Trigger point therapy, sometimes called neuromuscular therapy, is used to treat tender spots within the muscles or fascia. This form of therapy can help soften and release these points, creating less strain on the muscle and reducing pain and tension in the trigger point area, which may also relieve problems in other parts of the body associated with the trigger point.
Trigger Points
Janet Travell, MD, and David Simons, MD, are credited with writing the definitive books on trigger points. In their work they have defined a trigger point as "a focus of hyperirritability in a tissue that, when compressed, is locally tender and, if sufficiently hypersensitive, gives rise to referred pain and tenderness, and sometimes to referred autonomic phenomena and distortion of proprioception." Basically this means that there are points, or nodules, found in the muscle that are painful when pressed, sometimes creating pain in other areas of the body as well. These points are known as trigger points.
Trigger Point Origins
Where do these uncomfortable points in our muscles come from, and why are they there? Many times a trigger point results from overworking a muscle, or because of trauma or extreme chilling of the muscle. They are often found in people who perform repetitive tasks daily, such as athletes, office workers, musicians, or construction workers. Other contributing factors include poor posture, arthritis and emotional stress.
Types of Trigger Points
There are two main types of trigger points: latent and active. Both create pain within the body and both can be addressed with massage. A latent trigger point is only painful when pressed. An active trigger point is always painful, inhibits full stretching of a muscle and can sometimes weaken the muscle. You will be able to identify the type of trigger point by asking your client questions as you compress the muscle. If you find an area of sensitivity or pain, ask if the pain is always present or only when you press down. The answer to this question will identify the point as active or latent. You may want to address active points first, since they are the primary cause of pain. However, do not neglect any latent points you may find. They are a definite contributing factor to muscle tension, soreness or muscle shortening.
Manual Trigger Point Technique
The general location of trigger points has been mapped and produced on charts that you can buy. However, locations are not always exact. You may need to be patient and persevere. Begin by asking your client where he is experiencing pain, and perhaps have him draw a diagram for you. Once the client is on the massage table, you can use the diagram for reference. Remember to center yourself and your breathing, focusing on your breath and the breath of the client. Synchronizing your breath will help you to better focus on the needs of the client. Be certain that the muscles in the area you are working with are relaxed and not taut, and directly compress the trigger point area with your thumb. Maintain an active conversation with your client, who can direct you to the exact location of the trigger point. Be sure to ask the following questions:
- Am I on the trigger point?
- On a scale of one to ten, with ten being the worst, how would you describe your pain?
Once you are certain that you are compressing the proper location, slowly compress a little bit deeper, to the tolerance level of the client. Monitor your client, watching for signs that you have compressed to the limit. Hold the point for 30 seconds to one full minute, and slowly release. You can then slowly rotate or stretch the area as long as that is not contraindicated. Repeat on the next trigger point, working in a pattern so that you repeat working on each trigger point one to two times.
Massage Tips
* This is slow, methodical work. Compress and release slowly and carefully in order to lessen pain.
* You must maintain constant communication with your client to assess her comfort level.
* Trigger point therapy is not an exact science. Trigger point locations vary from person to person.
* Use your body weight and lean into your compressions.
* Be careful to keep your body and hands properly aligned to avoid injury to yourself.
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