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Clinical Trigger Point Therapy
Copyright Dr. Laura Perry DC, LMT - The Institute of Trigger Point Therapy
Visit Dr. Perry's Pain Disorder Directory to learn about which
of these trigger points may cause your specific pain.

What is Clinical Trigger Point Therapy?

Clinical Trigger Point Therapy is a systematic, comprehensive approach to relieving physical pain. The system is based on the research of Drs. Janet Travell M.D. and David Simons M.D. and was developed by Dr. Laura Perry in 2001. Dr. Perry's system distinguishes itself from other trigger point related therapies in the following ways:

  • Comprehensive Treatment Protocols: Years of study and clinical experience have established that most pain disorders are produced by multiple trigger points. Dr. Perry's understanding of how trigger points interact with each other, enabled her to design effective treatment protocols that address all of the trigger points typically involved with common pain disorders. Other approaches to Trigger Point Therapy fail to see and address the complete picture of a particular pain complaint, and therefore are ineffective at providing lasting pain relief.
  • Locating Trigger Points: Clinical Trigger Point Therapy uses a client's pain as a guide to locating the trigger points. In addition, Dr. Perry's protocols use specific anatomical "landmarks" to help consistently and reliably pinpoint the location of a trigger point. In contrast, the typical trigger point practitioner relies on his or her ability to physically feel for a trigger point in a given muscle--this approach has been shown to be ineffective in clinical studies.
  • Trigger Point Release Methods: Dr. Perry used her extensive understanding of trigger point theory to design specific protocols or trigger point release techniques. This enables the Clinical TrP Therapist to minimize the discomfort associated with Trigger Point Therapy while still providing the most effective client care. Through her years of protocol refinement, she found that most therapists over-treat a given trigger point, causing undue discomfort and sometimes bruising.
What exactly is a Trigger Point?

To understand exactly what a trigger point is, you have to know a little bit about the way a muscle is built and how it works. If you look at muscle tissue under a microscope, you see that each muscle is composed of thousands of tiny fibers, in the same way that a rope is composed of smaller stands bound together. At various points within a muscle, nerve fibers attach to groups of these tiny muscle fibers. Nerve impulses cause groups of muscle fibers to contract or shorten. Then when you relax your muscle, the nerve impulse stops and the groups of muscle fibers relax and lengthen.

A trigger point is caused by a malfunction of the junction between the nerve fibers and the muscle fibers. This malfunction causes the group of muscle fibers to stay contracted, even when the muscle itself is relaxed. This group of contracted muscle fibers resemble a knot in a rope, and affect the muscle in the following ways:
  • Increased Muscle Tension: The contracted group of muscle fibers prevent the muscle from completely relaxing, causing the muscle to be stiff and tense.
  • Muscle Weakness: The presence of the contracted fibers prevents the muscle from contracting fully and smoothly, thus impairing the strength of the muscle.
  • Muscle Fatigue: The constantly contracted group of muscle fibers use an incredible amount of energy, exhausting the supply of fuel for the rest of the muscle fibers. This causes the muscle to feel fatigued and lethargic.
  • Muscle Spasm: A trigger point is actually very much like a tiny spasm in a muscle. Over a period of time, as the muscle becomes exhausted, more and more groups of muscle fibers become involved, leading to a full fledged muscle spasm.
What causes Trigger Points?

In general, any activity or posture that overloads a muscle can cause trigger points to develop in that muscle. Some examples of muscular overload include:
  • Traumatic Injury (such as falls, automobile accidents, etc)
  • Heavy Lifting (especially lifting and twisting)
  • Beginning a New Exercise Program
  • Repetitive Tasks (such as typing or other job related activities)
  • Poor posture or holding static postures for long periods
  • Stress or Emotionally related muscle tension.
  • Periods of muscle disuse or immobilization.
  • Poor body mechanics due to injury
The "mystery" of referred pain.

In addition to affecting the proper functioning of muscles, trigger points affect the nervous system by producing referred pain. The term referred pain describes a type of pain that is projected to a region of the body that does not contain the source of the pain. This type of pain is typically associated with the body's internal organs. For example, you're probably aware that a person having a heart attack will often experience pain in their left arm, shoulder, and jaw. The source of the pain is the heart muscle, but the pain is actually not experienced deep in the chest where the heart is located; rather, it is projected or referred to the left arm, shoulder, and jaw regions.

In fact, all of the body's major organ systems refer pain to some adjacent region of the body, not just the heart. The "mystery" of trigger point referred pain results from the failure to recognize the fact that the muscular system is the body's largest internal organ, and therefore capable of producing referred pain.

Other symptoms related to trigger points.

Other neurological symptoms that can be produced by trigger points, besides referred pain, include:
  • Numbness or tingling sensations in various regions of the body.
  • Visual disturbances
  • Balance problems and vertigo
  • Excessive eye tearing or redness
  • Sore throat
  • Dry cough
  • Sinus discharge
  • Abdominal bloating
  • Pelvic cramping and/or dysmenorrhea

 

 

Arm & Shoulder

Gluteal/Sacrum

Headaches

Hip

Low Back

Shoulder

Scapula/Shoulder

Neck/Shoulder

Sciatica

Foot

Wrist

Ankle

Associated Bodywork & Massage Professionals
National Strength & Conditioning Association