Trigger Point Therapy for Myofascial Pain (37 page)

Flexor digitorum longus

Flexor hallucis longus

Long flexors of the toes pain pattern

Causative or perpetuating factors:
Running on uneven ground, particularly in footwear that does not provide adequate support in the sole or the heel; walking or running on soft sand or on crowned surfaces; wearing shoes that are insufficiently flexible.

Satellite trigger points
: Tibialis posterior, extensor digitorum longus, extensor digitorum brevis.

Affected organ system:
Genitourinary system.

Associated zones, meridians, and points:
Dorsal zone; Foot Tai Yang Bladder meridian; BL 56–59.

Stretch exercise:
Sitting with the legs extended in front of you, reach forward, placing the palms of the hands on the plantar surface of the toes. Slowly pull the toes and feet into dorsiflexion. Hold this position for a count of fifteen to twenty.

Strengthening exercise:

1. Using only the toes, grasp a small object such as a marble or pencil.
   
2. Place a towel on the floor and, using only the toes, try to grasp the towel. Repeat several times.
   

Stretch exercise: Long flexors of the toes

APPENDIX 1

M
ERIDIAN
P
ATHWAYS

According to the Oriental conception, the body is imbued with an intricate, weblike system of pathways that connect upper and lower aspects of the body as well as connecting superficial regions with internal organ systems. These pathways, or meridians, are connected to one another as well as to a specific organ or system. The often far-reaching effects of acupuncture or acupressure are attributed to the interconnectedness of this system of pathways.

The following basic information on meridian pathways and pairings is included for those who are unfamiliar with rudimentary Oriental anatomy. The interested reader can refer to the following texts to broaden his knowledge in this area:

The Foundations of Chinese Medicine
by Giovanni Maciocia (London: Churchill Livingstone, 1989)

Chinese Acupuncture and Moxibustion
edited by Cheng Xinnong (Beijing: Foreign Language Press, 1987)

The Manual of Acupuncture
by Peter Deadman and Maxin Al-Khafaji with Kevin Baker (East Sussex, England: Journal of Chinese Medicine Publications, 1998)

Meridian name:
Hand Tai Yin Lung

Hand/foot pairing:
Foot Tai Yin Spleen

Yin/Yang pairing:
Hand Yang Ming Colon

Organs through which the meridian passes in its internal pathway:
Lung, colon

Muscles traversed by the meridian:
Pectoralis major, pectoralis minor, anterior deltoid, biceps brachii, brachialis, brachioradialis, pronator teres, muscles of the thenar eminence

Meridian name:
Hand Yang Ming Colon

Hand/foot pairing:
Foot Yang Ming Stomach

Yin/Yang pairing:
Hand Tai Yin Lung

Organs through which the meridian passes in its internal pathway:
Colon, lung

Muscles traversed by the meridian:
Extensor pollicis longus, extensor pollicis brevis, extensor carpi radialis longus, extensor digitorum, supinator longus, brachioradialis, triceps brachii, deltoid, supraspinatus, trapezius, sternocleidomastoid, scalenes, orbicularis oris

Meridian name:
Foot Yang Ming Stomach

Hand/Foot pairing:
Hand Yang Ming Colon

Yin/Yang pairing:
Foot Tai Yin Spleen

Organs through which the meridian passes in its internal pathway:
Stomach, spleen, large intestine

Muscles traversed by the meridian:
Orbicularis oculi, zygomaticus major, orbicularis oris, masseter, temporalis, sternocleidomastoid, pectoralis major, rectus abdominis, external oblique, internal oblique, transversus abdominis, rectus femoris, vastus lateralis, tibialis anterior, extensor digitorum longus

Meridian name:
Foot Tai Yin Spleen

Hand/foot pairing:
Hand Tai Yin Lung

Yin/Yang pairing:
Foot Yang Ming Stomach

Organs through which the meridian passes in its internal pathway:
Spleen, stomach, heart

Muscles traversed by the meridian:
Extensor hallucis, flexor hallucis brevis, adductor hallucis, tibialis anterior, soleus, gastrocnemius, rectus femoris, sartorius, vastus medialis, adductor longus, adductor brevis, pectineus, iliopsoas, external oblique, internal oblique, transversus abdominis, pectoralis major, pectoralis minor, serratus anterior

Meridian name:
Hand Shao Yin Heart

Hand/foot pairing:
Foot Shao Yin Kidney

Yin/Yang pairing:
Hand Tai Yang Small Intestine

Organs through which the meridian passes in its internal pathway:
Heart, small intestine, lung

Muscles traversed by the meridian:
Biceps brachii, triceps brachii, pronator teres, palmaris longus, forearm flexors, flexor carpi ulnaris

Meridian name:
Hand Tai Yang Small Intestine

Hand/foot pairing:
Foot Tai Yang Bladder

Yin/Yang pairing:
Hand Shao Yin Heart

Organs through which the meridian passes in its internal pathway:
Small intestine, stomach, heart

Muscles traversed by the meridian:
Extensor digiti minimi, extensor digitorum, triceps brachii, latissimus dorsi, teres major, infraspinatus, teres minor, posterior deltoid, trapezius, supraspinatus, levator scapulae, scalenes, sternocleidomastoid, masseter, zygomaticus major, temporalis

Meridian name:
Foot Tai Yang Bladder

Hand/foot pairing:
Hand Tai Yang Small Intestine

Yin/Yang pairing:
Foot Shao Yin Kidney

Organs through which the meridian passes in its internal pathway:
Bladder, kidney

Muscles traversed by the meridian:
Orbicularis oculi, frontalis, occipitalis, splenius capitis, splenius cervicis, semispinalis capitis, semispinalis cervicis, trapezius, levator scapulae, rhomboids, latissimus dorsi, quadratus lumborum, erector spinae group, gluteus maximus, gluteus medius, gluteus minimus, piriformis, semimembranosus, semitendinosus, biceps femoris, soleus, gastrocnemius, tibialis posterior, peroneus brevis, peroneus longus

Meridian name:
Foot Shao Yin Kidney

Hand/foot pairing:
Hand Shao Yin Heart

Yin/Yang pairing:
Foot Tai Yang Bladder

Organs through which the meridian passes in its internal pathway:
Bladder, kidney, liver, lung, heart

Muscles traversed by the meridian:
Adductor hallucis, flexor digitorum brevis, flexor digitorum longus, tibialis posterior, soleus, gastrocnemius, gracilis, semitendinosus, semimembranosus, sartorius, adductor magnus, iliopsoas, quadratus lumborum, lower abdominals, rectus abdominis, pectoralis major

Meridian name:
Hand Jue Yin Pericardium (Heart Constrictor)

Hand/foot pairing:
Foot Jue Yin Liver

Yin/Yang pairing:
Hand Shao Yang Triple Warmer

Organs through which the meridian passes in its internal pathway:
Upper, middle, and lower burners

Muscles traversed by the meridian:
Pectoralis major, brachialis, biceps brachii, flexor carpi radialis, palmaris longus

Meridian name:
Hand Shao Yang Triple Warmer

Hand/foot pairing:
Foot Shao Yang Gall Bladder

Yin/Yang pairing:
Hand Jue Yin Pericardium (Heart Constrictor)

Organs through which the meridian passes in its internal pathway:
Upper, middle, and lower warmers; bladder

Muscles traversed by the meridian:
Extensor digitorum, triceps brachii, deltoid, infraspinatus, supraspinatus, trapezius, sternocleidomastoid, temporalis, orbicularis oculi

Meridian name:
Foot Shao Yang Gall Bladder

Hand/foot pairing:
Hand Shao Yang Triple Warmer

Yin/Yang pairing:
Foot Jue Yin Liver

Organs through which the meridian passes in its internal pathway:
Gallbladder, liver

Muscles traversed by the meridian:
Orbicularis oculi, temporalis, epicranius, occipitalis, sternocleidomastoid, levator scapulae, trapezius, deltoid, pectoralis major, serratus anterior, external oblique, internal oblique, transversus abdominis, quadratus lumborum, iliopsoas, gluteus minimis, gluteus medius, gluteus maximus, tensor fasciae latae, iliotibial band, vastus lateralis, tibialis anterior, soleus, peroneus brevis, peroneus longus, tibialis posterior, extensor digitorum

Meridian name:
Foot Jue Yin Liver

Hand/foot pairing:
Hand Jue Yin Pericardium

Yin/Yang pairing:
Foot Shao Yang Gall Bladder

Organs through which the meridian passes in its internal pathway:
Gallbladder, liver, lungs

Muscles traversed by the meridian:
Extensor hallucis longus, extensor hallucis brevis, tibialis anterior, soleus, gastrocnemius, sartorius, gracilis, vastus medialis, adductor magnus, adductor longus, adductor brevis, pectineus, iliopsoas, external oblique, internal oblique, transversus abdominis