Advanced Massage Techniques

Question 1

What is a Trigger Point ?

Answer 1

A hyper irritable spot within a taut band of skeletal muscle or fascia.
Tender with predictable pain, referral pattern and shortening of muscle.
No inflammation/Edema present and idiopathic in nature with stress/overuse/underuse increase chances.

Question 2

What are the 4 types of trigger points ?

Answer 2

• Active
• Latent
• Primary
• Satellite

Question 3

What is an Active Trigger Point?

Answer 3

• Painful at rest/movement of muscle - creates referral pattern and local twitch response
• Taut band within muscle that prevents lengthening/reducing strength

Question 4

What is an Latent Trigger Point ?

Answer 4

• Pain when palpated

- More common/Persist for years and may revert back to Active TrP

Question 5

What is a Primary Trigger Point?

Answer 5

• Activated in overworked synergists/Antagonist muscles

Question 6

What is a Satellite Trigger Point ?

Answer 6

• Found in muscle lies within referral pattern of another trigger point.

Question 7

What is Flat Palpation ?

Answer 7

• Used on muscle that can be approached from one side only (Infraspinatus/Rhomboids)
• Moving along the length of muscle to find the most tender spot is the TrP

Question 8

What is Pincer Grasp Palpation ?

Answer 8

• Used on muscle that be picked up b/w thumbs and fingers (SCM, Upper Traps and Pec Major)

Question 9

What are the 4 techniques for TrP?

Answer 9

• Slow Repetitive muscle stripping ?
• Alternating Ischemic Compressions
• Prolonged Ischemic Compressions
• Percussion and Stretch

Question 10

Explain Slow Repetitive Muscle Stripping ?

Answer 10

• Light and gradually increase

- Creates Local Ischemia / Hyperemia as pressure is released

Question 11

Explain Alternating Ischemic Compressions

Answer 11

• Compression applied to TrP held for 7-10 seconds and released (creating Ischemia and Hyperemia)
• Use Petrissage to flush metabolites from the muscle/heat and slow stretch

Question 12

Explain Prolonged Ischemic Compressions ?

Answer 12

• Compressions with 20 seconds to one minute until pain diminishes and TrP melts away.
• Use Petrissage to flush metabolites from the muscle/heat and slow stretch

Question 13

Explain Percussion and Stretch

Answer 13

• Use a rubber reflex hammer to tap 10 times to deactivate it and tapping every 5 seconds.

Question 14

How do you treat a TrP?

Answer 14

• Warm up/Muscle Stripping to find TrP and apply compression (7 out of 10 Scale)
• DDB / Compression / Repetitive Petrissage to flush area
• Heat and Passive Stretch

Question 15

What are Contraindications of TrP?

Answer 15

1. Vigorous / Deep Pressure Techniques for TrP not followed by stretch/heat/Full A-ROM= Kick Back Pain
2. Heat for TrP proximal to area of acute inflammation - use proximal effleurage to increase drainage
3. Acute/SubAcute overstretch injuries
4. Combining Compression/frictions and prolonged chilling
5. Percussion and Stretch