Trigger Point Release

Transcription

1 Trigger Point Release How To Remove 75% Of Your Back Pain INSTANTLY! Created by Dr Graeme Teague B.Sc, B.App.Sc(Chiropractic), CertHom, Reiki Master

2 Copyright Dr Graeme Teague 2007 ALL RIGHTS RESERVED No part of this e-book may be reproduced or transmitted in any form whatsoever, electronic or mechanical, including photocopying, recording, or by any informational storage or retrieval system without express written, dated and signed permission from the author. DISCLAIMER AND/OR LEGAL NOTICES The author and publisher shall in no event be held liable to any party for any direct, indirect, punitive, special, incidental or other consequential damages arising directly or indirectly from any use of this material, which is provided as is, and without warranties. Back Pain Advisor and Dr Teague do not warrant the performance or effectiveness of other sites linked to this website. All links are for information purposes only and are not warranted for content, accuracy or any other implied or explicit purpose. As always, the advice of your doctor or other medical professional should be sought.

3 Introduction Trigger point therapy has been used for many years, yet is still the most under-used of all physical therapies. This is quite amazing as it is well understood that trigger points can cause almost 75% of all back and neck pain. Does this mean by removing these phenomena that your back pain will have long lasting relief? No, in fact trigger points are one of the common symptomatic factors in back and neck pain. To have long lasting back pain relief, you still must address all the factors causing it. Trigger point release will help remove the symptoms quickly and allow you the freedom to enjoy life a lot more. One warning! Don t be fooled into believing that just because pain eases, that the causes have miraculously disappeared also. Pain is just a signal to make sure you take action, that is all. The diagnostic tools you have been taught are always the main technique to use to monitor your progress. Use the trigger point release to ease pain quickly so that you can remove the causes just as fast. As always with all our guides on back pain relief, the theory and background information is kept to a minimum. If you are like me when I suffered from back pain, all I wanted was the quickest and most effective way to remove it and stop it returning. Reading background information and theory does not speed up the process. Neither does understanding why techniques work. All you get in this guide are the best and quickest ways to find the trigger points and to remove them. So enough said, now onto what to do. But here is at least some minor background details to help you understand briefly the significance of trigger points. What are Trigger Points? Trigger points are nodules or masses within the muscle itself. They are commonly found where the motor neurons activate the muscle fibers for action. Once they form they restrict the muscular action and hence create pain and joint stiffness. The nodules once there for a period of time will also allow a build up of toxins or waste products from the muscles action. Trigger points can be present for many years and lie completely undetected. There are two types of trigger points although some therapists break the first type into two categories. The two types are: Active this is where the trigger point is tender to touch even with gentle pressure. These points will refer pain to a remote location or over the area of the point itself. This is where the classification can be broken down further those that refer and those that don t. Those that

4 don t refer will be acutely painful in the location. Latent these are points that are not felt and the muscle it self is not tender until you compress the trigger point. The tenderness tends to be less severe than the active trigger points. These types of points can create joint stiffness and are a common reason for many back pain techniques failing to succeed. In all back or neck pain cases, latent trigger points should be assessed. Trigger points should not be confused with Acupressure points. Trigger points are physical phenomena where the muscle is in spasm in a few fibers. Acupressure points are a condensation of energy or blockage of energy. Trigger points can create a variety of pain signals, from tingling through to sharp pain. The most common form of trigger points will refer pain remote to the actual site of the nodule. Even sciatica is commonly a trigger point situation rather than anything else more sinister. Trigger points will decrease in size and tenderness with the application of pressure. If they do not ease with the techniques outlined in this manual, then the point is likely NOT a trigger point. It is an Acupressure point, fat lump or possibly scar tissue. What Causes Trigger Points? Trigger points like all other factors in back pain can arise due to many different situations. They only ever form as the muscle tires, or fails to function correctly. Back and neck pain are complex issues. You can try to work out why these trigger point occur, or you can just remove them and stop them returning. Trying to work out the original cause is less likely than the proverbial needle in a haystack situation. They can occur due to poor joint movement, muscle weakness or muscle tension, stress or fatigue, nutritional imbalances, toxicity, over use and overload of the muscles and many other reasons. The cause of all back pain and trigger points are the various distortion patterns that exist in your body. These distortion patterns have occurred for numerous reasons. The reason they remain is simple. Habit. Once these trigger points and other back pain factors occur, if they remain for a period of time they become habitual. To remove these and to stop these returning you must change the habits of the body. Once again, this may sound difficult, but it is actually very easy. All you need to do is use simple, effective techniques on a regular basis. You should relieve pain and then keep using techniques until the distortion patterns have corrected. This is why the diagnostic tools you have learnt are so VITAL. Once these patterns have changed for the better, you still need to rebalance and improve your spinal health on a regular basis.

5 Long-term care only needs to take a few minutes once a week to maintain a healthy spine. Achieve this and you can look forward to your older years free of that dreaded back or neck pain that haunts so many in their older years. What is the Purpose of Trigger Point Therapy? The purpose of trigger point therapy is to eliminate pain and to re-educate the muscles into pain-free habits. After several treatments, the swelling and stiffness of neuromuscular pain is reduced, range of motion is increased, tension is relieved, and circulation, flexibility and coordination are improved. Sound like a good idea? Well let s get started. As always the first step is finding the trigger points How to Find the Trigger Points There are two simple ways to find trigger points. The first is palpation and the second is mapping. Palpation this is basically massaging the muscle and locating any tight tender nodules. For lower back pain the most common nodules are found either side of the spine or around the pelvic crest. The problem is, trigger points refer pain. You may think you have lower back pain but the trigger point can be remote to the location. This is why mapping is a more accurate way of finding the location of the points. Mapping each trigger point location has a mapped area of referral. Each muscle has motor points where the trigger points are most commonly found this way you can locate active or latent trigger points. The pictures below indicate where the trigger points are commonly located and the most common area of pain referral. You can look at these and identify where your pain is and map it to the trigger point in the muscle. For latent trigger points, look at the muscles close to the joint you have pain or stiffness in and then palpate around the location of the point. Remember, latent points will still be tender to compress. Trigger points are commonly found in the muscles that do most of the work. So look at your activity levels and then assess the muscles you use most. Signs of Trigger points: Restricted movement, stiffness of muscles Weakness in muscles

6 Passive or active stretching increases pain, including the PNF stretches you use with the X-Pain Method Resisted contraction causes pain, such as isometric contractions Subcutaneous tissue feels coarsely granular, ropy, knotty, Person "jumps" when pressure applied to trigger point Deep tenderness and paraesthesia (feeling "Numb" but skin sensation is normal) Exercise makes the pain worse when there are active trigger points, but helps heal the latent trigger points The following are images of the main trigger points that refer pain to your back and limbs. Trigger points are commonly found where the nerve attaches to your muscle. The locations are as indicated in the images and once you press around the area you should feel a lump and an area of tenderness. Trigger points can be quite large or they can be small. But they will be obvious once you feel their tenderness. The images below are the common sites, you may need to palpate around the areas marked by the colored circles to find the trigger points. You can also have more than one in the location as well. Once you find the trigger point, simply use the techniques in the next section to release them. Remember, trigger points can cause almost 75% of your pain. But pain is only the first thing to address. You still need to make sure you remove ALL the causes of your pain. If not, pain will return, it will become worse with time and eventually lead to chronic back pain in your older years. PLEASE NOTE: The following are the most common trigger points. You can get trigger points in any muscle of your body. The following are the common that cause back or neck pain, and some other common added areas such as your legs which will also allow back pain to occur. If you want a complete guide to trigger points there are many large and expensive books on the subject. Amazon has great deals on the books the main text is: Myofascial Pain and Dysfunction: The Trigger Point Manual vol 1 & 2 by Janet G. Travell &David G. Simons But the manual you are reading is here to teach you to remove your trigger points as quickly as possible, to find the ones causing your pain and to stop them returning. If you want the theory then the above book is best.

7 Lower Back Pain The most common trigger points are in the Gluteals, Quadratus lumborum, Erector spinae and Piriformis. The darker shaded areas are the areas that generally will have more pain. Gluteus maximus Gluteus med & min

8 Quadratus lumb Erector spinae

9 Piriformis Secondary Muscles The following muscles are still important to assess. They are less common but as trigger points form in muscles that are used and over-used often, these muscles will develop trigger points depending on the activity you do. The common point locations are shown, but you can always look around any part of your body to find trigger points if you wish. If you find a lump that is tender to compress, refers pain, then you have found a trigger point. Then use the techniques in the next section to remove them.

10 Hamstring Hip Flexors This has referral to the front and back of the body, you can also have just one area that has pain.

11 Abdominals Referral can be to the back or abdomen area. Tensor Fascia Lata

12 Adductor Group Quadriceps

13 Lower Leg

14 Upper Back and Neck As you use your upper back more and more in today s world, there are certain muscles that develop trigger points easily. The first group below is the common muscles that develop trigger points and where they refer. Neck Flexors & Extensors This includes the Sterno-Cleido-Mastoid (SCM), Scalenes, Sub-Occipital Muscles and muscles in the back of the neck. These are the muscles that control your neck and are the common locations of trigger points.

15 Trapezius Levator Scapulae Rhomboids

16 Rotator Cuff This includes the Teres Major & Minor, and Infraspinatus muscles. Secondary Muscles These muscles can also form trigger points commonly as they are muscle that do a large amount of work on your arms and movement of your head. Again if you find trigger points in the area, if they are tender to compress and refer pain, use the techniques in the next section to release them. Deltoid Latissmus dorsi

17 Pectoralis major & minor Sublcavius Supraspinatus

18 How to RELEASE the Trigger Points Releasing trigger points is very easy. All you need is pressure on the point for seconds and then the point will ease quickly. Sound too simple? Well, there is a little more you should do. Simple pressure will ease points and there are some therapists that will tell you that is all you need. However, trigger points that have been there for a while need a little more coaxing to remove them. To release trigger points you still need to follow a simple step-by-step process, which is: Pressure Relax- Pressure Stimulate Stretch Support If you follow this approach you will not only release the trigger points but will help to prevent them returning. However, to have good long term success with any back pain issue, trigger point work should be only part of the process. The X-Pain Method teaches you how to remove all the causes of your back pain. Please follow the advice contained within manual as temporary relief only, use it to remove pain and then make sure you remove all the causes. Your long term spinal health depends on you balancing all areas that are currently causing your pain. The following is the detailed Trigger Point Release Technique. Pressure You need to apply firm pressure to the trigger point. It may be easier to use an external device such as a tennis ball. You can use your knuckles, thumb or finger tip or have someone else apply pressure on the points. The pressure need to be firm, it will cause discomfort or pain on the point. Adjust the pressure so you can tolerate pressing on the trigger point for seconds. You can vibrate the point or move the tennis ball back and forth over the area if you wish. Don t be concerned if at first you cannot apply too much pressure. Even gentle pressure will release the trigger point to a degree. Then as you reapply the pressure you will find you can press harder before pain occurs.

19 Relax After the seconds of pressure, take a deep breath in and out and relax as much as possible. If you are lying/sitting on a tennis ball, you need to lift off the ball as you breathe out. With fingers or thumb, just ease the pressure as you breathe out. Pressure Repeat the above process 2 more times. Each time you should feel the trigger point is less painful, softer to touch and the referral of pain decreases. Once again don t worry if you find minimal relief after the first rotation. For most of you this process alone will reduce pain dramatically. For those who find minimal relief, it means the points are a bit more habitual and the remainder of the process is therefore essential. Neuro-Lymphatic Stimulation Once you have released the tension in the trigger point the next step is to stimulate the nerve supply and to remove any inflammation around the muscle. Neuro-lymphatic points to precisely that. Simply rub the neuro points below for seconds in a circular motion. If these points are tender, then it indicates the muscle is tired and rundown. After rubbing for this time period, you should find the tenderness in these neuro points will decrease. Rub the points firmly but not aggressively. Rub in a circular fashion and if you find the tenderness does not decrease, rub in the opposite direction for 10 seconds and the tenderness should ease. These points act as a pump, sometimes you need to rub in one direction to release these. You cannot rub them in the wrong direction to make them worse. Simply rub one way for 10 seconds or so, and then the opposite direction. For the neuro-lymphatic points, simply use the X-Pain Method text, or use the common points at the end of this text. Stretch Once you release the trigger point, then stimulate the neuro points a simple stretch will also help to encourage blood supply to the area. Just do a standard static stretch of the muscle. Hold the stretch for 20 seconds which is enough to encourage blood to target the area and to help elongate the muscle. You can then go for a gentle walk or you can also gently massage the area if you wish. This will help the blood supply to come to the area you have worked on. Stretching helps to encourage the tight knotted fibers to relax and stay relaxed. The next step improves this process and helps to prevent recurrences of the trigger points. If you are unsure how to stretch the required muscle, use the techniques in the main X-Pain Method text.

20 Acupressure - support Acupressure is a favorite technique for one big reason. It works and works well, you always have your fingertips with you, so you can apply Acupressure techniques at any given time of the day. Acupressure is easy to do, you cannot do it wrong, stimulate the wrong point or apply it too much. Simply rest your finger tips on the points; they are the size of your finger tips but have a three inch effective radius. You can not miss the point; you do not have to be too accurate. Acupressure points are an energy blockage, once the blockage eases, you will feel a gentle rhythmic pulsation in the Acupressure point. Feeling the pulsation doesn t make the points work better or worse. If you can t feel the pulsation just hold the points for a few minutes or more. The more you hold these points the better. But after a few days most people can feel the points pulsate, then you can check these points each day until they pulse within a few seconds. If Acupressure point pulse within those first few seconds, it means they are functioning correctly. Check them for a few days or more to make sure this continues to occur, if so then you can simply check these once every so often to make sure they remain functioning well. The following points will help release the trigger points and support the body to make sure they do not return frequently. The first point relates directly to tight knotted muscles, such as trigger points. The point is on the back of your knee just inside the Hamstring tendon. Once again you have a three inch effective radius, so you will not miss the point. You can cross your arms over to make holding these points easier if you wish. Hold these points for a few minutes or until you feel the rhythmic pulsation.

21 The second point helps to release tension in the body, helps with muscle flexibility and strength as well as targeting the Adrenal glands which are important for anti-inflammatory purposes. It is a good point to check long term as it also helps to improve your energy levels. Simply cross your arms and hold onto the crease of your elbow. Again, the three inches means you cannot miss the point. Water Intake support The next thing to do is to keep your water intake relatively high over the next few days. The toxins that are around the trigger points will be released also. Drinking plenty of water helps your body eliminate these without causing you any troubles. The longer the trigger points have been present, the greater the amount of toxins that will be released. These can come out as symptoms of a cold, or some minor digestive upset. Drinking the water helps prevent noticing any of these symptoms. It is best to add Apple Juice to the water as this helps the body absorb the water and take it to a cellular level quickly. Just have approximately ¼ glass of apple juice and the rest water. Try to drink at least a liter each day, 1 ½ -2 liters is ideal for the next 3 days and then drop it back to 1 1 ½ liters each day, which is good for structural health. Nutritional Support If you have many trigger points, which are very tender. If you find they struggle to release, then you may need some nutritional support for a month or so. Vitamin C and B-6 are essential as is Magnesium. Supplement with these for a month and this will help support the body s systems to prevent the return of any trigger points. Detox Bath After you release trigger points, if you found many points that were active, then it may be best to use a detox bath on the day you work on them. A detox bath helps your body to remove the toxins and helps to improve the muscle internal balance. Simply have a bath with 1 cup of Epsom Salts, 1 cup of Sea Salt and 1 cup of Baking Soda. Soak in the bath for minutes. If you live by the ocean you can also swim or walk in the ocean for the same period of time.

22 Detox baths do help prevent the symptoms that can occur once you release trigger points. Finally Trigger points are common, they can cause up to 75% of your back or neck pain. But they are only symptom related. You still must address all the causes of your back pain. The main X-Pain text is designed to teach you all the necessary techniques to remove all the issues causing your pain. Use the techniques above to release trigger points. You may find you are out camping, or on holiday and find pain occurs from doing new activities. Trigger points are a common source of pain in these circumstances. Simply press, relax, stimulate and stretch the area as soon as you notice these points developing. You can release them quickly and stop pain developing. Enjoy this brief ebook, and as always if you need help or advice me. Talk soon Dr Graeme Teague

23 Neuro-Lymphatic Points The following points are the locations for the Neuro-Lymphatics for the muscles that commonly have trigger points. Rub these in a circular motion to stimulate the antiinflammatory and nerve stimulation to the muscle. These are not small points, so generally rub around the area. Please Note: Neck Flexors & Extensors cover all the muscle in the neck region, including SCM and Scalenes.

24 Copyright Dr Graeme Teague 2007 ALL RIGHTS RESERVED No part of this e-book may be reproduced or transmitted in any form whatsoever, electronic or mechanical, including photocopying, recording, or by any informational storage or retrieval system without express written, dated and signed permission from the author. DISCLAIMER AND/OR LEGAL NOTICES The author and publisher shall in no event be held liable to any party for any direct, indirect, punitive, special, incidental or other consequential damages arising directly or indirectly from any use of this material, which is provided as is, and without warranties. Back Pain Advisor and Dr Teague do not warrant the performance or effectiveness of other sites linked to this website. All links are for information purposes only and are not warranted for content, accuracy or any other implied or explicit purpose. As always, the advice of your doctor or other medical professional should be sought.