Massage Therapy is a very confusing field now. Not being covered under insurance leaves the door wide open to what falls under the heading. A given massage therapist practices anything from spa relaxation to physical therapy type work.
To clarify what I do, the type of massage therapy modality I specialize in is “Neuromuscular Therapy” or “Trigger Point Myotherapy.”
What’s a Trigger Point & Why Work It?
“Trigger points” (TrPs) are tender points in soft tissue that radiate or refer pain to distant areas. These are found all over the human body usually in the belly of a muscle. Once formed, they radiate pain out from the belly similar to a wrinkle in a sheet or a ripple on the water, this is the referred pain felt. Trigger points are produced by muscle stress, such as overwork, repetitive motion, or sudden excessive stretch.
There are four types of trigger points:
- Active TrP – one that is spontaneously producing referred pain.
- Latent TrP – one that produces pain when pressure is applied during palpation.
- Primary TrP – one that is caused by muscle stress.
- Satellite TrP – one that is produced secondarily by a primary trigger point.
How Do They Go Away?
Trigger points generally stay inside the muscle until manipulated away. In layman’s terms, when a muscle is over-stressed it feels compromised and immediately protects itself. This tightening process forms TrPs within the muscle. Muscles are very stubborn and don’t forget experiences easily, hence the term “muscle memory”. Muscles will hold on to this protection until a manual process occurs which tells the brain to send a signal to the muscle that it’s safe to relax and return to a normal resting length. This is what I do.
Pressure is placed directly into a tight or sensitive trigger point area, which often causes radiating pain, and held until the tenderness disappears. This process repeats running along the rippled path of the TrPs. There is a delicate balance between applying enough pressure to release it and applying so much pressure that the TrP worsens. Releasing the points encourages increased circulation to the area allowing the underlying tissue to soften. This is the point when clients say, “I didn’t even know that hurt until you found it! How did you know that was there?”
What Is Neuromuscular Therapy?
Neuromuscular Therapy is also called Trigger Point Myotherapy. This technique alters the length muscles to teach them how to operate correctly. Muscles are manipulated back into the shape originally intended. Less is more during this treatment session to avoid bruising and soreness. This type of therapy consists of alternating levels of concentrated pressure on the areas of muscle spasm to release the lactic acid from the muscle, resulting in increased blood flow and oxygen. Fascia is also stretched to keep the body loose. If the shell of the body is loose, the muscles can loosen and relax back into their natural form.
Causes of Trigger Points
The common cause of trigger points results from various forms of trauma, ranging from a direct injury, excessive stretching, heavy lifting and twisting, or even emotional stress. These sensitive regions will often activate pain in referring areas. Once we eliminate the trigger point, massage aids in removing the waste products and restore circulation to the area.
Some trigger points will be more severe than others and patience is the key factor during the session. Less severe TrPs will release almost immediatley. More severe ones need worked longer. The reason the experience is so worth it, however, is that there is an immediate relief as soon as the TrP dissipates. There’s no waiting 3-5 days to see if the session was a success. You know right away.
Some severe trigger points can reform after a session. I always recommend icing the area worked after a session. The ice will increase circulation to the area and decrease inflammation, minimizing the odds of the TrP reforming.
Dr. Janet Travell is the person most often associated with trigger point therapy. She’s quoted as saying, “Active trigger points cause pain. Normal muscles do not contain trigger points. Individuals of either gender and of any age can develop trigger points.” Simple enough. Another great reminder that you don’t have to live with the pain. Come in and get those stinkers gone so you can feel good in your skin again.
See you on the table!
TMJ stands for the temporomandibular joint. Easy rule of thumb: everyone has TMJ, but not everyone has TMJ Disorder. TMJ is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull, in front of each ear. These joints are flexible and allow the jaw to move smoothly up and down and side to side, allowing us to chew, talk, yawn, etc. The muscles attached and around the joint control the position and movement of the jaw.
Outside of TMJ issues, the main muscles involved in everyday jaw tightness or discomfort are the masseter muscles. The masseter muscle is the primary chewing muscle. With regular talking, chewing, and stress these muscles develop 
Whiplash is a modern problem. Whiplash is also a very misunderstood problem. It comes in many forms and becomes a long-term condition if not treated correctly. After being evaluated by a physician, massage and bodywork is one of the most recruited modalities to help this soft tissue injury heal. When applied carefully and skillfully, massage therapy for whiplash can help clients find relief and prevent or begin reversing chronic pain. The information below will hopefully clear up some long-held confusion about living with whiplash and how to treat it.
Whiplash injuries are basically simple. During a collision (vehicle, contact sport, a bad fall), the head and torso are thrust in opposite directions in a very short period of time. The neck itself makes a whip-like motion bending first towards and then away from the point of impact. An S-shaped curve forms during the early phase of impact where the upper cervical spine flexes as the lower cervical spine extends. The most abnormal motion happens at the C4-C6 spinal segments and damages the longus colli and sternocleidomastoid muscles (muscles used to tilt the head or turn from side-to-side). Therefore, it is not surprising that most of the symptoms of whiplash center in that part of the body between the head and the torso – the neck – but can radiate into other areas forming long-lasting and highly uncomfortable issues if left untreated.
Many people walk around every day with whiplash symptoms and don’t realize it. They may simply associate their pain with “that’s just life” or “my bed is getting old”. Middle-aged adults who played contact sports in high school fall into this category. Some people experienced bad accidents in their youth but shrugged it off, not realizing that some of the chronic pain experienced into adulthood stems from these experiences. Whiplash injuries can have both a short and long-term impact on the accident victim. The first concerns involve the mechanical injury to the muscle, bone, ligament, nerve, and tendon tissue and the resulting pain, inflammation, and muscle guarding. Management of inflammation and pain is the main focus for mainstream medicine. Most attending physicians will prescribe anti-inflammatory, pain-killer, and muscle relaxant medications and send the patient on their way. The long-term concern is the effect of the neuromuscular guarding that can become neurologically habitual, causing health and postural problems years after the date of injury.
Healthcare professionals now say the best way to treat early whiplash pain is mobilization, not rest or a cervical collar. It is important to wait a few days after the accident to seek treatment. This allows the initial scar tissue to knit, which is an important part of the healing process. If there is a chance of a fracture, a concussion, any disc problem or other serious injury, the client should make sure to see a physician first. Myofascial damage is by far the most common source of neck pain in whiplash injuries. Therefore, a multidisciplinary approach is often the best and safest way to treat whiplash. With direct soft-tissue manipulation, massage therapy provides a quicker recovery process, avoiding a lifelong pattern of pain. Chiropractic treatment shows effectiveness in treating acute neck pain.
Surprising to most people, water is the only fluid that properly hydrates the body. Everything else that comes into the body registers as food and files accordingly. Drinking plenty of water daily is important, especially during the first 24 hours before and after a massage. But why is it so important?
With school and sports being in full swing again now is a good reminder that massage therapy isn’t just for adults. Kids today are moving at incredible speeds. From early morning practices and rehearsals to a full day at school, followed by more practices and rehearsals, then homework, it’s amazing they have time to eat dinner!
