Chapman reflex points

Summary

Chapman reflex points refer to nerve gangliform contractions located deep to the skin and subcutaneous tissue, most often within the deep fascia or periosteum of the bone. These neurolymphatic points are found at specific areas of the body that correspond to visceral dysfunctions (also termed viscerosomatic reflexes). Pain at any of these points represents potential internal dysfunction or pathology of a specific organ. They can be felt as small, discrete, and smooth palpable nodules, approximately 2 mm in diameter. Although Chapman points are typically diagnostic, they may also be used as a therapeutic modality.

Description

  • First described by Dr. Frank Chapman in the 1920s
  • He described them as “ganglia formed contracted lymphoid tissue nodules”
  • Due to lymphatic congestion or blockage from nerve sheaths at free nerve endings
  • Primarily correlated with the sympathetic fibers of the autonomic nervous system running along dermatomal patterns
  • Round, smooth, discrete and tender palpable nodules (∼ 2 mm in diameter)
  • Associated with visceral dysfunctions
  • Should not be confused with myofascial trigger points (MTrP) or Jones (counterstrain) tender points
  • Located in either the deep fascia or periosteum of bone
  • Corresponding anterior and posterior points
    • Anterior points used diagnostically
    • Posterior points used therapeutically

Anatomy

Chapman Point Location
Anterior Posterior
Eyes Surgical neck of the humerus -
Sinuses 1st rib -
Middle ear Superior to clavicles C1 posterior ramus
Tongue 2nd rib -
Tonsils 1st intercostal space (ICS) -
Pharynx Inferior aspect of sternoclavicular joint C2 articular pillars
Heart, Esophagus, Thyroid 2nd ICS proximal to sternum Between spinous process of T2 and T3
Upper lung & Upper extremities 3rd ICS -
Lower lung 4th ICS Transverse process of T4
Stomach 5th ICS on left Transverse process of T5 on left
Appendix Tip of the 12th rib Transverse process of T11
Pancreas Between the right transverse processes of T7 and T8 7th ICS on right
Liver 6th ICS -
Adrenals 1 inch lateral and 2 inches superior to the umbilicus Between the spinous and transverse process of T11 and T12
Kidneys 1 inch lateral and 1 inch superior to the umbilicus Between the spinous and transverse process of T12 and L1
Bladder Periumbilical region -
Colon Lateral thigh within the IT band just above the knee -

Approach

General considerations

  • Typically utilized selectively for diagnostic purposes
  • Somatic manifestations clue into visceral dysfunctions → conduct further evaluation of corresponding Chapman points
  • FIndings
    • Reflex points can be slightly painful to extremely tender without radiation → supports potential visceral dysfunctions of accompanying organ
    • Nontender reflex points by themselves are inconsequential

Treatment

  • Pelvic diaphragm release
  • Apply gentle pressure and concentric circular motions for 20–60 seconds (or until the point softens and pain is reduced)
  • Associated somatic dysfunctions may also be treated separately
  • Seffinger M. Foundations of Osteopathic Medicine. LWW; 2018.
  • Nicholas A. Atlas of Osteopathic Techniques. LWW; 2011.
last updated 06/14/2019
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