Clinical Application of Neuromuscular Techniques The Upper Body Volume 1

588 I NDEX N lymphatic drainage, 213 palpation and treatment, 182-189 massete� 367-368, 367, 368, 375, 375 psychosocial factors, 180, 180-181 Nasal muscles, 351-352 medial pterygoid, 369, 369, 379, 380 treatment tools, 190-191 Nasal region, 355, 356 middle trapezius, 433, 433 Neuropathic pain, 143-144 Nasal release technique, 336, 336 nasal region, 356 neurotoxins and, 144, 146-151 Nasalis, 350 occipitoatlantal restriction, 269 Neuropeptide Y (NPY), 137 Nasofrontal region, 390 palpebral region, 355-356, 355, 356 Neuroplasticity, 144 Neck, 290, 295 pectoralis major, 471-472, 471, 472 Neurosomatic disorders, 55-57 pectoralis minor, 476, 476 Neurotoxins, 1 44, 146-151 extension, 319 platysma, 299 Neurotrophic influences, 47 flexion test, 92, 92, 438 posterior forearm, 525-526, 526, 528-529 Neutral bath, 209 muscles, MET for, 299-300, 300 posterior thorax, 560-562 Neutralizers, 413 pain, 295, 359 pronator quadratus, 498 Newton's third law, 3 see also Cervical spine pronator teres, 497, 497 Nimmo's receptor-tonus techniques, 1 09-11 1 Needle electromyography (EMC), 111, 116 protocols, 569 Nixon & And rews, alkalosis, 75 Needle penetration methodology, 111 rectus capitis la teralis, 313-314, 313 NMDA (N-methyl-D-aspartic) channels, 59 Needling, 1 20, 154 rhomboids, 439-440, 440, 441 Nociceptive hypothesis, 226 Neer's sign, 408 roots of, 178 Nociceptors, 46 Nerve entrapment, 1 79, 489-492, 490, 491, scalenii, 316-318, 316, 317, 318 Non-nutritive circulation, 29 semantic confusion, 178 Non-steroidal antiinfla.mmatory drugs 507, 513, 524 serratus anterior, 465-466, 466 crosstalk and, 57-58 shoulder pain, 416 (NSAIDs), 130, 167, 1 69-170 soft palate, 382, 382 Norris, irmer range holding tests, 37 see also Carpal tunnel syndrome (CTS) soft tissue, 166-167 Nuchal ligament, 251 Neural influences, 53, 57-59 spinalis capitis, 286 N uclear factor Kappa-B (NFr;,B), 137 spinalis cervicis, 286 Nucleus, gelatinOUS, 244 overload, entrapment and crossta lk, 57-58 splenii tendons, 284-285, 285 pain, 458 sternocleidomastoid (SCM), 301, 302, 303 water imbibition, 247 repercussions of hyperventilation, 77 suboccipital region, 296-298, 296 Numerical rating scale (NRS), 190 tension testing, 224 subscapularis, 463, 463 Nutrition, 146, 179 threshold, facilitation and, 109 supina tor, 496, 496 see also Reporting stations suprahyoid muscles, 385, 385, 387 anti inflammatory, 1 29-130 Neurogenic inflammation cascade, 128 supraspina tus muscle, 446 circulation and, 28-29 Neurological fea tures, cervical region, 256 temporalis, 366, 366 and pain, 167-170 Neurological lens, 106 temporalis tendon, 373, 373 Neurolytic blocks, 154 teres major, 457, 457 myofascial, 1 67-168 Neuromuscular dysfunction and injury, 51 teres minor, 454-455, 454, 455 treatment, 1 67 Neu romuscu lar technique (NMT) (aka thoracic lamina groove, 562-563, 565-566 thorax, 556, 559 o Neuromuscular therapy) tongue muscles, 383-384, 384 abdominal muscles, 571-572 trapezius a ttachments, 434 Obliq ues, 557, 571 anconeus, 453, 494 triceps, 452, 452, 494 Obliquus capitis inferior (OCI), 292, 295-296, anterior forearm, 51 8-519, 518 trigger points, 97 biceps brachii, 483-484, 483, 484 upper trapezius, 277, 432-433, 432 321 brachialis, 493, 493 Neuromuscular techniques (NMT), Obliquus capitis superior (OCS), 292, 295, brachioradialis, 495 buccolabial region, 357, 357 European, 1 66, 178, 191-194 321, 330 cervical lamina, 320, 320 application position, 193 Observation, 89-90, 4 1 0, 547 assessment framework, 196 Occam's principle of universal economy, 498 gliding techniques, 281 -282, 281 INIT, 121, 197 Occipital bone, 86, 252, 328-332, 328, 354 cervical region, 273 lubricant, 194 Occipi talis, 321, 353 clinical applications, 119 research, 196-197 Occipitoatlantal area, 265 coracobrachialis, 481 , 481 thumb technique, 192-193, 192 cranial attachments, 320-321, 321 variable ischemic compression, 1 95-196, restriction, 268-269, 268 deltoid, 443, 443 tissue preference, 18 epicranium, 354-355 195 Occipitocervical ligaments, 251-253 finger strokes in, 569 variations, 1 94-195 Occipi tofrontalis, 341-342, 344, 352, 353 Colgi tendon organs, 216, 217 see also Lief's NMT manual treatment, 355 hand, 533-534, 533, 534 Neuromuscular therapy, American, 97, PRT for, 355 infrahyoid muscles, 307-308, 307 trigger points, 354 infraspinatus, 448, 448 1 77-178, 178, 275 OccipitomastOid attachment, 303 intercostal m uscles, 571, 571 acute inju ry, 181-182 OCCipitomastoid suture, 284 interspinales, 289 assessment Occipitosphenoidal junction, flexion, 330 intraoral, 372 Occlusal splints, 359 latera l pterygoid, 369, 369, 378-379, 378, protocols, 189, 281 Occupational hand cramps, 504 tools, 189-191 Odontoid process, 249, 249 379 biochemical factors, 179-180, 180-181 Off-body scan, 120 latissimus dorsi, 459, 459 biomechanical factors, 178-179, 180-181 Olecranon a ttachment, triceps, 494 levator scapula, 290-291 , 291, 436-437, 437 chronic pain, 1 82 Omohyoid, 306-307 longus capitis, 311-312, 311, 312 pain-rating tools, 190 resp iration function, 552 longus colii, 311-312, 311, 312 Opponens poliicis, 531 lower trapezius, 433-434, 433 Oral group of facial muscles, 357

Index 589 Oral habits, 359 temporomandibular joint (TMJ), 362 trick, 39--40 Orbicularis oculi, 342, 348, 350, 355 tendon, 127-128 wrap-around, 165 Orbicularis oris, 356 trigger point, 110 Patterns of dysfunction, 81-94 Organ dysfunction trigger points, 106-108 see also Chronic pain; Low back pain breathing assessments, 92-94 Oriental prayer test, 508, 509 chain reaction facia l/jaw pain, 84 Orthostatic posture, 370 (LBP) ethmoid, 336 Oschman Pain-rating tools, 190 from habits of use, 84-85 Paired bones, 328 frontal bone, 342 connective tissue, 5 Palatine bones, 350-3- 51, 351 Janda's functional screening seq uence, tensegrity systems, 14-15 Palatoglossus, 380, 381, 382 trauma and connective tissue, 17, 19 Palatopharyngeus muscles, 380, 381 88-92 Oschner 's test, 508, 509 Palmar interossei, 532 Janda's primary and secondary responses, Oscillatory methods, 231-233 Palmar ligaments, 510, 511 Osteoarthritis (OA), 529 Palmar radiocarpal ligament, 502 85-86 Osteogenesis imperfecta, 8 Palmar ulnocarpal ligament, 502 layer (stratification) syndrome, 83-84, 83 Osteoligamentous subsystem, 31, 67 Palmaris longis, 5 1 3-515, 514 lower crossed syndrome, 82-83, 83 Overbreathing, 31, 149-150 Palmer, muscle and joint dysfunction, 196 mandible, 339 see also Hyperventilation Palpa tion, 182-189 maxillae, 350 Overload, neural, 57-58 occipitoatlantal restriction, 269 Oxygen, 112 and compression techniques, 1 85-187, 186, occiput, 330 Oxytocin, 132 187 parietals, 343 recognizing, 86-88 p epicondylar region, 526 ribs, 554-555, 555 ethmoid, 336, 336 sphenoid, 334 Pacinian corpuscle, 51 frontal bone, 342-343, 342 temporals, 347 Page, cranial continuity of fascia, 2 infraspinatus, 448, 449 temporomandibular joint (TMJ), 339, 377 Pain intraoral, 372, 377 thoracic spine, 547 'loose-tight' exercise, 164 three-dimensional, 165-166 -spasm-pain cycle, 110 medial pterygoid, 379 upper crossed syndrome, 82, 82 adverse mechanical tension (AMT) and, nasal release technique, 336, 336 vomer, 337 observation with, 89-90 whole body, regional and local changes, 85 224 pectoralis major, 472, 474, 474 zygomae, 349 'cardiac-type' and sternalis, 472 precise technique, 1 22 Pectoralis major, 413, 415, 421, 467, 467, 468, cervical, 458 ribs and shoulder pain, 556 chain reaction facial /jaw, 84 skills, 120 469--470 chronic neck, 295 snapping, 187, 187, 454, 457, 519 assessment, 470--471, 470 chronic phase, 154 thenar eminence, 533 MET for, 472--473, 473--474, 473 components, 177 trigger points, 119-121, 187-188 MFR for, 474, 474 cycle, 141 see also Flat palpation NMT for, 471--472, 471, 472 development of, 152 Palpebral muscles, 351-352 respira tion function, 552 discomfort scale, 183 Palpebral region, 355 shortened, 409, 553 dysfunction and, 152 NMT for, 355-356 tighten and shorten, 82 epicondylar, 416 Pancreas, 132 Pectoralis minor, 293, 421 , 474, 476 gate theory of, 52 Panjabi, joint and spinal stability, 31, 67 MFR for, 477, 477 isometric contraction and, 273 Panniculitis, 186 NMT for, 476, 476 joint, 142 Panniculosis, 186 respiration function, 552 'loose-tight' concept and, 1 64-165 Pan tethine, 139 shortened, 82, 409, 422 management, 154-155, 1 71 Parallel muscle fibers, 25 trigger points, 476 muscle Paraspinal musculature, 561, 566-567 Pelvis, 293, 542 Parathyroid glands, 132 Pennate muscle fibers, 27 ischemia and, 101-102 Parietal lift technique, 344, 345 Personality see Behavior and personality non-treatment, 40--41 Parietals, 343-344, 343, 345, 372, 654 Petrissage, 215 radiculopathic model, 111 Partial pressure symbols, 76 Petrous bone (mastoid lift), longitudinal myofascial, 105, 105, 167-168 Pascal's law, 247 neuropatrue, 1 43-144 Passive oscillatory methods, 231 movement, 391 nutrition and, 167-170 Passive physiological intervertebral motion Phagocytosis, 31 pattern, subclavius, 477 Phalanges, 508-511 perception, 46 (PPIM), 544 progression, 126 testing p rocedure, 545 range of motion, 510 proprioception and, 52-53 Passive rotation, metacarpophalangeal joints, Phalen's test, 508, 509 psychosocial factors, 170-171 Pharynx, 387 radicular, 142 511 referred, 115, 295, 477, 495, 498, 499, 543 Patel, cervical range of motion, 196 muscles of, 386 on rotation, 288 Patrick's test for add uctors, 358 Phasic motor tone, 33 shoulder, 410 Patterns Phasic muscle fibers, 34-35, 36, 218 soft tissue, 143 Phasic muscles, 554 sources of, 142-144 contraction, 69 Phrenic nerve paralysis, 552 stimula tion, 38 and coupling, 255 Physical exercise, 172 strain/counterstrain (SCS) and, 229 encircling, 165 Physiological function, restoration of normal, fascial postural, 264-266 posture, 18-19, 65, 264-266, 499 154 referral, 450, 498 Pincer compression, 186-187, 186, 277, 302, 336

590 I N D EX Posterior longitudinal ligament, 250, 251, 253 contradictions, 53, 57 Posterior scapular region, 451 dysfunction, 52-53 latissimus dorsi, 459 Posterior sternoclavicular ligament, 407 fascia and, 2, 46--47 palmar and dorsal hand, 533 Posterior suboccipital muscles, 40 hypothesis, 225-226 teres major, 457 Posterior superficial thoracic muscles, manipulation, 58 teres minor, 454 Proprioceptive neurom uscular fac i l i tation for trapezius attachments, 434 557-560, 559 for upper trapezius, 432 Posterior thorax, 440, 541-550, 559 (PNF), 6, 235-236 Pincer palpation, pectoralis major, 471 posterior forearm, 526 'Pinch' test, 508 muscles, 438 techniques, 478 Pineal gland, 132 NMT for, 560-562 Psoas, 553, 557 Piriformis syndrome, 83 Postisometric relaxation (PIR), 211, 218, Psychological d istress, 41 Pisohamate ligament, 502 Psychosocia I factors, 153 Pisometacarpal ligament, 502 219-220, 219, 221, 236, 267 int1uences on health, 68 Pituitary gland, 132, 334 isometric contraction, 199 pa in managemen t, 170-171 Pizzorno & M u rray, functional Posttrauma fibromyalgia, 256 Psychosomatic symptoms, 144 Postural fibers, 36, 218 Pterygoid, 333 hypothyroidism, 133 Posture, 245 Pulsed muscle energy technique (Ruddy's Placebo power, 153-154 active, 248 Plastic and elastic features, fascia, 3, 5-6 distortion, forearm and, 499 method), 201, 212, 416, 550 Plasticity, 244 forward head, 247, 293, 362, 364, 469 Pump handle movement, 554, 555 Pla tysma, 298-299, 298, 338 imbalance, 73-75, 293 inappropriate, 213-214 Q NMT for, 299 influences, 179 Pollicis, 513 interpretations, 69 Quadratus l umborum, 91, 93, 552, 557 Polymodal rece ptor (PMR), 46 movement, 37 expiration fWlCtion, 552 Polyphenol sources, 150-151 muscles, 35, 210, 554 shortens, 83 orthosta tic, 370 sidelying, 553 Position of ease see 'Ease' patterns, 18-19, 65, 264-266, 499 perfect alignment, 248 Quebec Task Force, 261 Positional release technique (PRT), 198, respiratory function and, 64-67 225-230 retra ining program, 469 R slumping, 571 biceps brachii, 485 Potassium, 129 Radial collateral ligament, 502 carpal tunnel syndrome, 521 Practice, scope of, 409 Rad i a l. nerve, 493, 495--496, 496 cervical region, 267, 268, 271 Precontemplative behavioral attitude, 171 circumduction pain or restriction, 428 Pressure bars, 1 9 1 , 191, 494, 566, 571 entrapment, 492, 507 coracobrachialis, 481--482 Rad ia l pu lse, 410 ease and bind, 163, 164 see also Beveled-tip pressure bars Radial tunnel syndrome (RTS), 492 infraspinatus, 449 Radialis muscles, 513 internal rotation restriction, 429 Pressure release, 1 79 Radiate carpal ligament, 502 latissimus dorsi, 460, 460 brachialis, 493 Radicular pain, 142 leva tor scapula, 291-292, 292 brachioradia lis, 494, 495 Radiculopathic model, 111 masseter, 368-369 diaphragm, 572, 572 Radioulnar jOint, 485--486 occipitoatlantal restriction, 269 paraspinal musculature, 566-567 Rapid isotonic eccentric contraction /stretch occipitofron talis, 355 supraspinatus, 446 pronator teres, 498 (isolytic), 200 reporting station manipulation, 58 Pressure techniques, 2 1 6 Reactive hyperemia, 545-546 scalenii, 319, 319 serra tus anterior, 466 Reactive oscillatory methods, 231 shoulders, 416, 427, 428 static, 369 Receptor (publ ication), 110 soft tissue, 166 Receptor-tonus techniques, 109-1 11, 191 Spencer's sequence, 427--429 'Pressure threshold', 117 spinal levels, 542 'Prime mover ' , 35 Reciprocal inhibition (RI), 35, 211, 219, 236, 267 sternocleidomastoid (SCM), 304, 304 Proactive OSCillatory methods, 231 suboccipital region, 298 Probiotics and mercury, 146 isometric contraction and, 199, 218, 219, 220 subscapula ris, 464 Procerus, 342, 356 Reciprocal tension membranes teres major, 457, 458 Prolactin, 132 teres minor, 455, 455 Prolotherapy, 130-131 ethmoid, 335 trigger points, 120 Pronation, resisted, 497 frontal bone, 341 upper trapezius, 279-280, 279 Prona tion / supination occiput, 329 wrist dysfunction, 521 parietals, 343-344 humeroradial joint, 485 sphenoid, 333, 333 see also Stra i n /cou nterstrain (SCS) radioulnar joint, 485--486 temporals, 344 Pronator quadratus, 498 Rectus abdominis, 557, 571 Posterior atlantooccipital ligament, 248 NMT for, 498 Rectus capitis anterior, 256, 313, 329 Posterior atlantoaxial membrane, 251 Pronator syndrome, 497 Rectus capitis la tera lis, 256, 313, 330 Posterior auxiliary fold, 457 Pronator teres, 496--497 NMT for, 313-314, 313 Posterior cervical region, 275-292 assessment, 497 Rectus capitis posterior major (RCPMa), 292, Posterior deltoid, 4 1 3, 415 MFR for, 498 Posterior forearm, 521, 522-529, 522 NMT for, 497, 497 295, 297, 330 PRT fo- r, 498 Rectus ca pitis posterior minor (RCPMin), 52, deep l ayer, 527, 527 Prone hip extension, firing sequence, 88 NMT for, 528-529 Proprioception, 45--47 252, 292-293, 294-295, 294, 296, 330 a ltering, 52 evaluation and treatment, 53 gliding strokes, 526 superficial layer, 522-523 NMT for, 525-526, 526

Index 59 1 research, 52-53 articulations, 551-552 controlled, 130-13] Red reflex assessment, 544, 545-546 bucket handle movement, 555 MFR for, 223 Reeducation, 59-60, 211 depression of lower, 571 Scariati, colloids, 3 Referral pa tterns, triceps trigger points, 450 dysfunction test, 555 Schafer Referred pain, 115, 295, 377, 477, 495, 498, elevate d / depressed, 554, 555, 556 brain, 50 floating, 541, 554 reflexes, 50 499, 543 motion, 554-555 sensory receptors, 46 Reflex mechanisms, 47-51, 65 palpation, 554 subacromial bursitis, 419 p u mp handle movement, 555 Schleip central influences, 50-5] restriction, 412 connective tissue as sponge, 6 local, 50 structural fea tures, 541 fascial contractures, 182 muscular pain and, 141-142 upper, shoulder p a in and, 416-4 1 7, 556 tissue contractions, 7 rehabi litation and, 59-60 Rice, diaphragm on cervical range of motion, Schneid er, N i mmo's receptor-tonus tests, 411, 506 Regenera tion phase, 126, ]28 196-]97 techniques, 109-110 Rehabilitation, 155, 211, 230-23] RICE (rest, ice, compression and elevation), Scope of practice, 409 biopsychosocial model, 1 72-173 'Scraping' tissue, 533, 566 choices, 370 1 28, ] 8 1 Screening tests, shoulder dysfunction, 417 goals, 1 72 Richards & Richards Seaman low back pain, 172 reflex mechanisms and, 59-60 leptin hormone, 135-136 chronic inflammation, 131 sequencing, 182 diet and inflammation, 130 temporomandibular joint dysfunction Mastering Leptin, 131, 139 nutrients, 1 29 Second cervical plane, 274 (TMD), 365 Rigidi ty, 244 Segmental coupl ing, 55&-560 Relaxation methods, 231 Risorius, 350, 356 Segmental facilitation, 544, 544-545 Release Robbie, tensegrity, 15 Segmental muscles, 560 Ross, soft tissue trea tment technique, 308 Segmental testing, 550 definition, 327 Rotation Self-care, 155 precise technique, 122 Relief positions, 259 cervical region, 256, 262, 264, 269, 272 temporoma ndibular jOint (TMJ), 363 Relocation test, 408 internal, 412, 428-429, 478 Remodeling phase, 1 26, 1 2&-129 load ing, 1 66 Self-help, ] 21, 211 Repa ir process, stages, 180 palpation procedure, 547 Self-treatment Repetitive strain injury, 503-504 shoulder, 4 1 1 , 412, 429, 478 Reporting stations, 51-52 thorax, 542, 546-547, 549-550 SNAGs and, 289 d i rect i nfluences, 58 Rotator cuff muscles (SITS), 402 temporomand ibular joint dysfunction manipula ting, 58-59, 58 SITS tendons, 446, 447, 455, 455 Repose, 316 Rotatores, 281, 558, 564-565 (TMD), 365 Research trigger points, 287, 565 Selye chronic referred muscle pain, 98-100 Rotatores brevis, 287, 564-565, 564 NMT, 1 96-197 Rotatores longus, 287, 564-565, 564 GAS and LAS, 63-64 Residual muscle tension see Muscles, tone Ruddy's pulsed MET, 201, 212, 416, 550 neural threshold, 109 Residual postu re, 69 Ruddy'S reci proca l antagonist facilitation Semispinalis capitis, 282-283, 282, 296, 330 Resisted tests, 143, 418, 422 Semispinalis cervicis, 283 Respiratory alkalosis, 31-32, 75, 149 (RRAF), 212 Semispinalis group, 281, 558 Bohr effect, 32, 149 Ruffin i end-organs, 51 Semispinalis thoracis, 563 core stability, 32 'Rule of threes', 542 Sensitization, 57, 126, 224 defini tions, 32 Sensory motor approach, 60 Respiratory function, 75-78 s Sequencing cervical treatment, 273-321 assessment, 550, 552-553, 553 Serizawa, 'nerve reflex' theory, 207 core stabi lity and, 75-76 Sacroiliac joint (SIJ), 41, 107, 1 63-164, 358 Serratus anterior, 291, 403, 4 1 5, 464-465 mechanics, 551-552 Salivary glands assessment, 465 model, 551 MET for, 466, 466-467 muscles, 550, 567 compression of, 385 MFR for, 223 posture and, 64-67 submand ibular, 385 NMT for, 465-466, 466 Sanders & Hammond, subclavian vein, 477 pressure techniques, 466 see also Breathing Sapolsky, allostasis, 56 respiration function, 552 Satellite trigger points, 1 1 2-113, 113 trigger points, 464, 465 Respiratory synkinesis, 558 Scalenes, 256, 314, 315 weakened, 82, 409 Responses, Janda's primary and seconda ry, assessment, 554 Serratus posterior inferior, 70, 568 MET for, 3 1 &-319, 319 expiration function, 552 85-86 NMT for, 316-318, 316, 317, 318 trigger points, 568, 568 Resting muscle tone, 87 PRT for, 319, 319 Serratus posterior superior, 567-568 Restrictions, PRT and, 226 shoulder pain, 403 respiration function, 552 Rhomboids, 415 Scalp, 352, 354, 355 trigger points, 567-568, 568 brisk frictional massage, 354 Sex organs, 132 assessment for shortness, 439 Scapula stability, 553 Shah, microa nalysis of trigger pOints, 103 assessment for weakness, 439 Scapulohumeral dysfunction, 417 Sharpey's fibers, 253 MET for, 440-441 Scapulohumeral rhythm, 402-403 Shea, MFR, 222 NMT for, 439-440, 440, 441 test, 91-92, 91, 276, 410 Shearing loading, 166 weakened, 82, 409 Scapulothoracic jOint, 402-403 Sherrington, proprioception, 46 RhythmiC methods, 1 66, 231-233 Scar tissue, 114, 152 Sherrington's law, 35, 39 Ribs, 541

592 I N DEX Shoulder elasticity, 120, 121 Splenii, 280, 283-284, 283, 284, 557 and arm pain, 475 mobility, 120 Splenii tendons, NMT for, 284-285, 285 assessment see Shoulder assessment receptors, 51 Splenius capitis, 303, 329, 345, 370 key joints, 401-403, 401, 404 texture, 119 Splenius cervicis muscles, 321 ligaments, 405-407 Skin rolling, 183, 1 86, 356 Splinting (spasm), 37-39, 40, 151 muscles, 438 Skull Spontaneous electrical activity (SEA), 111, evaluations, 420-422 disarticulated, 327 relationships, 413 inferior view, 329 116, 118 soft tissue and, 404, 422 muscular a ttachments to, 329 Spray and stretch techniques, 166, 355 structure, 400-404 Sliding filament theory, 26-27 transverse section, 445 Slow isotonic eccentric contraction/stretch posterior forearm, 526 treatment, 429-485 trigger point treatment, 233-235 trigger points, 410 (SEIS), 200 Springing, 420, 422, 544, 544 Slow-adapting joint receptors, 51 Spurling's test, 408 Shoulder assessment, 404-429 Slump posture, 69, 474 Stabilizers, 413 imaging studies, 407 Smooth Muscle cells (SMCs), 31-32, 181 State dependent processing, 59 Janda and, 409-410 SNAGs see Sustained natural apophyseal Static compression muscle evalua tions, 420-422 pincer, 375 observation, 410 glides (SNAGs) pronator teres, 497 range of motion, 410-412 Snapping, 283 teres minor, 455 repetitions, 408-409 Static pressure, 380, 383 soft tissue palpation, 410 friction, 286 infraspina tus, 448 Spencer sequence, 422, 423-424, 425, palpation, 187, 187, 454, 457, 519 la tissimus dorsi, 459 427-429, 429 Social rehabilitation goal, 172 pectoralis minor, 476 tests, 408 Soft palate musculature, 380-382, 381, 383 release, 440 specific dysfunctions, 4 1 7-420 NMT for, 382, 382 subscapularis, 463 strength, 413-415, 414 Soft tissue supraspinatus, 446 dysfunction, 214 trapezius attachments, 434 Shoulder pain, 410, 415-416, 422 Static stretching, 236 scalene muscles and, 403 neuromuscular management of, 166-167 Staubesand therapeutic choices, 416-417 manipulation, effects of, 216 autonomic nervous system, 9 pain, 143 proprioception, 2, 46 Shoulder Pain (CaiUiet), 446 palpation, 410 Steiner, disc and facet syndromes, 259 Shoulder-arm syndrome, 409 release, Spencer 's general, 429 Sterling 'Sick building syndrome', 148 shoulder and, 404 flexor withdrawal reflex, 165 Side-to-side translation, atlantooccipital techniques, 51, 1 83, 211, 308 m usculoskeletal pain, 40 treatment and barriers, 164 Sternalis, 479 joint, 269 Somatic dysfunction, 114, 121 chest pain and, 479 Sidebending Somatization, 41-42, 1 52-153 Sternoclavicular jOint, 403 Somatosomatic reflexes, 47 MET for, 426 atlantooccipital joint, 269 Somatotropin, 132 restricted abduction, 425 cervica l region, 262, 269, 272 Somatovisceral reflexes, 47, 299, 305 Sternocleidomastoid (SCM), 300-301, 300, levator scapula, 438 Spasm, muscle, 37-39, 40, 151 longus capitis, 312 Specific adapta tion to imposed demand 346, 359, 370 palpation procedure, 547 attachments, 303, 345 spinal region, 256, 269 (SAID), 64 clavicular head, 318 Sideflexion, 540 Speed's maneuver, 408, 419 MET for, 303-304, 304 Sidelying position, 316, 318, 318 Sphenobasilar synchondrosis (SBS), 295, NMT for, 301, 302, 303, 316 anconeus, 453 PRT for, 304, 304 latissimus dorsi, 459 330-332, 334, 390 respiration function, 552 pectoralis major, 471 Sphenoid, 332-335, 332, 372 shortened, 409 SITS tendons, 455 Sternocostal joint, 403 subscapularis, 463, 463 transverse movement, 390 Sternocostalis see Transversus thoracis teres major, 457 Spinalis capitis, 285-286, 330 Sternohyoid, 305-306, 308 Simons Sternomastoid, 82 dysfunctional muscle spindle, 110-111 NMT for, 286 Sternosymphyseal syndrome (SSS), 542-543 Eagle's syndrome, 370 Spinalis cervicis, 285-286 Sternothyroid, 306, 308 endplate noise, 116 Sternum, 542 nutritional balance, 167 NMT for, 286 pump handle movement, 555 trigger points, 98, 1 02-103, 115, 118 Spinalis muscle group, 281, 558 structural features, 541 Simons & Mense, resting muscle tone, 87 Spinalis thoracis, 563 Stiff elbow, 492 Simons' integrated hypothesis, 111 Spine Stiffness, 5, 87, 141 Simons, myofascial trigger points (MTrPs), 8, Stiles' procedu re, 272 area facilitation, 108 Stomatognathic system, 358 113-114 curvatures, 245 Storungsfeld (focus of disturbance), 223 Sinus inflammation, 336 mobilization, 288 Straight leg raising (SLR) test, 224, 293 SITS (rotator cuff) muscles, 402 rhythmic treatment, 232-233, 232 Strain, 3 SITS (rotator cuff) tendons, 446, 447, 455, 455 segments, 543-544 and co-contraction, 54-55 Sitz baths, 210 stability, 31-32, 75-76, 245 and spra ins, 489 Skaggs, mandible range of motion, 338 structures, 416 Skin see also Cervical spine; Thoracic spine Spinous p rocesses, 250, 255, 542, 546, 'drag' palpation, 356 566-567 Spiral line, Myers', 12 Spiral MET, 478 Spiral muscle fibers, 27

Index 593 Strain /coWlterstrain (SCS), 198, 225 Sudden infant death syndrome (SIDS). , 389 dysfunction (TMD), 306, 359, 359-365, cervical extension restriction, 271-272, Sulcus sign, 408 361-362, 374 272 Superficial cervical plane, 274 cervical flexion restriction, 271, 271 Superficial heat, upper trapeZius, 121 pain, 362 cervical spine dysfunction, 267 Superficial lymph p a thways, 365 problems, 84, 380 latissimus dorsi, 460 Superficial posterior forearm, 521 trea tment, 339 methodology, 227-228, 229 Superior head of lateral p terygOid (SLP), 375 Temporoparietalis, 352, 354 rules and guidelines, 230 Superior longitudinal, 382 Tender points Supinator, 495-94- 6 biceps brachii, 485 Strap muscle fibers, 25 cervical spine, 271 , 272 Strength continuum, 27 assessment, 496 marking, 559 Strength tests, 229-260, 262 MET for, 496 scalene muscles, 319 MFR for, 496 strain/counterstrain (SCS) and, 228 for cervical spine, 262, 263 NMT for, 496, 496 teres minor, 455 elbow, 488 trigger pOints, 495 wrist dysfunction, 521 muscle, 39 Suprahumeral joint, 402 Tend initis, 417 shoulder, 413-415, 414 Suprahyoid muscles, 304, 305, 358, 384-385, Tendinopathy, 127 wrists, 506, 506 Tend inosis, 127-128 Stress, 3 385 Tendon hood, 530, 530, 532 -strain curve, S NMT for, 385, 385, 387 Tendons, palpation of, 119 tests shortness, 364 Tennis elbow, 127, 492, 522, 526 Supraspinatus, 402, 415, 443-446, 444, 445 Tenosynovitis ( tennis elbow), 127, 492, 522, elbow, 488-489 assessment, 446 wrist, 506 calcification, 419--420 526 Stretch, 179, 283 MET for, 421, 421, 446 TENS, 154 active isolated (AIS), 236 MFR for, 446--447, 447 Tensegrity, 14-16, 245 ballistic, 236 NMT for, 195, 446 Tension biceps brachii, 484 Supraspinatus tendinitis, 417--418 brachioradialis, 494, 495 Supraspinatus tendon, 402 loading, 1 66 facilita ted, 235 Sup raspinous ligament, 253 movement, 37 general cervical, 299-300, 300 Surface anesthesia, 233 muscle, 24, 24, 37-39 latissimus dorsi, 460 Surface electromyography (EMG), 1 1 6-11 7 Tensional integri ty, 14-16, 245 muscle, 375 Su rgery, elbow, 492--493 Tensor fascia lata (TFL), 91, 221 palpation and, 188 Sustained natural apophyseal glides Tensor veli palatini, 381 pectoralis major, 473 Ten torium cerebelli, 344, 347 postrnas tectomy, 470 (SNAGs), 217-218, 288, 565-566, 575, Teres major, 413, 415, 456--457, 456 sensitivi ty, 38-39 575 NMT for, 457, 457 spray and, 233-235 self-treatment and, 289 PRT for, 457, 458 supinator, 496 Sutu res, distraction of, 391 Teres minor, 402, 413, 415, 453 techniques, 112, 122, 235-236, 313 Swallowing, 386 assessment, 453--454 upper trapezius, 121 Symphysis pubis, 542 MET for, 448--449, 448 Synchronous temporal rolling exercise, 347 NMT for, 454-455, 454, 455 see also Proprioceptive neuromuscular Synergists, 37, 413 PRT for, 455, 455 Synkenesis, 201 Tetany, 77 facilitation (PNF) 'Tethering' of tissues, 163-164 Structural continuum, Ingber 's, 23-25 T Tetrahydrofolate enzyme, 167 Sty loglossus, 382 Theile massage, transvaginal, 107 Stylohyoid, 369-371, 383 Taleisnik, Dupuytren's contracture Thenar eminence, 533 Styloid process, 313, 313, 369-370, 371, 383 characteristics, 514 Thenar muscles, 530-531 Therapeutic sequencing, 19 palpation, 371-372 TART (tissue texture, asymmetry, restriction, Therapeutic touch, 231 Stylomastoid foramen, 346 tenderness), 254 Therapies, multiple, 236 Subacromial bursa, 445 Thermal a p p lications, 1 1 2 Subacromial bursitis, 419, 419 Tau t bands, 119 Thermoreceptors, 4 6 Subclavian artery compression, 257 Tea, 150-151 Third cervical plane, 274 Subclavius Tectorial membrane, 251 Thixotropy, 3, 4-5, 5 Temporal arteritis, 366 Thoracic lamina groove, NMT for, 562-563, MFR for, 477, 479 Temporal bones, 333, 344-347, 346, 372, 374 respiration fWlction, 552 Temporalis, 333, 338, 341, 344, 345, 358, 366, 565-566 Subcostales muscles, 570 Thoracic nerve, serratus anterior and, 465 Subdeltoid bursitis, 419, 419 370, 372-373 Thoracic outlet synd rome (TOS), 256, 259, Submandibular salivary glands, 385 NMT for, 366, 366 Suboccipital region, 292-298, 292 trigger points, 354, 373 477 Lief's NMT for, 297 Temporalis tendon, 367 pectoralis major and, 469 NMT for, 296-298, 296 NMT for, 373, 373 pectoralis minor and, 474 PRT for, 298 Temporomandibular intraarticular disc, Thoracic spine coupling, 542, 546, 547 see also individual muscles 360 facet joints, 540, 540 Temporomandibular joint (TMJ), 358, 374 flexion, 542 Subscapularis, 402, 403, 415, 460--462, 461 mobilization with movement (MWM), assessment, 421, 422, 462, 462, 463 assessment, 364, 364-365 MET for, 463-464, 463 associated structu res, 363-364 757-756 MFR for, 223 compression and decompression, 339, 339 NMT for, 463, 463 PRT for, 464

594 I N D EX Thoracic spine (contd) atlas, 321 Eagle's syndrome, 370 posterior cranial attachments, 321 evolution, 102-103 motion, 548 Transverse snapping palpation, 519 fibrotic scar tissue hypothesis, 110 palpation, 549-550 deep posterior forearm, 528 restriction pa tterns, 547 posterior forearm, 526 finger extensors, 524 rotation, 542, 546-547, 549-550 Transversospinal group of muscles, 280 flexor carpi umaris, 515 Transversus abdominis, 75, 571 forearm, 499 structural features, 540-541 core stability and, 32 hidden, serratus posterior superior, 441 vertebra, 540, 542, 551 Transversus thoracis, 70, 574-575, 574 hypothesis, 164 Trapezius, 256, 275, 280, 290-291, 296, 415, improved oxygenation, 110 flexion and extension, 548 incidence and location, 116 Thoracic wall, 555 429-430, 554 injections, 446, 476 a ttachments, NMT for, 434 Thoracic zygapophyseal joints, 541 displacement, 446 joint restriction, 114, 114 Thoracolumbar area, 265 trigger points, 430 key, 1 1 2-113, 113 see also Lower trapezius; Middle trapezius; tissue p reference, 19 lateral pterygoid, 380 Thoracolumbar spine, 543 Upper trapezius 'loose-tight' concept, 164-165 Thorax, 539-576 Trapezoid ligament, 406 lower trapezius, 433 Tra u m a lymphatic dysfunction, 120 anterior, 550-557 medial scapula, 440 interior, 572-573 adaptation to, 67 multifidi, 564, 565 connective tissue and, 1 7, 19 muscle spindle hypothesis, 110-111 posterior, 541-550 myofascial (MTrPs), 8, 38, 113-114, 1 1 8-122, structure, 540--541 Travell & Simons fibromyalgia and myofascial pain, 105 119, 154-155, 164, 374 treatment techniques, 557-576 low back pain, 152 nasal region, 356 upper, 544, 549 lymphatic dysfLU1ction, 120 Nimmo's receptor-tonus techniques, Three-d imensional equilibrium, muscle-spl inting pain, 40-41, 151 109-111 atlantooccipital jOint, 269 occipitalis, 321 Myofascial Pain and Dysfunction: The Trigger occipitofrontalis, 354 Thumb, 512 Point Manual, 97, 112 organ dysfunction, 106--108 'double-thumb' technique, 493, 494 trigger point activity, 119 palmaris longus, 514 Treatment program, 163 palpating, 187-188 ligaments, 511 Treatment tools, 190-191 patterns muscles, 527-528, 529 technique, 192-193, 192 see also Pressure bars in hand and wrist, 513 trigger, 517 Triangular muscle fibers, 27 of pectoralis major, 468 Thymus gland, 132 Triangularis stemae see Transversus thoracis of subclavius, 468 Thyrocricoid visor, 308 Triceps, 449-452, 493-494 Thyrohyoid, 306 pectoralis major, 469, 473 Thyroid cartilage, 311, 312 assessment, 452 ThyrOid gland, 132, 308 long head of, 413 pectoralis minor, 474, 476 underactive, 133-134 MET for, 452-453, 453 perpetuating factors, 119 Thyrotropin, 132 MET treatment, 453 posttraumatic scar tissue, 476 NMT for, 452, 452, 494 pressure release, 215, 481 Tightness, 165, 194, 266, 572 reflex, 488 primary, key and satellite, 11 2-113, 113 radiculopathic model, 111 see also Looseness, tightness and test, 411 referral patterns, 450, 528-529 Tilley, temporomandibular joint (TMJ), 363 trigger points, referral patterns, 450 referred inhibition, 117 Tinel's test, 508, 509 Triceps brachii, 54 rhomboid's scapular attachment, 439 caicifica hon, 420 rotatores, 287, 564, 565 Tinnitus, 374 Trick patterns, 39-40 satellite, 112-113, 113 Tissue preference, 18, 264-266 Trigeminal ganglion, 346 scalenii, 315 Tomlinson, restricted dorsiflexion patients, Trigger finger, 516 semispinalis capitis, 282 Trigger points (TrPs), 97-122 serratus anterior, 464, 465 196 activating factors, 113 serratus posterior inferior, 568, 568 Tongue m uscles, 382-383, 383, 384 active and latent, 113-114, 114 serratus posterior superior, 567-568, 568 acupuncture, 207 shoulder, 410, 416 movements, 358 anterior forearm, 514, 514, 519 Simons' integrated hypothesis, 111 attachment ( ATrP), 100, 112, 188-189, 448 soft tissues, 420 NMT for, 383-384, 384 Awad's analysis, 109 splenii, 284 Tonic motor tone, 33, 34 biceps brachii, 483 spray and stretch trea tment, 233-235 Tools biomechanics of, 1 78-179 sternalis, 479 brachioradialis, 494, 495, 523 assessment, 189-190 'cardiac arrhythmia', 472, 472 superficial posterior forearm, 525 pain-rating, 190 central nervous system and, 8-13 treatment, 190-191 cervical region, 293 supina tor, 495 Torticollis, 389 chains, 94, 94 supraspinatus, 195, 446 composite target zones, 456 symptoms other than pain, 120 spasmod ic (TS), 284, 301 connection, 102-103 target zones, 114, 142 deltoid, 441, 443 temporalis, 354, 373 Trachea, 312 digastric, 385 tenderness, 286 Traction, longus capitis, 312 digital flexors, 516 teres major attachment sites, 457 Trager®-style approach, 232, 233 teres minor, 454, 455 Translation assessment, cervical, 269-279, 270 Transverospinalis m uscles, 560 Transverse friction, 354, 437 Transverse humeral ligament, 406, 482 Transverse ligament, 251 Transverse lingual, 382 Transverse palpa tion, biceps brachii, 484 Transverse p rocess, 250, 250, 255, 313-314, 313

Index 595 testing and measuring, 114-118 Upper trapezius, 103, 275-276, 275, 329/ 359 Walther, strain/counterstrain, 55 thermography and, 117-118 assessment for shortness, 431-432 Ward, 'loose-tight' concept, 163 tinnitus, 374 attachments, 277-278, 278 Warming compress, 206-208 tissue microanalysis, 103, 103 flat compression, 432 Wartenberg pendulum test, 87 tongue muscles, 383 gliding teclmiques, 433 Wellness education, 172 trapezius, 430 Lief's NMT for, 278, 434-435 Whiplash, 256, 261-262, 276 treatment, 121-122, 194-195, 196 MET, 278-279, 422, 435 triceps, 450, 452 myofascial release, 279, 280-281, 435 -associated disorders (WAD), 261 upper trapezius, 431, 433, 435 NMT for, 277, 432-433, 432 White adipose tissue (WAT), 134-135 uvulae muscles, 382 pincer compression, 432 Whole-body approaches, 211 vertical muscular columns, 559 PRT for, 279-280, 279 Wiederholt, endplate potentials, 116 whole muscle problems and, 211 respiration function, 552 Wilson & Best, tendinopathies, 127 wrist extensors, 523 shortened, 82, 86, 276, 409 Wilson's syndrome, 133 see also Central trigger points (CTrPs) tissue layers, 280-281 Wind-up, 57, 58-59, 126 Trigger thumb, 517 trigger points, 431, 433, 435 'Winging', serratus anterior, 465 True joint, 401-402 Wolff's Law, 2, 3, 66 Trunk flexion test, 90, 90 Uvulae muscles, trigger points, 382 Wrap-around patterns, 165 Trunk pack (warming compress), 208 Wright maneuver, 474 Tumor-necrosis factor-alpha (TNF-a), 137 v Wrist and hand, 498, 499-508, 499 20th century syndrome, 148 Twisted muscle fibers, 27 Vaccines, mercury derived, 145 bones of, 500 Two-joint muscle testing, 39, 413 Van Griensven bony structures and ligaments, 501 deep structures, 532 u long-term potentiation, 58 MET for, 521 wind-up, 58 mobilization with movement (MWM), Ulnar collateral ligament, 502 Van Wingerden, sacroiliac joint (SIJ), 41, Ulnar nerve entrapment, 489-491, 490, 491, 520 1 63--164 range of movement, 505 507, 508 Vasilyeva & Lewitt, dysfunctional patterns, 86 Wrists Ulnar tunnel syndrome, 490 Vasonemoactive substances (VNS), 101 capsule and ligaments, 501-502, 501 Ulnaris muscles, 513 Vault bones, 328 dysfunction, 503 Ultrasound, 40, 116, 407 Vault hold, 330, 331 extensors, 523, 524 Verbal rating scale (VRS), 190 motion tests, 503, 505-506 upper trapezius, 121 Vertebra prominens (C7), 250 reflex and strength tests, 506, 506 Umami, 147 Vertebral artery-related vertigo, 257 stress tests, 506 Uncinate process, 250 Vertebral colmnn, 244-250, 244 tests, 508 Unidirectional transverse friction, 320 typical vertebrae, 250, 250 x for semispinalis cervicis, 283 Vertical linguai, 382 Unilateral transverse friction, pronator teres, Vertical muscular columns, trigger points, Xiphoid process, 472, 541 497 559 y U nipennate muscle fibers, 27 Vertigo, 257 United States of America (USA), 166 Vibration, 154, 231-233 Yergason's test, 408, 418, 418 Unpaired bones, 328 Viscerocutaneous reflex, 8 Yoga stretching, 236 Upledger & Vredevoogd, red reflex Viscerosomatic reflex, 48, 48 Yoshino, occlusal supporting zone, 358 Viscerovisceral reflex, 49 Yunus, fibromyalgia and myofascial pain, assessment, 546 Viscoelasticity, 3, 6, 39 Upper arm Viscoplasticity, 3, 6 105 Viscous drag, 3 MET for, 426 Visual analogue scale (VAS), 191 z restricted horizontal flexion, 425 Vitamin C, 170 Upper cervical region Vitamin D, 139 Zink & Lawson dysfunction, 268, 268 Vlaeyen, wellness education, 172 postural (fascial) patterns, 18 joint complex, 53 Vogt & Banzer, prone hip extension, 88 testing tissue preference, 264-265 ligaments, 251 Vomer, 336-337 tissue preference, 264-266 Zink tests, 266 Upper crossed syndrome, 82, 82, 162, 409 inflammation, 337 'Upper fist' functions, 70-71 w Upper limb tension tests (ULIT), 224, 475 WaUden, adaptation sequences, 66 Upper rectus abdominis, 293 Upper ribs, shoulder pain and, 416-417, 556 Upper thoracic area, 549