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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:

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:

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