Static Manual Release: Upper Trapezius, Levator Scapulae and Splenii (for Upper-Body Dysfunction and Cervical Dysfunction)
Manual release techniques for the commonly overactive muscles of the cervical spine. Soft tissue release techniques for the upper trapezius, levator scapulae, and splenii. Advanced soft tissue, massage, trigger point palpation, and mobilization techniques to inhibit antagonists. The reliability and validity of manual release techniques for forward head, shoulders elevate, neck pain, shoulder pain, headache, and upper body dysfunction.
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Course Description: Upper Trapezius, Levator Scapulae and Splenii Static Manual Release
This course describes static manual release techniques for cervical spine muscles commonly assessed as over-active and prone to trigger point development. Unfortunately, it is easy to be confused by a large number of synonyms for the terms used for these techniques. For example, the techniques described in this course may be considered refinements of neck massage, cervical massage therapy, therapeutic massage, deep tissue massage, sports massage, trigger point massage, static compression techniques, cervical soft tissue mobilization, muscle inhibitory techniques, and manual therapy techniques. Even the term trigger point is referred to by a variety of synonyms including muscle knots, nodules, adhesions, over-active muscle fibers, hypertonic fascicles, spasms, and acute points of hyper-contractility, and the trigger point phenomenon is likely part of every reference to short muscles, muscle tightness, muscle spasm, upper back stiffness, neck stiffness, etc. Part of the reason there are so many synonyms is the rich history of scientific inquiry, from multiple disciplines and cultures, that have contributed to our understanding of the techniques described in this course.
This course includes techniques for the upper trapezius, levator scapulae, splenius capitis, and splenius cervicis muscles. Release techniques for these muscles are commonly included in an integrated program designed to address neck pain, neck stiffness, upper back pain, scapular (shoulder blade) muscle pain, and potentially radiculopathy ("pinched nerve"). These techniques may also aid in addressing posture correlated with cervical and upper thoracic dysfunction including forward head posture, thoracic kyphosis, and often correlated with rounded shoulder posture. Last. these techniques may be beneficial when included in an integrated program designed to address shoulder dysfunction (e.g. shoulder impingement syndrome), upper back pain (e.g. thoracic spine dysfunction), and lower back pain (lumbar spine dysfunction).
The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) to develop an evidence-based, systematic, integrated, patient-centered, patient-centered, and outcome-driven approach.
Techniques Covered in this Course:
- Upper Trapezius Manual Static Release
- Levator Scapulae Manual Static Release
- Splenius Capitis and Splenius Cervicis Manual Static Release
Additional Static Manual Release Courses
- Static Manual Release: Upper Trapezius, Levator Scapulae and Splenii
- Static Manual Release: Suboccipitals, Sternocleidomastoid (SCM), Scalenes and Cervical Extensors
- Static Manual Release: Scapular Muscles
- Static Manual Release: Shoulder Muscles
- Static Manual Release: Trunk Muscles
- Static Manual Release: Hip Flexors
- Static Manual Release: Hip Internal Rotators
- Static Manual Release: Hip External Rotators
- Static Manual Release: Tibia External Rotators
- Static Manual Release: Lower Leg Muscles
For a review of muscle fiber dysfunction and trigger point etiology:
Pre-approved credits for:
Pre-approved for Continuing Education Credits for:
- Athletic Trainers
- Chiropractors
- Massage Therapists
- Occupational Therapists - Advanced
- Physical Therapists
- Physical Therapy Assistants
This Course Includes:
- AI Tutor
- Study Guide
- Text and Illustrations
- Audio Voice-over
- Research Review
- Technique Videos
- Sample Routine
- Practice Exam
- Pre-approved Final Exam
Course Study Guide: Static Manual Release: Upper Trapezius, Levator Scapulae and Splenii (for Upper-Body Dysfunction and Cervical Dysfunction)
Introduction1 Sub Section
Research Corner3 Sub Sections
Videos3 Sub Sections
Sample Intervention (General Neck Pain)
Bibliography
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- Deep Cervical Flexors
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- Serratus Anterior
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- Upper Trapezius
- Cerezo-Téllez, E., Torres-Lacomba, M., Mayoral-del Moral, O., Sánchez-Sánchez, B., Dommerholt, J., & Gutiérrez-Ortega, C. (2016). Prevalence of myofascial pain syndrome in chronic non-specific neck pain: A population-based cross-sectional descriptive study. Pain Medicine, 17(12), 2369-2377.
- Muñoz-Muñoz, S., Muñoz-García, M. T., Alburquerque-Sendín, F., Arroyo-Morales, M., & Fernández-de-las-Peñas, C. (2012). Myofascial trigger points , pain, disability, and sleep quality in individuals with mechanical neck pain. Journal of manipulative and physiological therapeutics, 35(8), 608-613.
- Sari, H., Akarirmak, U., & Uludag, M. (2012). Active myofascial trigger points might be more frequent in patients with cervical radiculopathy. European journal of physical and rehabilitation medicine, 48(2), 237-244.
- Fernández‐de‐las‐Peñas, C., Alonso‐Blanco, C., Cuadrado, M. L., Gerwin, R. D., & Pareja, J. A. (2006). Myofascial trigger points and their relationship to headache clinical parameters in chronic tension ‐type headache. Headache: The Journal of Head and Face Pain, 46(8), 1264-1272.
- Fernández-de-las-Peñas, C., Galán-del-Río, F., Alonso-Blanco, C., Jiménez-García, R., Arendt-Nielsen, L., & Svensson, P. (2010). Referred pain from muscle trigger points in the masticatory and neck-shoulder musculature in women with temporomandibular disorders. The Journal of Pain, 11(12), 1295-1304.
- Harvey, R., & Peper, E. (1997). Surface electromyography and mouse use position. Ergonomics, 40(8), 781-789
- Fernandez-de-las-Penas, C., Gröbli, C., Ortega-Santiago, R., Fischer, C. S., Boesch, D., Froidevaux, P., … & González-Iglesias, J. (2012). Referred pain from myofascial trigger points in head, neck, shoulder, and arm muscles reproduces pain symptoms in blue-collar (manual) and white-collar (office) workers. The Clinical journal of pain, 28(6), 511-518.
- Yoo, W. G. (2013). Changes in pressure pain threshold of the upper trapezius, levator scapular and rhomboid muscles during continuous computer work. Journal of physical therapy science, 25(8), 1021-102.
- Cagnie, B., Dhooge, F., Van Akeleyen, J., Cools, A., Cambier, D., & Danneels, L. (2012). Changes in microcirculation of the trapezius muscle during a prolonged computer task. European journal of applied physiology, 112(9), 3305-3312.
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- Zennaro, D., Läubli, T., Krebs, D., Klipstein, A., & Krueger, H. (2003). Continuous, intermitted and sporadic motor unit activity in the trapezius muscle during prolonged computer work. Journal of electromyography and kinesiology , 13(2), 113-124.
- Szeto, G. P., Straker, L. M., & O’Sullivan, P. B. (2005). A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work—1: neck and shoulder muscle recruitment patterns. Manual therapy, 10(4), 270-280.
- Vasseljen Jr, O., & Westgaard, R. H. (1997). Arm and trunk posture during work in relation to shoulder and neck pain and trapezius activity. Clinical Biomechanics, 12(1), 22-31.
- Wegner, S., Jull, G., O’Leary, S., & Johnston, V. (2010). The effect of a scapular postural correction strategy on trapezius activity in patients with neck pain. Manual therapy, 15(6), 562-566.
- Cools, A.M., Witvrouw, E.E., Declercq, G.A., Danneels, L.A., Cambier, D.C. (2003) Scapular muscle recruitment patterns: Trapezius muscle latency with and without impingement symptoms. The American Journal of Sports Medicine 31(4). 542-549
- Kwon JW, Son SM, Lee NK. (2015). Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders. J Phys Ther Sci. 27: 1739-1742.
- Szeto, G. P. Y., Straker, L. M., & O’Sullivan, P. B. (2005). EMG median frequency changes in the neck–shoulder stabilizers of symptomatic office workers when challenged by different physical stressors. Journal of electromyography and kinesiology , 15(6), 544-555.
- Weon, J. H., Oh, J. S., Cynn, H. S., Kim, Y. W., Kwon, O. Y., & Yi, C. H. (2010). Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. Journal of Bodywork and movement therapies, 14(4), 367-374.
- Cools, A. M., Witvrouw, E. E., Declercq, G. A., Vanderstraeten, G. G., & Cambier, D. C. (2004). Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms. British journal of sports medicine, 38(1), 64-68
- Lucas, K. (2007). Effects of latent myofascial trigger points on muscle activation patterns during scapular plane elevation.
- Lucas, K. R., Rich, P. A., & Polus, B. I. (2010). Muscle activation patterns in the scapular positioning muscles during loaded scapular plane elevation: the effects of latent myofascial trigger points . Clinical Biomechanics, 25(8), 765-770.
- Ge, H. Y., Arendt-Nielsen, L., & Madeleine, P. (2012). Accelerated muscle fatigability of latent myofascial trigger points in humans. Pain Medicine, 13(7), 957-964.
- Upper Trapezius Dysfunction Etiology
- Larsson, R., Cai, H., Zhang, Q., Öberg, P. Å., & Larsson, S. E. (1998). Visualization of chronic neck—shoulder pain: Impaired microcirculation in the upper trapezius muscle in chronic cervico-brachial pain. Occupational medicine, 48(3), 189-194.
- Larsson, S. E., Ålund, M., Cai, H., & Öherg, P. Å. (1994). Chronic pain after soft-tissue injury of the cervical spine: trapezius muscle blood flow and electromyography at static loads and fatigue. Pain, 57(2), 173-180.
- Kadi, F., Waling, K., Ahlgren, C., Sundelin, G., Holmner, S., Butler-Browne, G. S., & Thornell, L. E. (1998). Pathological mechanisms implicated in localized female trapezius myalgia . Pain, 78(3), 191-196.
- Kadi F, Hagg G, Hakansson R, Holmner S, Butler-Browne GS, Thornell LE. Structural changes in male trapezius muscle with work-related myalgia . Acta Neuropathol (Berl) 1998;95:352-360.
- Falla, D., & Farina, D. (2005). Muscle fiber conduction velocity of the upper trapezius muscle during dynamic contraction of the upper limb in patients with chronic neck pain. Pain, 116(1-2), 138-145.
- Sjøgaard G, Rosendal L, Kristiansen J, et al. Muscle oxygenation and glycolysis in females with trapezius myalgia during stress and repetitive work using microdialysis and NIRS. Eur J Appl Physiol. 2010;108(4):657–669.
- Flodgren, G. M., Crenshaw, A. G., Alfredson, H., Fahlström, M., Hellström, F. B., Bronemo, L., & Djupsjöbacka, M. (2005). Glutamate and prostaglandin E2 in the trapezius muscle of female subjects with chronic muscle pain and controls determined by microdialysis. European journal of pain, 9(5), 511-511.
- Rosendal, L., Larsson, B., Kristiansen, J., Peolsson, M., Søgaard, K., Kjær, M., … & Gerdle, B. (2004). Increase in muscle nociceptive substances and anaerobic metabolism in patients with trapezius myalgia : microdialysis in rest and during exercise. Pain, 112(3), 324-334.
- Rosendal, L., Kristiansen, J., Gerdle, B., Søgaard, K., Peolsson, M., Kjær, M., … & Larsson, B. (2005). Increased levels of interstitial potassium but normal levels of muscle IL-6 and LDH in patients with trapezius myalgia . Pain, 119(1-3), 201-209.
- Ghafouri B, Larsson BK, Sjörs A, Leandersson P, Gerdle BU. Interstitial concentration of serotonin is increased in myalgic human trapezius muscle during rest, repetitive work and mental stress – an in vivo microdialysis study. Scand J Clin Lab Invest. 2010;70(7):478–48
- Flodgren GM, Crenshaw AG, Hellström F, Fahlström M. Combining microdialysis and near-infrared spectroscopy for studying effects of low-load repetitive work on the intramuscular chemistry in trapezius myalgia . J Biomed Biotechnol. 2010;2010:513803
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- Ghafouri N, Ghafouri B, Larsson B, Stensson N, Fowler CJ, Gerdle B. Palmitoylethanolamide and stearoylethanolamide levels in the interstitium of the trapezius muscle of women with chronic widespread pain and chronic neck-shoulder pain correlate with pain intensity and sensitivity . Pain. 2013;154(9):1649–1658
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- Olausson P, Gerdle B, Ghafouri N, Larsson B, Ghafouri B. Identification of proteins from interstitium of trapezius muscle in women with chronic myalgia using microdialysis in combination with proteomics. PLoS One. 2012;7(12):e52560.
- Palpation (Upper Trapezius Continued)
- Gerwin, R. D., Shannon, S., Hong, C. Z., Hubbard, D., & Gevirtz, R. (1997). Interrater reliability in myofascial trigger point examination. Pain, 69(1-2), 65-73.
- Lew, P. C., Lewis, J., & Story, I. (1997). Inter-therapist reliability in locating latent myofascial trigger points using palpation. Manual therapy, 2(2), 87-90.
- Sciotti, V. M., Mittak, V. L., DiMarco, L., Ford, L. M., Plezbert, J., Santipadri, E., … & Ball, K. (2001). Clinical precision of myofascial trigger point location in the trapezius muscle. Pain, 93(3), 259-266.
- Myburgh, C., Lauridsen, H. H., Larsen, A. H., & Hartvigsen, J. (2011). Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility. Manual therapy, 16(2), 136-140.
- Barbero, M., Cescon, C., Tettamanti, A., Leggero, V., Macmillan, F., Coutts, F., & Gatti, R. (2013). Myofascial trigger points and innervation zone locations in upper trapezius muscles. BMC musculoskeletal disorders, 14(1), 179.
- Treatment (Upper Trapezius Continued)
- Ziaeifar, M., Arab, A., Karimi, N., & Mosallanejad, Z. (2014). The Effect of Dry Needling on Range of Motion of Neck Lateral Flexion in Subjects With Active Trigger Point in Upper Trapezius Muscle. Jentashapir Journal of Health Research., 5..
- Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2014). The effect of dry needling on pain, pressure pain threshold and disability in patients with a myofascial trigger point in the upper trapezius muscle. Journal of bodywork and movement therapies, 18(2), 298-305.
- Tsai, C. T., Hsieh, L. F., Kuan, T. S., Kao, M. J., Chou, L. W., & Hong, C. Z. (2010). Remote effects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle. American journal of physical medicine & rehabilitation, 89(2), 133-140.
- Cagnie, B., Barbe, T., De Ridder, E., Van Oosterwijck, J., Cools, A., & Danneels, L. (2012). The influence of dry needling of the trapezius muscle on muscle blood flow and oxygenation. Journal of manipulative and physiological therapeutics, 35(9), 685-691.
- Abbaszadeh-Amirdehi, M., Ansari, N. N., Naghdi, S., Olyaei, G., & Nourbakhsh, M. R. (2017). Neurophysiological and clinical effects of dry needling in patients with upper trapezius myofascial trigger points . Journal of bodywork and movement therapies, 21(1), 48-52.
- Chou, L. W., Hsieh, Y. L., Kao, M. J., & Hong, C. Z. (2009). Remote influences of acupuncture on the pain intensity and the amplitude changes of endplate noise in the myofascial trigger point of the upper trapezius muscle. Archives of physical medicine and rehabilitation, 90(6), 905-912.
- Chou, L. W., Hsieh, Y. L., Chen, H. S., Hong, C. Z., Kao, M. J., & Han, T. I. (2011). Remote therapeutic effectiveness of acupuncture in treating myofascial trigger point of the upper trapezius muscle. American journal of physical medicine & rehabilitation, 90(12), 1036-1049.
- Itoh, K., Katsumi, Y., Hirota, S., & Kitakoji, H. (2007). Randomised trial of trigger point acupuncture compared with other acupuncture for treatment of chronic neck pain. Complementary Therapies in Medicine, 15(3), 172-179.
- Montañez-Aguilera, F. J., Valtueña-Gimeno, N., Pecos-Martín, D., Arnau-Masanet, R., Barrios-Pitarque, C., & Bosch-Morell, F. (2010). Changes in a patient with neck pain after application of ischemic compression as a trigger point therapy. Journal of back and musculoskeletal rehabilitation, 23(2), 101-104.
- Aguilera, F. J. M., Martín, D. P., Masanet, R. A., Botella, A. C., Soler, L. B., & Morell, F. B. (2009). Immediate effect of ultrasound and ischemic compression techniques for the treatment of trapezius latent myofascial trigger points in healthy subjects: a randomized controlled study. Journal of manipulative and physiological therapeutics, 32(7), 515-520.
- Fernández-de-las-Peñas, C., Alonso-Blanco, C., Fernández-Carnero, J., & Miangolarra-Page, J. C. (2006). The immediate effect of ischemic compression technique and transverse friction massage on tenderness of active and latent myofascial trigger points: a pilot study. Journal of Bodywork and Movement therapies, 10(1), 3-9.
- von Stülpnagel, C., Reilich, P., Straube, A., Schäfer, J., Blaschek, A., Lee, S. H., … & Heinen, F. (2009). Myofascial trigger points in children with tension-type headache: a new diagnostic and therapeutic option. Journal of child neurology, 24(4), 406-409.
- Cagnie, B., Dewitte, V., Coppieters, I., Van Oosterwijck, J., Cools, A., & Danneels, L. (2013). Effect of ischemic compression on trigger points in the neck and shoulder muscles in office workers: a cohort study. Journal of manipulative and physiological therapeutics, 36(8), 482-489.
- Fryer, G., & Hodgson, L. (2005). The effect of manual pressure release on myofascial trigger points in the upper trapezius muscle. Journal of Bodywork and Movement Therapies, 9(4), 248-255.
- Lucas, K. R., Polus, B. I., & Rich, P. A. (2004). Latent myofascial trigger points: their effects on muscle activation and movement efficiency. Journal of Bodywork and Movement Therapies, 8(3), 160-166.
- Combination of Techniques
- Lari, A. Y., Okhovatian, F., sadat Naimi, S., & Baghban, A. A. (2016). The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females. Manual therapy, 21, 204-209.
- Ruiz-Sáez, M., Fernández-de-las-Peñas, C., Blanco, C. R., Martínez-Segura, R., & García-León, R. (2007). Changes in pressure pain sensitivity in latent myofascial trigger points in the upper trapezius muscle after a cervical spine manipulation in pain-free subjects. Journal of manipulative and physiological therapeutics, 30(8), 578-583.
- Fernández‐de‐las‐Peñas, C., Cleland, J. A., Palomeque‐del‐Cerro, L., Caminero, A. B., Guillem‐Mesado, A., & Jiménez‐García, R. (2011). Development of a Clinical Prediction Rule for Identifying Women With Tension‐Type Headache Who Are Likely to Achieve Short‐Term Success With Joint Mobilization and Muscle Trigger Point Therapy. Headache: The Journal of Head and Face Pain, 51(2), 246-261.
- Hains, G., & Hains, F. (2000). A combined ischemic compression and spinal manipulation in the treatment of fibromyalgia: a preliminary estimate of dose and efficacy. Journal of manipulative and physiological therapeutics, 23(4), 225-230.
- Lluch, E., Arguisuelas, M. D., Coloma, P. S., Palma, F., Rey, A., & Falla, D. (2013). Effects of deep cervical flexor training on pressure pain thresholds over myofascial trigger points in patients with chronic neck pain. Journal of manipulative and physiological therapeutics, 36(9), 604-611.
- Edwards, J., & Knowles, N. (2003). Superficial dry needling and active stretching in the treatment of myofascial pain–a randomised controlled trial. Acupuncture in medicine, 21(3), 80-86.
- Cerezo-Téllez, E., Torres-Lacomba, M., Fuentes-Gallardo, I., Perez-Muñoz, M., Mayoral-del-Moral, O., Lluch-Girbés, E., … & Falla, D. (2016). Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain, 157(9), 1905-1917.
- Levator Scapulae (18, 20, 24, 67-68, 71-72, 78 - 81)
- Sola, A. E., & Kuitert, J. H. (1955). Myofascial trigger point pain in the neck and shoulder girdle; report of 100 cases treated by injection of normal saline. Northwest medicine, 54(9), 980.
- Sola, A. E., Rodenberger, M. L., & Gettys, B. B. (1955). Incidence of hypersensitive areas in posterior shoulder muscles. A survey of two hundred young adults. American Journal of Physical Medicine & Rehabilitation, 34(6), 585-590.
- Lluch, E., Nijs, J., De Kooning, M., Van Dyck, D., Vanderstraeten, R., Struyf, F., & Roussel, N. A. (2015). Prevalence, incidence, localization, and pathophysiology of myofascial trigger points in patients with spinal pain: a systematic literature review. Journal of manipulative and physiological therapeutics, 38(8), 587-600.
- Hsueh, T. C., Yu, S. U. N. N. Y., Kuan, T. S., & Hong, C. Z. (1998). Association of active myofascial trigger points and cervical disc lesions. Journal of the Formosan Medical Association= Taiwan yi zhi, 97(3), 174-180.
- Fernández-de-las-Penas, C., Ge, H. Y., Alonso-Blanco, C., González-Iglesias, J., & Arendt-Nielsen, L. (2010). Referred pain areas of active myofascial trigger points in head, neck, and shoulder muscles, in chronic tension type headache. Journal of bodywork and movement therapies, 14(4), 391-396.
- Munoz-Munoz S, Munoz-Garcia MT, Alburquerque-Sendin, et al. (2012). Myofascial trigger points , pain, disability, and sleep quality in individuals with mechanical neck pain. Journal of Manipulative and Physiological Therapeutics. 35(8): 608-613.
- Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, Stergiou N. (2010). Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. Journal of Electromyography and Kinesiology. 20: 701-709 .
- Splenius Cervicis and Splenius Capitis (18, 20, 24, 67, 68, 71, 72, 78, 79, 81, 85, 86)
- Additional Studies
- Martin-Herrero, C., de Souza Rodrigues, D. P., Alburquerque-Sendin, F., Ortega-Santiago, R., & Fernández-de-Las-Peñas, C. (2012). Myofascial trigger points, pain, disability and quality of sleep in patients with chronic tension-type headache: a pilot study. Revista de neurologia, 55(4), 193-199.
- Palacios-Ceña, M., Castaldo, M., Wang, K., Catena, A., Torelli, P., Arendt-Nielsen, L., & Fernández-de-Las-Peñas, C. (2017). Relationship of active trigger points with related disability and anxiety in people with tension-type headache. Medicine, 96(13).
- Palacios-Ceña, M., Wang, K., Castaldo, M., Guillem-Mesado, A., Ordás-Bandera, C., Arendt-Nielsen, L., & Fernández-de-las-Peñas, C. (2018). Trigger points are associated with widespread pressure pain sensitivity in people with tension-type headache. Cephalalgia, 38(2), 237-245.
- Alonso-Blanco, C., Fernández-de-Las-Peñas, C., Fernández-Mayoralas, D. M., de-la-Llave-Rincón, A. I., Pareja, J. A., & Svensson, P. (2011). Prevalence and anatomical localization of muscle referred pain from active trigger points in head and neck musculature in adults and children with chronic tension-type headache. Pain Medicine, 12(10), 1453-1463.
- Fernández-de-las-Penas, C., Fernández-Mayoralas, D. M., Ortega-Santiago, R., Ambite-Quesada, S., Palacios-Cena, D., & Pareja, J. A. (2011). Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache. The journal of headache and pain, 12(1), 35.
- Ferracini, G. N., Florencio, L. L., Dach, F., Chaves, T. C., Palacios-Ceña, M., Fernández-de-las-Peñas, C., … & Speciali, J. G. (2017). Myofascial trigger points and migraine-related disability in women with episodic and chronic migraine. The Clinical journal of pain, 33(2), 109-115.
- Ferracini, G. N., Chaves, T. C., Dach, F., Bevilaqua-Grossi, D., Fernández-de-las-Peñas, C., & Speciali, J. G. (2016). Relationship between active trigger points and head/neck posture in patients with migraine. American journal of physical medicine & rehabilitation, 95(11), 831-839.
- Fernández-Pérez, A. M., Villaverde-Gutiérrez, C., Mora-Sánchez, A., Alonso-Blanco, C., Sterling, M., & Fernández-de-las-Peñas, C. (2012). Muscle trigger points, pressure pain threshold, and cervical range of motion in patients with high level of disability related to acute whiplash injury. journal of orthopaedic & sports physical therapy, 42(7), 634-641.
- Castaldo, M., Ge, H. Y., Chiarotto, A., Villafane, J. H., & Arendt-Nielsen, L. (2014). Myofascial trigger points in patients with whiplash-associated disorders and mechanical neck pain. Pain Medicine, 15(5), 842-849.
- Fernández-de-Las-Peñas, C., Alonso-Blanco, C., & Miangolarra, J. C. (2007). Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study. Manual therapy, 12(1), 29-33.
- Fernández-de-las-Peñas, C., Galán-del-Río, F., Alonso-Blanco, C., Jiménez-García, R., Arendt-Nielsen, L., & Svensson, P. (2010). Referred pain from muscle trigger points in the masticatory and neck-shoulder musculature in women with temporomandibular disoders. The Journal of Pain, 11(12), 1295-1304.
- Additional Studies: Treatment
- Doraisamy, M. A., Kumar, C. P., & Gnanamuthu, C. (2010). Chronic tension type headache and the impact of myofascial trigger point release in the short term relief of headache. Global Journal of Health Science, 2(2), 238. (compression)
- Moraska, A. F., Schmiege, S. J., Mann, J. D., Butryn, N., & Krutsch, J. P. (2017). Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial. American journal of physical medicine & rehabilitation, 96(9), 639-645.
- Quinn, C., Chandler, C., & Moraska, A. (2002). Massage therapy and frequency of chronic tension headaches. American journal of public health, 92(10), 1657-1661.
- Sedighi, A., Ansari, N. N., & Naghdi, S. (2017). Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache. Journal of bodywork and movement therapies, 21(4), 810-814.
- Fernández‐de‐las‐Peñas, C., Ge, H. Y., Arendt‐Nielsen, L., Cuadrado, M. L., & Pareja, J. A. (2007). Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache. European Journal of Pain, 11(4), 475-482.
- Hidalgo‐Lozano, A., Fernández‐de‐las‐Peñas, C., Calderón‐Soto, C., Domingo‐Camara, A., Madeleine, P., & Arroyo‐Morales, M. (2013). Elite swimmers with and without unilateral shoulder pain: mechanical hyperalgesia and active/latent muscle trigger points in neck–shoulder muscles. Scandinavian journal of medicine & science in sports, 23(1), 66-73.
- Bablis, P., Pollard, H., & Bonello, R. (2008). Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial. Chiropractic & Osteopathy, 16(1), 4. (Levator Scapulae)
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