Skip to main content

Trigger Point Therapy (TPT, or TrP): Theory I

This is the second post of my Modality/Theory series explaining the differences in massage modalities and their benefits.  If you have any questions about this post or other modalities you would like to know more about, please do not hesitate to contact me: FreedomBodywork305@gmail.com


We need to start with what a Trigger Point is:

Also referred to as Myofacial Trigger Points, these are localized contractions within muscles that are highly reactive to palpation and typically refer pain or other sensations in known and predictable patterns. 

As an example, I often encounter trigger points in the middle Trapezius.  When I isolate the contraction between fingers and thumb and squeeze, I feel a localized contraction of adjacent muscle fibers and clients indicate pressure at base of the skull or headache like symptoms on the side of the head even toward the temple.     

The way I explain this to clients sounds like this:
"A trigger point is a band of muscle stuck in contraction.  The pain signal it sends is basically a signal to other muscle fibers in that pain path as a deterrent to keep them from contracting fully since the muscles stuck in contraction cannot help to carry the load."  That's an over simplification of the full mechanics of what's happening, but helps to give a frame of reference for the pain they've been feeling.



How do Trigger Points form?

There are several factors that can contribute to trigger point formation:


  • Repetitive stress
    • Not just work tasks, also consider things like the strain on hands and neck from phone use.
  • Sustained loading
    • Lifting and moving of heavy objects, carrying children, or wearing a heavy backpack or bag.
  • Poor postural alignment
    • Muscles having to do extra work due to poor postural alignment are basically having to work in ways they're not designed for.
  • Traumatic injury
  • Inactivity
    • Another way to describe a trigger point is as an ischemic condition caused by a sustained local contraction in a muscle.  If our muscles aren't working, then there is less blood and therefore less nutrients flowing to the muscles. 
  • Nutrition
    • Over abundance of calcium, deficiencies of magnesium or potassium, and even dehydration can contribute to trigger point formation.


What is Trigger Point Therapy (TPT, or TrP), how do we treat them?

There are a few different methods or modalities that can be used to treat trigger points:
  • Active Release Technique (ART)
    • Putting a tissue into a shortened position, gripping or putting tension to hold this tissue, and slowly lengthening the tissue.  To grossly oversimplify: pinning and stretching tissue through active movement.
  • Myofacial Release (MFR)
    • Constant and sustained tension or traction of a tissue to stretch and release contractions.
  • Neuromuscular Therapy (NMT)
    • NMT does a lot of thumb gliding to identify contractions in muscles.  Most NMT practitioners treat trigger points with sustained pressure directly on the trigger point location, just matching its resistance to pressure, mechanically releasing the trigger point.

Just about every client I see is limited by trigger points so I have extensive experience treating them, if you have any questions about Trigger Point Therapy please don't hesitate to contact me:


Follow me on twitter @markcfreeman on Facebook, or Instagram.  Email me at mark@markcfreeman.com with any questions about bodywork techniques, modalities, or if there are any blog topics you want to know more about!

Comments

Popular posts from this blog

Traveling and Teaching: Yoga Massage for Two in Brazil

Yoga Massagem a Dois

Usually this blog is all about technical aspects of massage, but I recently helped teach a workshop in Brazil and had such a great time I wanted to share.

Through a connection I made several years ago during massage school, I was invited to partner up to teaching a course in Serra Grande, Uru├žuca, Brazil.  Cintia and I met at school in Miami and bonded when she patiently helped me deal with a protracted shoulder, and I gave her a very deep Iliopsoaz stretch.  We've kept in constant contact, always sharing techniques and bouncing ideas off of each other.  Cintia primarily works as an Ayurvedic healer and yoga teacher, and I work with Neuromuscular therapy and teach.  We were chatting about ways to share our bodywork outside of the treatment room or studio and she said: "Come to Brazil!"  I was a little confused since we were talking about how to reach people in other ways with our work and she was telling me to take a vacation and come visit.  She was …

Massage Draping Explained

A colleague and I were discussing draping techniques recently, in particular good techniques to keep a client protected and comfortable for stretching.  Unless our therapist is using more clinical techniques or moving us around much, we're usually draped with "Modesty" or "Spa" draping.

Regardless of what style of draping is used, it should always be explained by the therapist.  As I outlined in my post about safety of our clients in the treatment room, safety and informed consent are essential.

Modesty draping is simple, easy to do and effectively covers our personal areas, but as you can see below, it's not at all effective for keeping a client covered for major joint mobilizations or stretching.


The part of the body to be worked is uncovered, simply folding the sheet back on itself away from the area to be worked.  The sheet may also be tucked under the opposite side of the body without any mobilization.  Modesty draping is great when there are many area…

Everyday Ergonomics

Have you ever experienced a sudden pain or soreness that you can't explain?  Those deep aches in the neck, shoulder, or lower back that you can't find some accident, slip, fall, or injury to explain the pain?

An accident, lift, slip or fall is easy to remember, but those only last a few seconds.  The seemingly mundane everyday moments where nothing seems to happen can actually add up to have lasting effects in our body.  To understand the stress and strain we put on our body, we first need to understand what is called Anatomically Neutral:

Generally, good standing posture, or an anatomically neutral position can be summed by a straight line drawn down from the ears, to the shoulders, down through the hips, knees, and through the arch of the foot with all in the same plane of alignment.

If only everything we did was possible from this neutral standing position, we would have a better understanding of how to be in proper alignment and avoid injury and fatigue.


Depending on our b…