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Trigger Point Therapy Definitions
Trigger point -
(Myofascial): An area of hyper-irritability within soft tissue
structures, characterized by local tenderness and sometimes referred phenomena.
These referred sensations can include pain, tingling, numbness
burning,
or itching.
-
Not all trigger points refer pain, some are
just localized. Each person is different depending on their life
history.
-
Localized areas of deep tenderness and increased
tissue resistance that often produce referred pain.
-
The origin of the trigger point is thought
to be changes in the chemical balance in a local area, irritating the sensory
systems.
Active trigger point: Cause
of the immediate pain, prevents muscle from fully lengthening and
sometimes weakens.
Latent trigger point:
Unnoticed by the client until pressure is applied, Not actively painful.
Usually feels dense and fibrous.
Characteristics
-
Trigger points may be associated with Vitamin
B-6 and other vitamin deficiencies. Usually after a trauma
or stressful event, the body is lacking in B-6, magnesium or Vitamin C.
Trigger points are more likely to develop.
-
Trigger point are usually bilateral, with
one side being more symptomatic than the other. Both sides need to
be treated.
-
Trigger points may be a result of underlying
visceral disease, arthritic joints, or other trigger points.
-
The most tender trigger points are usually
not the source of the problem. Other areas need to be treated like the
referral area and the surrounding tissue. Look for tight stringy
band in small supporting musculature.
-
Trigger points can cause referred pain, but
not always.
-
The referral patterns are not the same in
any 2 people.
-
Referred pain does not follow segmental, scleratomal
or dermatomal patterns.
-
May cause pain and stiffness especially after
periods of inactivity such as sleeping or sitting for awhile.
Possible Causes:
-
Acute overload, overwork, fatigue, direct
trauma, chilling.
-
skeletal asymmetry such as short leg or pelvic
imbalances.
-
Other trigger points can cause new points to
occur.
-
Arthritic joints can cause trigger points.
-
Visceral diseases such as ulcers, renal colic,
myocardial infarction, gall stones, kidney problems, irritable bowel syndrome
can cause trigger points.
-
B-6, magnesium, vitamin C, folic acid deficiencies
which are common after injuries or trauma may cause trigger points
-
hypoglycemia
-
chronic infection from a viral or bacterial
disease.
-
food allergies or intolerances. Wheat
and dairy products should be checked first.
-
toxicity due to exposure to organic chemicals
or heavy metals
Location:
Trigger points may develop any where in
the body, but are most commonly found at the sites of the greatest mechanical
and postural stress.
Hints for locating:
-
look for changes in thickness of tissue, resistance
to gliding strokes, lumps or strings.
-
immobility
-
edema
-
pain or tenderness
-
temperature changes-area is usually colder
-
color most often somewhat pale and unhealthy
looking
-
muscle shortening with weakness
-
occasionally increased perspiration in reference
zone
-
hypertonicity
-
ischemia
Factors that can worsen trigger points:
-
fatigue, improper sleep
-
chronic infection
-
severe stress (mental, emotional, physical)
-
nerve entrapment, compression
-
excessive creatine in urine
-
postural imbalances
-
nutritional health of the tissue
-
food allergy, inhalant allergy
-
visceral (organ) disease - gall bladder problems,
ulcers, kidney problems, irritable bowel syndrome
-
exercise may worsen an active trigger point,
but helps heal a latent trigger points
Signs of Trigger points:
-
restricted movement, stiffness of muscles
-
weakness in muscles
-
passive or active stretching increases pain
-
resisted contraction causes pain
-
subcutaneous tissue feels coarsely granular,
ropy, knotty,
-
client "jumps" when pressure applied to trigger
point
-
deep tenderness and paresthesia
-
client may feel "Numb" but sensation is normal
-
dizziness
-
taut palpable band in the affected muscle
-
exercise makes the pain worse when there are
active trigger points, but helps heal the latent triggerpoints
-
hyperirritability, increased metabolism, decreased
circulation
Thing to pay attention to:
-
What layer of tissue are you working on?
-
How can you work more efficiently?
-
What does the tissue feel like? How
does it change?
-
What other areas may be associated with the
trigger point?
Cautions:
-
Triggerpoint therapy can relieve the pain
of angina, myocardial infarction and acute abdominal disease. Refer
clients to physicians when necessary.
-
Rule out such conditions as: Tendinitis, bursitis, giant cell arteritis, neuralgia, infection (both viral and bacterial),
neuropathies, disc problems, disc herniations.
-
Check for thyroid malfunction, anemia, hypoglycemia
and vitamin deficiencies.
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