M. quadratus lumborum
“The Joker of back pain”
from Travell + Simons „Handbuch der Muskeltriggerpunkte
© Kosub/Thieme 2004
M. quadratus lumborum
© Kosub/Thieme 2004
M. glutaeus minimus
1 from Travell + Simons „Handbuch der Muskeltriggerpunkte
© Kosub/Thieme 2004
M. glutaeus minimus
© Kosub/Thieme 2004
M. glutaeus medius
from Travell + Simons „Handbuch der Muskeltriggerpunkte
© Kosub/Thieme 2004
M. glutaeus medius
© Kosub/Thieme 2004
M. iliopsoas
from Travell + Simons „Handbuch der Muskeltriggerpunkte
© Kosub/Thieme 2004
M. iliopsoas
© Kosub/Thieme 2004
M. piriformis
from Travell + Simons „Handbuch der Muskeltriggerpunkte
“Double Devil”
© Kosub/Thieme 2004
M. piriformis • examination:
© Kosub/Thieme 2004
M. piriformis • palpation:
© Kosub/Thieme 2004
M. piriformis • anointment:
© Kosub/Thieme 2004
Anointing of the Skin Unction with Solum-Oel (Moor-Lavender oil) (company: Wala)
© Kosub/Thieme 2004
M. piriformis
© Kosub/Thieme 2004
M. piriformis • Spray:
© Kosub/Thieme 2004
Spray and Stretch • Stretch:
© Kosub/Thieme 2004
M. piriformis • Taping:
© Kosub/Thieme 2004
Risks and adverse effects Sistermann & Katthagen (1996): “…all worldwide performed Shockwave Treatments in Urology and Orthopaedics …. No serious complications could be found.”
absolute Contra-indications
relative Contra-indications
Applic. over lungs or thorax
Sick sinus syndrome, stenosis of the carotis
Coagulation dysfunctions
Medication with Acetylsalicylacid
Anticoagulants therapy
Cervical pain syndrome, tinnitus duriing prone-position
Applic. over vascular or nerval structures
Rotator cuff rupture
Pregnancy
Aneurysm
Height< 140 cm, Weight> 135 Kg
Local anaesthesia or analgetics allergy
Osteomyelitis, infected pseudarthrosis
cardiac pacemaker
Bone tumors
cardiac arrhythmia
Shelling the epiphysis
Insulin-, or analetics-Pump
© Kosub/Thieme 2004
Reactive Hyperaemia
© Kosub/Thieme 2004
Thank You!
© Kosub/Thieme 2004