TRIGGER POINT THERAPY

Myofascial trigger point therapy is a non invasive and comprehensive program for the release and control of acute and chronic pain. It is based on research and treatment protocol of Janet G. Travell, MD (1901-1997)The main feature in myofascial pain is the presence of trigger points in muscle tissue. 
 

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Fascia and Muscle

What is myofascial pain? The word "myo" means muscle and "fascia" is the connective tissue, a material that encloses and supports muscles. Connective tissues bind other tissues and parts of the body, and its function is varied and complex. Thus, myofascial pain is pain that originates in muscles and is caused by trigger points.

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What are trigger Points? 
Trigger points are hypersensitive nodules or knots located within a taught, ropy band of muscle. A trigger point always hurts when pressed on and usually refers pain on direct compression in a distant predictable painpattern specific to each muscle. The defining symptom of a TP is referred pain, meaning a trigger point is rarely located where the patient complains of pain.

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Activation of Trigger Points 
Trigger Point activity can either be "latent" or "active" A latent TP is only painful when palpated, but may cause restriction of movement, stiffness and weakness of the affected muscle. Active TPs typically refer pain to a other areas of the body. From repetitive overuse for example latent TPs become activated, meaning that they cause pain or sensations to travel or refer to another part of the body. An active TP cause pain at rest and increased pain when muscle is used.

SYMPTOMS CAUSED BY ACTIVE TP'S 
• Aching pain 
• Burning 
• Numbness 
• Tingling

SYMPTOMS CAUSED BY LATENT TP'S 
• Burning 
• Numbness 
• Tingling

Trigger Points can be caused or develop as a consequence of: 
• Overuse, misuse or repetitive use of muscles 
• Poor posture; poor body mechanics
• Anatomical conditions (Morton foot structure, short leg, short upper arms etc.)
• Accidents, fall, sports injury
• Occupational stresses (work station)
• Disease 

Pain can be very complex to solve, depending on various - Perpetuating Factors (maintain and recycle a person's pain experience!) such as:  
• Impaired sleep, sleep deprivation
• Allergies
• Emotional stress
• Prolonged immobility (sleep positioning, desk work, driving, standing etc)
• Postural-mechanical stress on muscles
• Nutritional imbalance (vitamin-mineral deficiencies etc) 
• Systemic PF's (hypothyroidism, viral or bacterial infection, parasites, low adrenal function)

The goal is to identify and correct these PF's, support the patient in becoming pain free on the physical, mental and emotional plane. It is essential to restore muscle function, improve posture and body mechanics, reduce stress, increase body and self awareness, and educate the patient using a self care program.  

HOW DOES MYOFASCIAL TRIGGER POINT THERAPY WORK? 
• Myofascial trigger point therapy consists of:
• Careful history taking (download from website)
• Careful listening to patient or client (Intake interview)
• Functional evaluation, Postural evaluation (tests)
• Mapping of pain (the fun part)
• Evaluation of muscles (palpation)
• Identifying muscles that harbor trigger points (source of pain)
• Range of motion and strength testing
• Identifying and elimination of perpetuating factors
• Correction of postural and mechanical PFs 
• Training patient with self-care techniques
• Treatment 

TREATMENT APPROACHES - Non invasive:
• Trigger point release
• Massage, soft tissue work
• Spray and stretch (vapocoolant)
• Neuromuscular Techniques (PIR PNF MET)
• Heat/cold
• Myofascial Release (MFR)