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The trigger point model states that unexplained pain frequently radiates from these points of local tenderness to broader areas, sometimes distant from the trigger point itself. Practitioners claim to have identified reliable referred pain patterns which associate pain in one location with trigger points elsewhere.
Symptoms of a myofascial trigger point include: focal point tenderness, reproduction of pain upon trigger point palpation, hardening of the muscle upon trigger point palpation, pseudo-weakness of the involved muscle, referred pain, and limited range of motion following approximately 5 seconds of sustained trigger point pressure. [2]
Some spread in association within the cerebral cortex may also explain the large distances between trigger points and referred sensation sites. [2] In the precentral area where the homunculus rests, it is known that hand and shoulder areas overlap the trunk area. And the area of the thumb overlaps that of the upper part of the tongue.
In 2009, Dorsher and Fleckenstein conclude that the strong (up to 91%) consistency of the distributions of trigger point regions' referred pain patterns to acupuncture meridians provides evidence that trigger points most likely represent the same physiological phenomenon as acupuncture points in the treatment of pain disorders. [28]
The subscapularis is covered by a dense fascia which attaches to the scapula at the margins of the subscapularis' attachment (origin) on the scapula. [1] The muscle's fibers pass laterally from its origin before coalescing into a tendon of insertion. [citation needed] The tendon intermingles with the glenohumeral (shoulder) joint capsule. [1]
The intrinsic muscles of the scapula include the muscles of the rotator cuff- the subscapularis, infraspinatus, teres minor and supraspinatus. [9] These muscles attach to the surface of the scapula and are responsible for the internal and external rotation of the glenohumeral joint, along with humeral abduction.
Snapping (grating) scapula . Snapping scapula syndrome, also known as scapulocostal syndrome or scapulothoracic syndrome, is described by a "grating, grinding, popping or snapping sensation of the scapula onto the back side of the ribs or thoracic area of the spine" (Hauser).
Myofascial release (MFR, self-myofascial release) is an alternative medicine therapy claimed to be useful for treating skeletal muscle immobility and pain by relaxing contracted muscles, improving blood and lymphatic circulation and stimulating the stretch reflex in muscles.