(BQ) Part 2 book “Dry needling for manual therapists” has contents: Muscles - Techniques and clinical implications; electroacupuncture, tendinopathy and tendon techniques. | Part IV NEEDLING TECHNIQUES Chapter 11 Muscles Techniques and Clinical Implications Supraspinatus Palpation: Sitting within the supraspinatus fossa, the supraspinatus runs along and underneath the acromion, attaching onto the greater tubercle of the humerus. Palpate the spine of the scapula as your landmark and move upwards into the fossa; the fibres of the supraspinatus run parallel to the spine. Pain referral pattern: The supraspinatus will primarily refer pain to the anterior portion of the shoulder and to the lateral epicondyle region; there are secondary referral sites in the posterior shoulder and upper arm. Needling technique: With the patient prone, palpate for areas of pain. The needle should be inserted near the supraspinatus fossa towards the bulk of the muscle with the direction in a longitudinal plane, aiming towards the greater tubercle of the humerus. Adaptations: The patient should ideally be prone or side lying. Needle length between 1 inch and inches. Clinical implications: This technique, whether used with the patient prone or side lying, will take the needle towards the front of the scapula, and expose the risk of passing into the intercostal space and towards the pleural cavity. The lung in a thin person lies –1 inch under the skin and there is the danger of pneumothorax if the needle is inserted too deeply. It is advised to use perpendicular needling techniques for areas close to the lungs, and in some cases it is also advised to grasp the muscle and pick it up to reduce the risks further. Figure Supraspinatus trigger points Infraspinatus Palpation: The infraspinatus sits within the infraspinatus fossa, with the bulk of the muscle being superficial to palpate; its insertion is on the greater tubercle of the humerus. Palpate the spine of the scapula as your landmark and move downwards into the infraspinatus fossa; the fibres run laterally towards the greater tubercle of the humerus and sit underneath the bulk of the .
