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Trigger Point Therapy - Torsional Release Technique (Seated)

 

 

Posterior Cervical Muscles - Important Trigger Points for Treating Common Head and Neck Pain

[Latin longissimus, longest; capitis, of the head; semispinalis, half spinal; cervicis, of the neck]

Comprising: longissimus capitis, semispinalis capitis, and semispinalis cervicis.

Origin

Longissimus capitis: transverse processes of upper five thoracic vertebrae (T1–T5). Articular processes of lower three cervical vertebrae (C5–C7).

Semispinalis cervicis: transverse processes of upper ve or six thoracic vertebrae (T1–T6). Semispinalis capitis: transverse processes of lower four cervical and upper six or seven thoracic vertebrae (C4–T7).

 

Longissimus Capitis Trigger Points

Longissimus Capitis - Common Trigger Point Sites

 

Longissimus capitis Trigger Points Pain Map

Longissimus Capitis - Trigger Point Referred Pain Pattern

 

 

Insertion

Longissimus capitis: posterior part of mastoid process of temporal bone. Semispinalis cervicis: spinous processes 2nd to 5th cervical vertebrae (C2–C5).
Semispinalis capitis: between superior and inferior nuchal lines of occipital bone.

Action

Longissimus capitis: extends and rotates head. Helps maintain correct curvature of thoracic and cervical spine in the erect and sitting positions.

Semispinalis cervicis: extends thoracic and cervical parts of vertebral column. Assists rotation of thoracic and cervical vertebrae. Semispinalis capitis: most powerful extensor of the head. Assists in rotation of head.

Nerve

Longissimus capitis: dorsal rami of middle and lower cervical nerves. Semispinalis cervicis: dorsal rami of thoracic and cervical nerves. Semispinalis capitis: dorsal rami of cervical nerves.

Basic Functional Movement

Longissimus capitis: keeps upper back straight (with correct curvatures).
Semispinalis cervicis and capitis. Examples: looking up; turning head to look behind.

 

Semispinalis Capitis/Cervicis Trigger Points

Semispinalis Capitis/Cervicis - Common Trigger Point Sites

 

Semispinalis Capitis (upper) Trigger Points 

 

Semispinalis Capitis (upper) Trigger Point Referred Pain Pattern

 

Semispinalis capitis (middle) and cervicis Trigger Points

 

Semispinalis Capitis (middle) and Cervicis Trigger Point Referred Pain Pattern

 

Multifidus Trigger Points

 

Multifidus (mid cervical). Even though not mentioned here, this muscle runs up the spine as part of the erector spinae, and so is relevant as part of the posterior cervical muscles.

 

 

Trigger Point Referred Pain Patterns

Several areas along the fibers, all radiating superiorly into head and skull and toward frontal region.

 

Treatment Techniques

Spray and Stretch Yes
Dry Needling Yes
Deep Stroking Massage Yes
Compression Yes
Muscle Energy Techniques Yes
Positional Release Yes
Wet Needling Yes

 

Indications

Headache, neck pain and stiffness, decreased cervical flexion, suboccipital pain, restricted neck rotation (often related to prolonged occupational positions), whiplash, pain using certain pillows, “burning” in scalp.

Causes

Poor posture, playing musical instruments, lying on front with head propped up, poor glasses, upper crossed pattern, kyphosis, scoliosis, wear and tear, cold drafts/ air conditioning, vertebral alignment issues, certain sports (e.g. archery), tight shirt/tie, depression.

Differential Diagnosis

Cervical mechanical dysfunction. Spondyloarthropathy of facets. Vertebral artery syndrome. Discopathy (cervical) 1st rib dysfunction. Polymyalgia rheumatica. Rheumatoid arthritis. Osteoarthritis. Ankylosing spondylitis (seronegative spondyloarthropathy). Paget’s disease. Psoriatic arthropathy.

Connections

Trapezius, erector spinae, temporalis, digastricus, infraspinatus, levator scapulae, SCM, splenius capitis/cervicis, suboccipital muscles, occipitalis, pectoralis major.

General Advice to Patients

Occupational ergonomics. Posture. Eyewear. Use of ergonomic pillows. Heat and stretch. 

 

Links

Find a Trigger Point Professional in your area

Recent Articles - Neck Pain

Recent Articles - Headache

Treating Whiplash - Torsional Release

Dry Needling for Trigger Points

NAT Professional Courses

Certify as a Trigger Point Therapist

Online CE/CPD/CPE Courses

 

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About Niel Asher Education

Niel Asher Education is a leading provider of distance learning and continued education courses.

Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.

Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.  

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NAMTPT AWARD

We are honored to have received the "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.

Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.

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Award Winning Instructors

Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.

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If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.

In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.

There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.

Most of our courses are accredited for CE/CPD/CPE. A full list of CE accreditations can be found by clicking on the link below. 

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Niel Asher Technique

Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.

The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.

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When you purchase a download edition, you receive immediate lifetime access to all course material. Course texts can be downloaded and printed if required. 

When you purchase a "Printed" edition, you will also receive free access to the download edition.

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Our courses are modular, and designed to build on what you already know. For more information, please visit our "Where to Start?" page.

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. 

 

  

   

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