OMM Review — Chapman's and Trigger Points
Original OMM review notes differentiating Chapman points and myofascial trigger points.
Chapman Points
Chapman points are small, firm, deep nodules found in the deep fascia. They are thought to reflect autonomic viscerosomatic reflexes. Each point has an anterior and posterior pair, and treatment uses gentle, sustained pressure or small rotary oscillations.
| Organ | Anterior Chapman point |
|---|---|
| Gallbladder | Right 6th intercostal space |
| Pancreas | Left 6th intercostal space |
| Stomach | Left 5th–6th intercostal space |
| Appendix | Right McBurney area |
| Liver | Right 6th intercostal space |
Myofascial Trigger Points
Trigger points are hyperirritable spots within a taut band of skeletal muscle. They produce referred pain, motor dysfunction, and autonomic phenomena. Treatment includes ischemic compression, spray-and-stretch, muscle energy, dry needling, and addressing perpetuating factors.
Active trigger points reproduce the patient's complaint. Latent trigger points are tender only with palpation and may not refer spontaneously.
Differentiation
| Feature | Chapman point | Trigger point |
|---|---|---|
| Location | Anterior and posterior fascial planes | Within muscle/taut band |
| Association | Visceral organ dysfunction | Muscle overuse or strain |
| Palpation | Small, deep, rubbery nodule | Taut band with twitch response |
| Treatment | Sustained pressure/rotary release | Ischemic compression, stretching, MET |
Q: A patient with stomach complaints has tenderness at the left 5th–6th ICS. What is this likely?
A: A Chapman point associated with the stomach.
Q: What distinguishes an active from a latent trigger point?
A: An active trigger point reproduces the patient's spontaneous pain pattern; a latent point is tender only when pressed.