Tender Point
Location
On posterior aspect of ascending ramus of mandible at
the level of earlobe
AC2-6
On anterolateral aspect of corresponding anterior
tubercle of transverse process
AC7
On posterior-superior surface of clavicle at the
clavicular attachment of SCM
AC8
On medial head of clavicle at sternal attachment of
SCM
Anterior Cervical Region
AC1
Treatment
RA
F SA RA
F ST RA
F SA RA
Posterior Cervical Region
Tender Point
Location
PC1 Inion
On inferior nuchal line, just lateral to inion
PC1 lateral (occiput)
Just below nuchal line midway between inion &
mastoid, associated with semispinalis capitis and
obliquus capitis superior
PC2 lateral (occiput)
On inferior nuchal line within the semispinalis capitis
muscle associated with greater occipital nerve
PC2 midline
Superior lateral surface of C2 spinous process
PC3 midline
Inferior/inferolateral aspect/tip of C2 spinous process
PC4-8 midline
Inferior/inferolateral aspect of spinous process (ie. PC4
inferior to C3 spinous process)
PC3-7 lateral
On posterior lateral aspect of articular process
Anterior Thoracic Region
Tender Point
Location
Treatment
F
E Sa Ra
E Sa Ra
E Sa Ra
F Sa Ra
E Sa Ra
E Sa Ra
Treatment
AT1 midline
AT2-6 midline
AT7-9 B/L
AT10-12 B/L
On episternal notch, midline or just lateral
On sternum at level of corresponding rib
AT7: distance tip of xiphoid and umbilicus
AT8: between tip of xiphoid and umbilicus
AT9: distance tip of xiphoid and umbilicus
AT10: distance umbilicus and pubic symphysis
AT11: between umbilicus and pubic symphysis
AT12: top of iliac crest at midaxillary line
Posterior Thoracic Region
Tender Point
Location
PT1-12 midline
Midline, on inferior aspect of spinous process
PT1-12 posterior
On inferolateral aspect of deviated spinous process
PT1-12 TP
On lateral aspect of transverse process
Anterior Costal Region
Tender Point
Location
F
F
F St RA
F St Ra
Treatment
e-E
e-E SA RA
e-E SA RT
Treatment
AR1
AR2
AR3-6
Below clavicle at first chondrosternal articulation
On superior aspect of 2nd rib at MCL
On dysfunctional rib at anterior axillary line
Posterior Costal Region
Tender Point
PR1
PR2-6
Location
On posterior-superior aspect of rib 1 just lateral to
costotransverse articulation
On posterior-superior angle of corresponding rib
Anterior Lumbar Region
Tender Point
Location
AL1
Medial to ASIS
AL2
Medial to AIIS
AL3
Lateral to AIIS
AL4
Inferior to AIIS
AL5
Anterior, superior aspect of pubic ramus just lateral to
symphysis
Anterior Pelvic Region
Tender Point
Location
f-F St RT
f-F St RT
f-F ST RT
Treatment
E SA Rt
f SA RA
Treatment
F ST RA
F SA RT
F SA RT
F SA RT
F SA RA
Treatment
Psoas
Iliacus
Low ilium
Inguinal
2/3 distance from ASIS to midline, pressing deep in
posterior direction
distance from ASIS to midline, pressing deep in
posterior-lateral direction
Superior surface of iliopubic eminence associated with
attachment of psoas minor
Medial aspect of inguinal ligament near pubic tubercle
in association with attachment of pectineus
Posterior Lumbar Region
Tender Point
Location
PL1-5 SP
On inferolateral aspect/tip of deviated spinous process
PL1-3 TP
On lateral aspect of transverse process
Quadratus Lumborum
On inferior aspect of 12th rib
On lateral tips of lumbar transverse process
On superior aspect of iliac crest
Posterior Pelvic Region
Tender Point
Location
F ST
F ER
F
F ADD IR
Treatment
e-E St Ra
e-E ST RA
E Abd ER
Treatment
Upper Pole L5
High ilium sacroiliac
Lower Pole L5
High ilium flare out
Gluteus medius PL3,
PL4
Piriformis
Sacral Region
Tender Point
PS1 B/L
Superior medial surface of PSIS
2-3cm lateral to PSIS, pressing medially toward PSIS
On ilium just inferior to PSIS, pressing superiorly
Lateral aspect of ILA and/or lateral aspect of coccyx
Upper outer portion of gluteus medius at level of PSIS
PL3: 2/3 lateral from PSIS to TFL
PL4: posterior margin of TFL
Midpoint between lower half and lateral aspect of
sacrum and ILA and greater trochanter
E add IR/ER
E Ab ER
F IR add
E Add
E er abd
Location
Medial to PSIS at level of S1
Treatment
Apply P-A pressure
on opposite ILA
2: apply P-A
pressure midline to
apex of sacrum
3: F or E
4: apply P-A
pressure midline to
base of sacrum
Apply P-A pressure
on opposite sacral
base
PS2, PS3, PS4
midline
Midline on sacrum at corresponding sacral level
PS5 B/L
Just medial and superior to ILA
Lower Extremities
Tender Point
Location
F Abd IR/ER
Treatment
TFL
Lateral trochanter
IT band
Lateral hamstring
Biceps femoris
Lateral meniscus
LCL
Medial hamstring
Semimembranosus
Semitendinosus
Medial meniscus
MCL
ACL
Inferior to crest of ilium in body of TFL
Along IT band distal to greater trochanter
f Abd
F Abd
In posterior thigh lateral to midline, approximately
halfway down shaft of femur
Lateral aspect of meniscus on joint line
F ER Abd
In posterior thigh medial to midline approximately
halfway down shaft of femur
F IR Add
Anteromedial aspect of meniscus on joint line
F IR Add
Superior aspect of popliteal fossa on hamstring tendon
PCL
In center/slightly below center of popliteal fossa
Popliteus
In belly of popliteus muscle, just inferior to popliteal
space
Extension ankle
gastrocnemius
Within proximal gastrocnemius muscles distal to
popliteal margin
Medial ankle tibialis
anterior
Inferior to medial malleolus along deltoid ligament
Lateral ankle fibularis
or peroneus longus,
brevus, tertius
Inferior and anterior to lateral malleolus in
talocalcaneal sulcus
Flexion calcaneous
Quadratus plantae
Anterior aspect of calcaneus on plantar surface of foot
as attachment of plantar fascia
Place pillow under
distal femur to
create fulcrum,
apply shearing force
by moving proximal
tibia posteriorly on
femur
Place pillow under
distal femur to
create fulcrum,
apply shearing force
by moving distal
femur posteriorly on
proximal tibia
Slight flexion of knee
with internal rotation
of tibia
Marked plantar
flexion of ankle with
knee flexion
Place fulcrum on
medial aspect of
ankle, apply
inversion force with
slight shear
Place fulcrum on
lateral aspect of
ankle, apply
eversion force with
slight shear
Marked flexion of
forefoot
approximating the
forefoot to the
calcaneus
Upper Extremities
Tender Point
Location
F Ab/ER
Treatment
Supraspinatus
Infraspinatus
Levator scapulae
Subscapularis
Long head of biceps
Short head of biceps
Corachobrachialis
Pectoralis minor
In belly of supraspinatus muscle
Upper: inferior and lateral to spine of scapula at
posterior medial aspect of GH join
Lower: in lower portion of muscle inferior to spine and
lateral to medial border of scapula
On superior medial border of scapula at attachment of
levator scapula
At anterolateral border of scapula on subscapularis
muscle, pressing from anterior-lateral to
posteromedial direction
Over biceps tendon in bicipital groove
At inferolateral aspect of coracoid process
Inferior and medial to coracoid process
Radial head lateral
On anterolateral aspect of radial head at attachment
of supinator
Medial epicondyle
On medial epicondyle of humerus at common flexor
tendon and attachment of pronator teres
On dorsal surface of 2nd metacarpal in extensor carpi
radialis
On dorsal surface of 5th metacarpal in extensor carpi
ulnaris
At palmar base of 2nd/3rd metacarpal in flexor carpi
radialis
At palmar base of 5th metacarpal in flexor carpi ulnaris
Dorsal wrist
Palmar wrist
F Abd ER
F IR Abd
Glide scapula
superiorly and
medially to shorten
muscle; could also
internally rotate
shoulder with
traction and slight
abduction
E IR
F Abd IR
F Add IR
Adduction of arm;
protract scapula
Elbow in full
extension, forearm
marked supination
and slight valgus
force
F Pronate Add
E Ab
E Add
F Ab
F Add
