Myofascial trigger points are an extremely common cause of pain. “Trigger Points” are painful when pressure is applied to the area and can cause referred pain. The pain from the trigger point in one muscle then creates pain in another muscle causing overall discomfort.
Modalities to The Affected Muscle
Heat is used to increase in temperature allow for more blood to circulate and promote relaxation of the affected muscle. Ultrasound can also be used as a heating modality to transmit vibrational energy to generate heat within the tissue. Electrical stimulation in various forms has also been utilized as a method in the treatment of trigger points as well as Low-level laser therapy. Electrical Stimulation allows for a further degree of relaxation to be achieved through the application of alternating (not continuous) current and an increase of intensity until the muscle produces gentle contractions. Low-level laser therapy (LLLT) can also be applied over the area with three 15-second applications for trigger point normalization.
Trigger Point Therapy
Trigger point therapy is a very effective treatment that can be applied in various forms. The Progressive Pressure Technique is a manual therapy technique that requires the use of hands and fingers to be applied in the form of flat palpitation or pincer palpitation. Fingers, knuckles, elbows or a combination of all may be used to apply pressure to the pained area. This technique is more gentle in order to avoid excessive pain and muscle guarding and uses the thumbs or four fingers on one or both hands to apply steady pressure, moving inward toward the center. This should be done until tissue resistance is felt, at which point the clinician should stop and wait with steady force against the tissue. This cycle is repeated several times for optimized results.
For effective trigger point therapy, it must always be followed up with myofascial stretching exercises. Before any activity is performed, a muscle must be able to properly stretch and lengthen without causing injury to any other structure in the musculoskeletal system. These stretching exercises maintain a degree of relaxation and bring the muscle to an ergonomically correct state. Proper myofascial stretching requires deep relaxation with proper concentration and breathing. This will inhibit a servo-mechanism within a muscle that causes the muscle to shorten when rapidly stretched.
