The upper back is part of the thoracic region of the spine, surrounded by various muscles that protect the thoracic joints and help assist with respiratory functionality for the lungs. The upper back muscles consist of the rhomboids and the trapezoid muscles that provide functionality to the scapula or shoulder blades. Other superficial muscles offer assistance to the thoracic spine. The serratus posterior muscle is one of the superficial muscles that helps the thoracic spine and, like all superficial muscles, can succumb to injuries that can lead to the development of overlapping referred pain symptoms known as trigger points. Today’s article focuses on the serratus posterior muscle function in the back, how trigger points are causing upper back pain, and various techniques to manage trigger points in the upper back. We refer patients to certified providers who are diverse in upper back pain therapies to aid many people suffering from myofascial pain syndrome or trigger points associated with the serratus posterior muscle along the upper back. We advised patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Serratus Posterior Muscle Function In The Back
Have you been dealing with constant upper back pain? Do you feel soreness at the base of your neck? Or are you having difficulty breathing? Most of the symptoms cause pain in the serratus posterior muscles that can lead to the development of myofascial pain syndrome or trigger points along the upper back. The serratus posterior has various roles in the upper back as it is not only part of the extrinsic muscles but also part of the accessory breathing muscle. The serratus posterior muscle helps with inspiration, which causes the chest cavity to expand as it is a superficial muscle attached to the ribs and is less commonly known. Studies show that the serratus posterior muscle is deep within the rhomboid muscles and is superficial. Even though this muscle is superficial when it has been overused through various activities, that can cause hypertrophy in the accessory respiratory muscles. Additional studies reveal that the serratus posterior superior muscle is considered clinically insignificant but has been impaired by myofascial pain syndrome or trigger points that can lead to upper back pain.
Trigger Points Causing Upper Back Pain
As stated earlier, the upper back is part of the thoracic region of the spine, and when various factors begin to affect the body, the back muscles tend to be involved. Studies reveal numerous sources of spinal pain in the thoracic spine. One is a myofascial pain syndrome affecting the serratus posterior muscles causing referred upper back pain. Myofascial pain syndrome or trigger points can be activated when the serratus posterior muscle is overloaded from thoracic respiratory issues like coughing due to pneumonia, asthma, or chronic emphysema. When respiratory problems affect the muscles in the thoracic region of the back, it leads to the development of trigger points, leading to overlapping issues like referred pain, motor dysfunction, and autonomic phenomena. According to Dr. Travell, M.D., in the upper back, trigger points can make the serratus posterior muscle cause overlapping risk profiles along the shoulder blades and have referred pain travel to the hands. This can make many individuals suffer from serious pain-like symptoms, causing them to be miserable.
Releasing Trigger Points Related Tension In The Upper Back-Video
Have you been dealing with respiratory issues causing you to be hunched over constantly? Do you feel soreness or tenderness at the base of your neck? Or are you suffering from upper back pain? These symptoms are associated with trigger points that are affecting the serratus posterior muscles causing upper back pain. Trigger points, or myofascial pain syndrome, is a musculoskeletal disorder that causes tenderness along the affected muscle that causes referred pain to the surrounding muscles in the body. Trigger points associated with the serratus posterior muscles can cause referred pain in the upper back and mimic various chronic conditions. Trigger point pain is difficult to diagnose but can be manageable with treatment. The video above gives examples of how to treat trigger points to relieve tension in the upper back.
Various Techniques To Manage Trigger Points In The Upper Back
When it comes to upper back pain, many individuals will go to pain specialists like massage therapists or chiropractors to relieve any issues affecting the upper back. These pain specialists utilize various techniques like stretching, spinal manipulation, massages, and ischemic compression to alleviate pain and manage trigger points from forming further in the affected muscle. Pain specialists like massage therapists or chiropractors are excellent for locating pain-like symptoms associated with trigger points. Even though treatment can help manage symptoms associated with trigger points, many people can still incorporate these techniques, like deep breathing or correcting their posture, to prevent the upper back muscles from becoming strained and causing more issues than before.
Conclusion
The serratus posterior muscles have various roles in the upper back region of the body. These superficial muscles are extrinsic and accessory breathing muscles that help expand the chest cavity. When multiple issues affect the upper back muscles, like strenuous activities or respiratory problems, it can develop trigger points along the serratus posterior muscles and invoke pain-like symptoms to travel down to the hand, causing mobility issues. Thankfully, various techniques that pain specialists like chiropractors and massage therapists use can help manage trigger points from escalating and can bring upper back mobility to the body once again.
Briggs, Andrew M, et al. “Thoracic Spine Pain in the General Population: Prevalence, Incidence and Associated Factors in Children, Adolescents and Adults. A Systematic Review.” BMC Musculoskeletal Disorders, BioMed Central, 29 June 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2720379/.
Mitchell, Brittney, et al. “Anatomy, Back, Extrinsic Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK537216/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Vilensky, J A, et al. “Serratus Posterior Muscles: Anatomy, Clinical Relevance, and Function.” Clinical Anatomy (New York, N.Y.), U.S. National Library of Medicine, July 2001, pubmed.ncbi.nlm.nih.gov/11424195/.
Mindful eating involves paying attention to what and how individuals eat, helping to become more aware of the body’s natural hunger and satisfaction cues. The process can help individuals become aware of the reasons behind their hunger and help to reduce cravings, control portion sizes, and develop long-term healthy eating habits.
Contents
Mindful Eating
It’s easy to rush through meals and snacks without pausing to enjoy the experience while refueling the body. Like meditation, individuals focus on what they are eating, how it smells, tastes, and the bodily sensations experienced. It is a way of checking in with the mind and body throughout a meal or snack. Mindful eating puts the individual in touch:
Hedonic hunger – emotional, stressful, conditioned, celebratory, etc.
Benefits
Individuals do not have to go all-in but can adopt some principles of slowing down and tuning into the body to improve health. Benefits include:
Better Digestion
Slowing down and chewing food properly makes it easier to digest.
Improved Nutrition
Fast foods can cause a feeling of sluggishness and bloating.
Eating nutrient-packed meals provides more energy.
Improved nutrition means improved immune system health.
The awareness reinforces making healthier choices.
Satisfaction After Meals
Rushing to finish a meal means not enjoying the flavors and texture factors that can generate a sense of fullness and satisfaction.
Training the mind and body to be truly satisfied with meals and snacks leads to less stress and less craving.
Healthier Food Relationship
The body needs food physiologically for fuel and nourishment.
Individuals also develop emotional attachments to food associated with experiences and memories.
Addressing all aspects and influences in food relationships allows individuals to become more aware of their learned behaviors, perceptions, emotions, and mindsets.
Identifies behaviors that are not beneficial so the individual can work to improve them.
Improved Cardiometabolic Health
Mindful or intuitive eating has been shown to improve:
Blood sugar levels in pregnant women.
Inflammatory markers in postmenopausal women.
Lipid and blood pressure in overweight adults.
Food Consumption Health
Put away electronics and set aside time and space for eating only.
Eat in a setting where you are relaxed.
Eating in the car, in front of a computer while working, or on the phone doesn’t give full attention to the eating process and, as a result, can cause the individual to eat more or eat foods that are not healthy.
Sit down and take a few deep breaths before starting the meal.
If emotions are running high and are geared towards eating, see if you can acknowledge and express those emotions rather than eat through them.
This will help the digestive process and get the most out of the meal.
Eat a palette of colors, sample various salty, sweet, spicy, and umami/savory flavors, and take in the food with all the senses.
Not eating a variety of flavors at a meal can cause a feeling of missing something that can lead to unhealthy cravings.
Eat with others, as sharing food can enrich everyone involved and help focus on the experience, not the amount of food consumed.
Chew thoroughly, as digestion begins in the mouth, where enzymes are secreted in saliva to break down food.
Not properly chewing and making the food smaller can cause indigestion and other digestive problems.
Listen to your body and recognize when you have had enough or want more.
Waiting five minutes before getting another serving can help the body become more attuned to hunger and fullness cues.
Eat Mindfully
References
Cherpak, Christine E. “Mindful Eating: A Review Of How The Stress-Digestion-Mindfulness Triad May Modulate And Improve Gastrointestinal And Digestive Function.” Integrative medicine (Encinitas, Calif.) vol. 18,4 (2019): 48-53.
Espel-Huynh, H M et al. “A narrative review of the construct of hedonic hunger and its measurement by the Power of Food Scale.” Obesity science & practice vol. 4,3 238-249. 28 Feb. 2018, doi:10.1002/osp4.161
Grider, Hannah S et al. “The Influence of Mindful Eating and/or Intuitive Eating Approaches on Dietary Intake: A Systematic Review.” Journal of the Academy of Nutrition and Dietetics vol. 121,4 (2021): 709-727.e1. doi:10.1016/j.jand.2020.10.019
Hendrickson, Kelsie L, and Erin B Rasmussen. “Mindful eating reduces impulsive food choice in adolescents and adults.” Health psychology: official journal of the Division of Health Psychology, American Psychological Association vol. 36,3 (2017): 226-235. doi:10.1037/hea0000440
Morillo Sarto, Hector, et al. “Efficacy of a mindful-eating program to reduce emotional eating in patients suffering from overweight or obesity in primary care settings: a cluster-randomized trial protocol.” BMJ open vol. 9,11 e031327. 21 Nov. 2019, doi:10.1136/bmjopen-2019-031327
Nelson, Joseph B. “Mindful Eating: The Art of Presence While You Eat.” Diabetes spectrum: a publication of the American Diabetes Association vol. 30,3 (2017): 171-174. doi:10.2337/ds17-0015
Warren, Janet M et al. “A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviors: effectiveness and associated potential mechanisms.” Nutrition research reviews vol. 30,2 (2017): 272-283. doi:10.1017/S0954422417000154
The chest in the body has many functions: it helps provide stability on the shoulders, helps protect the heart and lungs, and bears most of the weight of the rest of the upper body. The chest is home to the pectoralis (major and minor) and the serratus anterior muscles, providing mobility and compression to the chest. As the chest muscles protect the heart and lungs, the other muscles, known as the accessory muscles, aid the heart and lungs regarding respiratory and ventilation. In contrast, the primary chest muscles can not provide that function. The sternalis muscle is one accessory muscle that assists the heart and the lungs. Today’s article examines the sternalis muscle in the chest, how myofascial pain syndrome is associated with the sternalis muscle, and various techniques for managing myofascial pain syndrome on the sternalis muscle. We refer patients to certified providers specializing in chest pain therapies to aid many people suffering from myofascial pain syndrome associated with the sternalis muscle along the chest. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Sternalis Muscle In The Chest
Have you been experiencing respiratory issues that are affecting your chest? What about feeling muscle tightness in the middle of your chest? Or are you experiencing radiating pain traveling down your elbow? These symptoms are often associated with pain caused by trigger points along the chest affecting the sternalis muscle. Studies reveal that the sternalis muscle is an anatomical variant along the anterior thoracic region of the body. The sternalis muscle is located right in the middle of the chest and is toward the end of the pectoralis muscles. “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., explained that the sternalis muscle often occurs bilaterally or unilaterally in the body and may attach itself either in the pectoralis muscle or the sternocleidomastoid. The sternalis muscle could even become a continuation of these muscles as well.
One of the unique functions of the sternalis muscle for the body is that it is an accessory muscle. An accessory muscle refers to various muscles that assist the breathing muscles. Since the sternalis muscle assists the other muscles as an accessory muscle, this muscle help opens the airways to allow more oxygen to the lungs. This muscle is extremely useful when it comes to exercising the body. However, this muscle is superficial and can succumb to various issues that affect the chest and internal organs.
Myofascial Pain Syndrome Associated With The Sternalis Muscle
Since the sternalis muscle is superficial, many issues can affect the middle of the chest and invoke pain-like symptoms that overlap and develop myofascial pain syndrome or trigger points in the sternalis. The symptoms associated with myofascial pain syndrome affecting the sternalis muscle are intense, deep pain that can occasionally cause soreness in the sternum. Studies reveal that since the sternalis is an accessory muscle, it can be overlooked, and symptomatic incidences can affect the chest and surrounding organs. To that point, symptoms like muscular imbalances, overuse tendinopathies, or neural compression syndromes can cause the sternalis muscle to ache and activate trigger points. When active trigger points affect the sternalis muscle, it correlates with myocardial infarction or angina pectoris mimicking cardiovascular disorders. Myofascial pain syndrome is tricky to diagnose, but it is treatable with various techniques that can manage the pain.
Massage Techniques For The Sternalis Muscle-Video
Have you been experiencing pain in the middle of your chest? Are you experiencing symptoms of cardiovascular disorders? Or does your chest hurts when you’re coughing? Myofascial pain syndrome or trigger points affecting the sternalis muscle are associated with many symptoms. Myofascial pain syndrome is a condition that affects the musculoskeletal system by causing the affected muscles to be overused and causing referred pain. Studies reveal that issues like myofascial pain syndrome begin to affect the chest wall cavity of the body; many patients think they have a cardiac disease causing greater impairment in their daily activities, causing emotional stress and a higher level of anxiety. All is not lost, though, as there are various techniques to reduce the pain and other chronic symptoms while managing myofascial pain syndrome on the sternalis muscle. The video above explains the sternalis muscle and shows different approaches to stretching and massaging the sternalis muscle on the chest.
Various Techniques For Managing Myofascial Pain Syndrome On The Sternalis Muscle
When a doctor examines the sternalis muscle, many individuals will often complain about experiencing chest and heart pain since the muscle is located in the front-middle of the chest. However, all is not lost, as various techniques can help relieve the pain along the sternalis muscle while managing myofascial pain syndrome. As stated earlier, trigger points can mimic other chronic conditions that can affect not only the muscle itself but the surrounding organs. Gently stretching the chest can help reduce the aches in the surrounding muscles and trigger point formation. Another technique that many people can incorporate is ischemic compression on the sternalis muscle combined with moist heat. The ischemic compression allows a sense of discomfort, but no pain should be inflicted to reduce pain symptoms and manage myofascial pain syndrome.
Conclusion
The sternalis muscle is located in the middle of the chest and helps the surrounding muscles to breathe and expand. This muscle works together with the pectoralis and the sternocleidomastoid muscle by attaching itself to these muscles in a unilateral or bilateral muscle. When traumatic forces or events affect the chest, this superficial muscle can be affected and develop myofascial pain syndrome that mimics cardiovascular disorders. Fortunately, various techniques like gentle chest stretch and ischemic compression can help manage trigger points and reduce pain in the chest.
Raikos, Athanasios, et al. “Sternalis Muscle: An Underestimated Anterior Chest Wall Anatomical Variant.” Journal of Cardiothoracic Surgery, BioMed Central, 16 May 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3117696/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Verdon, François, et al. “Chest Wall Syndrome among Primary Care Patients: A Cohort Study.” BMC Family Practice, BioMed Central, 12 Sept. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC2072948/.
Diagnosing ankylosing spondylitis usually involves multiple tests. When doctors order blood tests to diagnose ankylosing spondylitis, an individual is experiencing worsening symptoms in their back and joints. Often, a blood test diagnosis means the doctor is looking for evidence of anything else that could be causing the symptoms. However, blood tests by themselves cannot definitively diagnose ankylosing spondylitis, but when combined with imaging and assessment, they can provide important clues that point to the answers.
Contents
Ankylosing Spondylitis Blood Test Diagnosis
Ankylosing spondylitis is arthritis that primarily affects the spine and hips. It can be difficult to diagnose as no single test can provide thorough information for a definitive diagnosis. A combination of diagnostic tests are utilized, including a physical exam, imaging, and blood tests. Doctors are not only looking for results that will point to ankylosing spondylitis, but they are looking for any results that might point away from the spondylitis results that might provide a different explanation for symptoms.
Physical Exam
The diagnostic process will begin with the individual’s medical history, family history, and physical exam. During the exam, the doctor will ask questions to help rule out other conditions:
How long have symptoms been presenting?
Do symptoms get better with rest or exercise?
Are the symptoms getting worse or staying the same?
Are the symptoms worse at a particular time of day?
The doctor will check for limitations in mobility and palpate tender areas. Many conditions can cause similar symptoms, so the doctor will check to see if the pain or lack of mobility is consistent with ankylosing spondylitis. The feature sign of ankylosing spondylitis is pain and stiffness in the sacroiliac joints. The sacroiliac joints are located in the lower back, where the base of the spine and pelvis meet. The doctor will look at other spinal conditions and symptoms:
Back pain symptoms caused by – injuries, posture patterns, and/or sleeping positions.
The HLA-B27 gene corresponds with ankylosing spondylitis; if an individual has it, one of their parents has it.
Imaging
X-rays often serve as the first step to a diagnosis.
As the disease progresses, new small bones form between the vertebrae, eventually fusing them.
X-rays work best at mapping the disease progression than the initial diagnosis.
An MRI provides clearer images in the early stages as smaller details are visible.
Blood Tests
Blood tests can help rule out other conditions and check for signs of inflammation, providing supportive evidence along with the results of imaging tests. It typically only takes about a day or two to get the results. The doctor may order one of the following blood tests:
Antinuclear antibodies, or ANA, go after the proteins in the cell’s nucleus, telling the body its cells are the enemy.
This activates an immune response that the body fights to eliminate.
A study determined that ANA is found in 19% of individuals suffering from ankylosing spondylitis and is higher in women than men.
Combined with other tests, the presence of ANA provides another clue to a diagnosis.
Gut Health
The gut microbiome plays an important role in triggering the development of ankylosing spondylitis and its treatment.
Tests to determine the gut’s health can give a doctor a complete picture of what is happening inside the body.
Blood test diagnoses for ankylosing spondylitis and other inflammatory conditions rely heavily on piecing together different tests alongside clinical exams and imaging.
Causes, Symptoms, Diagnosis, and Treatment
References
Cardoneanu, Anca, et al. “Characteristics of the intestinal microbiome in ankylosing spondylitis.” Experimental and therapeutic medicine vol. 22,1 (2021): 676. doi:10.3892/etm.2021.10108
Prohaska, E et al. “Antinukleäre Antikörper bei Spondylitis ankylosans (Morbus Bechterew)” [Antinuclear antibodies in ankylosing spondylitis (author’s transl)]. Wiener klinische Wochenschrift vol. 92,24 (1980): 876-9.
Sheehan, Nicholas J. “The ramifications of HLA-B27.” Journal of the Royal Society of Medicine vol. 97,1 (2004): 10-4. doi:10.1177/014107680409700102
Wenker KJ, Quint JM. Ankylosing Spondylitis. [Updated 2022 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK470173/
Xu, Yong-Yue, et al. “Role of the gut microbiome in ankylosing spondylitis: an analysis of studies in the literature.” Discovery medicine vol. 22,123 (2016): 361-370.
The chest has the pectoralis major muscle that works with the upper half of the body that provides mobility and power. The pectoralis major also surrounds the clavicle skeletal structure and works with the thoracic spine. The chest allows mobility to the arms and stability to the shoulders while working together with the shoulder and arm muscles. Many individuals utilize the upper body more when working out, lifting, or carrying objects from one place to another. This causes the muscle to become overused and succumb to injuries that can affect the functionality of the chest and invoke pain-like symptoms in the body. One of the chest muscles affected by pain is the pectoralis muscles, especially the pectoralis minor muscle. Today’s article looks at the pectoralis minor muscle, how myofascial pain affects the pectoralis minor, and how to manage myofascial pain associated with the pectoralis minor. We refer patients to certified providers specializing in chest pain therapies to aid many people suffering from trigger point pain affecting the minor muscles of the pectoralis. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Pectoralis Minor Muscle
Have you been experiencing pain in your upper-mid back? Do you feel like your chest is feeling compressed constantly? Do you feel the tension in your shoulders that makes it difficult to reach behind your back? Most of these symptoms are signs that many individuals are developing myofascial pain along the pectoralis muscles, especially the pectoralis minor. The pectoralis minor muscle is a thin triangular-shaped muscle below the pectoralis major. It has a crucial part of the chest as it helps stabilize the scapula (the shoulder blades) and is in front of the thoracic wall of the spine. The pectoralis minor is also part of the respiratory muscle group that works with the lungs. The pectoralis minor muscle has many functions for the shoulder blades, which include:
Stabilization
Depression
Abduction or Protraction
Internal Rotation
Downwards Rotation
When environmental factors begin to affect the lungs and cause respiratory issues in the body, the surrounding respiratory muscle group also gets involved, causing the body to be hunched over.
Myofascial Pain Affecting The Pectoralis Minor
When environmental factors begin to affect the lungs, it causes the respiratory muscles to contract and become compressed. This is just one of the many factors that can affect the pectoralis minor muscle. The other factor is that the pectoralis minor muscle may be short in the chest and when individuals try to reach behind their backs. This causes the pectoralis minor muscle to to be overstretched and develop myofascial pain or trigger points along the muscle fibers. The book, “Myofascial Pain and Dysfunction,” written by Dr. Travell, M.D., described the pain from myofascial pain associated with the pectoralis minor to be similar to cardiac pain. This is known as referred pain caused by myofascial pain syndrome and it can be a bit difficult to diagnose since it can mimic other chronic issues. Studies reveal that shortening or any sort of tightness of the pectoralis minor is one of the potential biomechanical mechanisms that is associated with an altered scapular alignment which causes pain and shoulder movement impairments. Overusing the pectoralis minor muscles creates tiny nodules that can affect the stability of the shoulders and causes upper-mid back problems in the thoracic region of the spine.
An Overview Of Trigger Points On The Pectoralis Minor- Video
Have you been experiencing difficulty inreaching behind your back? Do you feeling your body becoming more hunched over than usual? Or have you been experiencing chest pain constantly? These pain-like symptoms are caused by myofascial pain associated with the pectoralis minor muscle. The pectoralis minor muscle helps with the stability of the shoulders and studies reveal that when the presense of myofascial trigger points are linked to shoulder and upper body disorders, it can increase the risk of overlapping conditions that trigger points can mimic. Myofascial trigger points are a common complaint as it can significantly impact a person’s daily activites by causing the taut muscle band to be tender or hypersenitive. When this happens, it can lead to issues of muscle imbalance, weakness and impaired motor function. Thankfully, there are various techniques that can help reduce the pain symptoms and issues in the pectoralis minor muscle, while mananging the trigger points. The video above explainshow to tell when your chest muscles are tight and various tests to know when the pectoralis muscles (both the minor and major) are being affected by trigger points.
Managing Myofacial Pain Associated With Pectoralis Minor
When dealing with chest pains associated with myofascial pain along the pectoralis minor, there are many techniques they can incorporate to prevent myofascial pain from causing further damage to the muscle itself and the surrounding muscles. Various chest stretches can help gently loosen the stiff muscles, warm the pectoralis minor, and improve mobility to the chest and shoulders. Correct posture can help prevent the body from being hunched over constantly and let the surrounding muscles and the pectoralis minor relax. If the pain is unbearable, studies reveal that treatments like dry needling and palpations on the pectoralis minor muscles can help manage the pain caused by trigger points. This kind of treatment allows the muscle to release the trigger point and, combined with a hot or cold pack, can reduce the chances of myofascial pain from forming again in the muscle.
Conclusion
Underneath the pectoralis major muscle, the pectoralis minor is a thin triangular-shaped muscle that helps stabilize the shoulder blades and is located in the front of the thoracic wall of the spine. This tiny muscle is part of the respiratory muscles that have a causal relationship with the lungs and can succumb to environmental factors that can lead to the development of myofascial pain or trigger points on the pectoralis minor. Myofascial pain associated with the pectoralis minor muscle can mimic cardiovascular issues and invoke pain in the muscle. Fortunately, various treatments can help relieve and manage myofascial pain from re-occurring in the pectoralis minor.
References
Bagcier, Fatih, et al. “Three Simple Rules in Pectoral Muscle’s Trigger Point Treatment, Which May Be a Cause of Chest Pain: Position, Palpation, and Perpendicular Needling.” American Board of Family Medicine, American Board of Family Medicine, 1 Nov. 2020, www.jabfm.org/content/33/6/1031.long.
Baig, Mirza A, and Bruno Bordoni. “Anatomy, Shoulder and Upper Limb, Pectoral Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK545241/.
Morais, Nuno, and Joana Cruz. “The Pectoralis Minor Muscle and Shoulder Movement-Related Impairments and Pain: Rationale, Assessment and Management.” Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, U.S. National Library of Medicine, Jan. 2016, pubmed.ncbi.nlm.nih.gov/26530726/.
Ribeiro, Daniel Cury, et al. “The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature.” BMC Musculoskeletal Disorders, BioMed Central, 25 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6060458/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Back injuries from vehicle collisions vary from person to person. Common injuries may include strains, sprains, herniated discs, and fractures, and individuals dealing with certain spinal conditions like spinal stenosis may cause the medical condition to accelerate. Still, the force and physical impact the body absorbs during a crash, no matter how minor the accident or how safe the car is, will cause bodily aches and pains with the potential for other spinal conditions. Chiropractic care, massage, decompression, and traction therapy can relieve symptoms and restore mobility and function.
Contents
Back Injuries From Vehicle Collisions
Depending on how the impact affects the spine, problems can present in various areas of the back. The violent motion can sprain, strain, and fracture spinal components. Even minor incidents can impact mobility. Symptoms can stem from inflammation, compressed nerves, or fractures. Any damage can have long-lasting effects on the vertebrae, nerve roots, and back muscles. A vehicle collision can affect the following:
Lumbar vertebrae – lower back
Thoracic vertebrae – middle/upper back
Cervical vertebrae – neck
Each area consists of bones, tissues, muscles, nerves, tendons, and ligaments extending from the neck to the pelvis.
The most common back injuries are to the neck and lower back, where the most movement and shifting occurs, often causing nerve damage.
The central placement and rigid structure make middle back injuries less common.
Upper back injuries that connect the rib and chest region can affect breathing.
Soft tissue injuries might not show up immediately.
Symptoms
After a vehicle collision, it’s common to feel sore all over. The symptoms can range from manageable discomfort to complete immobility. Individuals may experience the following:
Muscle spasms
The muscle may repeatedly twitch, feel like hard knots, and feel tender to the touch.
Muscle spasms can vary in pain levels from mild to debilitating.
Stiffness
Individuals may not feel as flexible because of the muscle tension that activated during the crash to protect the body.
Stiffness can go away after light stretching or continue throughout the day.
Burning or Shooting Pain
A burning or shooting pain may travel down the back and buttocks through the back of one or both legs.
It can be mild, dull aches and pains that go away quickly or last for days.
Changing positions, such as sitting up after waking up or standing up after sitting, can cause sharp acute pain.
Certain physical activities can cause a throbbing sensation or mild pain when attempting to perform various tasks.
Tingling and/or Numbness
Tense muscles can pinch nerves leading to sensations of tingling or numbness in the legs, feet, arms, or hands.
Head Issues
Headaches, dizziness, or disorientation can present.
Spinal Disorders
Back injuries from vehicle collisions can result in a degenerative disc disorder months or years later. It can also speed up health issues individuals didn’t know they had before the crash. As the body ages, previous damage combined with degeneration can result in:
Micro-tears within the muscles and ligaments are common and cannot be found through a standard x-ray.
Spinal adjustments can bring the spine back into alignment, producing natural anti-inflammatory properties to assist with discomfort and heal the tears.
Scar Tissue Breakdown
Muscles can get scarred, causing stiffness and soreness.
Chiropractic massage targets these areas and breaks down the build-up quicker than if it was left to heal on its own.
Less scar tissue means faster recovery.
Range of Motion and Mobility Restored
Back injuries can result in restricted mobility.
It may be difficult to turn or move when the muscles are inflamed.
Mobilizing the spine through adjustments restores the proper range of motion.
Decreased Medication Use
Prescription pain medications can turn into dependency.
Chiropractic adjustments can ensure that the injury is healed and the pain is not just masked.
Long-Term Benefits
Receiving chiropractic care can help prevent minor injuries from worsening into serious and chronic conditions.
Post Whiplash Symptoms
References
Erbulut, Deniz U. “Biomechanics of neck injuries resulting from rear-end vehicle collisions.” Turkish neurosurgery vol. 24,4 (2014): 466-70. doi:10.5137/1019-5149.JTN.9218-13.1
National Spinal Cord Injury Statistical Center. (2020) “Spinal Cord Injury: Facts and Figures at a Glance.” www.nspine injurysc.uab.edu/Public/Facts%20and%20Figures%202020.pdf
Rao, Raj D et al. “Occupant and Crash Characteristics of Elderly Subjects With Thoracic and Lumbar Spine Injuries After Motor Vehicle Collisions.” Spine vol. 41,1 (2016): 32-8. doi:10.1097/BRS.0000000000001079
Rao, Raj D et al. “Occupant and crash characteristics in thoracic and lumbar spine injuries resulting from motor vehicle collisions.” The spine journal: official journal of the North American Spine Society vol. 14,10 (2014): 2355-65. doi:10.1016/j.spinee.2014.01.038
The chest in the upper half of the body comprises various structures that each have a job to keep the body functioning. The chest has different large muscles surrounding the ribcage and helps protect the vital organs that allow the host to breathe. The essential organs protected by the ribcage and the chest muscles include the heart and the lungs. These two organs aid the chest with blood circulation, breathing, and digestion to keep the body moving and functional. When injuries or chronic conditions begin to affect the chest, it can cause the muscles surrounding the ribcage to contract and tighten, causing the heart and lungs to work harder and causing various issues to affect the body. This can lead to chronic symptoms in the chest and affect a person’s life. Today’s article looks at the pectoralis major muscle in the chest, how trigger point pain is associated with chest pain, and how to manage trigger points in the chest. We refer patients to certified providers who specialize in chest pain therapies to aid many people suffering from trigger point pain affecting the pectoralis major muscles. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., takes note of this information as an educational service only. Disclaimer
The Pectoralis Major Muscles In The Chest
Have you been experiencing unexplainable chest pains that mimic heart issues? Do you feel muscle stiffness near your clavicle? Or do your chest muscles feel tenser and sorer than usual? Many of these issues affecting the chest could result from trigger points associating with the chest along the pectoralis major muscles. The pectoralis major is the superior and largest muscle in the chest wall’s front area. This muscle looks like a thick fan that surrounds the clavicle and works with the chest and arms to provide mobility and power to the upper body. Studies reveal that the pectoralis major muscle plays an important role in upper limb movements. To that point, it can help with the adduction and medial rotation of the arm, according to the book by Dr. Travell, M.D. “Myofascial Pain and Dysfunction,” the pectoralis muscle works with the rest of the chest muscles while being assisted by the teres major and minor muscles, the anterior and posterior deltoid muscles, the subscapularis muscles, and the tricep muscles. The pectoralis major muscles can also be affected by multiple issues affecting the chest and the rest of the upper half of the body.
Trigger Point Pain Associated With The Chest
When the pectoralis major muscles are affected by various issues, they can mimic other chronic conditions that are causing referred pain in different body areas. This is known as trigger point pain, and it can cause overlapping risk profiles on the pectoralis major muscles that can affect the chest. Trigger points are slightly difficult to diagnose as many factors, like repetitive motions or lifting heavy objects, can cause the affected muscles to develop tiny knots along the muscle fibers and cause pain-like symptoms. Many people with chest pains often complain that something is affecting their heart as they place their hands on their chest and gently rub the affected area. However, when their doctors examine them, the issue is not their hearts but their chest muscles. Studies reveal that trigger points affecting the affected muscle can mimic issues like cardiovascular dysfunction in the heart. To that point, active trigger points in the pectoralis major muscle can cause somato-visceral pain to the heart, mimicking cardiovascular issues like paroxysmal arrhythmia. It can also cause visceral-somatic pain where the heart suffers from cardiovascular problems affecting the pectoralis major muscles.
Trigger Point Therapy On The Pectoralis Major-Video
Have you been dealing with chest pains that cause you to hunch over? Does your chest seem to feel tight when you stretch? Or have your chest muscles feel tender to the touch? These pain symptoms are caused by trigger points affecting the pectoralis muscles. Trigger points are generated when a person overuses their muscles from daily activities or succumbs to muscle injuries that cause referred pain in different body areas. So trigger points affecting the pectoralis major muscle may cause chest pains. The video above explains the pectoralis muscles and where the trigger points are located that cause referred pain to the shoulders and the rest of the upper half of the body. Trigger points associated with the chest along the pectoralis major muscles can be treatable through various treatments and techniques that can reduce the symptoms and prevent trigger points from forming along the affected muscle in the future.
Ways To Manage Trigger Points On The Chest
When trigger points affect the pectoralis major muscles, they can invoke chest pain-like symptoms that resemble a cardiovascular disorder. Fortunately, pain specialists like chiropractors, massage therapists, and physiotherapists can utilize various techniques to help reduce the pain caused by trigger points. Studies reveal that when local and referred pain affects the pectoralis major muscle, multiple massage treatments targeting the trigger points can help alleviate the symptoms causing chest pains. Another way people can manage trigger points is by stretching the pectoralis major muscle to relieve tension and soreness in the chest. Incorporating various stretching techniques to alleviate chest pain can help loosen up the stiff muscles and warm them up before a vigorous workout. This allows the pectoralis muscles to provide optimal output on a person’s health and wellness.
Conclusion
The pectoralis major is a thick fan-shaped muscle located on the chest. This muscle works with the shoulders and upper half of the body while protecting the heart and the lungs from various injuries and chronic conditions. When these muscles become affected by injuries or chronic conditions, they can develop trigger points along the chest, causing referred pain to the pectoralis major muscles. This can lead to somato-visceral and visceral-somatic pain symptoms in the chest and make many individuals miserable. Luckily pain specialists who can help manage trigger points along the affected muscle utilize various techniques to reduce the symptoms and prevent trigger points from forming in the affected muscle again. This allows the individual to continue with their daily activities without worrying about chest pains.
References
Haładaj, Robert, et al. “Anatomical Variations of the Pectoralis Major Muscle: Notes on Their Impact on Pectoral Nerve Innervation Patterns and Discussion on Their Clinical Relevance.” BioMed Research International, Hindawi, 2 Apr. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6466946/.
Moraska, Albert F, et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.” American Journal of Physical Medicine & Rehabilitation, U.S. National Library of Medicine, Sept. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5561477/.
Simons, David G. “Cardiology and Myofascial Trigger Points: Janet G. Travell’s Contribution.” Texas Heart Institute Journal, U.S. National Library of Medicine, 2003, www.ncbi.nlm.nih.gov/pmc/articles/PMC152827/.
Solari, Francesca, and Bracken Burns. “Anatomy, Thorax, Pectoralis Major Major.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 26 July 2021, www.ncbi.nlm.nih.gov/books/NBK525991/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Nerves control muscle fibers. Muscle twitching is an involuntary contraction of the muscle fibers. When individuals play sports/work out vigorously or for a long time, they may experience muscle twitching and can often see and/or feel the twitches happening. The most worked-out muscles are likely to twitch, which includes the biceps, thighs, and calves, but twitches can occur in any muscle. Chiropractic care, massage therapy, and functional medicine can help relax the muscles, improve circulation, restore function, and train individuals to prevent future episodes.
Contents
Muscle Twitching
A muscle twitch often occurs after intense physical activity or a hard workout because the muscle or muscles have been overworked, and there is hyper-excitability of the nerve/s that makes the muscle/s continue to contract.
A muscle twitch that can be seen is called fasciculation.
A muscle twitch that cannot be seen is called fibrillation.
If there is pain or the twitching is prolonged, it is a muscle spasm.
Causes
The most common causes include the following:
Intense exercise and rigorous physical activity build up lactic acid in the muscles.
Dehydration is a very common factor for shaky muscles.
Vitamin D and calcium deficiencies could cause muscle spasms in the hand, calves, and eyelids.
Using caffeinated products to increase physical performance.
Not enough or a lack of healthy sleep.
Anxiety or stress.
Certain medications like estrogen and corticosteroids.
Nicotine and tobacco use.
Physical Activity/Exercise
Intense exercise and physical activity can cause muscle fatigue.
Muscle fatigue triggers twitching and cramping in overworked muscle fibers.
Electrolytes play a role in muscle contraction.
Electrolyte loss and imbalances within muscle fibers through sweating can lead to twitching.
Dehydration
Muscle mass comprises 75% water.
Water carries nutrients and minerals to muscles to support function.
Not being properly hydrated can cause twitching and cramping.
Vitamin D Deficiency
Nerves need vitamin D to relay messages to and from the brain to the body’s muscles.
A vitamin D deficiency can cause muscle weakness and twitching.
Lack of sleep can affect neurotransmitter function.
A common site of fasciculation tiredness occurs in the eyelids.
Anxiety and Stress
Experiencing psychological stress or high anxiety levels can cause excess muscle tension.
This can lead to muscle twitching.
Muscle fasciculation caused by stress can occur anywhere in the body.
Certain Medications
Certain medications can lead to involuntary muscle twitching.
The reaction can be a side effect due to interactions with other medications.
Individuals should discuss side effects and medication interactions with their doctor when taking a new medication.
Chiropractic Care
Chiropractors are experts on the musculoskeletal system and have many techniques to treat muscle fasciculation and spasms. It often depends on the cause/s, and specific treatment varies on a case-by-case basis. Common chiropractic treatments include:
Massage therapy
Heat and ice therapy
Manual manipulation
Joint adjustments
Ultrasound
Stretches to keep the muscles flexible
Exercises to strengthen the muscles
Nutritional recommendations
Fasciculation
References
Bergeron, Michael F.. Muscle Cramps during Exercise-Is It Fatigue or Electrolyte Deficit?. Current Sports Medicine Reports July 2008 – Volume 7 – Issue 4 – p S50-S55 doi: 10.1249/JSR.0b013e31817f476a
Gragossian A, Bashir K, Friede R. Hypomagnesemia. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK500003/
Küçükali, Cem Ismail, et al. “Peripheral nerve hyperexcitability syndromes.” Reviews in the neurosciences vol. 26,2 (2015): 239-51. doi:10.1515/revneuro-2014-0066
Maughan, Ronald J, and Susan M Shirreffs. “Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining.” Sports medicine (Auckland, N.Z.) vol. 49, Suppl 2 (2019): 115-124. doi:10.1007/s40279-019-01162-1
Miller, Kevin C et al. “Exercise-associated muscle cramps: causes, treatment, and prevention.” Sports health vol. 2,4 (2010): 279-83. doi:10.1177/1941738109357299
Riebl, Shaun K, and Brenda M Davy. “The Hydration Equation: Update on Water Balance and Cognitive Performance.” ACSM’s health & fitness journal vol. 17,6 (2013): 21-28. doi:10.1249/FIT.0b013e3182a9570f
Many people use their hands when going to work or doing normal things in their daily lives. The hands correlate with the five finger digits that provide grip strength when holding onto items in various sizes and weights that the hand muscles can handle. The hands have multiple muscles, tendons, and ligaments that travel past the wrist and forearms. These three components in the upper body have a casual relationship with the shoulders to provide stability and mobilization to the upper extremities. When the various muscles, tendons, and ligaments succumb to traumatic forces or injuries that cause pain to the forearms, wrists, and hands, it can develop myofascial pain syndrome or trigger points to generate overlapping risk profiles that mask other symptoms. Today’s article looks at the thumb muscles, how myofascial trigger pain affects the thumb, and how to prevent and manage the trigger thumb from occurring further in the hands. We refer patients to certified providers specializing in hand and wrist pain therapies to aid many people suffering from trigger thumb and fingers affecting their hands. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer
A Look At The Thumb Muscles
Have you been experiencing a strong decrease in your grip when holding something? What about hearing popping or snapping sounds when moving your fingers or thumb? Or have you experienced pain near your wrist or at the palm of your hands? When people are experiencing pain along their fingers, especially thumbs, it can develop into myofascial trigger pain along the thumb. As part of the hand, the thumb has muscles that provide movement and motor skills to make the thumb mobile. The two muscles: the adductor pollicis and the opponens pollicis, allow the thumb to move and touch each of the other finger digits. The adductor pollicis in the hand has deep, intricate, superimposed layers of muscles, tendons, and fascial compartments that work together to be versatile to the thumb. This muscle is triangular-shaped with a two-headed structure, and its main function is to adduct the thumb. This means that the adductor pollicis allows the thumb to move, touch the palm, and be close to the index finger. To that point, this muscle provides the thumb pinching and gripping movements.
The other muscle is known as the opponens pollicis, and this muscle helps provides small hand movements for the thumb by allowing it to touch the tips of each of the digits. The opponens pollicis muscle works together with the adductor pollicis muscle as it allows the hand to cup objects while also making the pinching grip possible for the hand. The oppponens pollicis muscle also works with the various muscles, nerves, and bones to be in sync in providing movement to the hands and provide mobility strength.
How Myofascial Trigger Pain Affects The Thumb
The adductor and oppenens pollicis muscles can provide gripping and pinching motions to the hands without causing pain; however, when the thumb muscle ligaments have been overused or been through trauma, they can develop into myofascial trigger pain along the thumb muscles, causing trigger thumb. Studies reveal that causes for the trigger thumb to form are repetitive gripping motions and overusing of the thumb muscle. This causes the flexor tendon sheath to narrow along the thumb joint and causes clicking or popping sensations when the thumb is trying to extend, thus leading to the development of myofascial trigger pain. According to the book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., when myofascial trigger pain begins to affect the hand’s functionality, it can make many individuals lose the pinching motion in their hands as they aren’t able to hold the object they are using. Even simple actions like pulling weeds in the garden can cause stress on the thumb and cause tenderness to the affected muscle.
An Overview Of Trigger Finger & Trigger Thumb-Video
Are you having difficulty holding items in your hands? Do you feel like your fingers are locking up constantly? Or does it hurt when you extend your thumb or fingers? If you have been experiencing these pain symptoms in your hands and fingers, it could be due to myofascial trigger pain associated with the thumb and fingers along the hands. Trigger fingers or trigger thumbs is a common ailment that affects the mobility function of the hands and can invoke pain in the affected joints causing them to lock up. The video above explains what trigger fingers and trigger thumbs, the symptoms and causes, and how to treat and manage the pain. When pain is associated with the hands and fingers, causing trigger points to form along the affected muscle, many individuals begin to feel hopeless when they aren’t able to hold items. Thankfully, there are various ways to manage trigger thumb and prevent pain from causing further damage.
How To Manage & Prevent Trigger Thumb
When trigger thumb begins to affect a person’s ability to grasp objects, it can cause them to feel miserable and can greatly affect their quality of life. All is not lost, as there are various ways to manage trigger thumbs and prevent future pain symptoms from continuously affecting a person’s mobility in their hands. Studies show that multiple treatments like splinting can help gain mobility back to the thumb and prevent the joint from locking up, causing pain. Other therapies like hand and wrist stretches can help loosen up the stiff tendons and muscles and even bring back mobility strength to the hands. Many doctors advise their patients to start using different hand and wrist exercises to relax the aching muscles and get circulation back to the hands. Another way to prevent the trigger thumb from affecting the hands is to do stretch exercises for the adductor and opponens pollicis muscles with heat to relax and loosen the stiff muscles while also restoring flexion and extension to the thumb.
Conclusion
The thumbs provide the functionality to the hands by allowing gripping and pinching motions when people pick up objects. The two muscles that provide this motion are the adductor and oppnens pollicis muscles. When traumatic forces begin to affect these two muscles in the thumb, it can develop a trigger thumb associated with pain. This causes the thumb to lock up and invoke pain when someone tries to extend their thumbs. Trigger thumbs occur when individuals overuse the thumb muscles and causes the grip strength to weaken. Luckily, available treatments can help restore mobility to the thumb and prevent it from locking up.
Reference
Acosta, Jonathan R, et al. “Anatomy, Shoulder and Upper Limb, Hand Adductor Pollicis.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK526059/.
Akhtar, Sohail, et al. “Management and Referral for Trigger Finger/Thumb.” BMJ (Clinical Research Ed.), BMJ Publishing Group Ltd., 2 July 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC558536/.
Nguyen, John D, and Hieu Duong. “Anatomy, Shoulder and Upper Limb, Hand Opponens Pollicis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK546603/.
Pencle, Fabio J, et al. “Trigger Thumb.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 July 2022, www.ncbi.nlm.nih.gov/books/NBK441854/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
The Adams forward bend test is a simple screening method that can help with scoliosis diagnosis and help in developing a treatment plan. The exam is named after the English physician William Adams. As part of an examination, a doctor or chiropractor will look for an abnormal side-to-side bend in the spine.
Contents
Scoliosis Diagnosis
The Adams forward-bend test can help determine if there are indicators for scoliosis.
It is not an official diagnosis, but the results can be used as a starting point.
The Adams test will reveal signs of scoliosis and/or other potential deformities like:
Uneven shoulders
Uneven hips
Lack of symmetry between the vertebrae or the shoulder blades.
The head does not line up with a rib hump or the pelvis.
Detection of Other Spinal Issues
The test can also be used to find spinal curvature issues and conditions like:
Kyphosis or hunchback, where the upper back is bent forward.
Scheuermann’s disease is a form of kyphosis where the thoracic vertebrae can grow unevenly during a growth spurt and cause the vertebrae to develop into a wedge-like shape.
The Adams test by itself is not enough to confirm scoliosis.
A standing X-ray with Cobb angle measurements above 10 degrees is required for diagnosing scoliosis.
The Cobb angle determines which vertebrae are tilted the most.
The higher the angle, the more severe the condition and the more probable it will produce symptoms.
Computed tomography or CT and magnetic resonance imaging or MRI scans can also be used.
Forward Bend Test
References
Glavaš, Josipa et al. “The role of school medicine in the early detection and management of adolescent idiopathic scoliosis.” Wiener klinische Wochenschrift, 1–9. 4 Oct. 2022, doi:10.1007/s00508-022-02092-1
Grossman, T W et al. “An evaluation of the Adams forward bend test and the scoliometer in a scoliosis school screening setting.” Journal of pediatric orthopedics vol. 15,4 (1995): 535-8. doi:10.1097/01241398-199507000-00025
Letts, M et al. “Computerized ultrasonic digitization in the measurement of spinal curvature.” Spine vol. 13,10 (1988): 1106-10. doi:10.1097/00007632-198810000-00009
Senkoylu, Alpaslan, et al. “A simple method for assessing rotational flexibility in adolescent idiopathic scoliosis: modified Adam’s forward bending test.” Spine deformity vol. 9,2 (2021): 333-339. doi:10.1007/s43390-020-00221-2
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