Trigger Point Therapy MADE SIMPLE

Trigger Point Therapy MADE SIMPLE: Notes

Introduction

• Sally's Dilemma: Sally's back pain at 3:00 a.m. highlights the loneliness of pain without hope.

• Purpose of the Book: To provide hope and skills for pain relief.

• Target Audience: Both beginners and those experienced in pain management.

• Author's Journey: The author's experience with pain after a bicycle accident led to becoming a myofascial trigger point therapist and educator.

• Importance of Self-Treatment: Emphasizes that personal involvement in healthcare is crucial for success.

• Book Focus: Practical methods that work for pain management.

• Goal: To help readers understand and deal with their pain, offering a fighting chance for relief.

PART ONE: What to Know

• Purpose: To provide foundational knowledge about the origins of pain and available treatments.

• Analogy: Part 1 is the vocabulary needed to understand the more complex concepts in Part 2.

CHAPTER ONE: Trigger Points 101

• Goal: To provide essential information about trigger points and their therapy to understand the source of pain and how the book's techniques can help.

Trigger Points: The Basics

• Definition: A trigger point is essentially a tender spot or knot in a muscle.

• Technical Explanation: Trigger points are areas where muscle fibers have shortened and remain contracted.

• Mechanism: The shortening occurs near the nerve supplying the muscle, causing stretching on either side of the knot.

• Identification: Professionals find trigger points by identifying taut bands of muscle fibers and nodules.

• Myofascial Pain: These nodules cause pain related to muscles or fasciae.

• Inflammation: A 2008 study by Jay Shah found inflammatory chemicals within trigger points, explaining their tenderness.

What Causes Trigger Points?

• Limited Research: Muscles lack a dedicated medical specialty, leading to less research on trigger points.

• Imaging Challenges: Trigger points are small and made of soft tissue, making them undetectable on standard imaging tests.

• Current Theory: Nerve irritation can cause muscle fibers to shorten into a knot, sending pain signals and causing numbness or tingling.

• Detection: Trigger points can be felt as BBs, beans, or marbles.

• Common Causes: Physical trauma, stress, and chronic diseases can lead to trigger points.

• Important Note: Muscle pain can stem from various causes, including ulcers or appendicitis, necessitating consultation with a doctor to rule out other underlying causes.

What Are the Effects of Trigger Points?

• Varied Sensations: Trigger points can cause pain, numbness, or tingling, often described as dull and aching.

• Pain as Experience: Pain is an experience influenced by understanding, feelings, and physical input.

• Association with Conditions: Trigger points are common in fibromyalgia, arthritis, carpal tunnel syndrome, TMJ disorder, headaches, and plantar fasciitis.

• Referred Pain: Trigger points can cause pain in areas distant from the trigger point due to interconnected muscles, fasciae, and nerves.

• Spinal Involvement: It's crucial to treat both the spine and the muscle.

A Note on Medication

• Emphasis on Alternatives: Given the opioid epidemic, the book promotes non-opioid pain relief techniques.

What Is Trigger Point Therapy?

• Origin: Trigger point therapy was developed by Dr. Janet G. Travell, prompted by her own experience with referred pain.

• Application: Used in massage, chiropractic, physical therapy, and self-care at home.

How Does Trigger Point Therapy Work?

• Nervous System Response: Pressure can lengthen shortened muscle fibers, prompting the brain to release natural painkillers.

• Skin Nerve Response: Gentle pressure signals pleasant touch, reducing tension. Intense pressure releases endorphins.

• $Happy brain, decreased pain$

• Recurrence: Re-irritation can bring back trigger points, but the book teaches how to manage this.

“It’s All in Your Head”?

• Validity of Pain: Emphasizes that chronic pain is real, even if not understood by others or detectable by standard tests.

• Mental Component: The brain processes pain based on input from the body, emotions, experiences, and understanding of the issue.

Does Trigger Point Therapy Hurt?

• Control Over Pressure: Individuals control the amount of pressure applied during therapy.

• Comfort Level: Discomfort should be bearable or even comfortable, and breathing should remain normal.

Do I Need Professional Help?

• Emphasis on Self-Care: Highlights that individuals are often their own best therapists, especially with chronic pain.

• Benefits of Professional Help: Recommends myofascial trigger point therapists, neuromuscular massage therapists, chiropractors, and physical therapists.

Beyond Massage

• Spray and Stretch: Topical anesthetic with gentle stretching.

• Dry Needling: Acupuncture needles on trigger points.

• Wet Needling: Anesthetics injected into trigger points.

• Frequency-Specific Microcurrent (FSM): Electrical current with profound effect.

• Avazzia: Electrical current to decrease sensitivity and restore flexibility.

What to Expect

• Relief: Expect to control or reduce pain with regular treatment.

• Maintenance: Continued daily work may be needed for well-established trigger points.

• Benefits of Self-Treatment: Significant decrease in pain, improved daily function, and reduced reliance on medication.

• Independence: Self-management of trigger points provides freedom from pain.

CHAPTER TWO: Essential Pain Relief Techniques

• Goal: To equip readers with the basic tools and techniques for performing trigger point therapy at home.

Massage Techniques

• Importance of Specific Techniques: Addresses the disappointment from generalized massage.

• Optimal Approach: Involves paraspinal massage, nerve flossing, compression massage, and Swedish movements.

Paraspinal Massage

• Mechanism: Nerves transmit sensations through the spine, so massaging muscles alongside the spine (paraspinal muscles) can treat pain in other areas.

• Spinal Regions: Spine consists of 33 vertebrae divided into cervical, thoracic, lumbar, sacral, and coccyx regions.

• Treatment Example: Massaging paraspinal muscles near C5-C7 can alleviate trapezius pain.

Nerve Flossing

• Definition: (nerve gliding or neural gliding) is considered a form of friction massage.

• Mechanism: Nerve flossing involves movements that slide nerves back and forth, improving range of motion and reducing pain.

• Application: Nerve flossing before trigger point treatment can relax muscles and improve treatment effectiveness.

Finding the Trigger Point

1. Stretch the muscle causing pain and pinpoint a pull or tightness.

2. Probe using fingers across the muscle for the tender band.

3. Rub fingers across the muscle's fibers to find a tender spot.

Trigger Point Compression Massage

• Technique: Apply direct pressure to the trigger point for 10-60 seconds.

• Tools: Use fingers or self-massage tools.

• Sensation: Aim for a sensation between pleasure and pain, while maintaining normal breathing and muscle relaxation.

Swedish Movements

• Background: Gentle range-of-motion movements to improve circulation.

• Decline and Revival: Declined after the polio epidemic.

• Technique:

  1. Start in a neutral position.

  2. Move muscle from a neutral position toward a lengthened position without holding.

  3. Return to the neutral positoin, pause for one second.

  4. Move muscle from neutral position toward a shortened position wihtout holding.

  5. Return to the neutral positoin, pause for one second.

  6. Repeat four more times for a total of five repetitions.

The Right Tools for the Job

• Importance of Proper Tools: Like carpenters or mechanics, having the right tools is essential for effective self-massage.

Your Hands

• Guidance: Trimming, gentle pressure, straight wrist, leveraging Pisiform bone lock, utilizing elbow, and emphasize leverage.

Hooks and Knobs

• Description: Recommended to save the hands and reach inaccessible regions.

  • Big Bend Backnobber: Target paraspinal muscles.

  • Thumbby/Knobble: Small knobs to apply pressure.

  • Acumasseur: Nutcracker-like device with golf balls to squeeze muscle knots.

Balls

• Technique: Use tennis balls (gentle), racquetballs (higher back), and large toy-store balls (belly) for gentle treatment

  • Original Worm: Four balls in a soft neoprene case.

Rollers

• Description: Tiger Tail (portable).

Pain Relief Gel

• Description: DERM Creations' O2 Derm Relief (applied on spinal verve supply and trigger point).

Safety First

• Key Points: avoid pulsing a pulse, red areas (lymph nodes, artery) and

Term 1: What is a trigger point?
Definition 1: A tender spot or knot in a muscle where muscle fibers have shortened and remain contracted.
Term 2: How do professionals identify trigger points?
Definition 2: By identifying taut bands of muscle fibers and nodules.
Term 3: What are common causes of trigger points?
Definition 3: Physical trauma, stress, and chronic diseases.
Term 4: What sensations can trigger points cause?
Definition 4: Pain, numbness, or tingling, often described as dull and aching.
Term 5: What is referred pain?
Definition 5: Pain in areas distant from the trigger point due to interconnected muscles, fasciae, and nerves.
Term 6: Who developed trigger point therapy?
Definition 6: Dr. Janet G. Travell.
Term 7: How does trigger point therapy work?
Definition 7: Pressure can lengthen shortened muscle fibers, prompting the brain to release natural painkillers.
Term 8: What is the emphasis of the book given the opioid epidemic?
Definition 8: Non-opioid pain relief techniques.
Term 9: What should individuals control during trigger point therapy?
Definition 9: The amount of pressure applied.
Term 10: What are some benefits of self-treatment?
Definition 10: Significant decrease in pain, improved daily function, and reduced reliance on medication.
Term 11: Define nerve flossing
Definition 11: Movements that slide nerves back and forth, improving range of motion and reducing pain. It is considered a form of friction massage
Term 12: Why is paraspinal massage important?
Definition 12: Nerves transmit sensations through the spine, so massaging muscles alongside the spine can treat pain in other areas.
Term 13: What is Trigger Point Compression Massage?
Definition 13: Apply direct pressure to the trigger point for 10-60 seconds using fingers or self-massage tools, aiming for a sensation between pleasure and pain.
Term 14: Provide one safety tip for massage
Definition 14: Avoid pulsing a pulse, red areas (lymph nodes, artery)
Term 15: Name one kind of tool that can be used for self massage
Definition 15: Hooks and Knobs, Balls, Rollers