Open Access Highly Accessed Research article

Myofascial trigger points and innervation zone locations in upper trapezius muscles

Marco Barbero12*, Corrado Cescon1, Andrea Tettamanti3, Vittorio Leggero3, Fiona Macmillan2, Fiona Coutts2 and Roberto Gatti3

Author Affiliations

1 Department of Health Sciences, University of Applied Sciences and Arts of Southern Switzerland, SUPSI, Manno, Switzerland

2 Queen Margaret University, School of Health Sciences, Edinburgh, United Kingdom

3 Vita-Salute San Raffaele University, School of Physiotherapy, Milan, Italy

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BMC Musculoskeletal Disorders 2013, 14:179  doi:10.1186/1471-2474-14-179

Published: 8 June 2013

Abstract

Background

Myofascial trigger points (MTrPs) are hyperirritable spots located in taut bands of muscle fibres. Electrophysiological studies indicate that abnormal electrical activity is detectable near MTrPs. This phenomenon has been described as endplate noise and it has been purported to be associated MTrP pathophysiology. Thus, it is suggested that MTrPs will be overlap the innervation zone (IZ). The purpose of this work was to describe the location of MTrPs and the IZ in the right upper trapezius.

Methods

We screened 71 individuals and eventually enrolled 24 subjects with neck pain and active MTrPs and 24 neck pain-free subjects with latent MTrPs. Surface electromyography (sEMG) signals were detected using an electrode matrix during isometric contraction of the upper trapezius. A physiotherapist subsequently examined the subject’s trapezius to confirm the presence of MTrPs and establish their location. IZ locations were identified by visual analysis of sEMG signals. IZ and MTrPs locations were described using an anatomical coordinate system (ACS), with the skin area covered by the matrix divided into four quadrants.

Results

No significant difference was observed between active and latent MTrPs locations (P = 0.6). Forty-five MTrPs were in the third quadrant of the ACS, and 3 were included in second quadrant. IZs were located approximately midway between the seventh cervical vertebrae and the acromial angle in a limited area in the second and third quadrants. The mean distance between MTrP and IZ was 10.4 ± 5.8 mm.

Conclusions

According to the acquired results, we conclude that IZ and MTrPs are located in well-defined areas in upper trapezius muscle. Moreover, MTrPs in upper trapezius are proximally located to the IZ but not overlapped.

Keywords:
Myofascial trigger point; Myofascial pain; Innervation zone; Endplate; Surface EMG