Trigger Point Massage Guide

Trigger Point Guide Theory
Karri Koivula
PDF created with pdfFactory Pro trial version www.pdffactory.com

Legal notices
Disclaimer
Huge effort is made that this book represents generally accepted medical practises and that
this information doesn’t pose a risks for anybody who uses it.
But it is very important that you realize that you read this book at your own risk.
All material provided in this e-book is for informational and educational purposes only, and not
to be construed as medical advice.
No action should be taken solely based on this e-book
Absolutely consult you physician before you take any actions related to your you health
By downloading/reading this book
You understand and agree that in no event shall the author nor the publisher of this e-book be liable
to you or any other user of this e-book for the use of the information.
Statements mentioned within this e-book are not intended to diagnose, treat, cure or prevent
any disease.
The statements made within this e-book have not been evaluated by the Food and Drug
Administration.
If you don’t understand or agree these terms then please quit reading this book right now and
delete this book from your computer.
Thanks.
Copyright notice
It’s illegal to copy any material from this book and distribute it.
I regularly search the internet for illegal copies.
And I will press criminal charges against those who illegally distribute it.
Copyright. 2004 Karri Koivula

Start here
Foreword
The focus here is in practical advice.
The bottom line,
And all that matters,
Is that trigger points cause referred pain,
And that they “relax” trough massage.
And that the pain symptoms they cause will vanish along them…
Call to action
Read some theory below then go to the pain patterns section and…
Look at the body part pictures and try to pin point your pain, then look at the muscle pain index and
see which muscles are generally involved.
Then go to work, use the side menu to easily jump to what ever muscles you need to massage, and
use the pictures and written guidelines if any to get the job done.
Theory section starts

Trigger points are hyper contracted bundles of muscle cells. Also because of this contraction there
are taut bands of stretched muscle attached to these contraction knots that run to both directions and
end up in the muscles attachments points.
Putting pressure on the trigger point will eventually make them relax.
Even pressing at the taut band can make this happen as it forces a stretch to the contracted knots
that are in the center.
But for best effect you want to aim center.
you’ll locate the center/trigger point by its pressure tenderness, pressing it moderate/hard force
should cause noticeable pain both ate the spot and in the pain referral zone.
You can test this by pressing a spot few centimetres of the spot, and see that you can barely feel the
pressing.
Normal muscle tissue can take a lot of force applied to it; until you start to feel even slight
discomfort.

Trigger point identification -important
Pressure tender spot
Spot that hurts to press
Twitch reaction
When you press the spot or taut band you can feel the taut band to twitch violently.
It’s good indicator from trigger points, but it doesn’t happen, or you can’t always feel it.
Reappearing of referred pain symptom
When you press the tp you feel something on the actual pain zone were the symptom that bothers
you exists.
Sometimes it’s the exact feeling of the pain but most cases you just feel some weird sensations in
the general area of you pain zone.
Brief massage guide lines
Find the spot and the direction of applying pressure massage that hurts the most.
Massage multiple short session though out the day.
As long as it takes for the spots to become none-tender, or as long as it takes to get relief.
This will in most cases take weeks.
Ways to massage
Repetitive stroke massage or continuous pressure
Il like the best from continuous pressure applied by tool and using bodyweight for applying the
pressure. It’s the lazy person’s way to do it and works just perfect.
Continuous pressure
Hold 8-15 seconds pressure move to another spot come back later repeat about 2-3 per spot 2-5
times per day
Massage
Massage 10 strokes move to another spot come back repeat 2-3 times per spot 6-10 times per day
There are no rules once you get the hang of it youll make you own system.

Case example
Acute pain phase
Massages points in many sessions a day for two weeks
Holy smoke I am full of these buggers it seems that every inc of my body is is a tender spot.
Pain symptoms regress backwards old injuries start to feel again maybe resulting in more pain.
My muscles are twitching like there no tomorrow.
Where is this all going to lead..
Then every other day for couple of weeks
Things start to normalize
I got to tell everybody about this.
This is pretty cool, why the doctors didn’t tell me about this.
Upkeep/ maintenance
Then once a week, or when needed.
Massage is getting boring but some of the points are still a bit tender, although generally it gets
harder and harder to find them
Then once a moth, one session holding for 5 seconds,per spot.
I’m so lazy I should do the massage more often.
Some spots may get tender but they don’t seem to cause those old referred pain symptoms,
strange…
Where I ever in pain? It seems so distant…

Pain shift - important
What you get is a pain shift or the pain gets worse.
You can aggravate the current tp and your pain symptom worsens this is common although it
doesn’t seem to postpone the relaxation of the tp.
Which is bit odd, but that’s the practice of things.
And thus some use very rough methods from the beginning to get things handled as quickly as
possible and suffer a little extra pain.
Pain shift can be like going back in time.
Pain shift happens when the pull of the muscles changes and it flares old latent trigger points.
For example if you hurt you foot and got longstanding knee pain that eventually settled in you hip.
You can experience the same knee pain again as the trigger point will flare upp again as the balance
between the pull of the muscles changes as you massage tps.
But at this point don’t call me and get angry at me but continue to massage the points that are
responsible of this newly appeared symptom.
They should vanish eventually.
I don’t know a case where this pain shift or regression back to old symptoms haven’t vanished-
I don’t see any logic reasons for this but realize that there is a risk for this.

Trigger Point Guide Pain patterns
Karri Koivula

Index
1. Head and neck pain
2. Upper back, shoulder, upper arm pain
3. Middle back, lower back ,hip and buttock pain
4. Chest, abdominal and groin pain ,
5. hip, thigh, knee pain
6. Leg and ankle pain
7. Foot pain

Head and Neck pain

Eye area pain
Sternocleidomastoid
Temporalis
I pain/muscle index slpenius cervicis
massater
occipitalis
Top of head orbicularis oculi
sternocleidomastoid suboccipital group
splenius capitis trapezius
Back of head pain Ear and chin joint pain

Trapezius sternocleidomastoid
sternocleidomastoid massater
semispinalis capitis lateral pterygoid
semispinalis cervicis trapezius
splenius cervicis buccinator
suboccipital group Platysma
occipitalis orbicularis oculi
digastric zygomataticus major
temporalis digastric
medial pterygoid
Side of head
Trapezius Tooth pain
sternocleidomastoid temporalis
temporalis massater
splenius cervicis digastric
suboccipital group
semispinalis capitis
Back of neck
Trapezius
Front of head multifidi
sternocleidomastoid levator scapulae
Frontalis splenius cervicsis
zygomaticus major
semispinalis capitis Front of neck
sternocleidomastoid
digastric
korva ja leuka nivel medial pterygoid
särky
lateral pterygoid
massater
sternocleidomastoid
medial pterygoid

Trapezius
Use Stick and tennis ball against the wall.
Picture:
For trigger points, lower down in the trapezius, lye down in the floor and use
tennis ball and use it to apply the pressure and find the right spots.
picture:

Sternocleidomastoid
Just grab the muscle like in I am doing, bend the head to the side you are
pinching the muscle to give it some slack and make it easier to grab.
Just go trough the whole muscle pinch gripping it and find the trigger points.
The muscle two branches on top of each others, you can see them divide in the
lower attachment point.
But for the most part of the muscle you don’t have to distinguish them.

Temporalis
Use your knuckles or some hard tool to locate temporal trigger points.
But go easy on them.
Its really spooky kind of pain that they can make and reappear when pressed.

massater
I find it helpful to press little towards ears to hit the muscle in right direction.
Use fingers, knuckles or tool

Splenius Capitis Splenius Cervcis
Tool against wall or against floor.

Semispinalis Capitis
Tool against wall or against floor.
10

multifidi , rotatores
Tennis ball is too big to hit the trigger points but some tool that is smaller
works fine.
Be little extra careful when applying pressure near vertebrae, use common
sense.
To be extra cautious use tool with your hands not against floor or wall-
Buccinator
11

It refers pain to the teeth near the muscle
Use your fingers for pressure
Lateral pterygoid
12

The x is the trigger point spot and grey areas on both side it the referred pain
areas.
use fingers to locate and hit the spot.
Medial pterygoid
To reach this muscle you need to press it from below your chin.
It is on the x spot
orbicularis oculi
13

No it’s not the Frankenstein’s bride wearing an eye patch, even thou it kind of
a looks like it.
The pain pattern is the grey shadow that seems to sculpt the nose and the
trigger point is the small x just in the eye brow line or little below, like it is in
this case.
Just track down the bones around the eye looking for tender points.
The black patch describes the muscle.
zygomaticus, levator labii
14

Indian war painting, or maybe not.
Use fingers to locate and aply pressure
15

digastric
Again you need to venture to the underneath of the chin.
Use fingers an to search tender spots and referred pain.
16

frontalis occipital
Move your eyebrows and try to wiggle your ear can you feel the occipital
muscle in the back of your head.
Fingers, knuckles or a tool there aren’t any rules.
suboccipitalis
Use a tool to reach the muscle easily, against wall if necessary.
17

Upper back, shoulder, upper arm
18

teres minor
Index II subscapularis
serratus posterior superior
triceps brachii
Upper back pain trapezius
scaleni
Scaleni lats
levatorscapulae erector spinae
trapezius
multifidi Shoulder front
splenius cervicis
supraspinatus infraspinatus
rhombodei deltoid
triceps brachii scaleni
biceps brachii supraspinatus
pectoralis major
Back of shoulder pectoralis minor
biceps brachii
deltoid coracobrachialis
levator scapulae sternalis
supraspinatus subclavius
teres major
latissimus dorsi scaleni
biceps brachii
Back of upper arm triceps brachii
scaleni
teres major subclavius
triceps brachii supraspinatus
deltoid sternalis
subscapularis infraspinatus
supraspinatus Deltoid
teres minor brachialis
latissimus dorsi latissimus
serratus posterior superioir dorsi
coracobrachialis
scalenus minimus
Front of upper arm
19

scalanes
Locate your collar bone use your fingers o pull to the collar bone.
20

trapezius
Tennis ball or similar tool against the floor is the way to go, just lye on it and
move it to the tenderest spots and hold for awhile.
21

Levator Scapulae
22

Latissimus Dorsi
23

Rhomboid
Serratus posterior superior
24

supraspinatus
Stick as a tool is great to reach this, tennis ball on the floor can
work also.
infraspinatus
25

Teres Minor
Teres Major
26

Subscapularis
coracobrachialis
27

deltoid
28

Triceps
Biceps
29

Middle back, lower back, hip and buttocks/sacral pain
30

Index III hamstrings
soleus
Middle back pain
Buttock/sacral pain
spinae erectors
multifidi rotatores quadratus lumborum
rectus abdomis erector spinae
serratus anterior gluteus minimus
serratus posterior inferior gluteus medius
latissimus dorsi gluteus maximus
intercostals piriformis
hamstring
Lower back pain soleus
gluteus medius
gluteus maximus Hip pain
gluteus minimus
psoas quadreceps vastus lateralis
multifidi rotators (syvät gluteus minimus
elkälihakset) gluteus maximus.
spinae erectors ( piriformis
pinnalliset selkälihakset) quadratus lumborum
quadratus lumborum tensor fasciae latae
rectus abdomis
obiliques
31

Gluteus maximus
32

Gluteus medius
Gluteus minimus
33

piriformis
Quadratus lumborum
34

Spinae erectors & multifidi ja rotatores
Rectus abdomis
35

liopsoas
obiliques
36

Hamstring
37

Chest, abdominal, genital pain
38

latissimus dorsidiaphgram
Index IV Abdominal pain
Chest pain rectus abdomis

pectorals abdominal obliques
scalenes superficial spinal muscles
sternocleidomastoid deep spinal muscles
sternalis quadratus lumborum
intercostals
superficial spinal muscles Groin pain
subclavius
rectus abdomis Rectus abdomis
diaphgram Abdominal obiliques
intrapelvic muscles
Side pain adductor magnus
serratus anterior psoas
abdominal obiliques piriformis
intercostals
39

Pectorals
40

Serratus anterior
Latissimus Dorsi
41

Rectus abdomis
Obiliques
42

Hip, thigh, knee pain
43

Index V rectus femoris
vastus medialis
abductor longus
Groin Pain
pectineus Inner knee
abductor longus vastus medialis
abductor magnus gracilis
rectus abdominis rectus femoris
abdominal obiliques sartorius
psoap intrapelvi muscles adductor longus
Outer knee
vastus lateralis
Hip pain
gluteus minimus
Back of thigh
gluteus minimus
vastus lateralis
semitendinosus
piriformis
biceps femoris
qiadratus lumborum
piriformis
tensor fasciae latae
intrapelvi muscles
vastus intermedialis
gluteus maximus Inner thigh
pectineus
vastus medialis
grazilis
Front thigh pain adductor magnus
Abductor longus
Back of knee
psoas
gastrocnemius
abducto magnus
biceps femoris
vastus intermedialis popliteus
pectineus semiteninosus
sartorius
semimembranus
quadratus lumborum soleus
rectus abdominis plantaris
Front of knee
44

Tensor latia fascae Vastus intermedialis
45

Vastus medialis
46

Rectus femoris
vastus lateralis
47

Pectineus
48

Abductor brevis Abductor longus
49

Abductor magnus
Gracialis
50

Hamstrings
51

plantaris Popliteus
52

Leg and ankle pain
53

Side of leg
Index VI Gastrocnemius
gluteus minimus
peroneus longus
Front of leg
peroneus brevis
Tibialis anterior
vastus lateralis
adductor longus
inner ankle
Front of foot
Abductor hallucis
tibialis anterior
flexor digitorum lonngus
peroneus tertius
extensor digitorum longus
outer ankle
peroneus longus
Back of leg
peroneus brevis
Soleus
peroneus tertius
gluteus minimus
abductoe digiti minimi
gastronomicus
semitendinosus
semimembranus back of ankle
soleus
flexor digitorum longus tibialis posterior
tibialis posterior
Plantaris
54

tibialis anterior
extensor hallucis longus & extensor digitorum
55

peroneus longus & Peroneus brevis
peroneus tertius
56

gastrocnemius
57

soleus
tibialis posterior
58

Flexor digitorum longus & flexor hallucis longus
59

Foot pain
60

Index VII
Top of foot Bottom of the foot Front

extensor digitorum brevis flexor hallucis brevis
extensor hallucis brevis flexor digitorum brevis
extensor digitorum longus adductor hallucis
extensor hallucis longus flexor hallucis longus
flexor hallucis brevis interosseus
interosseus abductor digiti minimi
tibialis anterior flexor digitorum longus
tibialis posterior
Big toe flexor digigti minimi brevis
top
tibialis anterior
extensor hallucis longus Bottom of the foot
flexor hallucis brevis middle
under gastrocnemius
flexor hallucis longus flexor digitorum longus
flexor hallucis brevis adductor hallucis
tibialis posterior soleus
interoseus
Other toes tibislis posterior
top
interosseus Heel pain
extensor digitorum longus soleus quadratus palnatae
under abductor hallucis
flexor digitorum longus tibialis posterior
tibialis posterior abductor digiti minimi
61

Extensor digitorum brevis & extensor hallucis brevis
introsseus
Abductor hallucis
62

abductor digiti minimi
flexor digitorum brevis
quadratus plantae
63

Abductor hallucis & flexor hallucis brevi
Flexor digiti mininmi brevis
64

Elbow, arm, wrist, hand pain
65

Index VIII
Elbow Wrist outer arm

extensors
supinator subsscapulari
brachioradialis sascalenes
extensor latissimus dorsi
anconeus serratus posterior superior
triceps brachii coracobrachialis
supraspinatus
pectoralis major Wrist inner hand pain
serratus anterior
serratus posterior superior flexors
palmaris longus
Outer elbow pronator teres
opopnens pollicis
trticeps pectorals
scalanes latissimus dorsi
extensors serratus anterior
brachioradialis
brachialis Inner finger pain
flexors
infraspinatus flexores digitorum
teres major superficialis and profundus
cocabrachialis introssei abductor digiti
supraspinatus minimi
subclavius lats
serratus
Inner elbow pain subclavius
palmaris longus Top of finger pain

pronator teres
serratus anterior extensor digitorum
triceps brachii introssei
latissimus dorsi scalene
pectoralis major abductor digiti mininimi
serratus posterioer superior pectorals
66

lats
subclavius
Thumb pain
supinator
scalene brachialis
brachioradialis
opponenns pollicis
abductor pollicis
extensor carpi radialis longus
first dorsal introsseus
flexor pollicis longus
subclavius
infraspinatus
brachialis
67

extensor carpi radialis longus
brachioradialis
68

supinator
extensor carpi radialis brevis
69

extensor carpi ulnaris
anconeus
70

extensor digitorum
Extensor indicis
71

flexor carpi radialis
flexor carpi ulnaris
72

palmaris longus
flexor digitorum
73

pronator teres & pronator quadratus
flexor pollicis longus
74

opponens pollicis & abductor pollicis
75

introsseus
76

Trigger Point Massage Guide

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Trigger Point Massage Guide

Uploaded by

Copyright:

Available Formats

Trigger Point Guide Theory

PDF created with pdfFactory Pro trial version www.pdffactory.com

No action should be taken solely based on this e-book

By downloading/reading this book

I regularly search the internet for illegal copies.

Copyright. 2004 Karri Koivula

PDF created with pdfFactory Pro trial version www.pdffactory.com

The focus here is in practical advice.

The bottom line,

And all that matters,

Is that trigger points cause referred pain,

And that they “relax” trough massage.

Theory section starts

But for best effect you want to aim center.

PDF created with pdfFactory Pro trial version www.pdffactory.com

Spot that hurts to press

Reappearing of referred pain symptom

Brief massage guide lines

Massage multiple short session though out the day.

This will in most cases take weeks.

Repetitive stroke massage or continuous pressure

PDF created with pdfFactory Pro trial version www.pdffactory.com

Massages points in many sessions a day for two weeks

My muscles are twitching like there no tomorrow.

Where is this all going to lead..

Then every other day for couple of weeks

Things start to normalize

I got to tell everybody about this.

Then once a week, or when needed.

Then once a moth, one session holding for 5 seconds,per spot.

I’m so lazy I should do the massage more often.

Where I ever in pain? It seems so distant…

PDF created with pdfFactory Pro trial version www.pdffactory.com

Which is bit odd, but that’s the practice of things.

Pain shift can be like going back in time.

They should vanish eventually.

PDF created with pdfFactory Pro trial version www.pdffactory.com

PDF created with pdfFactory Pro trial version www.pdffactory.com

1. Head and neck pain

2. Upper back, shoulder, upper arm pain

3. Middle back, lower back ,hip and buttock pain

4. Chest, abdominal and groin pain ,

5. hip, thigh, knee pain

6. Leg and ankle pain

PDF created with pdfFactory Pro trial version www.pdffactory.com

PDF created with pdfFactory Pro trial version www.pdffactory.com

Back of head pain Ear and chin joint pain

PDF created with pdfFactory Pro trial version www.pdffactory.com

Use Stick and tennis ball against the wall.

PDF created with pdfFactory Pro trial version www.pdffactory.com

PDF created with pdfFactory Pro trial version www.pdffactory.com

But go easy on them.

PDF created with pdfFactory Pro trial version www.pdffactory.com

Use fingers, knuckles or tool

PDF created with pdfFactory Pro trial version www.pdffactory.com

Tool against wall or against floor.

PDF created with pdfFactory Pro trial version www.pdffactory.com

Tool against wall or against floor.

PDF created with pdfFactory Pro trial version www.pdffactory.com

PDF created with pdfFactory Pro trial version www.pdffactory.com

PDF created with pdfFactory Pro trial version www.pdffactory.com

use fingers to locate and hit the spot.

PDF created with pdfFactory Pro trial version www.pdffactory.com