Myofascial Meridians

Trigger Points Tend to Develop Along “Myofascial Meridians”

Clinically, trigger points (and super trigger points) tend to emerge in the warp and weft of the myofascia along
certain predetermined lines of force, or meridians. The reasons for this have been suggested by Thomas Myers
(2001) and are based on the earlier work of Ida Rolf. The concept of “myofascial channels,” or chains, helps to
explain the way the body dissipates and distributes forces from right to left, up to down, and deep to superficial.
It is useful therefore to understand and visualize these myofascial meridian train lines.

Muscles do not operate in isolation, but might be regarded as the contractile elements within a myofascial
continuum, which runs throughout the body. These meridian maps may help to explain how and why the
development of primary, central trigger points in one area of the body may lead to secondary or satellite trigger
points distally. The term meridian derives from acupuncture and Traditional Chinese Medicine (TCM): it
describes bioenergetic lines or channels that are said to flow throughout the body.

Myokinetic Chains and

Sublinks

The brain/body
employs a range of
neuromuscular
strategies to
coordinate muscular
contraction and thus
facilitate stability and
spatial orientation. All
of our body systems and
structures work
together in
interdependent and
connected ways.
Myers (2001)
presented several ideas
for the myofascial
component of these
connections in his
seminal work
Anatomy Trains, labeling them “myofascial meridians.” Sharkey (2008) developed this concept further: he
presented these meridians as a series of “functional kinetic chains.” Sharkey suggested that the body dissipates
kinetic forces (energy) through the “spiral/oblique chain, lateral chain, posterior sagittal chain, and anterior
sagittal chain.” Several other secondary chains and/or connections also coexist, being both deep and superficial.
Super trigger points: (a) anterior view, (b) posterior view.

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The Spiral (Oblique) Chain (S/OC)

The spiral (oblique) chain includes

the external oblique, internal
oblique (contralateral), adductors,
iliotibial (IT) band, tibialis
anterior, and peroneus
longus/brevis. This chain may also
include the following links:
serratus anterior, ipsilateral
rhomboids, and contralateral
splenius capitis.
The spiral (oblique) chain (S/OC):
(a) anterior view, (b) posterior
view.

Posterior Sagittal Chain (PSC)

The posterior sagittal chain

includes the thoracolumbar fascia
and muscular links both above
and below, offering movement
and support to the joints of the
periphery as well as to the spinal
joints. At the midsection,
sublinks include the transversus
abdominis and posterior fibers of
the internal obliques. The pelvic
floor muscles include the
pyramidalis, multifidi, and
lumbar portions of the
longissimus, iliocostalis, and
diaphragm, more commonly
known collectively as the core
muscles. Of course, this joint
support system is also present at

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the glenohumeral and lumbopelvic-hip complexes.
A deep posterior or sagittal chain involves local, deep, segmentally related muscles providing localized support
for motion in segments or joints (tonic or type II fibers).
A superficial oblique posterior chain involves prime movers or more global muscles that are, as the name
implies, predominantly superficial. These muscles are primarily phasic and are heavily populated with type I
fibers with a high resistance to fatigue.
The posterior sagittal chain includes the occipitofrontalis, erector spinae, thoracolumbar fascia, multifidus,
sacrotuberous ligament, and biceps femoris (short head). This link can be continued to include the
gastrocnemius and plantar fascia. The posterior oblique link (POL) includes the latissimus dorsi, contralateral
gluteus maximus, and thoracolumbar fascia. This chain can be continued to include the following links: IT
band, tibialis anterior, and peroneals.

(a) The posterior sagittal chain (PSC). (b) The posterior oblique link (POL).

The Lateral Chain (LC)

The lateral chain includes the peroneals, IT band, TFL, gluteals, external and internal
obliques, ipsilateral adductors, and quadratus lumborum (contralateral). This chain
may also include the following links: intercostals, sternocleidomastoideus, splenius
capitis/cervicis, and scalenes.

The lateral chain (LC).

The Anterior Sagittal Chain (ASC)

The anterior sagittal chain includes the dorsal surface of the foot, tibial
periosteum, rectus femoris (including articularis genu), anterior
inferior iliac spine (AIIS), pubic tubercle, rectus abdominis, sternal
periosteum, sternocleidomastoideus, and periosteum of the mastoid
process.

The anterior sagittal chain (ASC).

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The Deep Anterior Chain (DAC)

The deep anterior chain includes the inner arch of the plantar surface (first
cuneiform), tibialis posterior, medial tibial periosteum, adductors, linea
aspera, ramus of the ischium and pubis, lesser trochanter, iliacus, anterior
longitudinal ligament, psoas major, central tendon of the diaphragm,
mediastinum and pericardium, pleural fascia, prevertebralis fascia, fascia
scalenes, longus capitis, hyoid and associated fascia, mandible, occiput, and
galea aponeurotica.

The deep anterior chain (DAC).

Trigger points on demand—TODs

Ever heard of “Video on Demand”? Because trigger points make the host muscles weak, they are a useful
mechanism for rapidly switching off muscle power around an injury.

This is essential if, for example, there is a fracture: it is an important part of our defense, protect, and repair
mechanisms. The nervous system uses myofascial trigger points as part of its feedback vocabulary to
accomplish this.

This may also help to explain the local and rapid neurogenic responses in the muscles to acute injury or
fracture.