Static Manual Release: Upper Trapezius, Levator Scapulae and Splenii (for Upper-Body Dysfunction and Cervical Dysfunction)

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:

• Muscle Fiber Dysfunction and Trigger Points
• Trigger Point Assessment and Palpation

Pre-approved credits for:

• Integrated Manual Therapist (IMT) Certification

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

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   • Deep Cervical Flexors
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    • Serratus Anterior
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    • Upper Trapezius
18. 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.
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33. 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.
34. 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.
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    • Upper Trapezius Dysfunction Etiology
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    • Palpation (Upper Trapezius Continued)
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59. 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)
60. 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..
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62. 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.
63. 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.
64. 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.
65. 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.
66. 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.
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68. 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.
69. 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.
70. 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.
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72. 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.
73. 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.
74. 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
75. 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.
76. 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.
77. 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.
78. 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.
79. 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.
80. 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.
81. 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)
82. 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.
83. 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.
84. 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.
85. 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.
86. 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.
87. 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.
88. 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
89. 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.
90. 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).
91. 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.
92. 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.
93. 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.
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97. 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.
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101. 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.
102. Quinn, C., Chandler, C., & Moraska, A. (2002). Massage therapy and frequency of chronic tension headaches. American journal of public health, 92(10), 1657-1661.
103. 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.
104. 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.
105. 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.
106. 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)