Trapezius muscle needling

Anatomy

Origin

• Medial 1/3 rd of superior nuchal line
• Ligamentum nuchae
• Spinous processes of C6 to T12.

Insertion

• Lateral 1/3rd of the clavical
• Spine of scapula and medial acromion process.

Nerve supply

1. Spinal accessory nerve 12CN (motor)
2. Cervical spinal nerve C3 and C4 (motor + sensory).

Actions

1. Upper fibres elevate scapula.
2. Upper and lower fibres rotates scapula upwards during abduction. Thus, involved in scapulohumeral rhythm.
3. Laterally flexes and extends the neck.

Triggers and RP

Dry needling procedure

Upper trapezius

• Patient position: supine or prone.
• Needle size: 30-45mm
• Hold the upper trapezius muscle with one hand.
• Needling direction: perpendicular needling - posterior to anterior (For prone lying). avoid needling towards caudal direction to avoid lung penetration.

Middle and Lower trapezius

• Patient position: prone
• Needle size: 30mm
• Lift and hold the middle or lower trapezius with one hand.
• Needling direction: Perpendicular needling - lateral to medial. avoid posterior to anterior direction.