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Understanding Trigger Point Therapy

Chris talks about Trigger Point Therapy..

Understanding and using trigger points can be an incredibly useful tool within your massage toolbox. Rather than seeing it as a standalone treatment, trigger point therapy should be used alongside other massage techniques; such as myofascial release and general massage work; to help alleviate your clients presenting musculoskeletal issues and speed up their recovery.

Trigger points are a very common problem that occur in millions of people every year. While these trigger points are found in many areas throughout the body, they commonly display themselves as neck pain. These trigger points typically occur due to overuse in the general area or a standard muscle injury.

Q. What are trigger points?

A Myofascial Trigger Point is a small area of spasm within the fibres of the muscle. The trigger point can be latent (not in spasm but with potential) or active (spasmed and painful). Trigger points can radiate pain throughout the body or in a specific location. Trigger point therapy can be a highly effective solution for these knots.

Q. What causes trigger points?

Activation of trigger points may be caused by several lifestyle factors such as exercise, stress, diet and water consumption. Other factors include poor posture, acute or chronic muscle overload/ stagnation and direct trauma to the region. When considering the causes of trigger points, it’s important to understand the environment that comes together to make a trigger point occur.

Trigger Points form as a local contraction in a small number of muscle fibres in a larger muscle or muscle bundle. These in turn can pull on tendons and ligaments associated with the muscle and can cause pain deep within a joint where there are no muscles. These sustained contractions of muscle sarcomeres compress local blood supply restricting the energy needs of the local region. This crisis of energy produces sensitizing substances that interact with some nociceptive (pain) nerves traversing in the local region which in turn can produce localized pain within the muscle at the neuromuscular junction (Travell and Simons 1999).

When trigger points are present in muscles there is often pain and weakness in the associated structures. These pain patterns in muscles follow specific nerve pathways and have been readily mapped to allow for identification of the causative pain factor. Many trigger points have pain patterns that overlap, and some create reciprocal cyclic relationships that need to be treated extensively to remove them.

Q. How do you identify the trigger points?

If a trigger point is active, when pressed on, it will set off a pain pattern around the area and for the connecting muscles. The pain can travel along the muscle fibres over tendon attachments from muscle to muscle. This is normal and shows us how chronic or acute the muscle spasm is.

What is covered on the Trigger Point Therapy Course?

The Trigger Point Therapy course is accredited by the Federation of Holistic Therapists with attendance over 2 days. On the course you will cover the following:

  1. The common trigger points, pain referral patterns and how to find and treat trigger points.
  2. Developing observation skills in postural assessment - posture can play a significant role in musculoskeletal disfunction.
  3. Core techniques to release (treat) the trigger points: pressing and holding, releasing, muscle movement, palpation, client reassurance, lengthening and stretching.
  4. The location of the 6 main skeletal muscles; finding their origins and insertions. These are the ‘big hitter’ muscles - the Levator Scapula, Quadriceps Femoris Group, Gluteals, Pectoralis, Trapezius Major and Quadratus Lumborum.

Recommendations from Chris..

" Using a trigger point map is a great resource; providing it’s used alongside your palpation work – every client is different.
" Always look at the entire muscle group. It’s important to look at the muscles that surround the trigger point.
" Always consider the fascia alongside the muscle, it will also harden and change shape.
" Buy
The Trail Guide to the Body
text book! It’s a fantastic hands-on guide to locating muscles and bones; with beautifully illustrated information for learning palpation and the musculoskeletal system.
" Start with identifying a comfortable pain threshold on a 1-5 basis. Talking to your client throughout will reassure them.
" Following any work on tight muscles or trigger points, always stretch the area. Hold all stretches for as long as you can 20 seconds to 1 minute; explain what you are doing again to reassure your client.
" Share your knowledge of muscles and trigger points as you go through the treatment; this will impress your client and show your commitment to the industry.