Trigger Point Therapy

March 3, 2006

Good Morning!

Trigger Point Therapy or Myofascial Therapy is a unique treatment

protocol for the treatment of myofascial pain. Trigger Points produce

pain locally and in a referred pattern and often accompany chronic

musculoskeletal disorders. The purpose of trigger point therapy is to

eliminate pain and to re-educate the muscles into pain-free habits.

Treatment of trigger points involves the application of sustained

pressure for a period long enough to release the muscle spasm, which

is causing the pain.

The Trigger Point Therapy procedure is one of the most powerful, yet

simplest ways to treat muscle pain.

Based on the idea that pain in a certain muscle group stems from

where the muscle insertion is, the particular muscle group innervates

and its origin, great relief can be accomplished by massaging these

regions.

Refer to Chart found here:

http://health.ph./photos/view/1961?b=6

Trigger Points

1,2. Occiput: The back part of the head or skull at insertion of

subocciptal muscles.

Lower cervical: at the anterior aspect of the intertransverse spaces

at C5 - C7

3,4. Sternocleidomastoid: (SCM) muscle, rotation of the head and

neck, upper cervical extensor, a flexor of the cervical spine on the

thoracic spine, and lateral flexor.

5,6. Trapezius: midpoint of upper border, spinous processes and

supraspinous ligaments to T12. Laterally rotates, elevates and

retracts scapula. If scapula is fixed, extends and laterally flexes

neck

7, 8. Rhomboids: bring the scapula in towards the spinal column,

squeeze the shoulder blades together when they are used at the same

time.

Supraspinatus: at origins above scapula spine medial border

9, 10. 2nd Rib: second costochondrial junction, just lateral.

11, 12. Lateral epicondyle: 2cm distal to epicondyles, action

includes grasping muscles (extensor carpi radialis brevis and longus)

and supination muscles (supinator longus and brevis) of the forearm,

which originate on the lateral epicondyle of the elbow.

13, 14. Greater trochanter: posterior to the trochanteric prominence

15, 16. Gluteal: upper outer quadrant, anterior fold of muscle

Piriformis: muscle originates at the front the sacrum, passes through

the greater sciatic notch to attach to the top of the femur at its

bony prominence called the greater trochanter. The gluteus maximus

covers the piriformis muscle.

17, 18. Knees: medial fat pad, proximal to the joint line

Sartorius: the longest muscle in the body, originates from the iliac

spine and goes across the front of the upper thigh from the side to

the middle and then descends vertically to the knee. It inserts into

the surface of the body of the tibia.

The muscles involved with pain are frequently found by recognizing

the " pain pattern " .

1. A history of widespread pain of at least 3 months in duration.

2.Widespread pain falls into the following categories:

* Present- pain on the left side of the body

* Pain on the right side of the body

* Pain above and below the waist

* Plus axial skeletal pain (cervical spine or anterior chest or

thoracic spine or low back) must be present.

Fibromyalgia Diagnostic Criteria:

1. Pain in 11 of 18 designated tender point sites on digital

palpation.

2. Plus some or all of the following:

Sleep disturbance, fatigue, anxiety, headache, irritable bowel

syndrome, subjective swelling, numbness as well as modulation of

symptoms by activity, weather factors and aggravation by stress or

anxiety.

How to Use the Charts:

1) Identify the region on the body closest to the patient's pain

2) Check the muscles at the top of the list first. They are most

likely to be the cause of pain in the area, although any one of the

muscles may be the cause.

3) Check each muscle for restricted range of motion. The muscle or

muscles which can not sustain full stretch or which cause pain " on

the stretch " should be palpated and checked for trigger points.

4) Once the trigger points have been located, treat them with Trigger

Point Elimination Techniques.

5) Always follow Trigger Point Elimination Techniques with proper

stretching, range of motion exercise and self-care treatments. Do not

attempt strengthening exercises for affected muscles until trigger

points and referred pain are eliminated.

Trigger Point Elimination Techniques

1. With a Tennis Ball, lay on the floor and place the tennis ball

under you in the points between and under the shoulder blades.

Massage the area by gently rocking over the tennis ball.

2. Move the ball around to different trigger points on your back. The

trapezius muscles at the base of the neck

3. The occiput at the base of the skull

4. The dimples of the buttock, is where we hold a lot of tension that

crawls all the way up the spine to the behind the shoulder blades,

which in turn burn up to the base of the skull.

5. Let your body relax over the tennis ball until the tension

dissolves.

6. Still lying on the floor, when the ball is under your upper back

and neck, rotate the arm slowly along th floor to over your head and

slowly back.

7. When the ball is under the right buttocks, with the foot flat on

the floor, slowly lower the right knee to the floor on the right

side. Move to ball to the left buttock and repeat the motion.

8. Use the tennis ball on each one of the 18 trigger points. Gently

massage these areas.

9. This is often a painful procedure. The trick is to find your pain

threshold, then pass it. Once, you stand up, you will understand how

you got the amazing results.

10. Always use the breath when working with the tennis ball. Inhale

deep and then exhale as you dig the ball into the trigger point.

Andrew Pacholyk, MS, L.Ac.

Peacefulmind.com

Therapies for healing

mind, body, spirit

March 5, 2006

I heard that Myofasial Release Therapy on the back can relieve up to 80% of the trigger points in that region. Myofasial Release is light pressure with the palms (crossed over) applied to the area spreading the tissue until the fascia starts to move like taffy. I prefer myofascial release first, massage and then go back in and release trigger points that usually refer on a deeper level.yogiguruji <yogiguruji wrote: Good Morning!Trigger Point TherapyTrigger Point Therapy or Myofascial Therapy is a unique treatment protocol for the treatment of myofascial pain. Trigger Points produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders. The purpose of trigger point therapy is to eliminate pain and to re-educate the muscles into pain-free

habits. Treatment of trigger points involves the application of sustained pressure for a period long enough to release the muscle spasm, which is causing the pain. The Trigger Point Therapy procedure is one of the most powerful, yet simplest ways to treat muscle pain. Based on the idea that pain in a certain muscle group stems from where the muscle insertion is, the particular muscle group innervates and its origin, great relief can be accomplished by massaging these regions. Refer to Chart found here:http://health.ph./photos/view/1961?b==6Trigger Points 1,2. Occiput: The back part of the head or skull at insertion of subocciptal muscles. Lower cervical: at the anterior aspect of the intertransverse spaces at C5 - C7 3,4. Sternocleidomastoid:

(SCM) muscle, rotation of the head and neck, upper cervical extensor, a flexor of the cervical spine on the thoracic spine, and lateral flexor. 5,6. Trapezius: midpoint of upper border, spinous processes and supraspinous ligaments to T12. Laterally rotates, elevates and retracts scapula. If scapula is fixed, extends and laterally flexes neck 7, 8. Rhomboids: bring the scapula in towards the spinal column, squeeze the shoulder blades together when they are used at the same time.Supraspinatus: at origins above scapula spine medial border 9, 10. 2nd Rib: second costochondrial junction, just lateral. 11, 12. Lateral epicondyle: 2cm distal to epicondyles, action includes grasping muscles (extensor carpi radialis brevis and longus) and supination muscles (supinator longus and brevis) of the forearm, which originate on the lateral epicondyle of the elbow.13, 14. Greater trochanter:

posterior to the trochanteric prominence 15, 16. Gluteal: upper outer quadrant, anterior fold of muscle Piriformis: muscle originates at the front the sacrum, passes through the greater sciatic notch to attach to the top of the femur at its bony prominence called the greater trochanter. The gluteus maximus covers the piriformis muscle. 17, 18. Knees: medial fat pad, proximal to the joint line Sartorius: the longest muscle in the body, originates from the iliac spine and goes across the front of the upper thigh from the side to the middle and then descends vertically to the knee. It inserts into the surface of the body of the tibia. The muscles involved with pain are frequently found by recognizing the "pain pattern".1. A history of widespread pain of at least 3 months in duration. 2.Widespread pain falls into the following categories:* Present- pain on the left side of the body* Pain on the right

side of the body* Pain above and below the waist * Plus axial skeletal pain (cervical spine or anterior chest or thoracic spine or low back) must be present. Fibromyalgia Diagnostic Criteria: 1. Pain in 11 of 18 designated tender point sites on digital palpation. 2. Plus some or all of the following: Sleep disturbance, fatigue, anxiety, headache, irritable bowel syndrome, subjective swelling, numbness as well as modulation of symptoms by activity, weather factors and aggravation by stress or anxiety. How to Use the Charts: 1) Identify the region on the body closest to the patient's pain2) Check the muscles at the top of the list first. They are most likely to be the cause of pain in the area, although any one of the muscles may be the cause.3) Check each muscle for restricted range of motion. The muscle or muscles which can not sustain full stretch or which cause pain "on the stretch"

should be palpated and checked for trigger points. 4) Once the trigger points have been located, treat them with Trigger Point Elimination Techniques. 5) Always follow Trigger Point Elimination Techniques with proper stretching, range of motion exercise and self-care treatments. Do not attempt strengthening exercises for affected muscles until trigger points and referred pain are eliminated. Trigger Point Elimination Techniques 1. With a Tennis Ball, lay on the floor and place the tennis ball under you in the points between and under the shoulder blades. Massage the area by gently rocking over the tennis ball. 2. Move the ball around to different trigger points on your back. The trapezius muscles at the base of the neck 3. The occiput at the base of the skull 4. The dimples of the buttock, is where we hold a lot of tension that crawls all the way up the spine to the behind the shoulder blades, which

in turn burn up to the base of the skull. 5. Let your body relax over the tennis ball until the tension dissolves. 6. Still lying on the floor, when the ball is under your upper back and neck, rotate the arm slowly along th floor to over your head and slowly back. 7. When the ball is under the right buttocks, with the foot flat on the floor, slowly lower the right knee to the floor on the right side. Move to ball to the left buttock and repeat the motion. 8. Use the tennis ball on each one of the 18 trigger points. Gently massage these areas. 9. This is often a painful procedure. The trick is to find your pain threshold, then pass it. Once, you stand up, you will understand how you got the amazing results. 10. Always use the breath when working with the tennis ball. Inhale deep and then exhale as you dig the ball into the trigger point. Andrew Pacholyk, MS,

L.Ac.Peacefulmind.comTherapies for healingmind, body, spirit