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Pointer Plus

Pointer Plus

The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The Trapezius is a back muscle which connects the upper extremity to the spinal column.

Anatomical Attachments:

  • Origin: It attaches to the external occipital protuberance and the superior nucha line of the occiput via the ligamentum nuchae, which also attaches to the spinous processes of C7 and all the thoracic vertebrae.
  • Insertion: Attaches to the lateral 1/3 of the clavicle, medial margin of the acromion and into the posterior border of the spine of the scapula.

Action: It adducts, rotates, retracts and stabilizes the scapula. Draws back the acromion and when acting unilaterally, extends the head and neck while assisting in cranial rotation to the opposite side.

Synergist: Pectoralis major and minor, Subclavius, Serratus anterior, Latissimus dorsi, Rhomboid major and minor, Levator scapulae, and SCM.

Antagonist: Deltoid, Supraspinatus, Infraspinatus, Teres major and minor, Subscapularis.


Click for Muscle Test for Upper Portion  

Click for Muscle Test for Lower Portion 


Nerve Supply: Cervical Spinal Accessory Nerve (Cranial nerve XI, C3, C4).

Nerve Entrapment: Travell and Simons state that while the trapezius does not directly entrap, it can attribute to the entrapment on the semispinalis capitis when triggers in the cervical region exert an indirect shearing stress. They further note that SCM entrapment of the spinal accessory nerve may weaken the trapezius.

Vascular supply: Descending scapular artery.

Travell and Simons Trigger Point Pain Referral:  
Upper referral pattern Lower referral pattern

Click on a small image to view an enlarged image


Trigger Point Signs and Symptoms: Stiff neck, burning pain, localized pain and tenderness over the acromion, restriction of neck movement, headaches, upper back, shoulder and neck pain.

Trigger Point Activating and Perpetuating Factors: Trauma, acceleration/deceleration injury, talking on a telephone with the phone cradled on the shoulder for extended periods of time, pressure from tight bra straps, heavy backpack, prolonged bending.

Differential Diagnosis: Degenerative disc disease, (Segmental, Subluxation, Somatic dysfunction) C1 C2 C3 C4 C5 C6 C7 C8 T1 T2 T3 or T4 radiculopathy, Spasmodic torticollis (Wryneck syndrome), Cervical spondylosis, Intervertebral stenosis, Cerebrovascular Accident (CVA), Cerebral aneurysm, Pericarditis, Myocardial infarction, Angina, Pleurisy, Pulmonary carcinoma, Temporomandibular disorder, Fibromyalgia, Articular dysfunctions of the cervical spine, Thoracic outlet syndrome (Scalenus anticus – Costoclavicular), Tension headaches, Occipital neuralgia, Cervicogenic, vascular or histamine headaches, Concussion, Post Concussion Syndrome, Eye strain, Hypermobility of C4, Acceleration/Deceleration injury (whiplash), Stingers or burners, Shoulder separation, Glenohumeral separation, Sprain/Strain injury, Shoulder pointer, Adhesive capsulitis (Frozen shoulder), Charcot’s arthropathy, Bursitis, Osteoarthritis, Rheumatoid arthritis, Osteoporosis, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.


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