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Tender Point

Location
On posterior aspect of ascending ramus of mandible at
the level of earlobe
AC2-6
On anterolateral aspect of corresponding anterior
tubercle of transverse process
AC7
On posterior-superior surface of clavicle at the
clavicular attachment of SCM
AC8
On medial head of clavicle at sternal attachment of
SCM
Anterior Cervical Region
AC1

Treatment
RA
F SA RA
F ST RA
F SA RA

Posterior Cervical Region


Tender Point
Location
PC1 Inion
On inferior nuchal line, just lateral to inion
PC1 lateral (occiput)
Just below nuchal line midway between inion &
mastoid, associated with semispinalis capitis and
obliquus capitis superior
PC2 lateral (occiput)
On inferior nuchal line within the semispinalis capitis
muscle associated with greater occipital nerve
PC2 midline
Superior lateral surface of C2 spinous process
PC3 midline
Inferior/inferolateral aspect/tip of C2 spinous process
PC4-8 midline
Inferior/inferolateral aspect of spinous process (ie. PC4
inferior to C3 spinous process)
PC3-7 lateral
On posterior lateral aspect of articular process

Anterior Thoracic Region


Tender Point

Location

Treatment
F
E Sa Ra
E Sa Ra
E Sa Ra
F Sa Ra
E Sa Ra
E Sa Ra

Treatment

AT1 midline
AT2-6 midline
AT7-9 B/L
AT10-12 B/L

On episternal notch, midline or just lateral


On sternum at level of corresponding rib
AT7: distance tip of xiphoid and umbilicus
AT8: between tip of xiphoid and umbilicus
AT9: distance tip of xiphoid and umbilicus
AT10: distance umbilicus and pubic symphysis
AT11: between umbilicus and pubic symphysis
AT12: top of iliac crest at midaxillary line

Posterior Thoracic Region


Tender Point
Location
PT1-12 midline
Midline, on inferior aspect of spinous process
PT1-12 posterior
On inferolateral aspect of deviated spinous process
PT1-12 TP
On lateral aspect of transverse process

Anterior Costal Region


Tender Point

Location

F
F
F St RA
F St Ra

Treatment
e-E
e-E SA RA
e-E SA RT

Treatment

AR1
AR2
AR3-6

Below clavicle at first chondrosternal articulation


On superior aspect of 2nd rib at MCL
On dysfunctional rib at anterior axillary line

Posterior Costal Region


Tender Point
PR1
PR2-6

Location

On posterior-superior aspect of rib 1 just lateral to


costotransverse articulation
On posterior-superior angle of corresponding rib

Anterior Lumbar Region


Tender Point
Location
AL1
Medial to ASIS
AL2
Medial to AIIS
AL3
Lateral to AIIS
AL4
Inferior to AIIS
AL5
Anterior, superior aspect of pubic ramus just lateral to
symphysis

Anterior Pelvic Region


Tender Point

Location

f-F St RT
f-F St RT
f-F ST RT

Treatment
E SA Rt
f SA RA

Treatment
F ST RA
F SA RT
F SA RT
F SA RT
F SA RA

Treatment

Psoas
Iliacus
Low ilium
Inguinal

2/3 distance from ASIS to midline, pressing deep in


posterior direction
distance from ASIS to midline, pressing deep in
posterior-lateral direction
Superior surface of iliopubic eminence associated with
attachment of psoas minor
Medial aspect of inguinal ligament near pubic tubercle
in association with attachment of pectineus

Posterior Lumbar Region


Tender Point
Location
PL1-5 SP
On inferolateral aspect/tip of deviated spinous process
PL1-3 TP
On lateral aspect of transverse process
Quadratus Lumborum
On inferior aspect of 12th rib
On lateral tips of lumbar transverse process
On superior aspect of iliac crest

Posterior Pelvic Region


Tender Point

Location

F ST
F ER
F
F ADD IR

Treatment
e-E St Ra
e-E ST RA
E Abd ER

Treatment

Upper Pole L5
High ilium sacroiliac
Lower Pole L5
High ilium flare out
Gluteus medius PL3,
PL4
Piriformis

Sacral Region
Tender Point
PS1 B/L

Superior medial surface of PSIS


2-3cm lateral to PSIS, pressing medially toward PSIS
On ilium just inferior to PSIS, pressing superiorly
Lateral aspect of ILA and/or lateral aspect of coccyx
Upper outer portion of gluteus medius at level of PSIS
PL3: 2/3 lateral from PSIS to TFL
PL4: posterior margin of TFL
Midpoint between lower half and lateral aspect of
sacrum and ILA and greater trochanter

E add IR/ER
E Ab ER
F IR add
E Add
E er abd

Location
Medial to PSIS at level of S1

Treatment
Apply P-A pressure
on opposite ILA
2: apply P-A
pressure midline to
apex of sacrum
3: F or E
4: apply P-A
pressure midline to
base of sacrum
Apply P-A pressure
on opposite sacral
base

PS2, PS3, PS4


midline

Midline on sacrum at corresponding sacral level

PS5 B/L

Just medial and superior to ILA

Lower Extremities
Tender Point

Location

F Abd IR/ER

Treatment

TFL
Lateral trochanter
IT band
Lateral hamstring
Biceps femoris
Lateral meniscus
LCL
Medial hamstring
Semimembranosus
Semitendinosus
Medial meniscus
MCL
ACL

Inferior to crest of ilium in body of TFL


Along IT band distal to greater trochanter

f Abd
F Abd

In posterior thigh lateral to midline, approximately


halfway down shaft of femur
Lateral aspect of meniscus on joint line

F ER Abd

In posterior thigh medial to midline approximately


halfway down shaft of femur

F IR Add

Anteromedial aspect of meniscus on joint line

F IR Add

Superior aspect of popliteal fossa on hamstring tendon

PCL

In center/slightly below center of popliteal fossa

Popliteus

In belly of popliteus muscle, just inferior to popliteal


space

Extension ankle
gastrocnemius

Within proximal gastrocnemius muscles distal to


popliteal margin

Medial ankle tibialis


anterior

Inferior to medial malleolus along deltoid ligament

Lateral ankle fibularis


or peroneus longus,
brevus, tertius

Inferior and anterior to lateral malleolus in


talocalcaneal sulcus

Flexion calcaneous
Quadratus plantae

Anterior aspect of calcaneus on plantar surface of foot


as attachment of plantar fascia

Place pillow under


distal femur to
create fulcrum,
apply shearing force
by moving proximal
tibia posteriorly on
femur
Place pillow under
distal femur to
create fulcrum,
apply shearing force
by moving distal
femur posteriorly on
proximal tibia
Slight flexion of knee
with internal rotation
of tibia
Marked plantar
flexion of ankle with
knee flexion
Place fulcrum on
medial aspect of
ankle, apply
inversion force with
slight shear
Place fulcrum on
lateral aspect of
ankle, apply
eversion force with
slight shear
Marked flexion of
forefoot
approximating the
forefoot to the
calcaneus

Upper Extremities
Tender Point

Location

F Ab/ER

Treatment

Supraspinatus
Infraspinatus

Levator scapulae

Subscapularis
Long head of biceps
Short head of biceps
Corachobrachialis
Pectoralis minor

In belly of supraspinatus muscle


Upper: inferior and lateral to spine of scapula at
posterior medial aspect of GH join
Lower: in lower portion of muscle inferior to spine and
lateral to medial border of scapula
On superior medial border of scapula at attachment of
levator scapula

At anterolateral border of scapula on subscapularis


muscle, pressing from anterior-lateral to
posteromedial direction
Over biceps tendon in bicipital groove
At inferolateral aspect of coracoid process
Inferior and medial to coracoid process

Radial head lateral

On anterolateral aspect of radial head at attachment


of supinator

Medial epicondyle

On medial epicondyle of humerus at common flexor


tendon and attachment of pronator teres
On dorsal surface of 2nd metacarpal in extensor carpi
radialis
On dorsal surface of 5th metacarpal in extensor carpi
ulnaris
At palmar base of 2nd/3rd metacarpal in flexor carpi
radialis
At palmar base of 5th metacarpal in flexor carpi ulnaris

Dorsal wrist

Palmar wrist

F Abd ER
F IR Abd

Glide scapula
superiorly and
medially to shorten
muscle; could also
internally rotate
shoulder with
traction and slight
abduction
E IR
F Abd IR
F Add IR
Adduction of arm;
protract scapula
Elbow in full
extension, forearm
marked supination
and slight valgus
force
F Pronate Add
E Ab
E Add
F Ab
F Add