Have the client lay supine on a massage table. We start the procedure from the feet, recording findings on the NeuroReflex Assessment form.
Plantar Aponeurosis
Palpate the tissue of the plantar aponeurosis using a firm pressure.
Abductor Hallucis
Palpatewith the thumb into the belly of the abductor hallucis.
Medial gastrocnemius
Palpate deep into the belly; compare to the lateral head.
Vastus Medialis
Palpate just above the medial aspect of the knee
Sartorius
Palpate the mid-point of medial line of the Gracilis.
Gracilis
Palpate the mid-point of medial line of the Gracilis.
Adductor Longus
Rectus Femoris
Iliacus/Psoas
Obliques
Rectus Abdominis
Diaphragm
Strum along the antero-lateral ribs (6-10) going at 90 degrees to their direction feeling for crepitus (be careful for osteoporotic ribs, so go lightly).
Latissimus Dorsi
Costosternal junction
Palpate with an AP pressure at about a 45-degree angle toward the lateral border of the scapula. Examine along the entire C/S junction being careful for osteoporosis. For women, ask permission to examine there first explaining what you’re looking/feeling for.
C7/T1
Similar to the upper T spine except specifically at the CT junction
1st & 2nd Ribs
Spring from superior to inferior and PA (check for scalenes if unsure remembering posterior scalene attaches to the 2nd rib); also R/O upper trapezius involvement, especially for the 1st rib.
Ligamentum Nuchae
Palpate going across the ligament just lateral to the spinous processes from C2-C7 and attempt to elicit crepitus.
Splenius capitus
Palpate in the mid to lower cervical region over the articular pillars and along the attachment into the occiput.
Rectus Capitis Posterior Minor
Palpate just to the right and left of midline at the occipital area of attachment attempting to come up and under the occiput
Occipitalis
Palpate right to left along muscle belly superior to the OM suture; ask patient to lift eyebrows to trigger contraction so you’ll feel the muscle belly easier.
Sphenoid
Press gently inward over the greater wing of the sphenoid and note the fullness visually and by palpation.
Zygomatic arch
Press down in a caudal direction gently and note the spring or lack there of. Also note if one side is superior (usually the right)
Masseter (Superficial Head)
Palpate along the attachment to the mandible for crepitus going cross fiber to muscle belly; note in an atlas of anatomy the direction of the fibers.
Anterior Belly of Digastric
Palpate for tension comparing right vs. left.
Omohyoid
Palpate the lower half of the muscle after it goes through the sling and heads toward the attachment to the scapula.
Flexor pollicis brevis (deep head)
Palpate deep into the thenar eminence.