JOHN EVERARD, L.M.T.

TRIGGER POINT MASSAGE

What can be done to help headaches, migraines, plantar faciatis, bunions, neck stiffness, carpal tunnel like symptoms, tennis elbow, bursitis, frozen shoulder, back pain, low back stiffness, sciatica, and shin splints and even TMJ pain?

If we are to have long, quality lives we must take care of our largest organ, the muscle. The pain we feel in our muscles will slow us down. The every day stress and pressures along with injuries, trauma, arthritis, and fibromyalgia (muscle fiber pain) will take years off of our lives.

Trigger points can present themselves as referred patterns of sensation such as sharp pain, dull ache, tingling, pins and needles, hot or cold, as well as can create symptoms such as nausea, ear ache, equilibrium disturbance, or blurred vision. These small, hyperirritable sites in the muscle tissue sometimes refer pain to other locations as in headaches or sciatica. Skin conditions such as wrinkles, moles, and birth marks can also be indications of trigger points.

Trigger point therapy may be the answer. It is a type of massage therapy which examines and treats muscles and muscle attachments in layers. It addresses surface muscles and connective tissues and deeper ligaments and connective tissues.

Trigger points usually occur up and down your body along the length off the muscle. They are most common in the muscles that control movement of the body from side to side, especially those used to maintain posture, but can be found throughout the body.
Trigger points will occur where the nerve attaches to the muscle. They are invisible when they start, so they go unnoticed at first.

Referred Pain
Trigger point pain can be felt where it seems to originate but most often the pain is “referred” in consistent patterns. A pain in our lower back might actually be a trigger point in out calf muscle or an abdominal muscle issue.

Trigger point areas have been charted and are predictable, consistent, and usually the pain is experienced in areas located away from the trigger point. The referred pain is often described as dull, aching, and deep, and it can be constant or occur off and on. Manipulating a trigger point elicits referred pain and often slight nausea.

Active and Latent Trigger Points
Like a volcano trigger points can be classified as either active or latent. Silent, merely smoking or out and out hot lava. Active trigger points cause ongoing, persistent pain. Most often causing other trigger points to act up in the muscles.; latent trigger points are pain free until pressed. The pain on this kind of trigger point has been dispersed out; relatively unnoticeable except having a general feeling of unwellness. The “smoking” trigger point will hurt on and off, depending on circumstances such as weather, nutrition and daily activities. They all will react to a local twitch response when pressed. They are often associated with decreased range of motion, weakness in the affected muscle group, and decreased ability of the muscle to stretch. Often, active trigger points can cause “satellite,” or secondary, trigger points in the reference zone that respond because of the increased stress to the involved muscle groups. For example an active trigger point in the back can create pain and eventually and satellite trigger point in the shoulder. Treating the shoulder trigger point will not have a lasting effect without treating the originating trigger point in the back.

Trigger points will eventually cause spasms when many become active all at once such as in “restless leg syndrome”. (A condition is referred to as a ‘syndrome’ when no known reason can be determined for the actual issue a person experiences. I personally believe that many of these ‘syndromes‘ are actually caused by trigger points thus supplying the REASON for the issues!) Spasms will cause a reduction of blood flow to the affected area thus reducing the supply of oxygen. This will cause poor posture, short leg ‘syndrome’ and guarded movements of all sorts.

Origins of Trigger Point Therapy
Trigger point therapy is one of the largest and fastest growing muscle therapies today. Janet Travell, M.D., the White House physician under former President John F. Kennedy, and Dr. David Simons initially coined the phrase “trigger point therapy” to describe their then cutting edge treatments involving saline injections into muscle, stretches and heat therapy to resolve trouble spots. Travell used these techniques to treat JFK’s back pain. In the 1970’s Bonnie Prudden advanced Travell and Simons’ methods by developing a system of non-invasive techniques, which are widely used today by professional athletes, massage and physical therapists, and prescribed and recommended by medical doctors.

A Typical Treatment Session
A thorough physical examination should be performed, with a focus on the area of pain and discomfort. The therapist should start by observing the patient’s movements and posture, looking for poor posture, muscle strain, pain that increases guarding, and increased pain in other muscle groups. Trigger points cause muscle shortening with secondary weakness and decreased range of motion which can be observed.

To facilitate the identification of trigger points, you should be as relaxed as possible. Trigger points can be felt by palpating the muscles; trigger points will consist of tender, hard (or ropy) knots or nodules surrounded by what feels like normal muscle tissue. Once a trigger point has been found, the local twitch response may be elicited as muscle or skin twitching. You should feel sour or numb, but not knife-cut like pain when the trigger point is pressed. The trigger points are usually between or beside the bones and tendons or ligaments, on a depression, never on the bones or blood vessels. Next, the patient should be evaluated for referred pain. Knowledge of reference zones is essential to the diagnosis.

The therapist locates and deactivates `trigger points’, which are often tender areas where muscles have been damaged or acquired a re-occurring spasm or `kink’ that worsens painfully when aggravated. The major goal is to reduce spasms inducing new blood flow into the affected area. This will in turn increase the regrowth of healthy muscles as well as the connective tissues surrounding the muscles. Eliminating trigger points will also decrease the vein blood being “bottled up” meaning less toxins trapped in the system. ( This explains why some people feel nausea during treatments since these toxins are no able to move out through the blood systems) This is important for total systemic relief. Medical reports say we have anywhere from 60-70 % vein blood. In addition to this our lymph and interstial fluid carry another 15 % of “dirty”, used fluids away from our muscles. Our arteries make up between 15 and 25 % of healthy blood. Trigger point therapy can increase a more healthy circulation system, faster healing time from injuries, as well as a better immune system. We can have more energy and less stress. Our organs are designed to operate with efficiency and trigger point therapy can help our organs to get back to do this very thing!

Trigger Points – How they are created
Trigger points are clustered areas of pain in or around muscles that usually radiate pain in a predictable pattern. When a muscle, or group of muscles, incurs injury, it automatically contracts around the painful site to support and protect the area. If pain is resolved quickly, the muscles can relax. If pain persists, muscles can become habitually contracted. STRESS in the body! Sometimes contractions press on nerves causing tingling, numbness, and more pain. Like a sponge that is squeezed, a contracted muscle can’t hold much blood. Blood transports oxygen and nutrients to the muscles and carries away waste products. When a muscle is deprived of healthy circulation, it doesn’t receive enough oxygen and nutrients, and waste products accumulate. This can result in fatigue and soreness. It can also irritate nerves in the area, causing pain to spread beyond the congested area.

Nutrition
Good nutrition is essential too! Lack of vitamins, minerals, and proper hydration also cause stress to our musculature. Green leafy vegetables, colorful vegetables of all kinds should be the mainstay of our diets. Good quality fiber sources found in whole grains are important. We are what we eat and the health of our muscles are a window to our whole body health and well being. Good health to you!