Active trigger points in the splenius capitis may refer pain to the top of the head.
Active trigger points in the levator scapulae will refer pain over the top of the shoulder, down over the scapula, and down the medial border of the scapula.
Active trigger points in the multifidi may refer pain up to the base of the skull and down the back of the neckto the medial border of the scapula.
Three positions to work with:
Lateral Displacement (Egyptian movement) - best for suboccipital muscles.
Rotate away and flex toward point - good for upper trapezius.
Rotate toward and flex toward point - good for levator scapulae.
These are suggestions for finding the best position, but the best position will be any position in which they feel no pain. Once you find the best position, add compression by pressing the top of the head inferiorally. The points on the neck are being pressed with the middle finger. Hold for 30 - 90 seconds, or until you feel a release, then bring your client back to a neutral position while continuing to hold the trigger point, and ask your client how it feels.
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