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 manipulated for therapeutic purposes.
Description
- First described by Dr. Frank Chapman in the 1920s as “gangliform contracted lymphoid tissue nodules”
- Arise due to lymphatic congestion or blockage from nerve sheaths at free nerve endings
- Primarily correspond to 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
Anatomy
| HEENT | ||
|---|---|---|
| Chapman point | Anterior | Posterior |
| Eyes | Surgical neck of the humerus | Squamous portion of occipital bone below the superior nuchal line |
| Middle ear | Superior to clavicles | C1 articular process |
| Sinuses | 1st rib | C2 midway between spinous and transverse process |
| Pharynx | Inferior aspect of sternoclavicular joint | |
| Larynx | 2–3 inches lateral to sternocostal junction on 2nd rib | |
| Tonsils | 1st intercostal space (ICS) | Atlas midway between spinous and transverse process |
| Tongue | 2nd rib | - |
| Cardiorespiratory | ||
|---|---|---|
| Chapman point | Anterior | Posterior |
| Heart | 2nd ICS proximal to sternum | Intertransverse space between T2 and T3 lateral to the spinous process |
| Bronchi | T2 midway between spinous and transverse process | |
| Upper lung | 3rd ICS | Intertransverse space between T3 and T4 midway between spinous and transverse process |
| (Upper extremities) | - | |
| Lower lung | 4th ICS | Intertransverse space between T4 and T5 midway between spinous and transverse process |
| Gastrointestinal | ||
|---|---|---|
| Chapman point | Anterior | Posterior |
| Esophagus | 2nd ICS proximal to sternum | T2 midway between spinous and transverse process |
| Stomach (acidity) | 5th ICS on left | Left intertransverse space between T5 and T6 midway between spinous and transverse process |
| Stomach (peristalsis) | 6th ICS on left | Left intertransverse space between T6 and T7 midway between spinous and transverse process |
| Pylorus | - | Costotransverse junction on the right 10th rib |
| Liver | 5th and 6th ICS on right | Right intertransverse spaces between T5 and T7 midway between spinous and transverse process |
| Gallbladder | 6th ICS on right | |
| Pancreas | 7th ICS on right | Right intertransverse space between T7 and T8 midway between spinous and transverse process |
| Spleen | 7th ICS on left | Transverse process of T7 on left |
| Duodenum | 8th ICS near costochondral junction | Intertransverse space between T8 and T9 midway between spinous and transverse process |
| Jejunum | 9th ICS near costochondral junction | Intertransverse space between T9 and T10 midway between spinous and transverse process |
| Ileum | Below 10th rib near costochondral junction | Intertransverse space between T10 and T11 midway between spinous and transverse process |
| Appendix | Tip of the 12th rib | Right intertransverse space between T11 and T12 midway between the tips of the transverse processes |
| Cecum | Upper 1/5 of the right lateral thigh | Triangular area between the transverse process of L2, iliac crest, and transverse process of L4 |
| Ascending colon | Middle 3/5 of the right lateral thigh | |
| Hepatic flexure | Lower 1/5 of the right lateral thigh | |
| Sigmoid colon | Upper 1/5 of the left lateral thigh | |
| Descending colon | Middle 3/5 of the left lateral thigh | |
| Splenic flexure | Lower 1/5 of the left lateral thigh | |
| Rectum | Proximal inner thighs on the lesser trochanter | Sacrum, level of S2, near the lower end of the sacroiliac articulation |
| Genitourinary | ||
|---|---|---|
| Chapman point | Anterior | Posterior |
| Kidneys | 1 inch lateral and 1 inch superior to the umbilicus | Intertransverse space between T12 and L1 midway between spinous and transverse process |
| Bladder | Periumbilical region | L2 transverse process |
| Urethra | Superior aspect of the pubic symphysis | L3 transverse process |
| Ovaries | T10 transverse process | |
| Testes | ||
| Broad ligament | Lateral aspect of the thigh from greater trochanter to 2 inches proximal to the knee | Between the posterior superior iliac spine and the transverse process of L5 |
| Prostate | ||
| Uterus | Medial edge of the obturator foramen | |
| Fallopian tubes | - | |
| Seminal vesicles | - | |
| Vagina/Clitoris | Posterior aspect of the proximal inner thigh | |
| Endocrine | ||
|---|---|---|
| Chapman point | Anterior | Posterior |
| Thyroid | 2nd ICS proximal to sternum | - |
| Adrenals | 1 inch lateral and 2 inches superior to the umbilicus | Intertransverse space between T11 and T12 midway between spinous and transverse process |
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 corresponding organ
- Nontender reflex points by themselves are inconsequential.
Treatment
- Pelvic diaphragm release
- Apply gentle pressure in concentric circular motions for 20–60 seconds (or until the point softens and pain is reduced).
- Associated somatic dysfunctions may also be treated separately.