Trigger points are distinct knots or taut bands of contracted fibers within muscles or muscle groups that cause myofascial pain to spread to the surrounding tissue and joints as the contracted muscles pull on tendons and ligaments. These trigger points can be activated by a variety of systemic conditions, including overuse, physical injuries, strains, infections, allergies, stress, and psychological distress. They may lie dormant for years as latent trigger points until switched on by pressure or strain. Pain can also radiate (be referred) to more distant places in the body along nerve pathways, and secondary and satellite trigger points can be activated when the primary point is palpated. When muscles are working normally, they exhibit the capacity to respond to stimuli and to contract and extend in a balanced way. But if trigger points have been activated, the muscles will not return to their normal position after a contraction. The symptoms of the dysfunction can be pain, weakness, or restrictions in mobility. There are more than 600 potential trigger points in the human body, and their pain and referral patterns are the same in most people. This has allowed therapists to create trigger-point maps that can be used in treating these points.
The therapy that has evolved over the years offers a precise neuromuscular treatment for the relief of acute or chronic muscle pain that often presents itself as spasms and cramping. Dr. Janet Travell pioneered the practice of Trigger Point Release Therapy in the 1940s after these points were first identified in Europe. Dr. Travell and later Dr. David Simons both undertook research that revealed much about the causal relationship between chronic pain and its source. Originally, injections of a saline solution were used to treat these points. In fact, Dr. Travell used injections to treat President John F. Kennedy’s back pain while she was the White House physician. At that time, assisted stretching along with cooling sprays were also employed as part of the treatment.
Further development of this therapy came about in 1976 when physical therapist Bonnie Prudden began using manual pressure to release trigger points. Over the next decade, she developed a method known as Myotherapy, the umbrella system under which Trigger Point Release is now found. Myotherapy is a form of treatment that applies pressure on the painful points that may be triggering pain in other areas of the body. The complete therapy can call on a variety of bodywork methods such as Deep Tissue Massage, Myofascial Release, Proprioceptive Neuromuscular Facilitation stretching exercises, joint mobilization, electrostimulation, heat therapies, Cryotherapy, and some ancient healing methods. The primary aim of this therapy is to seek out sensitive trigger points and apply specific techniques to deactivate them in order to restore full muscle length and strength. However, sustained relief also requires resolution of the factors that caused the problem.
A key part of a Trigger Point Release session is encouraging the client to be personally responsible by communicating fully with the therapist. During a session, specific palpation techniques are used to identify trigger points within a muscle. Then these points are treated with intense, sustained pressure and compression applied by fingers, knuckles, elbows, or specially designed tools intended to prevent stress on the practitioner’s body. The goal of the treatment is to break up cycles of spasm or pain and reeducate the muscles in order to return them to normal functioning. The practitioner needs to apply sufficient pressure on these points to release their chronic condition by interrupting the stress reflex. Although the amount of pressure may be uncomfortable, it should not be so strong that the muscle contracts further to protect itself. Pressure is commonly held on each point until the recipient feels the soreness dissipate, typically within five to eight seconds. After compression, the practitioner gently stretches and manipulates the surrounding muscle tissue to further help reduce local constrictions, free the nerves, relax the muscles, and prevent further stress from reactivating the trigger points. These manipulations include lengthening strokes, stretching, spreading, and finger, knuckle, and elbow pressing. Friction strokes are also used to release any tight muscle bands that are associated with the trigger points. These help warm up the muscles, thus improving circulation and the removal of waste from the body. As the muscles relax into a natural extended position, the bones can also return to their correct position, and the body will be in proper alignment. The specific corrective measures taken vary with each practitioner, and sometimes heat or a jet of water may be used to passively stretch the muscles or an anesthetic agent may be injected into the trigger point. Trigger Point Release Therapy can also include the use of a tapping technique, in which a tennis ball is applied over sensitive spots on the spine that may align with acupressure points. In all cases, the goal of this corrective therapy is to prevent the problems from recurring. At the end of a treatment, the client is instructed in corrective self-help exercises and stretching techniques that can be practiced at home as part of a pain-management program. Since a period of muscle soreness can exist for a time after a treatment, a nice hot bath is considered a good follow-up indulgence if any pains persist. Although this form of therapy does not specifically address the release of trauma, individuals who hold significant emotional issues in their tissues may very well realize a beneficial emotional release.
Contact: American Institute of Myofascial Studies – www.aims-llc.org or National Association of Myofascial Trigger Point Therapists – www.myofascialtherapy.org