key trigger is directly caused by the original stress or trauma to the muscle Trigger points are involuntary tight tender spots in a contracted muscle. This creates pain and dysfunction within the muscle. They are in parts of the muscle where there is decreased circulation, increased muscle contraction, spasm and increased nerve sensitivity causing a sharp pain or a constant ache

Supraspinatus Trigger Points (Overview - Self Treatment Tips)

A trigger point is a small, taut patch of involuntarily contracted muscle fibers within a muscle or muscle fascia. The tightly contracted fibers that form a trigger point effect blood supply to the nearby tissue, which in turn makes the area hyperirritable when compressed. In addition to the local pain they cause, trigger points often refer. Trigger Points. Trigger points in these small muscles of the hand cause their characteristic pain patterns (see illustrations below), along with clumsiness of the thumb, and a great deal of misunderstanding concerning the attention and care of the owner of that thumb. The ability to catch, grip and pinch may be compromised or lost

What are trigger points? First, YES they are real! Trigger points are described as hypersensitive spots in skeletal muscle that are associated with palpable nodules (knots) in taut bands (ropes) of muscle fibers. Active Trigger points are a very common cause of pain, which can be mild to annoying to quite severe and even debilitating What Are Trigger Points? A trigger point is basically a knot of tension that can cause pain and neuropathy symptoms in patients. By definition, it is a sensitive area of the body, stimulation or irritation of which causes a specific effect in another part of the body. Patients will feel musculoskeletal pain in an area of the body when a. A malfunctioning of this myoneural junction is what causes trigger points to form in the muscle. In over-simplified terms, a junction gets stuck in the 'on' position, causing the muscle fibers that are controlled by it to remain in a state of constant contraction, forming a micro-spasm in the muscle

Trigger points in the adductor magnus can cause a host of referred pain to groin and inner thigh, pelvic and pubic bones, rectum and vagina and can cause menstrual cramping (as can TrPs in the. Myofascial trigger points are a ubiquitous problem that can lead to severe pain and sometimes puzzling symptoms, which often end up misdiagnosed. Myofascial trigger points are painful, hyperirritable areas in muscles that can cause pain, stiffness, limited range of motion and sometimes other symptoms Trigger points that cause lower back pain must be located and treated properly and thoroughly if you are ever going to achieve a relatively painless lower back. What is Referred Pain? Referred pain is the pain that is radiated as a dull, aching pain or even a sharp one when a trigger point is pressed or aggravated Go to http://lifeafterpain.com/LP/Trigger-Point-YTBE-90-01.html to find out what causes myofascial trigger points and how to switch them off Trigger points cause the muscle to become tighter and shorten. When muscles shorten, they cannot go through the full range of motion, altering the way you move, sit or stand. This leads to strength and flexibility issues, creating more trigger points. Research suggests that fibromyalgia pain is largely due to myofascial trigger points.

Myofascial Trigger Points - Symptoms and Cause

Trigger Point Pain - What You Need to Kno

  1. Trigger points cause pain more often than any other condition and are drastically under-diagnosed due to lack of information. Trigger point pain is usually a factor in most injuries although treating the trigger points is often overlooked. A common condition related to triggers points is known as myofascial pain
  2. This postural strain may cause trigger points leading to active trigger points, causing radiating somatic pain, muscle atrophy, fibrosis or tissue hardening, and decreased tensile strength. Additionally, this muscle group has a high density of proprioceptors, so muscle atrophy may lead to loss of proprioceptive balance
  3. That trauma and the ensuing tightness can lead to trigger points, either immediately or over time. For instance, getting in a car crash and having whiplash can create stress to the neck that might prompt trigger points to develop. Referred pain: In some cases, a trigger point in one part of the body actually causes pain in another area
  4. Trigger points in SCM. Any changes in the SCM muscle can be associated with Trigger Points (TPs) whom can be the cause itself or the consequence of the syndrome. If present,TPs are oftentimes found as well in the upper Trapezius. If TP is active within SCM, it can broadcast the referral pain often away from the SCM muscle
  5. The X's represent the Trigger Points. The red dotted area is the referred pain caused by the Trigger Point and the solid red means more people experienced pain in that area. The dark green color areas represent the muscles of the human body

Complete Guide to Trigger Points & Myofascial Pain (2021

The major reported difference is that trigger points produce pain in a referred pattern, whereas tender points generate pain at the site of palpation. 9 Trigger points are further classified as active versus latent. Latent trigger points elicit painful sensation only with the application of direct compression Trigger points are painful when pressure is applied. And it also refers pain to another area of the body. In the case of the upper trapezius muscles, the referred pain can be located on the side and top of the neck, base of the skull, lower jaw and side of the head triggering headache pain

Trigger finger and trigger thumb are painful conditions. Learn more about the causes, symptoms, diagnosis, and treatment of trigger finger Piriformis Trigger Points & Why They Cause Pain. The piriformis muscle is a small but mighty muscle located deep in the buttock. It starts at the lower spine and connects to the upper surface of each femur or thighbone. The function of the piriformis muscle is to help you rotate your hip and allow you to turn your leg and foot outward Myofascial trigger point pain is an extremely prevalent cause of persistent pain disorders in all parts of the body, not just the head, neck, and face. Features include deep aching pain in any structure, referred from focally tender points in taut bands of skeletal muscle (the trigger points) Trigger points in the SCM muscle have been shown to produce all kinds of symptoms, including tearing of the eye, headache, sinus congestion, ear and jaw pain, pain with swallowing and vertigo. The joints of the neck also have strong effects on the whole head region, with similar effects Extensor Digitorum Trigger Points Causes and Symptoms. The extensor digitorum muscle is responsible for extension of the fingers, and pain derived from trigger points in the extensor digitroum could be mistaken for arthritis pain in the fingers or even Tennis elbow because of symptoms at the elbow. Sore and tender fingers and aching.

Although The Trigger Point Therapy Workbook is a fantastic resource and recommended highly, Davies had the unfortunate tendency to want MOST conditions to be related to trigger points and treatable by trigger point massage. 4 Anderson, Marcia K. Chp. 12: Lower Leg, Ankle, and Foot Conditions. Fundamentals of Sports Injury Management The lower trigger point lies just above the superior angle of the scapula and the upper trigger point lies 1-3 inches above the lower trigger point. Both trigger points lie deep to the upper trapezius muscle and both refer pain laterally to the shoulder and along the medial aspect of the shoulder blade. Trigger points in the Levator Scapulae. A migraine trigger point sometimes causes tenderness when an individual puts pressure on it, too. Does each migraine patient have a single migraine trigger point? The answer to this question depends on the patient. Sometimes, patients have multiple trigger points. In these scenarios, different migraines occur at various migraine trigger points However, TrP1 (Trigger Point 1) at the curve of the neck/shoulder is one of the myofascial TrPs observed the most often : There are about seven common trigger points located in the upper, middle and lower portions of the trapezius muscle: Point 7 (x) produces pilomtor activity or gooseflesh to the upper extremit Myofascial pain syndrome is a condition in which those trigger points cause pain to occur: During movement. When pressure is applied. In seemingly unrelated parts of the body (referred pain) Treatment focuses on relieving pain and getting tight fascia and muscle fibers to relax. Medical options include pain relievers, physical therapy and.

This condition of unknown cause includes painful trigger points in the neck's muscles and fascia (connective tissues). When a trigger point in the neck is pressed, it may refer pain down into the shoulder or other nearby areas. Shoulder osteoarthritis . The breakdown of protective cartilage within the shoulder joint can lead to pain and. Rectus Abdominis Trigger Points Irritable bowel syndrome (IBS) is a common condition of the digestive system whose full cause is unknown. IBS is the most common gut problem worldwide, with an estimated 20% of the population of the US experiencing symptoms, 13% in Canada, 12% in the UK, and 6.9% in Australia.. Full and reliable statistics are not available for the whole world and diagnosis. Related trigger point and referred pain diagrams for Dry Cough. Relevant primary and secondary muscles are shown

Trigger points - Overview & self-treatmen

One of the causes of myofascial trigger points is repeatedly performing the same action over and over. It may be a strenuous but ordinary action such as vacuuming, or it may be non-strenuous such as typing or playing on electronic handheld devices. Repetitive actions are not the only causes of trigger points Trigger finger or trigger thumb is a condition that causes your fingers or thumb get stuck in a bent position. Those with trigger finger or trigger thumb may have stiffness when bending the finger(s) or hear snapping and popping when moving the finger(s). Depending on the severity of the condition, treatment options can range from rest to surgery

What Are Myofascial Trigger Points? (And 5 Ways To Release

Even though the trigger point that causes front lower tooth pain is in the portion under the chin, it is still a good idea to treat the whole muscle. Watch the video to see how to find and treat both portions. Start behind the jaw bone (Mandible) and come around the angle and underneath it all the way along until the chin What are Myofascial Trigger Points? The most common cause of muscle pain is a phenomenon called 'Myofascial Trigger Points'. These are points of exquisite tenderness within a taut band of tight muscle which causes pain to refer in a particular pattern (Gerwin,1984). Myofascial trigger points often develop following overload of a particular. Besides these typical activities, there are trigger points that could prompt pain in the deltoid. Trigger points cause sensitivities to the body. Some of these factors include: Falling on the shoulder. Overloading the body, such as reaching out to catch a fall. Using power tools. Any repetitive activity with the hands and shoulders

Fibromyalgia: Causes, Trigger Points, Treatment, and Mor

There are 18 painful trigger points identified causing Fibromyalgia. Fibromyalgia is diagnosed when 11 painful trigger point areas are identified during examination at one time. Pain is intolerable because of severe intensity and widespread distribution of tender spots A trigger point can be described as a spot or point in a muscle that refers a sensation, be it pain or weakness, to another area of the body. For example, a trigger point in your upper trap muscle may cause a referral pattern into the side of the head, behind the ear (see Figure 1) What Causes Trigger Points to Form? Blunt trauma - such as a car accident or a fall. Overuse - perhaps a muscle working too hard by compensating for other muscles. Lack of use - muscle dysfunction and a decrease in lack of blood flow can be due to lack of use. This can lead to the formation of trigger points Myofascial trigger points can be found anywhere on the body and are one of the most common causes for chronic musculoskeletal pain, also known as myofascial pain. A certified DGSA Trigger Point Therapist can release these painful and tense points in a muscle and assist in achieving long-term results

Trigger points cause weakness in your adductors, which mean sthat they can no longer perform their function- to stabilize your leg. What that means is that the leg will constantly try to rotate outward, which causes the muscles on the outside of your hip and thigh to overwork and become really tight and shortened Trigger points in the gastrocnemius muscle in the calf can cause calf cramps at night (27). Feet - Plantar Fasciitis Pain in the soles of the feet in plantar fasciitis is technically not myofascial pain since it does not arise from muscle fascia but from a thick sheet of connective tissue called plantar fascia

Trapezius Trigger Points: Causes, Treatment, and Preventio

Myofascial pain or trigger points in the Gluteus medius and Piriformis muscles can cause pain in the buttock area. A trigger point is a tiny localised knot in the muscle. It will cause pain in the buttock or lower back which may spread to other areas. Movement around the hip will be difficult, but this can be helped by stretching and massage Trigger points often cause what doctors call referred pain. When a person presses on the trigger point, the pain spreads from the trigger point to nearby muscles. Sometimes, the muscle may twitch. Figure: Side view of the three scalene muscles on the right side of the neck showing possible trigger points in yellow. Contact sports such as hockey, football, rugby, and wrestling where whiplash-like motions are encountered regularly will produce trigger points in each of the scalene muscles. Even daily activities can cause them, as well as.

Trigger Point Causes: How Muscle Injury Leads To Neck And

Trigger fingers are more common with certain medical conditions. Rheumatoid arthritis, gout and diabetes are risk factors for this condition. Repeated and strong gripping may lead to the condition. In most cases, the cause of the trigger finger is not known This post may contain affiliate links. Please read the disclaimer for more info.. For some odd reason, the practices of trigger point therapy, myofascial release, or deep massage (whichever you prefer) are all typically overlooked to resolve plantar fasciitis (PF).Maybe its because the experts we look to rarely recommend it because it's too woo-woo for them Trigger points that cause lower back pain must be located and treated properly and thoroughly if you are ever going to achieve a relatively painless lower back. You can take all the drugs manufactured for pain, inflammation, or muscle relaxation, receive hundreds of chiropractic adjustments,.

The first test involves placing the forearm across the low back. It usually produces pain in the shoulder. Pain worsens as you reach up the middle of the back. Notably, this may also indicate trigger points in the coracobrachialis with a different pain pattern. In the second test, reach around the back of your head like the pic Trigger points are hyper-tensed muscles (aka muscle knots) that cause jaw aches and pains. When it comes to TMD, we can blame the pain on the masseter muscle, which covers the jaw over your. Trigger points in the middle and lower portions of the muscle are shown as Location 3 and refer into the back of the head on the same side. Frontalis. Trigger points form in the frontalis from direct trauma, over stress from prolonged intense frowning or wrinkling of the forehead. The referral pattern for the frontalis is local and spreads. Upper trapezius trigger points are the primary trigger points responsible for neck pain and headaches. The upper traps are the most reactive muscles in your body to emotional stress. To effectively resolve most trigger points, they should be treated multiple times (3-5 times) per day

What Causes Trigger Points in the Sternocleidomastoid Muscle? The SCM extends the head and turns it to the opposite side, so any position where the neck is held in an awkward position can create trigger points. It is also an auxiliary muscle of breathing, meaning it is used when you are breathing hard or in the chest, rather than with the. Myofascial pain syndrome (MPS) is a common musculoskeletal disorder caused by myofascial trigger points. 1 This painful disorder can affect any of the skeletal muscles in the body and the prevalence varies by medical specialty—it accounts for 21% of orthopedic clinic visits, 30% of general medicine visits, and approximately 85% to 93% of pain management clinic visits. 2 MPS has become a. Trigger Toe - Symptoms, Causes, Treatment & Prognosis. Trigger toe is an injury that most commonly affects ballet dancers, due to the physical demands of dancing en pointe, a position that requires a dancer to stand on her or his toes, placing all body weight on the big toe (the hallux ). Inflammation of the flexor hallucis longus (FHL. Tender points are defined by the ACR as 18 bilateral points on the body—nine on one side and nine on the other—where pain can be felt immediately beneath the skin when pressed. These are not to be confused with trigger points, which cause pain in another part of the body when pressed A trigger point is a knot in your muscle that doesn't relax and is very sensitive to touch. Trigger points can also cause muscle spasms (twitches) or a feeling of tightness. When pressure is applied to the trigger point, you will feel some pain in that area. The injections usually sting slightly but there typically is immediate pain relief.

Myofascial Pain Syndrome Medical ExhibitBrachioradialis Trigger Points (Overview - Self TreatmentThe Suboccipital Trigger Points (Free Full Video) - YouTubeGluteus Minimus Trigger Points (Overview - Self TreatmentQuadratus Lumborum Trigger Points (Overview - Self Treatment)

None of Us Have Any Idea What Trigger Points Really Ar

Trigger points can cause burning, or numbness and tingling if the TrP is entrapping a nerve. Circulation changes can occur if a TrP is located next to a blood vessel, which can cause skin. Triggers vs. Causes. There is also a difference between a trigger of anxiety and a cause of anxiety. A cause of anxiety is something that resulted in the formation of your anxiety disorder. For example, your upbringing and genetics are causes of your anxiety. Triggers are issues that make the anxiety you already struggle with worse or more. Dr. Perry describes the trigger points that cause hip pain and hip dysfunction Cause of trigger points in the trapezius muscle. There are multiple causes of trigger points in the trapezius muscles. Stress: Being stressed out can result in the shoulder muscles tightening up and hence referring pain to other parts of the body Bad posture: Sitting or standing improperly can result in extreme stress on the spine and shoulder muscles resulting in trigger points and pai Trigger points can be identified by pain that results when pressure is applied to a specific area of a person's body. In the diagnosis of myofascial pain syndrome, two types of trigger points can.

Trigger Points: Diagnosis and Management - American Family

The trigger point is identified when the tip of the needle causes marked tenderness. The injection of local anesthetic serves as a therapeutic trial and may not provide permanent relief. However, a significant number of patients experience pain relief after one or two injections. 5 A major goal of trigger-point injection is to confirm the. Trigger Points cause: - Chronic ongoing pain. - Pain that likes to mimic the symptoms of other issues. - Nerve irritation. - Patterns of Pain Referral eg: commonly seen as self mutilation as dog gnaws at area of pain which is actually coming from a different area. - Worsening of orthopaedic pain eg: Hip Dysplasia, Arthritis

Symptoms, Causes And Treatments Of Muscle Knots Piedmont

Trigger points of the gluteus maximus muscle may also be the cause of either acute or chronic low back pain. A possible way to alleviate symptoms caused by disorders related to MTrPs is by direct approach using acupuncture, dry needling treatment, or other kinds of physical therapies, and clinical improvement has been reported by some authors. Myofascial pain syndrome (MPS) is described as the sensory, motor, and autonomic symptoms caused by myofascial trigger points (TrPs). Knowing the potential causes of TrPs is important to prevent their development and recurrence, but also to inactivate and eliminate existing TrPs. There is general agreement that muscle overuse or direct trauma to the muscle can lead to the development of TrPs The upper trigger point pain areas refer to the lower back, crest of the hip, and the groin areas. The middle trigger point pain areas of the Quadratus Lumborum are around the sacro iliac joint and the buttocks. This particular trigger point may cause sharp lightening-like pain to shoot into the thighs Trigger points within muscles of the head, neck, and shoulders can cause headache by themselves, and this type of condition is often called myofascial pain. In addition, trigger points can be present in patients with migraine, tension-type, post-traumatic, and other headache disorders, and can be worsening or perpetuating factors for the.

Acting bilaterally, it causes both flexion of the lower cervical spine and extension of the upper cervical spine. 2. The SCM may develop myofascial trigger points in both heads. 3 Trigger points are typically taut bands of muscle fiber Trigger points in your scalene neck muscles can cause pain from your neck right down into your fingers. They can also cause numbness, pins and needles down your arms. They can be hard to diagnose, and many people continue to suffer agonizing pain simply because they can't find the source of the problem Trigger Point Injection Process: Trigger points can be the cause of sexual pain in women and ejaculatory pain in men. Trigger point injections involve the infiltration of muscles with an anesthetic solution, sometimes with steroids as anti-inflammatories, which is useful in identifying the exact location of the pain and simultaneously relieving the pain Trigger points in the serratus posterior superior frequently cause pain near or under the shoulder blades, or in other regions throughout the upper extremities. This article will discuss ways to identify trigger-point patterns in the serratus posterior superior, as well as provide tips for treating the area