I recently started adding some new illustrations of muscles into my blog posts.
Years ago, started illustrating because I wanted to support my manuals with illustrations that struck a balance between simple and clear. I studied lots of illustrations and began to see the advantages and disadvantages of different styles; realistic, line drawings, photos, etc. I saw that even very respected illustrators like Frank Netter of the Color Atlas of Human Anatomy or B.D. Cummings from Myofascial Pain and Dysfunction, The Trigger Point Manual, had errors. Somehow, that both discouraged and encouraged me.
As I worked, I realized that trigger points could be activated and de-activated by the nerve endings in joints. More than that, the specific way that the joint was displaced determined which trigger points were activated in the muscles that crossed that joint. Using this understanding, I made great progress in cases where the client had already seen many other practitioners without success.
So, I started illustrating musculoskeletal anatomy in a way that focused on the local joints of those muscles. I put them on a slide show in my treatment room. I would glance up from my work and have epiphanies about anatomical relationships that I had worked with for years.
Supraspinatus is a simple example.
- The bone where it originates (scapula) is blue.
- The bone where it inserts (humerus) is green.
- The glenohumeral joint is the local joint.
The posterior scalene is a little more involved.
- It originates on C4-C6.
- It inserts on the second rib
- C7-T2 are between the bones of origin & insertion
- The intervertebral joints from C4-T2 and the costovertebral joint of T2 are local joints.
It is interesting that the scalene is difficult to release with lasting effect without releasing the displaced rib at C2, which proprioceptively governs the scalene trigger points.
This simple color coding of bones makes it easy for the bodyworker that releases trigger points through local joint work. The implications of what to do and what order to treat become clearer by understanding the bones and joints that are between the point of origin and insertion. This creates easier treatment, muscles that relax and contract more completely, and longer lasting results.
It is interesting to see how many muscles wedge the lower cervicals between their origin and insertion. It made my checklist for faster, longer lasting treatment more effective.
Here’s a string diagram of iliocostalis cervicis. It says a lot about its contribution to pain between the shoulder blades and in the base of the neck.
By the way, because of the attachment of ribs on the sternum, other ribs could be considered in the joints between the origin and insertion. Unless they are the only joints between origin and insertion (like levator scapula) I don’t highlight those tertiary joints created by the rib cage. I don’t find them to be relative in joint work for that muscle and they can make the illustration very confusing.
Here’s an illustration of semispinalis capitis. Look how broadly it is attached to the lower cervicals and thoracics. It, along with other muscles in this area, skip the upper cervicals, extend the neck and wedge the atlas forward, a key factor in forward head posture.
Looking for what may be compressing the base of the neck? This illustration of semispinalis cervicis is very interesting and not often considered as other muscles are more obvious because of their pain pattern.
There are so many interesting relationships that are revealed in these illustrations. I’ve already put too many words in this blog and will talk about those more in the posts about each muscle.
Tony Preston has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.
He has a practice in Atlanta, Georgia where he sees clients.