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6

The Myofascial Examination

Rick Wall 1,2

1 Animal Clinics of The Woodlands, The Woodlands, TX, USA
2 Center for Veterinary Pain Management and Rehabilitation, The Woodlands, TX, USA

6.1 Introduction

Myofascial pain syndrome (MPS) is defined as muscle, sensory, motor, and autonomic nervous
system symptoms caused by stimulation of myofascial trigger points (MTPs; Stecco et al. 2013).
Because many definitions exist for MPS, so as to avoid confusion, within this chapter, the defini-
tion of MPS will be used to describe a form of myalgia that is characterized by the presence of
MTPs. MPS is a common cause of pain and disability in people (Weller et al. 2018) and lameness
associated with canine MPS has been reported by several authors (Janssens 1991, 1992; Frank
1999; Wall 2014). Yet, identification and treatment of MPS is not commonly performed in veteri-
nary practice.
A simple definition of myofascial examination would be examination of muscles for pain and
dysfunction. More specifically it could be defined as the examination of skeletal muscle to identify
MTPs. The goal of this chapter is to provide the current status of knowledge and an introduction
to the myofascial examination.

6.2 Characteristics of Myofascial Trigger Points

In human healthcare, MTPs are defined as discrete, focal, hyperirritable spots located in a taut
band of skeletal muscle (Alvarez and Rockwell 2002). These spots are painful when pressed and
have been associated with referred pain, motor dysfunction, and autonomic phenomena. As such,
MTPs have been described to have three major characteristics: sensory, motor, and autonomic.
The sensory component includes local pain, referred pain, as well as both peripheral and central
sensitization. The muscle pain or myalgia associated with MTPs is described in people as diffuse
and is difficult to localize with defined referred pain patterns. A common referred pain pattern
found in people is pain down the back of the thigh and calf from MTPs in the caudal portion of the
deep gluteal muscle.
The motor component includes the development of the taut band within the muscle, a local
twitch response, and muscle weakness:

Canine Lameness, First Edition. Edited by Felix Michael Duerr.
© 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
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