Page 116 - Canine Lameness

88 6 The Myofascial Examination

(A) (C)

(B) (D)

Figure 6.1 Palpation techniques for myofascial examination. Palpation is performed initially while the
patient is (A, C) standing but examination of the muscle in the relaxed state requires palpation in (B, D)
lateral recumbency. (A, B) Pincer palpation is used for muscles that are distant from an underlying firm
structure. (C, D) Flat palpation is used for muscles that can be compressed against a firm underlying
structure (e.g. bone).

Palpation of an MTP in the canine can result in a pain response (such as vocalization and/or with-
drawal) as pressure is applied. Therefore, when performing the myofascial examination, the use of
an assistant to provide gentle patient restraint is recommended. With experience, palpation tech-
niques to locate MTPs require less pressure and produce minimal to no patient response.

6.5 Myofascial Pain Syndrome Patterns Associated with Lameness

MTPs are categorized as “active” MTP and “latent (passive)” MTP (Shah and Gilliams 2008). Active
MTPs spontaneously produce pain whereas latent MTPs only produce pain when examined by
palpation. However, with the exception of pain, all other MTP characteristics are shared by active
and latent MTPs. This is of clinical importance since latent trigger points also cause muscle short-
ening and the other above‐described changes and thereby affect function (Janssens 1991).