Trigger Point 
Myotherapy Castro District of San Francisco

TriggerPoint Myotherapy

When a muscle or group of muscles are compromised due to injury such as a blow to the muscle, broken bones, whiplash, surgery, repetitive motion or strain (RSI) or immobilization due to a chronic holding pattern, overuse patterns and physical and/or emotional stress trigger points develop in the muscle often presenting as knots or tight bands of fiber.  These activated trigger points can cause the muscle to gradually shorten and become chronic spasms ie: a muscle that is in constant contraction.  Because muscles are meant to contract and release constantly with use, these muscle spasms lead to chronic pain, weakness and decreased range of motion all of which impair movement and activity, as well as decrease the general quality of life for the sufferer.  Trigger points have incredibly long “memories” and can remain either in a latent state leading to a sensation of tightness and decreased range of motion or in an active state resulting in pain, which can be severe, for many years.  A troubling aspect of active trigger points is the “distant pain referral patterns” characterized by the experience of pain which has no apparent cause or origin and does not respond to treatments of the areas exhibiting symptoms.  A common example of this phenomenon is the experience of wrist and hand pain which is actually originating in deep neck muscles called Scalenes.  Many misdiagnoses of carpal tunnel syndrome are because of a lack of knowledge about the role that trigger points play in chronic pain and overuse symptoms.  Many instances of “plantar fascitis” are actually referred pain from the calf  and ankle muscles, especially the Soleus, as well.  Though exercise and stretching can help manage the recurrence of the worst of the symptoms accompanying trigger point activity, they rarely alleviate them.

Trigger points are deactivated with deep eschemic pressure applied slowly but steadily without circling or palpating the points.  This applied pressure can lead to an experience of deep dull ache, sharp pain or even a stabbing sensation, but as the controlled pressure is held, the trigger point releases and the muscle softens resulting in cessation of the discomfort.  People often report a feeling of  “it hurts so good” and a resultant deep relaxation and sense of relief when the trigger point has released.  This technique interrupts the cycle of spasm and pain of the sensory motor mechanism, softening tense muscle tissue, increasing range of motion and creating relaxation and pain relief in general.  There can be a residual soreness that lasts up to a couple of days, but if the pressure is applied properly there is little bruising.  Some soreness is the natural outcome of a muscle that has been in contraction over a long period of time.  After a treatment the application of moist heat, as in hot packs or herb filled packs that can be microwaved, as well as baths with Epsom salts can facilitate the further release of trigger points, as well as decrease possible soreness resulting from the applied pressure.  Topical analgesics such as preparations of Arnica Montana found in products such as Traumeel can also speed recovery after treatment.  A program of regular exercise, stretching, good nutrition, ergonomic assessment of work environments and regular sleep coupled with changing the habits and holding patterns which initiated the trigger points, such as those found in RSI; an epidemic computer overuse injury,  are essential for permanently eliminating and managing trigger point pain symptoms.

Some of the most common complaints that can be managed or alleviated are:   Repetitive Stress Injury (RSI), plantar fascitis, frozen shoulder, chronic back pain, false sciatica, migraine headaches, chronic jaw and neck pain such as TMJ and bruxism related, wrist/forearm/thumb pain, decreased ROM in arms and shoulders, rotator cuff injuries and chronic knee complaints.

Myofascial Release Therapy

The human body is covered in a web of connective tissue called fascia with concentrations of this tissue distributed in areas relating to particular groups of muscle such as along the lateral side of the legs.