Just about everyone has trapezius trigger points. In most cases they can be treated simply and effectively for relieving headaches.
Treating trigger points in the upper trapezius can have a profound effect for many headache sufferers.
In addition to compression techniques, we often use the following muscle energy techniques (MET's) to target the treatment areas (taught bands).
MET Treatment of Right Upper Trapezius
The therapist places the right upper trapezius in a position of bind, and asks the patient to either side bend the cervical spine to the right or elevate the right shoulder. Alternatively, the patient may be requested to perform both of these actions at the same time against a resistance from the therapist. Another way of communicating the technique is to ask the patient to bring the ear to the shoulder, or the shoulder to the ear, against a resistance, holding for 10 seconds.
After the 10-second contraction, the patient is asked to relax, take a breath in and on the relaxation phase the cervical spine is taken further into a left side bend. If the side bending causes any discomfort, the shoulder can be taken into further depression, as this will also have the effect of lengthening the upper trapezius.
If an RI technique is desired, the therapist takes complete control of the patient’s cervical spine and shoulder as described above. From this position the patient is asked to reach slowly towards their lower right leg with their right hand, until a point of bind is felt. This approach will activate the lower trapezius as the patient is causing a depression of the right shoulder girdle. This will induce an inhibition of the right upper trapezius, allowing a safe way of lengthening as it will override the activation of the muscle spindles.
Targeting Specific Fibres
The upper trapezius has three fibre components: anterior, medial and posterior. If you decided that certain fibres were tight, a simple rotation of the cervical spine would target specific fibres. Figure (1) shows the patient’s cervical spine in a half rotation to the left; this targets the middle fibres of the upper trapezius. If you were to take the cervical spine into full rotation, this would target the posterior fibres as seen in figure (2). No rotation of the cervical spine would target the anterior fibres.
Figure (1) The patient is asked to side bend to the right or elevate the right shoulder, or both. Half rotation of the cervical spine emphasises the middle fibres of the trapezius.
Figure (2) The therapist lengthens the right trapezius by applying caudal pressure. Full rotation of the cervical spine emphasises the posterior fibres.
An alternative hand position for the treatment of the upper trapezius is illustrated in figure (3) below. As in figures (1) and (2), the therapist uses a cradle type of hold with their left hand; Figure (3) demonstrates a different hand contact with the therapist using their left hand. Some patients find this position more comfortable.
Figure (3) An alternative hand position for the treatment of the upper trapezius.
About the Author
John Gibbons is a qualified and registered osteopath with the General Osteopathic Council, specialising in the assessment, treatment, and rehabilitation of sport-related injuries. Having lectured in the field of sports medicine and physical therapy for over 12 years, John delivers advanced therapy training to qualified professionals within a variety of sports. He has also published numerous articles on various aspects of manual therapy.
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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