Properties of muscle nodules recognized by manual physical therapy practitioners.

Participants recalled nodules from memory and drew them on a questionnaire, so the drawings could not be checked against actual tissue. Only nodules near one marked buttock point were studied, so the findings may not apply to neck, shoulder, or low back nodules. The authors classified shapes and hardness categories themselves, and did not verify those classifications with participants. Of 133 responses, 97 were analysed after several exclusions, including missing thickness, impossible thickness, outliers, and unclear hardness responses. Most participants were physical therapists or occupational therapists, so differences between job qualifications could not be examined. Hardness was reported by naming objects, so the pressure used during palpation may have changed the answer. No objective imaging or measurement was used, so the study cannot say whether these nodules were trigger points, taut bands, or another structure.

The authors declared no conflicts of interest. This work was supported in part by JSPS KAKENHI Grant No. JP24500520.

Do not read the round shape, the reported mean long axis, or the eraser hardness comparison as proven anatomy. These came from practitioner-recalled drawings, and the authors could not verify their accuracy.