Question

Spray and Stretch(practice the technique, name the referral pattern) Describe the referral patterns below.

a. Upper Trapezius

b. Levator Scapulae

c. Supraspinatus

d. Gastrocnemius

Answer 1

(a) Upper Trapezius

Stretch and spray are considering the another method of treating the cervical pain myofascial pain that radiating through trapezius muscle . This technique is performaed by using a vapocoolant spray that applied to the affected upper trapezius muscle after it has been placed in the passive stretch . Apply the vapocoolant spray to the region around the trigger point and the   area of referred pain using the pararllel strokes in th same direction . Some where are prefered to first spraying then stretching and only then repeating the spraying .

• Patient seated relaxed
• Anchor arm end of muscle
• Spray skin over muscle
• Stretch muscle passively
• spray over pain pattern
• repeat using parallel sweeps .

(b) Levator scapulae

The levator scapulae muscle extends from C1 to C4 to the medial aspects between the superior angle and the root of the scapular spine . The levator scapulae can present with trigger point located in the lower half of the muscle . The lower point lies just above the superior angle of the scapula and the upper trigger point lies 1-3 inches above the lower trigger point . Both trigger points lie deep to the upper trapezius muscle and both refer pain laterally to tehshoulder and along the medial aspect of the shoulder. blade .  

Treatment option to releive the tension in muscle is stretching technique and the spraying is the best to perform . the stretching teh levator scapulae and the surrounding muscles like the trapezius ( upper and lower) are beneficial in reduscing the pain and increasing the  range of motion and quality of life . and spraying the vapocoolant spray on the levator scapulae are also beneficial to correct the chronic pain .

(c) Supraspinatus

The spray and stretch technique involves passively stretching the target muscles that is supraspinatus while simultaneously applying dichlorodifluromethane - trichloromonofluromethane or ethyl chloride spray topically . this sudden drop in skin temperature is thought to produce temporary anesthesia by blocking the spinal stretch reflex and the sensation of pain at a higher center. the decreased pain sensation allows the muscle to be passively stretched toward normal length which then helps to inactivate trigger point at supraspinatus muscle and releive the muscle spasm and reduced referred pain.

(d) Gastrocnemius

The gastrocnemius is a part of the composite muscle known as the triceps surae , which forms the prominent contour of the calf . .The trigger points inthe gastrocnemius are typically associated with calf pain / stiffness , nocturnal cramps , foot pain and pain in the back of the knee on mechanical activity , The basic spray and stretch technique is quite straight forward as it does not requirre the same precise localizaton of trigger point as for needling or injection . The spray is aimed out of the inverted bottle nozzle at 30 degree to the skin in a fine jet over aa distance of about 20 - 50 cm ( aim at an area rather than a single spot) And stretch is the therapeutic component of the technique while two to three sweeps of sprays are applied to the affected / host muscle , the muscle is gently extended ti its full stretch length . Test the range of motion before and after the spray and stretch technique , make sure that the muscle to be treated is fully relaxed and support it where possible --- treatment can be performed sitting , side , lying , prone or supine .