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TRIGGER POINT RELEASE THERAPY |
In utilizing Trigger Point Release therapy, we are able to "turn off" the injured/overused/misused muscle at its trigger point (imagine it as the "light switch" of the muscle). Depending on the degree of injury and/or length of time of injury, the client's initial experience of relief can last from a few hours to a couple of days. The more often the primary Trigger Point can be "switched off", the quicker the pain relief and the longer the release will last (mostly due to muscle memory and the re-training of that muscle memory). If you decide that you'd like to try Trigger Point Release therapy, you can use it as an add-on to a massage (Swedish or Deep Tissue) or as a 30-minute standalone. Please do not expect a tranquil spa-like experience with this modality - it was created to assist in healing muscular aches and injuries. An active trigger point can be very sensitive and painful but the good news is that it won't take longer than about 90 seconds to release and feel better. You'll be amazed at how looser and more relaxed your muscles will feel afterward. In order to facilitate in the client's own healing and their increase in body awareness (realizing what their body is doing and where it's holding tension), there is constant verbal feedback between the therapist and client throughout the session - this is not an option and once you experience a session, you will understand why. A bit of soreness can sometimes be experienced by the client after the session (approximately 24 hours). If you would like more information about this technique, click on the links at the top of this page. 8-8-2008 Gilda Hart, LMT Wholeness Therapeutic Massage |
| DEFINITION OF TRIGGER POINTS |
(Cited from http://en.wikipedia.org/w/index.php?title=Trigger_point&oldid=204576766 )The term "trigger point" was coined by Dr Janet Travell (1942) to describe a clinical finding with the following chacteristics:
One criticism of the trigger point concept is that practitioners do not necessarily agree on what constitutes a trigger point. A study by Gerwin et al. found that independent examiners were generally able to identify myofascial trigger points (MTrP), but only with sufficient training and agreement on the definition and features of MTrP's. Gerwin et al. said: Three previous studies (Nice et al., 1992; Wolfe et al., 1992; Njoo and Van der Does, 1994) have examined this problem, and none of them could establish the reliability of MTrP examination in all of its major manifestations. ... The present study shows that four examiners can achieve statistically significant agreement, at times almost perfect agreement, about the presence or absence of five major features of the MTrP and on the presence or absence of the TrP, whether it be latent or active. This establishes the MTrP as a reliable clinical sign. The present study also shows that these features are identified with greater or lesser reliability depending on the specific feature and the specific muscle being examined. ... A training period was found to be essential in order to achieve these results.[2]A 2007 review of diagnostic criteria used in studies of trigger points concluded that there is as yet limited consensus on case definition in respect of MTrP pain syndrome. Further research is needed to test the reliability and validity of diagnostic criteria. Until reliable diagnostic criteria have been established, there is a need for greater transparency in research papers on how a case of MTrP pain syndrome is defined, and claims for effective interventions in treating the condition should be viewed with caution.[1] |
| EXPLANATION OF TECHNIQUE |
(Cited from http://precision-fitness.net/tp_therapy.html ) A trigger point is an area of a muscle (about 50 cells) that may refer pain sensations to other parts of the body. Trigger Point Therapy applies manual pressure, or CO2 injections, to these points. With the proper pressure, duration and location, immediate release of tension and improved muscular functioning may occur. This therapy has been known to diminish migraine pain, mock sciatica, mock carpal tunnel syndrome and other pain syndromes, and other symptoms that may have been misdiagnosed. This work is based upon the trigger point research and manuals of Dr. Janet Travell, President Kennedy's physician. Sometimes this work is incorporated into other styles of massage therapy such as neuromusclar therapy (NMT) or even Swedish. ---------- In using Trigger Point Release therapy, I utilize the involvement and feedback of the client. When a trigger point has been located, pressure is held on it until the client feels that the pain has subsided to about half of what it was initially. Many times the client will feel the entire area completely relax and loosen as well. While Trigger Point areas are sensitive and painful initially, the pain only tends to last as long as one minute. Many describe Trigger Point pain differently as everyone's perception of pain is also different. I have found also that the Trigger Point pain will vary from one body location to another and the intensity may also rest on how long the muscle fiber has been contracted (the longer the injury, the more painful the site). Site pain has been described as anything from an electrical type pain to a burning stabbing pain. Gilda Hart, LMT |
| HISTORY |
(Cited from http://en.wikipedia.org/w/index.php?title=Trigger_point&oldid=204576766 ) Trigger points have been a subject of study by a small number of doctors for several decades although this has not become part of mainstream medicine. The existence of tender areas and zones of induration in muscles has been recognized in medicine for many years and was described as muscular rheumatism or fibrositis in English; German terms included myogelose and myalgie. However, there was little agreement about what they meant. Important work was carried out by J. H. Kellgren at University College Hospital, London, in the 1930s and, independently, by Michael Gutstein in Berlin and Michael Kelly in Australia (the latter two workers continued to publish into the 1950s and 1960s). Kellgren conducted experiments in which he injected saline into healthy volunteers and showed that this gave rise to zones of referred extremity pain. Today, much treatment of trigger points and their pain complexes are handled by Myofascial Trigger Point Therapists [4], massage therapists, physical therapists, osteopaths, occupational therapists, myotherapists , some naturopaths, chiropractors, dentists and acupuncturists[5], and other hands-on somatic practitioners who have had experience or training in the field of neuromuscular therapy (NMT). |
| Janet Travell, MD and David Simons, MD |
(Cited from http://www.triggerpointbook.com/travell.htm ) Janet G. Travell, MD (1901-1997)Among those who recognize the reality and importance of myofascial pain, Janet Travell is generally recognized as the leading pioneer in its diagnosis and treatment. Few would deny that she single-handedly created this branch of medicine. Many would contend that it's the world’s great loss that her amazing career was not crowned with the recognition that would have come with a Nobel Prize. At the time the first volume of her book went to press in 1983, she had been studying and treating trigger points and referred pain for over forty years. She had already published more than forty articles about her research in medical journals, the first appearing in 1942. Her revolutionary concepts about pain have improved the lives of millions of people. Trigger point massage, the most effective modality used by massage therapists for the relief of pain, is based almost entirely on Dr. Travell’s insights. The innovative clinical techniques for the treatment of pain that are beginning to be used by physicians and physical therapists all over the world wouldn’t have existed without Dr. Travell’s dedicated energy and intelligence. Dr. Travell’s personal success with one particular patient had a far-reaching effect on history. Not many people remember that Janet Travell was the White House Physician during the Kennedy and Johnson administrations. President Kennedy honored her with that position in gratitude for her treatment of the debilitating myofascial pain and certain other ailments that in 1955 had threatened to prematurely end his political career. It’s a stunning example of how trigger point therapy can change someone’s life and destiny. Although in her sixties at the end of her duties at the White House, Dr. Travell had no intention of retiring or even slowing down. She went on developing and teaching her methods with vigor and enthusiasm for the next thirty years. She was past eighty when the first volume of her grand opus, Myofascial Pain & Dysfunction: The Trigger Point Manual was published, and past ninety when the second volume appeared. She refused to rush into print: she wanted to get it right. David G. Simons, MD (1922- )David Simons lends authority to the study of myofascial pain with his long experience as a research scientist. In his early areer, Dr. Simons worked as an aerospace physician, developing improved methods of measuring physiological responses to the stress of weightlessness. A fascinating sidelight to Dr. Simons’s career is the world altitude record for manned balloon flight he set in 1957 as a young Air Force Flight Surgeon. In point of fact, he beat Sputnik into space. He was featured on the cover of Life magazine that year and subsequently wrote a book, Man High, about his adventure. Drs. Travell and Simons first met when she lectured about trigger points and myofascial pain at the Air Force’s School of Aerospace Medicine. Simons was so intrigued by Travell’s work that he eventually retired from the Air Force and began a long informal apprenticeship under her wing. An intense synergy developed between the two over the next twenty years, culminating at last in the production of The Trigger Point Manual, an inspiring testament to the transcendent power generated when two minds of uncommon intelligence work together. Dr. Simons’s strict attention to detail and adherence to scientific method helped him bring rigorous objectivity to the documentation of myofascial pain. He was the driving force in getting the Travell and Simons books written, doing most of the actual writing himself, with Dr. Travell’s vast knowledge and experience as his primary resource. One day, when ordinary people know about trigger points and the diagnosis and treatment of myofascial pain is taught widely in medical schools, physicians everywhere will honor Doctor Simons, along with his mentor, Dr. Travell, as true medical pioneers. Into his eighties now, David Simons is still hard at work promoting further research concerning trigger points. His latest book, Muscle Pain: Understanding its Nature, Diagnosis, and Treatment, with coauthor Doctor Siegfried Mense, seeks to impart a better understanding of the neurophysiology of muscles. |
| Trigger Point Research |
(Extracted from PMID: 14723558 [PubMed - indexed for MEDLINE] ) Pain and Orthopedic Neurology, Charlotte Spine Center, Charlotte, North Carolina 28207, USA. pon@caro.net Voluntary muscle is the largest human organ system. The musculotendinous contractual unit sustains posture against gravity and actuates movement against inertia. Muscular injury can occur when soft tissues are exposed to single or recurrent episodes of biomechanical overloading. Muscular pain is often attributed to a myofascial pain disorder, a condition originally described by Drs Janet Travell and David Simons. Among patients seeking treatment from a variety of medical specialists, myofascial pain has been reported to vary from 30% to 93% depending on the subspecialty practice and setting. Forty-four million Americans are estimated to have myofascial pain; however, controversy exists between medical specialists regarding the diagnostic criteria for myofascial pain disorders and their existence as a pathological entity. Muscles with activity or injury-related pain are usually abnormally shortened with increased tone and tension. In addition, myofascial pain disorders are characterised by the presence of tender, firm nodules called trigger points. Within each trigger point is a hyperirritable spot, the 'taut-band', which is composed of hypercontracted extrafusal muscle fibres. Palpation of this spot within the trigger point provokes radiating, aching-type pain into localised reference zones. Research suggests that myofascial pain and dysfunction with characteristic trigger points and taut-bands are a spinal reflex disorder caused by a reverberating circuit of sustained neural activity in a specific spinal cord segment. The treatment of myofascial pain disorders requires that symptomatic trigger points and muscles are identified as primary or ancillary pain generators. Mechanical, thermal and chemical treatments, which neurophysiologically or physically denervate the neural loop of the trigger point, can result in reduced pain and temporary resolution of muscular overcontraction. Most experts believe that appropriate treatment should be directed at the trigger point to restore normal muscle length and proper biomechanical orientation of myofascial elements, followed by treatment that includes strengthening and stretching of the affected muscle. Chronic myofascial pain is usually a product of both physical and psychosocial influences that complicate convalescence. |
http://generalmedicine.suite101.com/article.cfm/trigger_points_for_muscle_pain http://www.easyvigour.net.nz/trigger_points/h_triggerpoint4.htm http://www.trisoma.com/trigger-point.html http://triggerpoints.net/ |
