Myofascial Trigger Point Release

Question 1

History question?

Answer 1

1. How is the clt’s general health? Is there a history of metabolic disorders, such as hypothyroidism, or chronic infection, such as sinusitis? These factors may perpetuate the trigger point pain.
2. Has there been any previous acute or overuse injury to the affected muscle?
3. When was the onset of pain?
4. Where is the pain located? Does the pain refer anywhere else? The clt can mark this referred pain on the health history form or show the location on a trigger point chart or point to the referral pattern on her body. The therapist records the referred pain on the health history form.
5. What is the quality of pain? Trigger point pain is aching, deep and steady. It is described as referred pain. This is distinguished from the pain of nerve root irritation or peripheral nerve compression syndromes, which is described as radiating pain. Nerve pain is prickly and often accompanied by numbness.
6. Are any autonomic symptoms present, such as sweating or gooseflesh? Where are they located? For example, an involved limb may feel cool, due to ischemia, in comparison to the unaffected limb.
7. What aggravates or alleviates the trigger point? For example, the trigger point is aggravated by use of the muscle, increased stress, compression of the trigger point and cold; it is alleviated by rest, slow stretching and heat.
8. Was the involved mm placed in a shortened position for a long period of time ? for example, the clt may have fallen asleep in the fetal position that aggravated iliopsoas trigger points.
9. Is muscle stiffness, limitation of movement or weakness present?
10. Are there any known perpetuating factors? Examples are pain made worse by overusing a muscle, a headache that occurs at the end of a work day due to repetitive actions or shoulder pain that is made worse by standing outside in cold weather.
11. If the client is returning for subsequent treatment of trigger point pain, has the pattern of referral changed or stayed the same? A changed referral pattern indicates that, while the initial trigger point has been successfully eliminated, secondary trigger points need to be treated. An unchanged pattern indicates that perpetuating factors need to be addressed before the trigger point can be eradicated.

Question 2

Contraindication?

Answer 2

1. Avoid vigorous techniques or deep pressure when treating hyperirritable TP (avoid kick back pain)
2. Using heat as post-treatment hydro on treating tp that are proximal to an area of acute inflammation
3. Tp local to Acute and early subacute overstretch injuries such as strains, sprains
4. Percussion and stretch on the anterior and posterior log
5. Prolonged chilling
6. Overtreat by using 2 aggressive techniques ( prolonged ischemic compression + frictions)
7. Fully stretch mm that cross a hypermobile joint

Question 3

Treatment goals?

Answer 3

1. Promote relaxation to decrease sympathetic nervous system firing
2. Increase circulation to improve tissue health
3. Treat tp to reduce pain
4. Decrease autonomic and proprioceptive symptoms if present
5. Increase local circulation to remove irritating metabolites, increase tissue health
6. Treat the synergist and antagonist muscles

Question 4

Treatment process?

Answer 4

1. Ask for consent for the treatment
2. Ask for consent to undrape
3. Undrape and get visual on it
4. Hydro
5. Eff + Swedish
6. Mm stripping
7. Prolonged ischemic compression (20 sec-1 min) ( ask the clt if the pain refer or radiate any where)
8. Swedish ( to flush it out in circ)
9. Slow stretch

Question 5

Home care?

Answer 5

Rest, hot bath, self massage, stretch short mm, strengthen weak mm, reduce perpetuating factors ( prolonged chilling), correct postural imbalances.