Practitioner/Clinic Name: Body Map

1 Practitioner/Clinic Name: _____ body Map Contact Information: _____. Name: _____ Date: _____. Note the finding next to the muscle checked: T = Tension, hypertonicity P = Pain S = Spasm I = Inflammation N = Numbness/tingling Arm Chest Neck Back Biceps/Tricep Supinator ____ Diaphragm ____ Scalenes Anter/Med/Post ____ Erector Spinae ____. Brachialis ____ Ext/Int Oblique ____ Splenus Capitus ____ Iliocostalis ____. Coracobrachialis ____ Intercostals ____ Splenus Cervicus ____ Infraspinatus ____. Deltoids: Ant/Lat/Post ____ Pectoralis Major/Minor ____ Sternocleidomastoid ____ Interspinalis ____. Pronator Teres ____ Rectus Abdominis ____ Supra Infra Hyoids ____ Intertransversarii ____.

2 Ribs ____ Latissimus Dorsi ____. Hip/Leg Head Levator Scapula ____. Serratus Anterior ____. Add Long/Brev Mag ____ Auricularis Post/Sup ____ Longissimum ____. Subclavius ____. Biceps Femoris ____ Buccinator ____ Multifidus Rotatores ____. Transverse Abdominis ____. Gemellus Sup/Inf ____ Masseter ____ Quadratus Lumborum ____. Gluteus Max/Med/Min ____ Foot Orbicularis Oris/Oculi ____ Rhomboids: Major/Minor ____. Obturator Int/Ext ____ Abd/Add Hallucis Brev ____ Pterygoid Med/Lat ____ Serratus Post/Sup/Inf ____. Pectineus ____ Abductor Digiti Brevis ____ Transverse Nuchae ____ Spinalis/Semispinalis ____. Piriformis ____ Dors/Plan Interossei ____ Temporalis ____ Subscapularis ____.

3 Iliopsoas Major/Illacus ____ Flexor Digiti Minimi Brevis ____ Supraspinatus ____. Lower Leg Quadratus Femoris ____ Flexor Digitorum Brevis ____ Teres Major/Minor ____. Flex/Ext Digitorum Long/BR ____. Rectus Femoris ____ Flexor Hallucis Brevis ____ Trapezius ____. Flex/Ext Hallucis Long ____. Sacrospinalis ____ Lumbricals ____. Sartorius/Gracilis ____. Gastrocnemius ____ Quadratus Plantae ____. Peroneus Tert/Brev/Lon ____. Semi-Tend/Membranosus ____ Calcaneal Tendon(Achilles) ____. Plantaris/Popliteus ____. Tensor Fascia Latae ____. Soleus ____. Trochanteric ____. Tibialis Post/Ant ____. Vastus Int/Med/Lat ____. Procerus Frontalis Temporalis Semispinalis Capitis Buccinator Trapezius Orbicularis Oculi Depressor Anguli Oris Sternocleidomastoid Deltoid Masseter Orbicularis Oris Trapezius Tricep Pectoralis Major Deltoid Infraspinatus Latissimus Dorsi External Abdominal Obliques Biceps Brachii External Abdominal Obliques Brachialis Pronator Teres Serratus Anterior Brachioradialis Lumbodorsal Fascia Rectus Abdominis Flexor Carpi Radialis Anconeus Iliopsoas Flexor Carpi Ulnaris Tensor Fascia Latae Extensor Carpi Ulnaris Gluteus Maximus Sartorius Iliotibial Tract Adductor Magnus Tensor Fascia Latae Pectineus Semitendinosis

4 Adductor Longus Vastus Lateralis Semimembranosus Biceps Femoris Rectus Femoris Gracilis Adductor Magnus Vastus Medialis Gastrocnemius Plantaris Tibialis Anterior Extensor Digitorum Communis Longus Gastrocnemius Soleus Peroneus Longus Patellar Ligament Calcaneal Tendon (Achilles). Cruciate Ligament Soleus MEMBER. Associated Bodywork & Massage Professionals