Inflicting The Good Pain - The Ins and Outs of Trigger Point Release

Inflicting the good pain.

Almost daily people come to me with discomfort in one area and to get at the origin of their pain I treat supplementary areas that they didn't even know were involved. Sometimes this treatment approach is used to create whole-body myofascial balance and other times it is because they are experiencing referred pain from active trigger points.

A muscle becomes injured from causes such as over use, immobilization, nutritional, metabolic or endocrine inadequacies which result in a myofascial trigger point. Trigger points are often experienced as aching or super-tender areas within a muscle, often with a referral pattern of discomfort that affects other areas that are seemingly unrelated to the injured muscle.

Trigger points in the gluteus minimus can present with symptoms
all the way to your ankle!

Because of this intramuscular damage the body responds with an inflammatory response to protect the injured muscle cells and speed  recovery. Unfortunately, when a cell is damaged it creates more metabolic waste in the process of healing itself but because of the swelling it is incapable of attaining the nutrition required nor is it able to get rid of the waste it has created because the vessels in the damaged area are compressed by the inflamed tissues. This only results in the perpetuation of the problem: an increased need for circulation but a decreased supply. It is thought by some that pain is perceived in trigger points far from the source injury because the swelling and metabolic waste irritates nocioceptive (pain perceiving) nerve endings in that area.

So you've injured a muscle, developed a tender trigger point, and booked an appointment with your RMT, now comes the skillful application of trigger point therapy. Imagine that your muscle is a sponge that has soaked up liquid. When the correct pressure (ischemic compression) is applied to the muscle (sponge) the fluid (blood and lymph) is squeezed out. When pressure is released, the sponge draws in fresh blood and lymph allowing the needed exchange of wastes and nutrients that your sore tissues require. Often the ischemic compression causes an increase in your symptoms until the intramuscular waste is squeezed out of the tissue, which can take several seconds to minutes of steady pressure.

I often encourage my clients to visualize the muscle as they are breathing through the release of a trigger point. With acute and chronic pain overwhelming feelings of anger, helplessness, and even claustrophobia can arise. It is thought that visualizing what is happening in the body can help it to heal while allowing the person experiencing the pain to accept the sensations but still feel in control. This is not only an effective coping tool but it also helps me avoid gaining a reputation as a pain inflicting masochist of a massage therapist.

The stretch to use following a gluteus minimus TrP release

Although it may seem like your RMT has super-human intuitive skills when easing your suffering, but often a trigger point referral is a textbook symptom of the underlying culprit. While he or she may indeed be extremely intuitive, when it comes to trigger points, referring to the attained banks of rote knowledge is often the secret massage therapy tool.

Following a trigger point release it is not uncommon to experience residual pain or discomfort. The application of heat - by taking a hot epsom salt bath, shower, or using a hot compress - combined with specific stretches of the treated muscles are used to promote full recovery and lasting results of the treatment. I always leave my clients with an arsenal of tools to help them recover from a trigger point release. So if this is what you are dealing with, be prepared to be taught stretches and other homecare techniques for use after your massage.

These interactive wall accents were designed for stylish in-home
self-administered trigger point release.

German design house, Touchy-Feely has created heated plaster wall nodules for self treatment.
Although fun, please consider that you may aggravate a trigger point, which will leave you with more pain than you started with. There is a certain protocol to follow to ensure the proper release of a muscle, so don't neglect booking in with your RMT after encountering such wall nodules;)

See you in the clinic,
Dana

Sources: 

• http://the-healthy-diva.com/2012/03/19/motivational-monday-the-benefits-of-breathing/
• http://www.aafp.org/afp/2002/0215/p653.html
• http://www.triggerpoints.net/
• http://www.docpods.com/Illiotibial-Band-Wall-Stretch