Section 3: Muscles of the Shoulder Girdle
Trapezius (Trap)
TrP Figure 29 Right and left trapezius. A, Lateral view
showing the location of a TrP in the most vertical fibers
of the upper trapezius. B, Another upper trapezius TrP on
the left side; the right side illustrates middle trapezius
TrP locations. C, Two lower trapezius TrPs and their referral zones.
30 Stretches of the three functional parts of
S Figure
the right trapezius. A, To stretch the right upper trapezius, the patient flexes, left laterally flexes, and rotates
the neck and head (ipsilaterally) to the right. To keep
the shoulder girdle down, the right hand holds onto
the bench. B, A stretch of the right middle trapezius.
A weight is held in the right hand; its tractioning force
protracts and stretches the middle trapezius. Medially
rotating the right arm will enhance the stretch because
it requires further protraction. C, A stretch of the right
lower trapezius. A pole is grasped at approximate head
height and the patient leans back causing protraction
and elevation of the scapula.
Rhomboids
Levator Scapulae
TrP Figure 31 Right levator scap
ulae, posterior view.
32 To stretch the right levator
S Figure
scapulae, the patient flexes, left laterally
TrP Figure 33 Right rhomboids, poste-
S Figure 34 To stretch the right rhomboids,
rior view.
the patient uses his arm to protract and de-
flexes, and rotates the neck to the left (contralaterally). To keep the shoulder girdle
down, the right hand holds onto the bench.
Copyright 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
S03_07-10_A05170.indd 7
press the right scapula.
TrP = Trigger Point Illustration
S = Stretching Illustration
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Section 9: Muscles of the Thigh
Quadriceps Femoris Group
TrP Figure 123 A, Rectus femoris, anterior view. B, Vastus medialis, anterior view. C, Vastus lateralis, lateral view. D, Vastus
intermedius, anterior view.
124 To stretch the right quadriceps femoris group, the paS Figure
tient stands and uses his hand to pull the knee joint into full extension. If the hip joint is extended while doing this stretch, it targets the
stretch more to the rectus femoris; if the hip joint is flexed, it targets
the stretch more to the vastus muscles.
Note: It is important when doing this stretch to make sure that the
knee joint is not rotated.
Tensor Fasciae Latae (TFL)
TrP Figure 125 Right TFL,
lateral view.
126 To stretch the right TFL, the patient adS Figure
ducts the right thigh behind the body while using the
wall for support.
Note: It is important to not place too much weight on the
ankle joint of the foot in back.
Copyright 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
S09_24-26_A05170.indd 24
Sartorius
TrP Figure 127 Right sartorius,
anteromedial view.
S Figure 128 To stretch the right sartorius, the
patient medially rotates, extends, and adducts
the right thigh while leaning forward with the
pelvis and trunk to increase the stretch across
the hip joint.
Note: It is important to not let the pelvis fall into
anterior tilt and to make sure that excessive weight
is not placed on the ankle joint of the foot in back.
TrP = Trigger Point Illustration
S = Stretching Illustration
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