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of metha-epiphysis. The rest part of the periosteum is mostly covered by soft tissues which include not only skin and hypodermis, but thick layer of muscles as well. In these areas, the PM is not applied.

1. The most important part of the diagnostic procedure is the correct mobilization of soft tissues. Thismobilization makes maximum accessibility of the periosteum surface possible. Proper completion of this technique will allow the practitioner to obtain the optimal efficiency of each massage session. To do this, place one hand on the area directly adjacent to the examined part. Using the edge of one hand, push the soft tissues in the direction of greatest mobility. As a result, of this, the maximal periostal surface available for diagnostic examination is exposed. The mobilization of soft tissues in the knee region is shown in Fig. 74.

Fig. 74. Mobilization of soft tissues for PM on the medial surface of the knee.
The dashed line indicates the initial position of the hand.
The shaded area is an additional part of the periosteum that has become available after the mobilization of soft tissues.

 2. The goal of the diagnostic session is to determine the following: any local degenerative changes (roughness, depressions) and trigger points in the periosteum. All trigger points that are detectable and usable for PM treatment are divided into 2 types:

a. Chief trigger points.
Chief trigger points are areas of the periosteum with the maximal pain and structural changes.
b. Supporting trigger points.
Supporting trigger points are areas of the periosteum in which the pathological symptoms are lesspronounced. These trigger points are also divided into two further subtypes: