Musculoskeletal Illustrations

Years ago, I started creating my own illustrations. I wanted my manuals to display illustrations that struck a balance between simple and clear. After studying the work of other illustrators, I began to see the advantages and disadvantages of different styles (realistic, line drawings, photos, etc). However, I also found 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, the errors in those revered texts both discouraged and encouraged me.

HOI - supraspinatus

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. Applying this understanding, I made great progress addressing clients’ issue. Even those who 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 the anatomical relationships. Even those I had worked with for years.

Supraspinatus is a simple example.  Note that in this illustration,

  • The bone where it originates (scapula) is blue.
  • The bone where it inserts (humerus) is green.
  • The glenohumeral joint is the local joint.

HOI - scalenus posticus

The posterior scalene is a little more involved.

  • It originates on C4-C6.
  • It inserts on the second rib
  • C7-T2  are trapped 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 to comprehend how to release trigger points through local joint work. The implications of what to do and what order to treat become clearer by understanding which bones and joints are between the point of origin and the point of insertion.  This creates easier treatment, muscles that relax and contract more completely, and, thus, longer lasting results.

In this case, 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.

iliocostalis cervicis - string diagram

Here’s another example: a string diagram of iliocostalis cervicis. This illustration says a lot about the 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.

This is a lateral view of the splenii muscles. These muscles get overstretched triggering pain. We discuss this in Forward-Head Posture.

The illustration also shows why forward head posture stresses the C3, which is shown in tan as it is wedged between the attachments. Interestingly, The pain pattern associated with the multifidi trigger point at C3 is the most searched trigger point in this blog.

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 come more immediately to mind because of their positioning to the pain pattern.

I’ve chosen a simpler, less organic style and focused less on more subtle fascial attachments. In this way, I can highlight the relationships of muscles and joints.

Translucent illustrations show how one muscle fits and works in relationship to others. This illustration shows how gluteus medius, gluteus minimus and gluteus maximus all share a vector of pull that pushes the foot posterolateral.

This illustrations shows the layers of extrinsic chest muscles that depress the pecotoral girdle. This illustration is seldom seen but very helpful for the therapist who is looking to understand what may need to be adjusted in shoulders that are slumped or are high and tight.

I also love this view of the axial skeleton.

I’m always working on new views and perspectives that help bodyworkers. Your comments or suggestions are appreciated.

This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.

Weekly Featured Post

Pain relief that is
quicker and more effective
than traditional stretching.

This post covers the basics of Ice-and-Stretch, a tool that is used extensively in these posts combined with Active Isolated Stretching and Yoga poses.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.

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*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read, more accessible, and
to include more patterns with better self-care. In the meanwhile, there will be inconsistency in formatting, content, and readability until we get the old posts updated. Please excuse our mess.