title: Myofascial trigger points and innervation zone locations in upper trapezius muscles.
abstract: BACKGROUND
  Myofascial trigger points (MTrPs) are hyperirritable spots located in taut bands of muscle fibres. Electrophysiological studies indicate that abnormal electrical activity is detectable near MTrPs. This phenomenon has been described as endplate noise and it has been purported to be associated MTrP pathophysiology. Thus, it is suggested that MTrPs will be overlap the innervation zone (IZ). The purpose of this work was to describe the location of MTrPs and the IZ in the right upper trapezius.
  
  
  METHODS
  We screened 71 individuals and eventually enrolled 24 subjects with neck pain and active MTrPs and 24 neck pain-free subjects with latent MTrPs. Surface electromyography (sEMG) signals were detected using an electrode matrix during isometric contraction of the upper trapezius. A physiotherapist subsequently examined the subject's trapezius to confirm the presence of MTrPs and establish their location. IZ locations were identified by visual analysis of sEMG signals. IZ and MTrPs locations were described using an anatomical coordinate system (ACS), with the skin area covered by the matrix divided into four quadrants.
  
  
  RESULTS
  No significant difference was observed between active and latent MTrPs locations (P = 0.6). Forty-five MTrPs were in the third quadrant of the ACS, and 3 were included in second quadrant. IZs were located approximately midway between the seventh cervical vertebrae and the acromial angle in a limited area in the second and third quadrants. The mean distance between MTrP and IZ was 10.4 ± 5.8 mm.
  
  
  CONCLUSIONS
  According to the acquired results, we conclude that IZ and MTrPs are located in well-defined areas in upper trapezius muscle. Moreover, MTrPs in upper trapezius are proximally located to the IZ but not overlapped.
authors.affiliation: Department of Health Sciences, University of Applied Sciences and Arts of Southern Switzerland, SUPSI, Manno, Switzerland. marco.barbero@supsi.ch
authors.forename: Marco
authors.initials: M
authors.lastname: Barbero
authors.forename: Corrado
authors.initials: C
authors.lastname: Cescon
authors.forename: Andrea
authors.initials: A
authors.lastname: Tettamanti
authors.forename: Vittorio
authors.initials: V
authors.lastname: Leggero
authors.forename: Fiona
authors.initials: F
authors.lastname: Macmillan
authors.forename: Fiona
authors.initials: F
authors.lastname: Coutts
authors.forename: Roberto
authors.initials: R
authors.lastname: Gatti
mesh_terms: D004576:Electromyography; D006801:Humans; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000294:innervation*; D009209:Myofascial Pain Syndromes / Q000473:pathology* / Q000503:physiopathology; D019547:Neck Pain / Q000473:pathology* / Q000503:physiopathology; D061028:Trigger Points / Q000473:pathology* / Q000503:physiopathology