AndyCho.com

Trigger Point Therapy

May 1, 2006 | Updated: July 25, 2006

Do you have chronic pain that resulted from an injury? Diagnosed with tendonitis or bursitis? Given the ice, stretch, physical therapy routine with some ultrasound? Nothing seems to help and you end up with pain and restricted movement. If so, you need to learn about trigger points.

Trigger points are the knots and nodules that develop in your muscles when they are stressed. This can be caused by an injury, repetitive stress, bad posture. They have a few characteristics that make them very them hard to deal with:

Trigger points often refer pain elsewhere.

Not knowing this makes diagnosis confusing, even impossible. You might have a trigger point in your calf muscle, but you feel the pain in your heel. Or the pain might be in your wrist, but what’s causing it is a trigger point in the forearm muscle near your elbow. A Headache is probably the most common symptom of trigger points. You feel the pain in and around your head, but the culprits are likely in your neck, jaw, or trapezius muscles.

Trigger points and restricted movement form a negative feedback loop.

After the formation of a trigger point, you will feel pain when you try to use the muscle. As a result, you will stop using that muscle to lessen the pain and shift to using other muscles to compensate. This will weaken and tighten the muscle, and the compensation will cause other muscles to be overloaded and develop associated trigger points. After a while, you begin holding and moving your body in restricted ways.

Rest won’t make trigger points go away.

In fact, resting too much will begin to atrophy the muscle. You have to either massage out the trigger point, or stretch it out when it’s warm. Stretching after exercise will prevent or lessen trigger point formation but the problem is that it’s very hard to stretch a particular section of muscle to work on a specific knot and that stretching might make things worse if the trigger point is bad enough. You end up over-stretching the muscles around the trigger point and even tendons/ligaments, but do nothing to the trigger point itself.

A few years back, I had major pain in my wrists and numbing in my fingers diagnosed as carpal tunnel syndrome. I also had pain in my knees that were diagnosed as patellar tendonitis (jumper’s knee) combined with chondromalacia (degeneration of knee cartilage). I would have pain whenever I walked down stairs. I saw dozens of doctors and physical therapists who gave the usual ice, rest, stretch routine or told me to give up certain physical activities. Fortunately, I didn’t accept this advice and tried many alternative therapies and doctors. I can now do any physical activity without pain again. Unfortunately, it took many years and thousands of dollars.

If you have chronic joint/muscle pain or migraine headaches, give trigger point therapy a try. There are two very accessible books on trigger points. The Trigger Point Therapy Workbook by Clair Davies and Trigger Point Self-Care Manual by Donna Finando. As far as I’m concerned, everyone should own a copy of these books. They’re easy to read and understand, and the focus is self-treatment. You can check out some of the excerpts from the Clair Davies book on his website.

I’m not a huge fan of the Thera Cane. There are other tools designed to massage trigger points, like the TP Massage Ball or the variety available from Pressure Positive. I’ve found that for the big muscles in the legs, hips, and back, simply lying on a golf ball or a hard rubber ball works great. For smaller muscles, I use the wooden/plastic knobs. Be creative; as you practice on yourself, you’ll find out what works and what doesn’t. Leaning on hard surface at different angles using your bodyweight will work too.

It also helps to get treatment from a professional therapist that understands trigger points. You can get the benefit of their greater knowledge and diagnostic capabilities. You’ll find that the best therapists are usually deep-tissue massage therapists, chiropractors, or other “alternative” types that practice things like Rolfing, ART, Graston, etc. In New York City, the best place I’ve found is Dr. Winnick & Associates. They don’t take insurance, you have to pay upfront and get reimbursed. Don’t be surprised to run into athletes and celebrities there.

Working on your trigger points doesn’t mean they won’t come back. Like a car or a house, you’ll have to do regular maintenance. However, the rewards are more than worth the effort. Here’s to a long, active, and pain-free life.

Legal Disclaimer: You should follow my advice at your own risk; I am not giving medical advice nor am I responsible for the consequences of your application of the information. Check with your doctor before trying out new treatments.

Entry Filed under: Health & Fitness