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TOP 30
Manual Trigger Point Therapy
and Dry Needling
W
Top 30 Muscles
The present book is a textbook and thus an integral component of the Top 30
Course of the David G Simons Academy™. It is not for sale in book trade.
The depicted techniques of dry needling describe the supericial application of dry
needling. The regions of the body on which intramuscular dry needling can be used
will be taught in the practical part of the David G Simons Academy™ course.
The techniques in this textbook may be executed only by trained professionals.
Improper application can lead to disability or to death. The authors of this
textbook decline any liability arising from the use of this textbook.
Authors: Fernando Colla, MD; Christian Gröbli, PT; Ricky Weissmann, PT.
Illustrations: All anatomy igures and referred pain patterns are from David G.
Simons, MD, Janet G. Travell, MD & Lois Statham Simons «Myofascial Pain &
Dysfunction – The Trigger Point Manual», Volume 1, Copyright 1999, and
Janet G. Travell, MD & David G. Simons «Myofascial Pain & Dysfunction –
The Trigger Point Manual», Volume 2, Copyright 1992, with permission of the
publisher Lippincott Williams & Wilkins.
All other illustrations are produced by the authors.
© 2010 by Myopoint AG, Switzerland
Please send correspondence to: David G. Simons Academy ™,
Merkurstrasse 12, 8400 Winterthur, Switzerland, www.dgs.eu.com
4
Top 30
David G. Simons Academy
TM
Contents
5 Introduction
6 Terminology
7 Aetiology of MTrPs
8 Diagnosis of MTrPs
9 Indications for Manual Trigger Point Therapy
& Dry Needling
10 Contraindications for Manual Trigger Point Therapy
11 Contraindications for Dry Needling
12 Complications of Manual Trigger Point Therapy
13 Complications of Dry Needling
15 Hygiene
16
52
Sternocleidomastoid Muscle
22
Subscapularis Muscle
58
Temporalis Muscle
28
Teres Major Muscle
80
Tibialis Posterior Muscle
44
Trapezius Muscle – Lower Part
42
Trapezius Muscle – Upper and Middle Part
30
Triceps Brachii Muscle
74
Vastus Lateralis Muscle
72
Vastus Medialis Muscle
Manual Trigger Point Therapy
17
Dry Needling
18
Materials for Dry Needling
19
Checklist for Dry Needling
40
Adductor Pollicis Muscle
32
Anconeus Muscle
36
Brachioradialis Muscle
26
Deltoid Muscle
34
Extensor Carpi Radialis Longus Muscle
38
Extensor Digitorum Muscle
76
Gastrocnemius Muscle
62
Gluteus Medius and Gluteus Minimus Muscle
68
Iliopsoas Muscle
20
Infraspinatus Muscle
60
Lateral Pterygoid Muscle
50
Levator Scapulae Muscle
54
Longissimus and Iliocostalis Muscles
56
Masseter Muscle
70
Pectineus Muscle
24
Pectoralis Major Muscle
66
Quadratus Lumborum Muscle
46
Rhomboideus Muscle
48
Scalene Muscles
78
Soleus Muscle
Introduction
Top 30 Muscles
The choice of the Top30 muscles is the result of a
survey among 14 triggerpoint and dry needling
instructors from around the world. They were
asked which are the most common treated muscles
in your practice for speciic pain syndromes. Depen-
ding on different patient populations the Top30
may vary. With the Top30 muscles in this course
you will be able to help a large majority of your
patients.
Needles used in MTrP-Dry Needling have a diame-
ter of approximately 160–300 μm, which would
cause very small focal lesions without any signii-
cant risk of scar tissue formation. In comparison,
the diameter of human muscle ibers ranges from
10–100 μm. It is important to emphasize that we do
not practice acupuncture during our dry needling
courses. The only similarity between acupuncture
and dry needling is the actual needle. Clinicians
practicing dry needling should inform their patients
that they do not practice acupuncture.
Manual Trigger Point Therapy
The art of Trigger Point Therapy is to focus on the
smallest changes within the soft tissue, without
loosing the view for the big picture of the patient’s
current diagnosis. Trigger Point Therapists are
expert in functional anatomy and differential dia-
gnostic by palpation of the neuro-musculo-skeletal
system. The manual techniques described in this
workbook are mainly based on the knowledge of
David G. Simons and Janet Travell. Another impor-
tant source for the techniques described in this
course are the works from Beat Dejung.
While manual trigger point therapy and dry need-
ling are very effective approaches in the treatment
of myofascial pain, it does not necessarily stand
alone and might often be integrated into a com-
prehensive treatment plan of patients with chronic
and acute pain.
Janet Travell &
David G. Simons (1996)
Dry Needling
The Dry Needling technique we teach is based on
the clinical experience of many clinicians such as
Peter Baldry, Chun Gunn, Karel Lewit and others.
The result of trigger point injections are not depen-
dent on the injectable, but rather on the accuracy
with which a needle is placed into a myofascial
trigger point (MTrP).
The use of syringes for dry needling may cause
unnecessary pain and injury. Instead, dry needling
is performed with solid acupuncture needles.
Acupuncture needles cause limited tissue damage.
5
Top 30
David G. Simons Academy
TM
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