<p>Pain PatternsPage Abdominal Muscles 942, 944, 945 Abdominis Obliqui and Transversus 942 Abductor Digiti Minimi 787 Adductor Pollicis 775 Anconeus 670 Anterior Neck Muscles 398 BicepsBrachii 649 Brachialis 661 Brachioradialis 693 Buccinator 418 Coracobrachialis 639 Deltoid 624 Diaphragm 863, 864 Digastric 398 Extensor Carpi Radialis and Extensor Carpi Ulnaris 692 Extensor Digitorum 715 Extensor Indicis 715 Facial Muscles 417, 418 Finger Extensors 715 Flexores Carpi Radialis and Ulnaris 756 Flexores Digitorum Superficialis and Profundus 756 Flexor Pollicis Longus 757 Frontalis 428 Hand and Finger Flexors 756,757 Hand Extensors 692 Iliocostalis Thoracis and Lumborum 915 Infraspinatus 553 Intercostal Muscles 863 Interossei of the Hand 787 Lateral Pterygoid 380 Latissimus Dorsi 573 Levator Scapulae 493 Longissimus Capitis 446 Longissimus Thoracis 904 Masseter 331 Medial Pterygoid 366 Multifidi Obliqui Capitis Superior and Inferior Occipitalis Occipitofrontalis Opponens Pollicis Orbicularis Oculi Palmaris Longus Pectoralis Major Pectoralis Minor Platysma Posterior Cervicals Pronator Teres Pyramidalis Rectus Abdominis Recti Capitis Posteriores Major and Minor Rotatores Rhomboid Major and Minor Scaleni Semispinalis Capitis and Cervicis Serratus Anterior Serratus Posterior Inferior Serratus Posterior Superior Splenius Capitis and Splenius Cervicis Sternalis Sternocleidomastoid Subclavius Suboccipital Muscles Subscapularis Supinator Supraspinatus Temporalis Teres Major Teres Minor Thoracolumbar Paraspinals Trapezius 279, Triceps Brachii Zygomaticus Major Page 917 473 428 428 775 417 744 820,822 845 417 447 757 945 944 473 917 614 506 447 888 909 901 433 858 310 823 473 598 729 539 351 588 565 915,917 280, 281 668, 669 417</p><p>HEAD AND NECK PAIN-AND-MUSCLE GUIDE CHAPTER 5</p><p>UPPER BACK, SHOULDER AND ARM PAIN-AND-MUSCLE GUIDE CHAPTER 18</p><p>FOREARM AND HAND PAIN-AND-MUSCLE GUIDE CHAPTER 33</p><p>TORSO PAIN-AND-MUSCLE GUIDE CHAPTER 14Pictorial index. The muscles that are likely to refer pain to an illustrated region of the body are listed in the Pain-and-muscle Guide to the corresponding Part of the Manual. A Guide is found at the beginning of each Part, which is marked by red thumb tabs.</p><p>Travell & Simons'</p><p>Myofascial Pain and Dysfunction:The Trigger Point ManualVOLUME 1. Upper Half of BodySecond Edition</p><p>Travell & Simons'</p><p>Myofascial Pain and Dysfunction:The Trigger Point Manual</p><p>VOLUME 1. Upper Half of BodySecond Edition</p><p>DAVID G. SIMONS, M.D., FAAPM&R, M.S., DSC (HON.)Clinical Emory Atlanta, Clinical Professor, Georgia Professor of Physical Medicine Irvine and Rehabilitation Rehabilitation Medicine University School of Medicine</p><p>Department</p><p>University of California, Formerly Clinical Electromyography Rehabilitation Long Beach, Veterans Affairs Chief and</p><p>Electrodiagnosis Service Center</p><p>Section</p><p>Medicine Medical California</p><p>JANET G. TRAVELL, M.D.Consultant, Myofascial Pain and Dysfunction</p><p>t</p><p>LOIS S. SIMONS, M.S., P.T. Illustrations by Barbara D. Cummingswith contributions by Diane Abeloff and Jason Lee</p><p>Williams &: WilkinsA U'AVKKLY ( O M P A N Y BALTIMORE PHILADELPHIA LONDON PARIS BANGKOK BUKNOS AIKI-.S HOW. KOW, < MUNICH SVHNHV I'OKYO WROCLAW</p><p>Dr. Janet Travell's genius and medical insight identified in the first edition the clinical picture of individual myofascial pain syndromes and many perpetuating factors. In addition, we were most fortunate to have had the benefit of her advice in preparing some of this edition. She emphasized the importance of including a new chapter that covers the respiratory muscles and supplied unique pearls of clinical wisdom that sprinkle this revision.t</p><p>Editor: Eric Johnson Managing Editor: Linda Napora Project Editor: Jeffrey S. Myers Marketing Manager: Chris Cushner Copyright 1 9 9 9 Williams & Wilkins 351 West Camden Street Baltimore, Maryland 2 1 2 0 1 - 2 4 3 6 USA Rose Tree Corporate Center 1 4 0 0 North Providence Road Building II, Suite 5 0 2 5 Media, Pennsylvania 1 9 0 6 3 - 2 0 4 3 USA All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner. The publisher is not responsible (as a matter of product liability, negligence or otherwise) for any injury resulting from any material contained herein. This publication contains information relating to general principles of medical care which should not be construed as specific instructions for individual patients. Manufacturers' product information and package inserts should be reviewed for current information, including contraindications, dosages and precautions. Printed in the United States of America First Edition, 1 9 8 3 Library of Congress Cataloging-in-Publication Data Simons, David G. Travell & Simons' myofascial pain and dysfunction : the trigger point manual / David G. Simons, Janet G. Travell. Lois S. Simons ; illustrations by Barbara D. Cummings, with contributions by Diane Abeloff and Jason Lee. 2nd ed. p. cm. Rev. ed. of: Myofascial pain and dysfunction / Janet G. Travell, David G. Simons. c l 9 8 3 - c l 9 9 2 . Includes bibliographical references and index. Contents: v. 1. Upper half of body. ISBN 0-683-08363-5 (v. 1) 1. Myofascial pain syndromesHandbooks, manuals, etc. I. Travell, Janet G, 1 9 0 1 . II. Simons, Lois S. III. Travell, Janet G., 1 9 0 1 - Myofascial pain and dysfunction. IV. Title. [DNLM: 1. Myofascial Pain Syndromes. WE 5 0 0 S 6 1 1 t 1998] RC925.5.T7 1998 616.7'4dc21 DNLM/DLC for Library of Congress 98-36642 CIP The publishers have made every effort to trace the copyright holders for borrowed material. If they have inadvertently overlooked any, they will be pleased to make the necessary arrangements at the first opportunity. To purchase additional copies of this book, call our customer service department at (800) 638-0672 or fax orders to (800) 4 4 7 - 8 4 3 8 . For other book services, including chapter reprints and large quantity sales, ask for the Special Sales department. Canadian customers should call (800) 6 6 5 - 1 1 4 8 , or fax (800) 6 6 5 - 0 1 0 3 . For all other calls originating outside of the United States, please call (410) 5 2 8 - 4 2 2 3 or fax us at (410) 5 2 8 - 8 5 5 0 . Visit Williams & Wilkins on the Internet, http://www.wwilkins.com or contact our customer service department at [email protected]. Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST, Monday through Friday, for telephone access. 99 00 01 02 03 1 2 3 4 5 6 7 8 9 10</p><p>This Volume is dedicated to Janet G. Travell, M.D. 1901 - 1997 To whom we all owe a great debt of gratitude for her inspirational pioneering of this field and for heading us in the right direction.</p><p>Foreword</p><p>In my 1992 Foreword to the now-famous mate, Volume 2, of the Trigger Point Manual Volume 1,1 boldly opined that Volume 2 was '.. even better than the other [Vol.1] because it reflects an enormous new recharging of energy that further experience, interaction, and thought have stimulated.. This new volume,' I went on to say, 'has the distinction of going beyond those areas [emphasized in the first edition of Volume 1] to discuss rationale, new principles arising from a ground-swell of experience, and the unique place of myofascial pain syndrome in the spectrum of musculoskeletal disorders.' 'Myofascial trigger points and their significance in painful conditions are no longer the rather controversial subject they were before Volume 1 appeared, nor are the treatment methods taught by Drs. Travell and Simons. These are firmly established and are increasingly being validated by once skeptical clinical investigators ..[Volume 2] goes beyond and opens up new ground in sensitizing clinicians to the important interfaces between myofascial pain syndromes and articular (somatic) dysfunctions on the one hand and fibromyalgia on the other hand. I applaud the wise manner in which these issues are addressed, assessed, and integrated.' How can this scribbler do any better than that eulogy to summarize his opinion of the macho younger mate of Volume 1 when the latter now produces an offspring that outshines both its parents? My scanning of the manuscript before its birth per-</p><p>mits me to predict a magnificent success. This is a gargantuan publishing effort that would have done Rabelais credit. But this Gargantua is not fantasy; it is hard-headed facts and a wise explication of many current ideas and new findings. The new edition clarifies for me the overlap of confusing similar conditions that must be distinguished. It illuminates improved testing methods and clearly puts others into their place, often outside. The authors are forthright and precise in the diagnostic criteria for an active trigger point for general clinical use as a '.. circumscribed spot tenderness in a nodule of a palpable taut band and patient recognition of the pain evoked by pressure on the tender spot as being familiar.' The thorough discussion of the nature of trigger points and their electrodiagnostic characteristics is very valuable and timely, as is the coverage of the histogenesis of trigger points. Updating and expansion throughout the volume now make the two volumes together one of the most impressive medical publishing efforts of modern times. Truly it becomes a tour de force. I am proud to be its 'godfather.'</p><p>John V. Basmajian, O.C., O. Ont, MD, FRCPC, FRCPS (Glasg] FACA, FAADMR, FSBM, FABMR, FAFRM-RACP (Australia), Hon Dip (St L C)Professor Hamilton, Emeritus, Ontario, McMaster Canada University</p><p>vii</p><p>At present, the only way to make a definite diagnosis of a trigger point is by physical examination. This figure emphasizes the fact that the ESSENTIAL first step is to learn how to recognize by palpation the nodule and taut band that are characteristic of a trigger point.</p><p>Each muscle has individual characteristics which the examiner needs to learn. When active trigger points in any muscle fail to respond to treatment, with few exceptions one or more perpetuating factors need to be identified and resolved.</p><p>Preface</p><p>The passing of Janet Travell, M.D., on 1 August 1997 at the age of 95 marked the end of the era when she gave life to the concept of myofascial trigger points (TrPs) and nurtured it through childhood. Others must now lead the concept through adolescence to maturity. As a memorial and tribute to Dr Travell's unique contribution, the following selection is quoted from the preface of the first edition of this volume: 'Dr. Travell describes in detail her introduction to myofascial trigger points in her autobiography, Office Hours: Day and Night. Although she was brought up on the unitary concept of disease that all of the patient's symptoms should be explained by one diagnosis, she soon learned that life is not like that. The man who has both heart disease and pulmonary tuberculosis may suddenly die of cancer of the lung. Patient complaints that originate in the musculoskeletal system usually have multiple causes responsible for the total picture. 'Early in her medical career, Dr. Travell served simultaneously on pulmonary, cardiology, and general medical services. On all the services, the major complaint she encountered among the patients was pain. The patient might be dying of a serious illness, but when asked, 'How are you?' would answer, 'Well, ok, except I have this terrible pain in my shoulder. I can't sleep. I can't lie on that side.' When asked the cause of the pain, the resident on the pulmonary service would say that it was reflex from the lung. On the cardiology service, in another hospital, patients had the same complaint of shoulder pain, but the resident explained the pain as reflex from the heart, of course. In the general medical clinic, a secretary who spent all day typing and pulling heavy file drawers would describe precisely the same pain complaint; but its origin was said to be 'psychoso-</p><p>matic.' In none of these patients did the doctors find objective evidence of disease to account for the patient's pain, but the skeletal muscles had not been examined. When Dr. Travell examined these patients, all three groups had isolated tender spots in muscles which, when compressed, reproduced the patient's pain in the shoulder, arm or chest. The common ailment was an unrecognized myofascial trigger point syndrome. 'Fortunately, these observations were made in an environment rich in experimental expertise. She regularly taught pharmacology to medical students whom, to answer their questions, she inspired to perform the appropriate experiments for themselves in the laboratory. The inquisitive students and faculty at the Cornell University Medical College helped Dr. Travell formulate her investigation of the nature of trigger points and how they function. 'She herself was inspired by the interchange of ideas and the criticism of leaders in basic and clinical research at the New York Hospital, Cornell Medical College Center. Foremost among these were Drs. Harry Gold, McKeen Cattell, Vincent du Vigneaud, Ephraim Shorr, Harold G. Wolff, Eugene F. Dubois, and the renowned neurologist, Frank Fremont-Smith, Director of the Josiah Macy Foundation. During the many years of their association, she was especially indebted to her cardiologist collaborator, Seymour H. Rinzler. 'The successful care rendered Senator Kennedy five years prior to his election as President led Dr. Travell to the position of White House Physician under Presidents John F. Kennedy and Lyndon B. Johnson. Except for that one short detour, she never strayed from her primary focus on the diagnosis and management of myofascial pain syndromes due to trigger points.' ix</p><p>x</p><p>Preface Previously no distinction was drawn between trigger points located in the middle portion of the muscle belly (central TrPs) and those located in a region of muscle attachment (attachment TrPs). The tenderness of each depends on different pathophysiological processes with significant therapeutic implications that have yet to be adequately explored. In the first edition, an attempt was made to document what we knew about myofascial TrPs, almost all of which was based on clinical observations. There is now the beginning of a peer-reviewed body of literature with blinded, controlled studies that are scientifically credible. Many more are urgently needed. Such studies of the effectiveness of TrP treatment by skilled clinicians should contribute greatly to a more widespread recognition of the importance of myofascial TrPs as a major source of musculoskeletal pain. To facilitate this transition, the present edition now calls attention to specific clinical conditions worthy of investigation (see 'Research Opportunities' in the Index). CHANGES IN THIS EDITION This edition incorporates a number of changes applicable to most chapter..</p>
![Travell Travell](/uploads/1/2/6/0/126041870/940662455.jpg)
Travell And Simons Pdf
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Travell And Simons Trigger Point
Travell & Simons' Myofascial Pain and Dysfunction: Upper half of body David G. Simons, Janet G. Travell, Lois S. Keygen torrent cs5. Simons Lippincott Williams & Wilkins, 1999 - Medical - 1038 pages. Fuyu ga owaru mae ni rar.