Myofascial Trigger Point Therapy

MYOFASCIAL TRIGGER POINT THERAPY

DID YOU KNOW?

Trigger points remain the most widely overlooked source of muscle problems and pain.

When activated, these contracted bands of muscle tissue can lead to widely differing pain symptoms, along with weakness, numbness and tingling, and reduced range of motion. Here’s how practitioners can learn to recognize and treat pain caused by trigger points.

What are trigger points and what causes them?

Trigger points can occur in any muscle of the body, typically in the muscle belly, musculo-tendinous junction or myoneural junction. When activated, trigger points typically replicate a pattern of pain that is recognizable by the patient. These referred patterns have been

mapped by Dr. Janet Travell and Dr. David Simons.



One common cause of trigger points is unaccustomed activity. Weekend warriors, for example, can end up with painful trigger points in various muscles after playing a game of basketball on a Saturday. The challenge is that these weekend warriors sit at a desk and sit at home all week, then play like pros once per week. An office worker who slouches at his desk and unconsciously holds his shoulders up even just a quarter-inch for an extended period of time can activate trigger points due to long-held low-threshold muscular effort. Overuse injuries and emotional/life stress can also lead to trigger point issues.



Mary Biancalana's article on 7-step Trigger Point Protocol

Referred Pain

When a trigger point is activated, it can refer pain in a number of directions. Here’s a common example used to illustrate trigger points: When office workers sit in a head-forward posture while working at their computers, this position places the scalene muscles into a non-neutral, stressed position. Trigger points in the scalene muscles (located near the cervical vertebrae) can refer pain to one of three areas:
  1. The front of the chest
  2. Down the thumb side of the arm and into the thumb, index and middle fingers
  3. Into the back between the shoulder blades

For example, many workers may believe they have carpal tunnel syndrome or other type of repetitive stress injury, when actually their pain is caused by referred pain from the scalene muscles, perpetuated by their poor sitting posture.

Trigger Point Therapy

Therapists who are interested in trigger point therapy can be board certified in trigger point pressure release techniques. The National Association of Myofascial Trigger Point Therapists offers information on certifications, a supportive community of practitioners and ongoing training programs; PHS Therapeutics is also a supporter of the NAMTPT and offers its own live education and webinars with experts in the field on trigger point therapy and etiology.

Treatment involves a therapist applying trigger point pressure release techniques, usually with an elbow or hand, while the patient is in a supported, stretched position. Gentle pressure restores biochemistry at the site to help normalize contracted muscle fibers and return them to their normal resting length. Patients actively participate by providing feedback on the discomfort of the pressure and by actively contracting the muscles involved to further facilitate normal biochemical status. Sessions usually take one hour and also include home care suggestions.
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