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Trigger Point Definitions

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Satellite Trigger Points
Secondary Trigger Points
Mytotic Group
Kinetic Chain
Libman's Test

 


Satellite Trigger Points

Additional trigger points found near the initial and usually most severe trigger point within the same muscle group or closely adjacent to it. (Primary Trigger Point in the hand primary digit extensor muscle. Satellite Trigger Points will be in the same muscle and may be in the other hand extensor muscles.)
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Secondary Trigger Points

Additional trigger points usually found distal to other trigger points which can be considered part of the same condition. (1. Primary Trigger Points in the brachial plexus region of the shoulder. Satellite Trigger Points in the Forearm. 2. Primary Trigger Points in the Gluteal Muscles associated with Sciatica. Satellite Trigger Points in the Hamstrings and Gastrocs.) Secondary Trigger Points may also be in muscles accommodating altered biomechanics of other muscles. (The left ankle is sprained and does have Primary Trigger Points in the left lower leg. Secondary Trigger Points are in the right Gluteals and Hamstrings.)
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Mytotic Group

ALL muscles associated with movement around any specific joint.
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Kinetic Chain

All muscles associated with movement of a body part which may be closed between two stopped or stationary set points (heel and butt while driving) or open (all the muscles associated with throwing a ball overhand from the feet to the hand).
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Libman's Test

A purely subjective orthopedic test to determine the pain threshold of the patient. It is performed seated or supine. The examiner slowly (count to 10 seconds) applies flat thumb pad pressure bilaterally to the mastoid processes in an attempt to crush the skull. Ask the patient when pain begins. At the point of pain the examiner determines the amount of their own strength required to elicit this pain. Based on normal sized examiner and patient, applied pressure of 20% or less of examiner strength indicates a low threshold or tolerance for pain. Up to 75% to 80% indicates normal tolerance. If the examiner has to exert almost all of their strength and the patient only describes discomfort and not pain the patient has a high tolerance or threshold for pain. This is used to set a basis for patient communication. Asking the patient for responses like "discomfort" instead of "pain" may be warranted.
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