Myofascial therapy: Frequently Asked Questions

What is a myofascial trigger point?

A myofascial trigger point is a lump, knot or tight band in the muscle that is tender to touch. A latent trigger point will only hurt when pressed. An active trigger point causes pain to be referred in a characteristic pattern, even when it is not being touched. Active myofascial trigger points are a major cause of chronic pain.

What causes active myofascial trigger points?
The following factors can cause an active trigger point to form, turn a latent trigger point into an active one, or perpetuate existing active trigger points:

· mechanical factors, such as muscle injury or strain, exposure to excessive cold, muscle overuse, body asymmetry or structural defect.

· biochemical factors, such as vitamin or mineral deficiency, hormonal deficiency.

· immune system factors such as infection, parasites, allergies and sensitivities.

What does a Myofascial Trigger Point Therapist do?

A Myofascial Trigger Point Therapist takes four steps to eliminate chronic myofascial pain:

1) Assess the patient: The therapist takes a history, and examines the patient, in order to identify active trigger points and perpetuating factors. This requires an understanding of muscle anatomy and of referred pain patterns, as well as understanding factors that can cause or perpetuate trigger points.

2) Eliminate the active trigger points: This is most commonly done by a process known as 'stretch & ice' or 'stretch & spray'. Where ice or coolant spray is applied to a passively stretched muscle, followed by the application of heat. Trigger points may also be eliminated by compression, or by deep massage. Some therapists eliminate trigger points by inserting a needle onto the trigger point. But whatever the method, the elimination of a trigger point will only be temporary, unless the next step is carried out.

3) Stretch the muscle to its full length. This step re-sets the muscle to a normal state.

4) Prescribe stretching exercises that will help to prevent trigger points occurring in the future, and will make further recommendations or referrals to eliminate or compensate for perpetuating factors.

What is it like to have Myofascial Therapy?

It can be uncomfortable, but is definitely worth it!

I had severe lower back pain for 20 years, that was eased in one session, and cured in 6 weeks. For me, it was a revelation, a minor miracle.

You will probably need to strip to your underwear or a swimsuit, although the therapist will also use a towel to protect your modesty. Some people like the sensation of having their muscles stretched, but personally, I don't.

The passive stretching can be uncomfortable, but is seldom painful. On the other hand, compression of the trigger points can be exquisitely painful. Remember, you can always ask the therapist to ease up, or stop for a moment. If your muscles have been significantly stretched, you may feel some discomfort later, or even the next day. But the bottom line is that after a relatively small number of sessions, your chronic myofascial pain will be gone.

Where can I learn more about Myofascial Trigger Point Therapy?

The classic reference is "Myofascial pain and dysfunction the trigger point manual" by Drs Travell & Simons.

A good reference for people with fibromyalgia and chronic myofascial pain syndrome: a survivors manual by D Starlanyl and M Copeland.

Gary Clark

The Manual of Trigger Point and Myofascial Therapy Author: Dimitrios Kostopoulos PT PhD Description The Manual of Trigger Point and Myofascial Therapy offers the reader a comprehensive therapeutic approach for the evaluation and treatment of Myofascial pain and musculoskeletal dysfunction. This user-friendly manual will serve as a quick reference for clinically relevant items that pertain to the identification and management of trigger points...

Trigger Point Therapy for Myofascial Pain: The Practice of Informed Touch Author: Donna Finando L.Ac. L.M.T. Description A clinical reference manual for the evaluation and treatment of muscle pain• Contains detailed illustrations of pain patterns and trigger-point locations• 15,000 copies sold in first hardcover editionMyofascial pain syndromes are among the fastest growing problems that physicians, osteopaths, acupuncturists, and physical, occupational, and massage therapists encounter in their patients...

Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection Author: Celeste Cooper R.N. Description Fibromyalgia, chronic myofascial pain from muscle trigger points, and chronic fatigue syndrome are often seen as interchangeable conditions. Nothing could be further from the truth--however, they do often coexist...

The Frozen Shoulder Workbook: Trigger Point Therapy for Overcoming Pain and Regaining Range of Motion Author: Clair Davies NCTMB Description Author Clair Davies' own case of frozen shoulder led him to undertake an extensive study of trigger points and referred pain that eventually resulted in his best-selling Trigger Point Therapy Workbook...

Myofascial Trigger Points: Pathophysiology and Evidence-Informed Diagnosis and Management (Contemporary Issues in Physical Therapy and Rehabilitation Medicine) Author: Jan Dommerholt Description Myofascial Trigger Points: Pathophysiology and Evidence-Informed Diagnosis and Management examines a special topic, JMMT. Emphasis is on the etiology of trigger points with a critical overview of current concepts...

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1. Myofascial Therapy