Advanced Massage Techniques: The power of trigger point therapy in the treatment of pain.
Sally, 36, came to me complaining of chronic low back pain and a persistent pain between her shoulderblades. Unable to sleep, Sally had seen a chiropractor, osteopath, and received epidural injections. None had any lasting results. She felt helpless and resigned to a life of constant pain.
John, 40, came into my clinic complaining of a sharp pain in his low back which was worse with movement. At work he had suddenly turned in his chair and the pain shot right through him. Due to play in a big golf tournament he was desperate for help.
Amenia, 23, had suffered from chronic migraine headaches since childhood; since the age of 4 she had been having at least one migraine a week causing her to have time off work and spend countless days in bed.
Do you know people like those above? Chances are that you do- members of your family, neighbours, work colleagues or perhaps you yourself. As a massage therapist, maybe similar people have come into your clinic and your heart sank as you felt their expectation to be "cured". You want to help but you just don't know how. Your qualifying course taught you to be of afraid of people in pain. To stay away from herniated discs, whiplash and any mysterious aches. Feeling dissatisfied, you give these clients a relaxation massage avoiding the area of pain, refer them on to your local osteopath or send them back to their GP for X-rays, MRIs and usuallly no answers.
It doesn't have to be this way. Using a combination of trigger point therapy, massage and advanced stretching techniques, Sally, John and Amenia experienced a decrease in their pain after just one treatment and were all 90% or more pain free within 6 weekly treatments. They now all come to me for regular maintenance sessions and between them have referred approximately 30 more clients.
Do I have any special magical powers as a massage therapist? The answer is no; just a knowledge of advanced bodywork techniques not usually taught to massage therapists in the UK . The good news is that as a bodyworker you can learn to bring your clients out of pain quickly, effectively and permanantly, within 1-6 weekly treatments using trigger point skills.
These highly effective techniques can be easily incorporated into your existing massage work. They will astound you and your clients with the power of their results. As one of our students said " I don't know who was more surprised- me or my clients- when they came back the next week reporting dramatic relief from long standing problems".
Students who have learned trigger point therapy through Jing Advanced Massage have reported:
• Increased confidence in their ability to treat pain conditions.
• Less need to refer clients on to osteopaths or other professionals.
• Increased clientele (and therefore more money!) without the need for formal marketing due to the new effectiveness of their treatments.
• A renewed enthusiasm and zest for their work.
• A bit too good to be true? Then read on!
The Begining.
Dr Janet Travell- the founder of trigger point techniques
Thanks to the work of the American medical doctor,Janet Travell, who pioneered trigger point work in the 1950s, we have a growing body of evidence that many pain conditions are actually caused by trigger points. Through scientific documentation, she was able to assess similar pain patterns in the musculature of thousands of patients, demonstrating trigger points are a component of up to 93% of the pain seen in pain clinics and the sole cause of such pain, as much as 85% of the time. ( Gershwin; Fishbain quoted in Travell and Simons: Myofascial Pain and Dysfunction: The trigger point manual Volume 1)
What exactly is a trigger point?
A trigger point is defined by Travell and Simons as;
"A hyper irritable locus within a taut band of skeletal muscle, located in the muscular tissue and/or its associated fascia. The spot is painful on compression and can evoke characteristic referred and autonomic phenomena".
In essence this means that a trigger point feels like a "knot" in a muscle, hurts when you press on it and can cause pain in a site distant from where it is located.
If you are a bodyworker, it is higly likely that you have felt many in your time. These "knots" can vary in size from very small to that of an olive or even a golf ball.
It is the element of referred, distant pain in a predicatable pattern that are the key characteristics of trigger points. It is the knowledge of these known patterns that is crucial to successful treatment . For example how many of you have spent hours massaging the nagging pain between your clients shoulder blades with little lasting successs? Five minutes each session spent treating trigger points in the scalenes (found in the anterior neck) could have brought you much more effective and long lasting results - trigger points in the scalenes can cause pain and numbness in the chest, upper back, shoulder, arm and hand. Who would have thought to look at the neck for the cause of back pain?
Symptoms caused by trigger points
Trigger points are known to cause or contribute to upper and lower back pain, carpal tunnel symptoms, tennnis elbow, neck pain, migraines, jaw pain, and many kinds of joint pain mistakenly attributed to arthritis. They can cause sinus pain and congestion, nausea, chronic dry cough and are thought to contribute to fibromyalgia
Trigger points are responsible for a whole array of pain related symptoms including:
• Referred Pain
Back pain usually has a trigger point component- although arthritis or slipped discs are often blamed. Low back pain can come from trigger points in unusual places, such as the buttocks, stomach muscles or even the calves! If you don't know where to look for the source of the pain, your ability to help your client is severely limited.
• Autonomic Effects
Amazingly, symptoms such as dizziness, ringing in the ears or a dry cough can all be caused by the effect of trigger points on the auntonomic nervous system.
• Compression of Nerves
Because trigger points cause muscles to shorten, this can cause a squeezing of nearby nerves, leading to symptoms such as tingling, burning and hypersensitivity. This is common in the arms and hands due to compression of nerves by the scalene muscles. This condition can be misdiagnosed and lead to unnecessary carpal tunnel surgery. The pain and numbness can very simply be alleviated through trigger point and massage work. Tingling down the leg can also be caused by shortening of the pirifomis from trigger points, mimicking a "slipped disc".
• Restriction of Movement
Trigger points are also responsible for causing restricted range of motion and treatment can easily correct this. A client of mine with a herniated disc reported after the first session, his wife was amazed that he could now touch his toes as he had never been able to do this in his life! Interestingly, his wife was a massage therapist- needless to say she booked on the next course with us to learn these techniques for herself!
Causes of Trigger Points
Trigger points are very common and can develop in any of the 200 muscles in the body. No one escapes them -not even children and babies. Trigger points can be caused by a variety of events including accidents, falls, repetitive motions, poor posture, pychological stresses and inadequate diet.
How to find and treat Trigger Points
For massage therapists the most efficient way to treat trigger points is either by deep stroking massage or direct sustained pressure applied directly to the point for about 8-12 seconds.
Compression of the trigger point should always be followed by stretching of the muscle.
Learning Trigger Points skills to integrate into your massage work
Like many bodywork modalities, effective trigger point technique is a subtle blend of art and science. Effective treatment depends on knowing how to accurately locate the muscles involved, confidence in your approach, focussed palpation skills and the opportunity to practice under experienced supervision.
Learning Trigger point Therapy with Jing
Jing Advanced Massage + Training is in a unique positon to offer you excellent tuition in trigger point therapy. Our unique series of holistic medical massage workshops gives you all the skills you will need to treat Sally, John and Amenia and the many hundreds of others like them. In addition, you will learn other cutting edge advanced techniques including myofascial release, Eastern bodywork approaches and advanced stretching techqniques (more about these in upcoming editions of Todays Therapist).
Check out trigger point therapy at complementary health expo 2005
If you still need to be convinced about the value of trigger point therapy, then come see us for yourselves at our hands on workshop at the chexpo October 2005. See you there!
About Jing
Jing Advanced massage + Training is an organisation dedicated to excellence in all aspects of postgraduate massage training. Offering a unique range of Holistic Medical Massage workshops for treatment of pain, we also offer courses in Hot Stone Fusion, Amma Fusion, On Site Massage and Pregnancy Massage. Based in Brighton, we offer courses around the country
Tel: 01273.628.942.
Email: info@jingmassage.com
www.jingmassage.com