Table Of ContentAdvanced Manual Techniques Using
TRIGGER-& ACCUPRESSURE POINTS
For Immediate Relief of
MUSCULAR PAIN, TENSION, & DYSFUNCTION
VOLUME I
UPPER EXTREMITIES
BY
TORBJORN M. HANSON, A.c., MANUAL THERAPIST
© T. HANSON 2012
TORBJORN HANSON, A.c.
Kinesiologist & Muscle Therapist
Torbjorn has 28 years of clinical experience in manual therapy for pain or
dysfunction in muscles, tendons, ligaments and joints. He holds a degree
from Sweden in Acupuncture and Physio Therapy, and has specialized in
Trigger Point Therapy, Acupressure, Kinesiology and Sports Medicine. For
5 years he wrote a column and answered reader questions on sports injuries
in B&K Sports Magazine, Scandinavia’s largest fitness publication.
In 1994 Torbjorn founded Sports Performance Therapy Center, with a vision
to bring together diversified therapies that would get patients Better, Faster.
This state of the art physical therapy clinic is located inside Club Sport of
Pleasanton, 184,000 square foot athletic club.
He is also the founder of POSTU-Rx, a computer software program
developed to prescribe custom made exercises, to stretch short muscles, and
to strengthen elongated muscles. This program brings a new concept to
sports medicine.
His extensive work with professional and recreational athletes has led to the
development of HandsOn Muscle Therapy. A cutting edge approach to
Injury Rehabilitation and Prevention as well as Performance Enhancement.
Torjorn has been teaching his techniques to therapists and physicians
throughout Europe. His hands-on work is followed by a long record of
success and gives instant relief and functional improvement in muscles/joint
pain syndrome and sports injuries. His unique use of manual muscle testing
provides feedback that assures specific therapy for each individual and every
injury.
HansOn Muscle Therapy
H.M.T. is an advanced manual technique using trigger and acupressure points for
immediate relief of muscular pain, tension and dysfunction.
H.M.T. is a diversified system that integrates Feedback from postural evaluation, range
of motion assessment and specific muscle testing to pinpoint areas of myofascial tension.
Muscular Imbalance
Sprains, strains or micro tearing due to overuse or trauma of certain muscles leads to an
accumulation of tension, i.e. muscle shortening and adhesions.
Anytime there is muscle shortening, and subsequent muscle lengthening of the
antagonistic muscles, there is a MUSCULAR IMBALANCE. In other words, the
body is out of ALIGNMENT.
The core theory in H.M.T. is that muscular imbalance is the cause of injuries and decreased
performance.
Muscle shortening causes:
Decreased range of motion
Postural imbalances
Change joint positions with decreased joint space
Decreased vascular circulation
Inhibition of lymphatic drainage
Decreased strength
Friction, pressure, compression and excessive pulling over time leads to dysfunction,
inflammation and pain. This pain is caused by soft tissue damage or nerve entrapment and
ultimately leads to neuropathy, joint pathology and joint degeneration.
Reading Body Feedback
H.M.T. uses postural and range of motion assessments together with manual testing of individual
muscles, the recognition of referred pain patterns, and acupressure meridian distribution to
determine primary muscles with the most accumulated tension.
1
Circuit Breakers
Accumulation of tension in muscles, fascia and tendons manifest as hypersensitive myofascial
reflex points know as trigger points or acupressure points. Those reflex points act as circuit
breakers and when overloaded with excessive tension can give rise to local or referred pain.
Trigger or acupressure points are activated directly by acute overload, overwork, fatigue or direct
trauma to the muscle they are located in. Those reflex points can also be activated indirectly by
other reflex points, visceral disease, joint dysfunction, or emotional distress. Once a reflex point
is activated, repeated muscular stress of a lesser degree can activate pain in the reference zone,
especially when the muscle becomes fatigued.
Research shows that a change in electrical resistance (3) and temperature (4) can be measured at
the dermal location of a reflex point. This can be confirmed with ohm meters and thermograms.
“Getting to the Point”
There are approximately 700 acupressure points on the human body and all skeletal muscles can
develop multiple trigger points. The acupressure points have definite anatomical locations while
the trigger point locations are not fixed.
The proper point to select for therapy is not always located at the site of pain, but rather at the
site of maximal accumulated tension. Due to the number of points possibly related too an injury,
the therapeutic skill lies in the ability to select the right point(s) for each specific injury.
H.M.T. teaches the relationship between different reflex points, referred pain patterns and
acupuncture meridian distribution.
H.M.T. utilizes patient muscle feedback by the unique use of indicator muscle testing in how to
select the primary point(s) for each individual condition. This muscle feedback takes away
the “guesswork” or the “hit or miss” approach in the selection of appropriate reflex points for a
specific condition.
Re-setting The Circuit/Releasing the Tension
Once a primary reflex point has been localized, it should be released of its excessive tension with
deep friction massage. Deep intermittent digital pressure to a reflex point in a specific direction
causes a form of “depolarization”. Digital pressure on a primary reflex point will elicit local
and/or referred pain. Complete release of tension with digital pressure to a reflex point will cause
all elicit pain to completely disappear.
2
Proper release of tension in a reflex point will immediately abolish readings of changed electrical
resistance. Inactivation of the reflex point allows associated muscle(s) to return to proper tone
and hence restore muscular balance.
Releasing tension to acupressure or trigger points in shortened muscles is very effective in
reducing joint pressure and restoring range of motion. Lasting results will be achieved in
eliminating local or referred pain caused by muscle shortening. This also improves vascularity
and lymphatic drainage which stimulates the body’s natural self-curative abilities.
Due to somatovisceral effects, a release of a hypersensitive myofascial reflex point can improve
tension related visceral ailments and provide emotional release.
Some theories suggest that digital pressure applied to acupressure points may also stimulate the
nervous system to release neuro-hormones (such as endorphins). Research has documented that
this is the case with acupressure (5). This would explain the analgesic effect often experienced
with the release of an acupressure point. The analgesic effect is generally short lasting in cases of
joint or nerve pathology. In other cases however, endorphin release may break the pain cycle and
promote lasting or permanent relief.
References:
(1) Travell J. Bigelow NH: Referred somatic pain does not follow a simple “segmental”
pattern. Fed Proc 5:106, 1046.
(2) Travell J. & Simons D: Myofascial pain and dysfunction. The trigger point manual,
upper extremities. Vol. 1, pg. 15, 1983.
(3) Sola AE and Williams RL: Myofascial pain syndromes. Neurol 6:91-95, 1956.
(4) Fisher AA: Thermography and pain. Arch Phys Med Rehabil 62:542, 1981.
(5) Mayer FJ, Price DD, Barber J, et al: Acupuncture analgesia: Evidence for activation
of pain inhibitory system as a mechanism of action. In advances in pain research and
therapy, edited by J.J. Bonica, D. Albe-fessard, Vol 1 Raven press, New York 1976
(pp. 751-754).
3
Objective #1
A) Find and relieve muscular tension
B) Immediate pain relief
C) Restore normal range of motion, posture and strength.
Muscular tension will cause muscular imbalance with uneven wear and tear
to muscles, tendons and ligaments thus causing tissue damage with pain and
inflammation.
Muscular tension will cause a blockage of circulation with a relative oxygen
deprivation as well as inhibited drainage of lymphatic waste products thus
becoming the cause of muscle contraction, spasm, inflammation, pain and
swelling.
Excessive muscle tension can trap and pinch nerves thereby causing
radiating pain patterns and neuropathy.
Muscular tension results in muscular imbalance with altered posture. This
misalignment will alter joint position and space, thus causing joint pathology
and eventual joint degeneration.
Muscular tension results in muscular imbalance with inhibited range of
motion, decreased function, strength and endurance.
4
Objective #2
A) Find the underlying cause of muscular tension
B) Educate to prevent recurrence of symptoms
Physical cause:
Direct trauma
- Impact
- Sudden uncontrolled body movement
= Immediate tissue damage and tension.
Microtrauma
- Repetitive movement patterns
- Improper movement patterns
- Poor posture
- Poor sleeping position
- Improper pedal foundation
= Accumulative structural stress causing tension and eventual tissue damage.
Mental / Emotional cause:
- ongoing mental / emotional stress
- past unresolved mental / emotional stress
= Accumulative emotional stress causing chronic muscular tension and
eventual tissue damage.
Nutritional / Chemical cause:
- Nutritional deficiencies
- Dehydration
- Toxic conditions
= Lymphatic congestion and muscular tension
Environmental cause:
- Allergies
= Lymphatic congestion with muscular tension.
5
Hanson Muscle Therapy
HMT
Synopsis
Posture and Range of motion evaluation is used together
with manual testing of individual muscles and recognition
of referred pain patterns to localize muscles with
accumulated tension.
Indicator muscle testing is used as feedback to pinpoint
the exact location of active trigger points and acupoints in
muscles with accumulated tension.
Digital intermittent friction massage is used to relieve
tension and inactivate those points.
HansOn Muscle Therapy will:
A) Relieve pain and tension immediately.
B) Restore muscular balance and joint integrity.
C) Improve vascularity and lymphatic drainage to
injured tissue which will initiate healing.
6
How to LOCALIZE MUSCLES with
ACCUMULATED TENSION
Evaluate posture of pain area
Use form A:1-3 for Anterior, Posterior and Lateral view Posture Evaluation.
Reference; “Postu-Rx Manual for Muscle Imbalance” or DVD to establish
standard for normal posture. Each postural imbalance indicates which muscles are
tense / shortened or elongated.
Evaluate range of motion of the joints proximal to the pain
area.
Use form B:1 for the upper extremities, form B:2 for lower extremities and spine to
establish standard for normal range of motion.
Reference; “Postu-Rx Manual for Muscular Imbalance” or DVD to establish
standards for normal range of motion. Each range of motion imbalance indicates
which muscles are tens / shortened or elongated.
Perform manual muscle testing of muscles in pain area
Use form C:1, for testing upper extremity muscles #1-35 or form C:2 for lower
extremity and spine muscles #36-72. Each muscle will test either normal,
hypotonic/weak/elongated, or hypertonic/tense/shortened.
Reference; HMT Manual Muscle Testing manual I (upper extremity, muscles # 1-
35), and II (lower extremity and spine, muscles #36-72).
“Muscle Testing and Function” by Kendall or “Applied Kinesiology, Synopsis” by
Walther, can also be used.
Ask the Patient where the pain is felt and fill in the
appropriate pain zones
Use form D:1, For the patient to indicate pain patterns on anterior, posterior or
lateral illustration.
7
How to prioritize which muscle to treat first
Postural Evaluation, Range of Motion Assessment, Manual Muscle Testing, Referred Pain
Patterns and Acu-Meridians is what determines which muscles have an accumulation of
tension and harbor active trigger points or AcuPoints. Use the Priority sheet (Form E) to
determine which muscle(s) are indicated the most.
Example I:
A patient presents with a right shoulder promlem.
Postural Exam:
Anterior view show a medially rotated right arm. See exam form A-1 on page #11
This indicares that the muscles that medially rotate the arms are relatively shorter (more
contracted) than the muscies that laterally rotate the arms. This also indicates that the
muscles that laterally rotate the arms are relatively elongated compared to the muscles
that medially rotate the arms.
Shortened muscles Elongated muscles
Medial rotators of arm Lateral rotators of arm
#8 Pectoralis Major Clavicular #16 Infraspinatus
#9 Pectoralis Major Sternal #17 Teres Minor
#10 Latissimus Dorsi #20 Deltoid Posterior
#12 Teres Major
#14 Subscapularis
#18 Deltoid Anterior
Posterior view shows and elevated right scapula. See exam form A-2 on page #12
This indicates that the muscles that elevate the scapula are shortened and the muscles that
depress the scapula are elongated
Shortened muscles Elongated muscles
#1 Trapezius Upper #3 Trapezius Lower
#5 Levator Scapulae (#10 Latissimus Dorsi)
#6 Rhomboids
#7 Pectoralis Minor
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Description:HansOn Muscle Therapy. H.M.T. is an advanced manual technique using trigger and acupressure points for immediate relief of muscular pain, tension
