  
Myofascial trigger points cause muscle dysfunction and loss of range of motion (ROM) even before they cause pain. Overlapping TrP pain patterns can cause confusion for health care providers and patients. Specific ROM tests can help you distinguish between different trigger points.
- Is it really carpal tunnel problems? or tight muscles of neck and chest?
- Is it really arthritic knees? or tight quads?
- Is the brutal migraine, unaffected by migraine drugs, actually migraine? or trapezius pain?
A great tool to help care providers find specific trigger points and document the dysfunction and its sources.
--Devin Starlanyl M.D., author
Fibromyalgia and
Chronic Myofascial Pain
Range-of-motion testing is a critical diagnostic (and treatment) tool for myofascial pain, mysterious knee pain, night-time calf-cramps, headaches, sore shoulders and other conditions. Used in conjunction with muscle pain charts, ROM testing allows you to distinguish overlapping pain patterns, locate areas where symptoms have not yet appeared, and differente between symptoms in individual muscles.
For example, Travell considered the Mouth Wraparound Test, shown above, to be the single most important test for shoulder girdle dysfunction. With head vertical and turned 45 degrees to torso, patient reaches arm around back of head and attempts to reach mouth. Short upper arms should reach corner of mouth; Normal arms to center of mouth. Hypermobile arms may reach to opposite side of mouth. Specific muscles inhibit the movement in specific ways. If patient is:
- Unable to reach back of neck: subscapularis
- Able to reach to ear only: infraspinatus.
- Able to reach over head but not behind it: posterior deltoid, coracobrachialis.
Tests are listed and cross-referenced with inhibiting muscles and their corresponding fascial lines (per Myers' Anatomy Trains). The muscles most likely to inhibit a motion are highlighted in red. Test instructions include clear line drawings showing patient and therapist positions, alerts for substitutions by the patient, and criteria for "Restriction" or "No Restriction." Cross references to additional tests (to further differentiate involved muscles) are also highlighted in red.
For further information, see our sampler of cervical ROM tests excerpted and adapted (for website viewing) from the charts. For examples of head pain that these charts help to evaluate, see our Intro to Headpain.
Set of 2 charts (Upper Body and Lower Body), 22" x 34", on heavy stock, suitable for framing. Note:
Wall charts are rolled and shipped in tubes and must ship separately from other products. U. S. Postage on charts is $8.00.
Charts are not laminated, but do have a protective aqueous coating. They won't survive a Sharpie (due to solvents), but extensive in-house testing shows that bean sauce, chocolate, mustard and ketchup wipe right off with a damp cloth.
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