Body Map Form
Date:
Name:
ARM - Biceps/Tricep Supinator: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
ARM - Brachialis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
ARM - Coracobrachialis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
ARM - Deltoids: Ant/Lat/Post: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
ARM - Pronator Teres: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Diaphragm: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Ext/Int Oblique: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Intercostals: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Pectoralis Major/Minor: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Rectus Abdominis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Ribs: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Serratus Anterior: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Subclavius: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
CHEST - Transverse Abdominis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
NECK - Scalenes Anter/Med/Post: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
NECK - Splenus Capitus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
NECK - Splenus Cervicus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
NECK - Sternocleidomastoid: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
NECK - Supra Infra Hyoids: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - HIP/LEG - Add Long/Brev Mag: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Biceps Femoris: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Gemellus Sup/Inf: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Gluteus Max/Med/Min: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Obturator Int/Ext: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Pectineus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Piriformis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Iliopsoas Major/Illacus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Quadratus Femoris: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Rectus Femoris: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Sacrospinalis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Sartorius/Gracilis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Semi-Tend/Membranosus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Tensor Fascia Latae: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Trochanteric: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HIP/LEG - Vastus Int/Med/Lat: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Abd/Add Hallucis Brev: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Abductor Digiti Brevis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Dors/Plan Interossei: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Flexor Digiti Minimi Brevis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Flexor Digitorum Brevis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Flexor Hallucis Brevis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Lumbricals: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Quadratus Plantae: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
FOOT - Calcaneal Tendon(Achilles): Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HEAD: Auricularis Post/Sup: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HEAD: Buccinator: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HEAD: Masseter: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HEAD: Orbicularis Oris/Oculi: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HEAD: Pterygoid Med/Lat: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HEAD: Transverse Nuchae: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
HEAD: Temporalis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
LOWER LEG - Flex/Ext Digitorum Long/BR: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
LOWER LEG - Flex/Ext Hallucis Long: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
LOWER LEG - Gastrocnemius: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
LOWER LEG - Peroneus Tert/Brev/Lon: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
LOWER LEG - Plantaris/Popliteus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
LOWER LEG - Soleus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
LOWER LEG - Tibialis Post/Ant: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Erector Spinae: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Iliocostalis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Infraspinatus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Interspinalis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Intertransversarii: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Latissimus Dorsi: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Levator Scapula: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Longissimum: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Multifidus Rotatores: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Quadratus Lumborum: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Rhomboids: Major/Minor: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Serratus Post/Sup/Inf: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Spinalis/Semispinalis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Subscapularis: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Supraspinatus: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling
BACK - Teres Major/Minor: Select the finding next to the muscle
T = Tension/hypertonicity
P = Pain
S = Spasm
I = Inflammation
N = Numbness/tingling