Trigger point information {TrPs} for short
 

A friend suggested that we make a thread on trigger points and the information that we have found and learned.

I dusted off my old speech recognition software, so any speak O's: That I don't correct please forgive.


I don't know when I first came upon information on trigger points.
someone must of mentioned it and then I started doing Internet searches and began reading from that point.

my chiropractor realized that I had trigger points in my scalenes and SCM { neck muscles }. he did something called NIMMO , which was mix of deep tissue trigger point and a slow stretching of the tight muscles.

some information on trigger points and NIMMO-
http://www.theamericanchiropractor.c...481&category=3
http://www.bridgerchiropractic.com/Nimmo-method.html

[The Problem: A Cycle of Pain

1. Trauma — Chronic pain can begin with a major injury or small harmful motions repeated over time.
2. Protective Reaction — To prevent further injury, the body responds with a protective measure. The nervous system sends an impulse to the muscles around the area of injury, causing them to tighten. The muscles that tighten create a network of tension sites called trigger points.
3. Repetition — These protective impulses are helpful while the injury heals, but the body learns through repetition. The nervous system does not sense healing and continues to send protective impulses, causing unnecessary muscle tension.
4. Chronic Discomfort — This constant tightening creates a cycle of pain that will remain until the protective impulses are interrupted.]
http://nimmoed.org/nimmocare/living-with-pain/

that is just a few of the links and information I have found- you can do a Internet search for a lot more.

Now I'll post the newest and best trigger point {TrPs} Internet links that I have found.
Explore other pages of the sites listed for more information.

http://saveyourself.ca/tutorials/trigger-points.php
http://www.pain-education.com/trigger-points.html
http://www.pressurepointer.com/pain_reference_chart.htm
http://www.triggerpointbook.com/triggerp.htm
http://en.wikipedia.org/wiki/Trigger_point
http://www.myofascialtherapy.org/
http://www.triggerpoints.net/


[Central Nervous System Sensitization

Recent research (Borg-Stein and Simons 2002) has shown that certain types of nerve receptors in muscles relay information to neurons located within part of the gray matter of the spinal cord. The pain is amplified there and then is relayed to areas of other muscles, thereby expanding the region of pain beyond the initially affected area.

Once this part of the central nervous system is involved, or sensitized, in this way (called central sensitization), the persistent pain leads to long-term or permanent changes in these neurons, which affect adjacent neurons through neurotransmitters (chemical substances that are produced and secreted by a neuron and then diffuse across synapses, or small gaps, between neurons, causing excitation or inhibition of another neuron). This may also cause the part of the nervous system that would normally counteract pain to malfunction and fail to do its job. The longer pain goes untreated, the greater the number of neurons that get involved, and the more muscles they affect, causing pain in new areas, and in turn causing more neurons to get involved . . . and the bigger the problem keeps getting, leading to the likelihood that the pain is going to turn into a chronic problem. The sooner pain is treated, the less likely it will become a permanent problem with widespread muscle involvement and central nervous system changes…]
http://www.triggerpointrelief.com/he.../chapter1.html



PDF info sheets/pages-
http://homepages.sover.net/~devstar/sheets.htm
Main page-
http://homepages.sover.net/~devstar/


Just found this - I had these symptoms bad for awhile and didn't know the cause at the time.
[TrPs in the sternocleidomastoid muscle (in the neck) alone can cause: clumsiness; blurred or double vision, tension headaches; runny nose; maxillary sinus congestion; spatial disorientation; unintentional veering, or cause patterns of light and dark (such as shadows along the road or escalator treads) or head motion to result in dizziness (among many other symptoms), and if you know this, you may save worry and unnecessary testing and be able to do something to relieve the symptoms]
http://thyroid.about.com/od/fibromya...tarlanyl_3.htm
first page of article here-
http://thyroid.about.com/od/fibromya...nstarlanyl.htm



A Google listing of TrP videos -
http://www.google.com/search?q=trigg...ed=0CFAQqwQwBQ


Your library should also have books on Trigger Points & therapy as well as Myofascial Trigger Point Syndrome.

I'll add more as I find info, feel free to add what you find or have learned about this topic.

Now I'll tell you how I did my own versions of TrP therapy.

I suggest that you be checked out for any other serious spinal problems, broken bones, tumors etc -before you decide to try any of this.


I rounded up a tennis ball, a golf ball, dog ball , finger/thumb - any thing that would fit where I needed - to get to the trigger point .

I even bought a Pressure Pointer tool to get at some of the many small ones in my upper back. But the hard wood ball ends were not that comfortable..They may have changed it.

I worked on TrPs and my stretches {mainly Sharon Butler TOS program stretches} quite a few times a day since I was off work anyway.
{work injury}

You need to keep hydrated with clear fluids during this time.

Keeps tissues lubricated , reduces any sticky tissues that might be a factor, and it helps flush out the toxins that are released with the TrP work, massages, and PT/DC therapy. { in case they forget to mention that part}

Generally I would do some mild warm ups or have a hot shower in the morning to get me loosened up.

Then I would start with the tennis ball against the wall or down on the floor rolling it around until I hit a very tender/sore spot.

Stay on the muscles and don't put any heavy direct pressure on the spine while doing this.

That sensitive spot is the trigger point, it will probably feel like a small knot in the muscle.

I did have TrPs in my scalenes & SCM but those I left to a professional as the main arteries and some very small bones are in the neck/throat areas.

Mainly I had to focus on my upper back, but some were in the pec/chest muscles as well as between the ribs in the rib cage.

after locating a spot I'd press into it with the ball or whatever tool would fit best.
hold the pressure for 20+ seconds or so until it softens and the tissue gives - plus the soreness should also fade away at this time.
Don't over do the pressure if it really hurts your body will fight the release.

after you get done do some stretches of that location - helps smooth out any left over restrictions.

Then after I was all done each time I would lay out on floor or bed - in the "corpse pose" as they call it in yoga.
http://www.nshouseofyoga.com/Savasana%20Nancy.jpg

This is when you do the relaxation techniques, deep diaphragm breathing, and also use this time to think of good things and positive thoughts.
If you have some spa sounds or relaxing music this is a good time to listen to it.
I would stay like this 20 mins or more at times. 3-4 x a day too.


I read somewhere , have to find it again for posting - but it said you cannot resolve a muscle spasm completely if trigger points are present.
I'll add that and more as I find good info.

I just noticed the pressure pointer site has a down loadable PDF file -
explains TrPs - with photos of locations and pain referral sites -
http://www.pressurepointer.com/Press...nterManual.pdf

Hi Jo,
The last time at the pain management the PA was working on trigger points to inject marcain etc, to calm down....
He was shocked at the amount of spasms and said a trigger is the "one" start of the spasm, he could not locate one...

DUH, with TOS, there is no "one" I gave him the ones that are the butcher knife by the wings to work on and it helped. Some of the cycle was broken.

He did trigger pressure up my spine too, and that assisted.

I remember Dr. Annest once took the time to tell my why I had the tightness up the side of my spine. It all clicked when he told me he muscles were making a splint around the injured flared nerves and protecting them, by the splint.

A lot of work on trigger points, but well worth it when they let loose. Try everything, and then keep trying for the ones that work.
di
I have to read the links to refresh the brain.

since ive been avoiding sitting at the computer for more than 5 minutes @ a time, this tp book has helped me

Frozen-Shoulder-Workbook-Overcoming-Regaining

more TrP info-
http://saveyourself.ca/articles.php
http://saveyourself.ca/tutorials/trigger-points.php
(they are selling a book & it may be in libraries - But I haven't checked yet -but lots of info on the site alone.)

TrPs = Check Your Symptoms
 

Check Your Symptoms

wow - a symptom checker for trigger points


http://triggerpointproducts.com/checkyoursymptoms

and another TrP symptom checker site-
http://www.myofascialtherapy.org/symptom-checker.html

Google document link
Devin Starlanyl
trigger points & tender points - why the difference is important for you

updated link-
Fibromyalgia and Chronic Myofascial Pain Information
Chronic Myofascial Pain

Ultrasound in the Treatment of Myofascial Trigger Points
 

Ultrasound in the Treatment of Myofascial Trigger Points

and more info on fibromyalgia & trigger points
http://www.drlowe.com/triggerpoint.htm
http://www.drlowe.com/myofascial/pra...ltrasound1.htm
http://www.drlowe.com/myofascial/pra...rasoundfms.htm

Hi
 

Good Trigger Point Article
 

This is a pretty good trigger point article. http://www.back-pain-causes-and-reli...s-in-neck.html

Thera Cane
 

A Thera Cane is a great tool for working on trigger points and muscle adhesions. It's pretty easy to reach pretty much anywhere on your body with it and you get a lot of pressure because of the leverage. It doesn't take much arm strength to get in there deep and break up those tight muscles. It's about 40 bucks on Amazon. http://www.theracane.com/

Nausea Following Trigger Point Work
 

I've been using a Thera Cane on my trigger points for a couple of weeks now and I noticed sometimes I feel nauseous afterwards. I was wondering if that was normal, so I Googled it, and yes, apparently that's pretty common. I guess it's because it makes your muscles release waste and toxins.

I was also told to drink plenty of water after any type of deep tissue massage to help rid the toxins. So make sure you are drinking lost of water to flush the toxins from your body after do this.

I agree, often this is not mentioned.
Lots of clear fluids after PT & massages is a good thing.

Sharon Butler often recommends plenty of fluids for all of us, to keep the fascia lubricated and slippery as well as helping to flush out toxins at all times.
She often mentions sticky tissues as a major factor for RSI's as well as TOS.
Fascia

Trigger points are a very important piece of the puzzle
 

I've been doing trigger point work with the Thera Cane for about four months now and I'm starting to realize that trigger points are a very important piece of the puzzle. I've had TOS for more than 30 years now, and I've done a little bit of trigger point work in the past, but really didn't think it was that helpful. I've even had trigger point injections, acupuncture, and hands on therapy, that didn't help that much. I think the main reason for that is, it just wasn't enough to make a difference. It takes more than a few therapy visits to correct many years of pain and dysfunction.

The reason I'm making progress now is, I'm consistent, I do trigger point work daily with the Thera Cane. I've also been doing joint mobility exercises daily for almost three years now. Those, along with trigger point work, have been a good combination for me. Muscles that are full of trigger points can't be stretched or strengthened without pain. Improvements come slowly so you have to think long-term. Consistency is very important.

Trigger points keep me going. The epidural I leave for lumbar. I have really nasty stuff in lumbar, sacroiliac and osteophyte on the left spine from curve.

Di

How did you guys learn do to the self trigger pt therapy? Did you learn it all from books, or did you have a specialist show you?

I learned mostly from youtube videos, plus, a lot of trial and error. The Thera Cane comes with a little instruction booklet that was helpful. I also get a lot of good ideas from Functionalpatterns.com.

http://www.functionalpatterns.com/me...ic-stretching/

Trigger point information {TrPs} for short
 

I've been using these Chinese vacuum cups for about three months now and I like them a lot. They seem to really help loosen up the trigger points and muscle adhesions. My movement has improved quite a bit.

What works well for me is, putting the cup, or cups on, and then moving around. It's kind of an active release type of thing. It's working well for me. I've also seen cupping referred to as, "Myofascial decompression."

The only downside I see to these is, the purple marks they leave on your skin, but they go away in a few days so it's no big deal.

This is the set I bought. So far, it's holding up well. Oops. I meant to put this in the trigger point sticky.

http://www.amazon.com/Professional-C...g+therapy+sets

Spikey Ball
 

Another good thing that I found to work on trigger points is a spikey ball. The set I have came with a larger, and softer ball, that actually looks more like a peanut. That one's okay, but the one I really like is a smaller 2 inch ball that is really hard. Those little spikes on the ball really dig into your muscles. It's almost like a meat tenderizer.

Not only do the little spikes dig into the muscles well, but they also help hold the ball in place. That's one problem I've had with with other kinds of balls. If you get on a tight spot, the ball squirts out of there. This one doesn't do that. It makes it much easier to use.

Here's what they look like. http://www.youtube.com/watch?v=957tflebvxM

Myofascial Release Tools
 

This video shows some good tools for myofascial release. I have everything but the medicine ball. Using these can be a bit painful but they get results.
http://www.functionalpatterns.com/th...fective-video/

I read a lot online and just tried it out.. it would be pretty rare to injure yourself by trying it. If anything hurts very bad then stop.

After rounds of PT, then 2 robotic partial rib resections, my child is in PT to strengthen wasted muscles from years of problems. With all rounds of PT my child had severe knots in the upper back muscles, neck muscles, and shoulder muscles. It wasn't until the physical therapist started using trigger point try needling did the muscles finally relax. There was a significant difference even after the first round of treatment. It accomplished what months of therapy and massage could not do. It eliminated pain that was associated with the tight muscles which was created by the natural position used to help her body cope with the arterial and venous TOS.

I use my foam roller to deactivate trigger points in my upper back and thighs. I use the stick on my lower legs when I get foot pain. I also use the theracane. My favorite resource has been the trigger point therapy workbook. We even purchased an ijoy massage chair from a furniture store…..great for scapular triggerpoints. Now that this current injury has caused symptoms that have become chronic, I need to get out all these tools again.

It's not for the TOS but it's pretty easy to say that the physio hit the right spot!! Graham Jarvis is one of the best dirtbiker in Canada. Watch this here. https://www.facebook.com/photo.php?v=10152043739324823

Alexis

LOL Yeah, it can be pretty painful when you find the right spot.

This is a good explanation. http://youtu.be/yJ-EdIffEow

Alexis

My quick question? Have any of the members here found significant long term benefits from myofascial therapy?

Also is deep tissue work reccomended for TOS? Is it safe?

I think it really depends on what your version of TOS is caused by.

If soft tissue is a factor, involving poor posture, forward head/forward shoulders, or repetitive, then most likely some very good physio, chiro, bodywork and lots of self care focus would be beneficial. This route does take time could be many months even years, and limiting re injury activity or what ever set the TOS off.

For me it took about 2+ yrs to get back to 80% and not working..
My version was from repeated /chronic RSIs and coupled with forward head posture/strain due to work postures & uses.

Jomar, thanks so much for your reply. If I may ask how bad was your TOS on a scale of 1-10. Can you describe your symptoms please?


My theory is that my TOS was caused by poor posture and provoked by a severe accident that took away all the marginal buffer I may have had within to avoid the compression.
I fell off a bike into my face. And my life became a living mess thereafter.

I got headaches from a combination of myocardial therapy and TENS, I am thinking of dropping the latter as I think it may be the cause. I hope it is so that I can continue with the myo therapy. TENs has been useless for me in the past but there is a miracle machine called Interex which is more intense which worked wonders on my TOS. Unfortunately I can't use it everyday or I would have.

this link goes to a thread with my symptoms listed in post #3-
https://www.neurotalk.org/thoracic-o...yndrome-2.html

Taping & trigger points-
Taping for Trigger Points - The Trapezius – Niel Asher Healthcare


Quick Self Help – Niel Asher Healthcare


posture connection -
Overcoming Chronic Neck Pain: Postural Causes and A Unique Exercise Fix