What is Myofascial Trigger Point Therapy?
To understand what Myofascial Trigger Point Therapy is, we must first define a trigger point.
What is a Trigger Point?
Trigger points are taut bands in the muscle, and are usually very tender. Healthy muscles do not contain tight bands, are not tender to pressure, and when relaxed, they feel soft and pliable to the touch, not hard and dense, even if you work-out.
Trigger points can cause pain tingling, burning, weakness and other symptoms. They have a special, property called referred pain. They may refer pain both in the local area and/or to other areas of the body, and common patterns have been well-documented and diagrammed. These are called “referral patterns.” Approximately 74% of the time trigger points are not located where you feel symptoms, and working on the area you feel the pain does not give you relief. To see referred pain patterns and whether they match your pain [click here – pain pattern images page]
Generally, the most common trigger points are either active or latent. If the trigger point is “active,” it will refer pain or other sensations. If it is “latent,” it may cause a decreased range-of-motion and weakness. Active trigger points often start with some impact to the muscle, such as an injury, poor posture or body mechanics, repetitive use, or a nerve root irritation. Any of the perpetuating factors can also indirectly activate trigger points and make you more prone to developing trigger points that are initiated by impacts to muscles. Active trigger points may at some point cease causing pain, and become latent. Latent trigger points can easily return to being active trigger points, often leading the patient to believe they are experiencing a new problem, when in fact it is an old problem being re-aggravated. Latent trigger points can be reactivated by overuse, over-stretching, chilling, or any other of the perpetuating factors.
What causes Trigger Points?
Trigger points arise from many different perpetuating factors, some of which include: poor posture, ergonomics, repetitive strain and movements of muscles, poor sleeping habits, lack of hydration/nutrition, an inactive lifestyle or an injury. All these things (and more) add up to a dysfunctional muscle that is chronically tightened, shortened, and can’t “turn off” or relax. These shortened muscles fill with various pain emitting chemicals that localize in a taut band, or Trigger Point. These chemicals then disrupt the muscle’s nerve signal and redirect a pain signal to another area of the body. Myofascial pain accounts for as much as 85% of the pain people suffer from. Acute and chronic myofasical pain due to trigger points is a very common condition and under diagnosed.
What is Myofascial Trigger Point Therapy?
Myofascial Trigger Point Therapy is the release of those taut bands. Trigger Points can be evaluated and located by postural evaluation, muscle range of motion testing, palpation, and evaluation of pain pattern. They are then addressed by using manual techniques such as compression, lengthening and stretching the muscle tissue to restore normal range of motion. A frequent topic of discussion is why Trigger Points are tender and sensitive. This is because the muscle is filled with chemicals that, when in the process of removal from the muscle, evoke a pain response. After these chemicals are flushed from the muscle, subsequent bodywork should not be painful. A skilled therapist can balance the amount of pressure needed to alleviate the trigger point, while staying within the patient’s comfort level.
How do I know if my pain will respond to Myofascial Trigger Point Therapy?
Since as much as 85% of the pain people suffer from has a myofascial component, it is likely that you will have a decrease in pain and an increase in range of motion once treatment has started. You may also have other underlying conditions that need to be addressed. Since treatment of your muscles is very specific, your response can also help the therapist and your doctor to determine what other conditions are present that are causing you pain.
Myofascial Trigger Point Therapy can assist with:
- Carpal tunnel syndrome
- Piriformis syndrome
- Rotator cuff injuries
- Pain associated with bulged or injured spinal disks (medical massage cannot ‘fix’ the disk, but can help alleviate much of the pain associated with the injury).
- Pain associated with pregnancy
- Range of motion issues
- Back and Neck pain
- Plantar fasciitis (involving pain in the foot)
- Repetitive use injuries such as those listed and tennis elbow, Golfer’s elbow
- Pain associated with restricted fascia
- Pain associated with postural imbalances
- Muscle cramps
- Restless Legs Syndrome
- Sports injuries
- Work Injuries
- Auto Injuries
- Edema (swelling)
- Injuries sustained in traumas such as falls or automobile accidents
- Thoracic Outlet Syndrome (numbness/tingling in hands/arms)
At Pro Massage & Chiropractic, Myofascial Trigger Point Therapy is typically performed over a series of sessions consisting of a thorough evaluation of the client’s posture, key muscle tests to find range of motion deficiencies (an indication of Trigger Points), and hands on therapy to address those deficiencies and restore normal, pain-free, movement. After the therapy, a self-care plan of treatment is customized for the individual patient’s needs to ensure maximum results, and future sessions are outlined.
The practice of self-care is essential for addressing Trigger Points. After a Myofascial Trigger Point Therapy session, the patient should continue self-care at home to prevent the Trigger Point from reforming and to keep the muscle(s) fluid and responsive. Self-care practices include: stretching, compression with hands or therapy tools, and the use of heat to keep the muscle loose and flexible. These techniques are usually performed daily to reinforce the muscles “memory” to remain loose and agile.
This is a picture of the pain referral pattern for the trapezius muscle, also the leading cause of Migraine headaches. The black X’s represent the probable location of Trigger Points, and the red areas are where the point refers pain to. In this example, pain from this trigger point would most likely be described (by patient) as a headache or migraine, when in actuality, Trigger Points are referring pain to the temples and back of the head and neck. Although there may not be “pain” where the trigger point is located, the pain is felt in the referral area.
This is why it is difficult to diagnose many of today’s common ailments. It is also a leading cause of misdiagnoses and unnecessary treatments or surgeries in today’s medical society. Luckily, most Trigger Points follow a general pattern; so by comparing “where it hurts” to Myofascial pain referral patterns, the therapist can usually narrow the culprit down to a few probable areas of focus, and create a plan to relieve and even eliminate chronic pain.
Although this massage can be painful while being done, most clients feel usually feel some relief after just one session. If you truly want to reduce the pain your body experiences, this type of massage will help.