What to expect from a trigger point massage

ession Description

 

A treatment with Bryan is very user friendly. And, no, you don’t have to remove any clothing. However, bringing a t-shirt and a pair of shorts or sweats is recommended.

 

The first time you come for a treatment you will be asked to fill out a Client History form. Bryan will go over the information you provide, asking for more detail and discussing the type of pain you are having and its location.

 

The treatment itself involves locating the Trigger Points in the muscle or soft tissue and applying a deep focused pressure to the Point. This will reproduce the pain and the referral pattern that is characteristic of that pain.

 

The treatment will be uncomfortable at first, but as the Trigger Points release, the pain will decrease. The pressure will always be adjusted to your tolerance level. If, at any time, you feel too uncomfortable you can ask Bryan to ease off a bit.

 

Depending on your specific problem, Bryan may also use some stretching and / or range-of-motion techniques, as needed.

 

After treatment, it is usually recommended that the client apply moist heat to the area treated.

 

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Trigger points

Trigger Points in muscle and other soft tissue are one of the most common causes of a wide variety of pain and dysfunction, including (but not limited to):

 

• Achy persistent pain
• Severe local pain
• Arm / leg pain
• Back pain
• Radiating pain
• Weakness
• Stiffness

• Pain resulting from a medical condition, such as
– Migraines
– Sciatica
– TMJ dysfunctions
– Arthritis
– Fibromyalgia
– Carpal tunnel syndrome
– Soft tissue injuries
– And more…

A treatment with Bryan Cobb RMT.

Session Description

A treatment with Bryan is very user friendly. And, no, you don’t have to remove any clothing. However, bringing a t-shirt and a pair of shorts or sweats is recommended.

The first time you come for a treatment you will be asked to fill out a Client History form. Bryan will go over the information you provide, asking for more detail and discussing the type of pain you are having and its location.

The treatment itself involves locating the Trigger Points in the muscle or soft tissue and applying a deep focused pressure to the Point. This will reproduce the pain and the referral pattern that is characteristic of that pain.

The treatment will be uncomfortable at first, but as the Trigger Points release, the pain will decrease. The pressure will always be adjusted to your tolerance level. If, at any time, you feel too uncomfortable you can ask Bryan to ease off a bit.

Depending on your specific problem, Bryan may also use some stretching and / or range-of-motion techniques, as needed.

After treatment, it is usually recommended that the client apply moist heat to the area treated.

 

What the Heck Is a Trigger Point?

By Bryan Cobb, Advanced Remedial Massage Therapist

What is a Trigger Point?

Trigger Points (TP’s) are defined as a “hyper-irritable spot within a taut band of skeletal muscle. The spot is painful on compression and can evoke characteristic referred pain and autonomic phenomena.”1

Put into plain language, a TP is a painful knot in muscle tissue that can refer pain to other areas of the body. You have probably felt the characteristic achy pain and stiffness that TP’s produce, at some time in your life.

TP’s were first brought to the attention of the medical world by Dr. Janet G. Travell. Dr. Travell, physician to President John F. Kennedy, is the acknowledged Mother of Myofascial Trigger Points.  In fact, “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.”2  Dr. Travell’s partner in her research was Dr. David G. Simons, a research scientist and aerospace physician.

Trigger Points are very common. In fact, Travell and Simons state that TP’s are responsible for, or associated with, 75% of pain complaints or conditions.1 With this kind of prevalence, it’s no wonder that TP’s are often referred to as the “scourge of mankind”.

Trigger Points can produce a wide variety of pain complaints. Some of the most common are migraine headaches, back pain, and pain and tingling into the extremities. They are usually responsible for most cases of achy deep pain that is hard to localize.

A TP will refer pain in a predictable pattern, based on its location in a given muscle. Also, since these spots are bundles of contracted muscle fibres, they can cause stiffness and a decreased range of motion.  Chronic conditions with many TP’s can also cause general fatigue and malaise, as well as muscle weakness.

Trigger Points are remarkably easy to get, but the most common causes are

TP’s (black dots) can refer pain to other areas (red)

Sudden overload of a muscle

• Poor posture

• Chronic frozen posture (e.g., from a desk job),  and

• Repetitive strain

Once in place, a TP can remain there for the remainder of your life unless an intervention takes place.

Trigger Points Not Well Known

With thousands of people dealing with chronic pain, and with TP’s being responsible for — or associated with — a high percentage of chronic pain, it is very disappointing to find that a large portion of doctors and other health care practitioners don’t know about TP’s and their symptoms.

Scientific research on TP’s dates back to the 1700’s.  There are numerous medical texts and papers written on the subject.

But, it still has been largely overlooked by the health care field.  This has led to needless frustration and suffering, as well as thousands of lost work hours and a poorer quality of life.

How Are Trigger Points Treated?

As nasty and troublesome as TP’s are, the treatment for them is surely straight-forward.  A skilled practitioner will assess the individual’s pain complaint to determine the most likely location of the TP’s and then apply one of several therapeutic modalities, the most effective of which is a massage technique called “ischemic compression”.

Basically, the therapist will apply a firm, steady pressure to the TP, strong enough to reproduce the symptoms.  The pressure will remain until the tissue softens and then the pressure will increase appropriately until the next barrier is felt.  This pressure is continued until the referral pain has subsided and the TP is released. (Note:  a full release of TP’s could take several sessions.) 

Other effective modalities include dry needling (needle placed into the belly of the TP) or wet needling (injection into the TP).  The use of moist heat and stretching prove effective, as well. The best practitioners for TP release are Massage Therapists, Physiotherapists, and Athletic Therapists.  An educated individual can also apply ischemic compression to themselves, but should start out seeing one of the above therapists to become familiar with

the modality and how to apply pressure safely.

1 Simons, D.G., Travell, D.G., & Simons, L.S. Travell and Simons’ Myofascial Pain and Dysfunction: the Trigger Point Manual.

Vol. 1.  2nd ed. Lippincott, Williams, and Wilkins, 1999.

2http://www.muscletherapyworks.com/MTW%20Biography%20T%20&%20S%2001.htm 

Bryan Cobb RMT.

Since 2005, Bryan has been dedicated to helping all people with chronic and acute pain caused by soft-tissue damage.

His training and experience make him uniquely qualified to treat a wide variety of pain and dysfunction and to give instruction on prevention and self-care.

Bryan is the only Massage Therapist in Manitoba — and one of the few in Canada — to be certified by the Certification Board for Myofascial Trigger Point Therapists (CBMTPT).

Bryan holds a degree as an Advanced Remedial Massage Therapist (ARMT) from the Massage Therapy College of Manitoba.  Course work at MTCM includes
• over 2,000 hours of practice, as well as
• intensive course work,
• a supervised clinical practicum, and
• community outreach placements.

MTCM has a credit transfer affiliation with the University of Winnipeg, ensuring that its courses are held to the highest level.  When Bryan studied at MTCM, the college was the only massage therapy college in western Canada accredited by the Commission on Massage Therapy Accreditation.  Today, the college is a member of the Canadian Council of Massage Therapy Schools.

Bryan is a member in good standing of the Natural Health Practitioners of Canada.

Bryan also has a background in Anatomy, Exercise Physiology, and Sport Sciences from the University of Manitoba, and he has worked as a personal trainer and fitness leader.

He is an avid natural bodybuilder and fitness enthusiast, and has a blue belt in Brazilian jiu-jitsu.

Trigger points in the Quadratus Lumborum muscle.

The quadratus lumborum muscle is a commonly overlooked source of low back pain and is often responsible for “pseudo disc syndrome”. This muscle originates on the inferior border of the 12th rib and lumbar transverse processes. It inserts on the iliac crest and iliolumbar ligament. The q.l.’s main actions are extension and lateral flexion of the spine. It also acts as a stabilizer of the lumbar spine. Trigger points in this muscle refer pain into the sacroiliac joint and the lower buttock. Pain can also spread anteriorly along the crest of the ilium into the lower abdomen and groin and to the greater trochanter.

What is Scoliosis?

Your spine is made up of 24 bones that stack on top of each other- normally in a straight line. “Scoliosis” means that your spine is curving from side to side, rather than being straight. Scoliosis affects between 1-3% of the population. Scoliosis may begin at any time between birth and adulthood but is most common during times that your skeleton is growing rapidly. Most cases of scoliosis begin between the ages of 13 and 18. Researchers are not completely certain why some people develop scoliosis, but they have found that the problem tends to run in families.

The curve of your scoliosis may be measured with an x-ray. Although some curves get worse, most do not. In fact, only ¼ of all adolescent idiopathic scoliosis curves will progress. Small curves in mature patients have a low risk of progression (2%), while large curves in younger patients progress more frequently. (70%) Curve progression is more common in girls, especially those with larger curves (greater than 20 degrees). Your doctor may need to monitor your scoliosis for progression by performing x-rays every 6-18 months.

Scoliosis may cause your shoulders, hips, or waist to be unlevel. Most curves are classified as “right thoracic”, which means that the peak of your curve protrudes toward the right. This is often accompanied by a forward rotation of your right shoulder and “winging” of your right shoulder blade. Many patients have a secondary curve in their lower spine that helps to balance their body. The majority of patients with mild to moderate scoliosis have no symptoms, but approximately ¼ report back pain. Unfortunately, scoliosis increases your risk of developing back pain later in life.

The primary goal of treatment is to stop curve progression. While many cases can be slowed or even reversed through appropriate management, it is important to recognize that others may progress in spite of the best care. Conservative care, including spinal manipulation (like the type provided in our office) has been shown to help some patients with scoliosis. Exercise is another effective treatment for scoliosis. It is important that you clearly understand your home exercise program and that you perform it consistently.

Patients with larger curves (30-40 degrees), or those who are at high risk for progression may benefit from wearing a brace. Braces have been shown to decrease the need for surgery in about three out of four patients. Fortunately, less than 0.3% of all scoliosis cases will ever require surgery.

You should avoid carrying heavy back packs and consider switching to a wheeled version, if necessary. Sports and exercise will not worsen most cases of scoliosis, and you should continue to participate in the things you enjoy unless directed otherwise by your doctor. The diagnosis of scoliosis is always discouraging, but you must focus on what it is really most important. Be confident in who you are! Don’t let something like a curved spine (or any other medical condition) define you as a person.

What to expect with a trigger point massage.

A treatment with Bryan is very user friendly. And, no, you don’t have to remove any clothing. However, bringing a t-shirt and a pair of shorts or sweats is recommended.

The first time you come for a treatment you will be asked to fill out a Client History form. Bryan will go over the information you provide, asking for more detail and discussing the type of pain you are having and its location.

The treatment itself involves locating the Trigger Points in the muscle or soft tissue and applying a deep focused pressure to the Point. This will reproduce the pain and the referral pattern that is characteristic of that pain.

The treatment will be uncomfortable at first, but as the Trigger Points release, the pain will decrease. The pressure will always be adjusted to your tolerance level. If, at any time, you feel too uncomfortable you can ask Bryan to ease off a bit.

Depending on your specific problem, Bryan may also use some stretching and / or range-of-motion techniques, as needed.

After treatment, it is usually recommended that the client apply moist heat to the area treated.