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Trigger Points

This is a group where massage therapists can share their voice on trigger points

Members: 331
Latest Activity: Aug 14

Discussion Forum

use of spray & stretch technique by LMTs 8 Replies

i've been using the spray and stretch technique this year with excellent results in myofascial trigger point cases of acute pain, short appointments with multiple muscle group involvement, and…Continue

Started by Jeff Sims. Last reply by Laura Garza Jun 24, 2012.

Trigger Points, easily eliminated 13 Replies

I can release trigger points anywhere on the body in 20 seconds with only finger tip pressure. Ive said it so many times.. No one believes me. Whatever... This time is that last I will say it..  Ive…Continue

Started by Gordon J. Wallis. Last reply by Shawnda Kettles Dec 7, 2011.

Observing breathing pattern disorders in the most chronic TP affected client. 1 Reply

My observation is those that are belly breathers are the worst.Do you do any diaphram release work and give corrective breathing advice? if so what do you ask your clients to do.? SteveContinue

Started by Stephen Jeffrey. Last reply by Dr. Ross Turchaninov Nov 4, 2011.

Follow up to the trigger point article

We observed so many misunderstanding in regard to trigger points and trigger point therapy that we decided to address them all at the same time in special article in the new issue of Journal of…Continue

Started by Dr. Ross Turchaninov Oct 26, 2011.

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Comment by Brenda Rowell on September 1, 2011 at 8:04am

Well, just joined this group and reading discussions. You don't have to be a rocket scientist to do trigger point therapy! My it is easy! I've had one class in school and have Travell and Simons, which I refer back to ALL the time for specific muscles. I do it if I find one or some in every massage practically just out of habit. Once you know how, it is quite easy.

I know exactly what you mean Boris. There seems to be this you have to be "advanced" and have all this multitudes of special training under a specific person to be qualified to be in the field! What did MT's do before they could jet set all over the country or world to train under such and such guru's way back in the olden days?

Comment by Boris Prilutsky on August 31, 2011 at 10:45pm

Hi Valerie.

Thanks for posting. It looks like we will be able to clarify a lot of stuff on this subject. I mean maybe we will not agree on all, maybe we will ask questions each other, but it will be in professional and practical way.

you said and it makes sense :When I said "trigger point therapist" I was referring to anyone who has received advanced training in trigger points”

You said:” If you claim to specialize in trigger points, you should have at least somewhere around …….

Valerie. on this one I have a question. What does it mean:” to specialize in trigger points therapy,? Is it separate scope of practice?

 

You said :”My classes are at http://triggerpointrelief.com/workshops.html (not trying to sell something, but the question got asked about hours, training, etc).

Rules of this site allow you at the time of discussions to offer your site address. You not only advertising your class but  participating in discussions, and this is what this site is about

 

 You said:I would like to note that the first step, “Differential Diagnosis,” is only for within the scope of your practice.

 I strongly know, not believing but know,   that In regards of trigger points    “Differential Diagnosis,” is not applicable, but contraindication are applicable. I mean pinpoint sharper/most intensive localization of pain is a trigger point, in case if one  palpating all type of  new formation, such as tumors, cysts, so-called muscle knots which is most likely is myogelosis, and even palpatable formation, will demonstrate localization of sharp level of pain, , it just prohibit to apply pressure, or any other techniques. You can feel /detect pathologically changed  muscular tone but not trigger points. Trigger points detected as well reported by clients, by describing sensation only.

You said:”  For example, I have a chiropractor and a naturopath to refer to for x-rays, MRI’s, blood work, treatment, etc.  “

it is nice to have this data but not crucial. There is many people who suffering untolerant pains, and even will demonstrate difficult neurological picture, but MRI will be perfectly good /negative. Because MRI cannot reflect myofascial tensions . With our hands we can detect this tensions as well by special techniques to eliminate the causes of difficult symptoms.

At the time MRI of other person, can provide images  of terrible changes, including disc  herniations but one will not complain on significant pains or at all. We should  be driving and directed accordingly to clinical symptoms.

 

You said: Though Travell & Simons was written for doctors who did injections, most of the text is still pertinent to anyone who treats trigger points. 

Valerie., most of the text, is a great presentation of the  pathology etc. and in my opinion can be used as an academic source including references, but not as a text book for massage therapists. I mean text that offering not only scientific review, but simply speaking what to do with hands. It doesn't offer it.

 

You said :”And they were updated -- Volume 1 was updated, and I know Simons was working on updated Volume 2 before he died (don't know what the status of that is).

I believe  am possessing the first eddition , and it is clearly text writing for medical doctors. Maybe new  updates adjusted to be more for us. Please be aware nor Dr. Travell as well Dr. Simmons did practice hands-on massage therapy.

You said :”There is no brief answer to identifying causes and then treating them -- each muscle has its on set of perpetuating factors & treatments, in addition to systemic perpetuating factors.  

In my previous post I presented main causes that leading to trigger points developments and not only within muscles. No doubt autoimmune diseases as well including systemic diseases can lead to trigger points developments. In such a case only our treatment alone will not help, most likely rheumatologist’s  involvement including medications will be needed. But trigger points is a trigger points with the same morphology as well different methodologies of trigger point therapy.

 

You said :”Thanks all for participating in this discussion, and glad the awareness is growing and trigger point knowledge/treatment is getting incorporated into your practice, whatever it is.  That, to me, is by far the most important thing.

Agree with you, and hope to hear from you again. Most important , we should remember is, that out there , many methodologies that allow successfully treat conditions, as well we should remember that there is room for your skills improvement. I try to remember it, and it works for me, hopefully for others too.

Best wishes.

Boris

PS. I have tried to order your book:”  self trigger point therapy for tension headaches.” It didn't allow me to get through . I have very bad skills to use all Internet services, but in any case doublechecking. This weekend my son will help me to order.

 

Comment by Noel Norwick on August 31, 2011 at 5:22pm
Hi Valerie:  Thanks for the links & for further explaining your perspective on the topic.
Comment by Valerie DeLaune, LAc on August 31, 2011 at 12:37pm

Hi all - I am traveling & don't have a lot of time right now.  When I said "trigger point therapist" I was referring to anyone who has received advanced training in trigger points -- meaning beyond 15-30 hours, whether they got it in massage school, physical therapy school, acupuncture school, or doctor school.  My original training was something like 72 hours (in addition to my massage training), and I went on to study Travell & Simons books from there.  If you claim to specialize in trigger points, you should have at least somewhere around 100 hours of training just in this subject (whether you got it from a program or just studying books extensively.)  I think trigger point treatment combines well with a number of other modalities - medical massage, physical therapy, chiropractic, Swedish massage, myofascial release, acupuncture…and there are others. 

Here is a link to some schools the NAMTPT lists:  http://myofascialtherapy.org/training/index.html.  My classes are at http://triggerpointrelief.com/workshops.html (not trying to sell something, but the question got asked about hours, training, etc). There is no legal requirement to have a certain number of hours to be able to call yourself a trigger point therapist, other than whatever your State requires for whatever license you practice under.  Here is the protocol the NAMTPT recommends:  http://myofascialtherapy.org/myofascial-therapy/protocol.html.  I would like to note that the first step, “Differential Diagnosis,” is only for within the scope of your practice.  For example, I have a chiropractor and a naturopath to refer to for x-rays, MRI’s, blood work, treatment, etc.  Since I can’t do all the diagnosis and treatments, I have a network of other professionals that I work with.  But as a practitioner, you do have to become familiar with perpetuating factors so you know who to refer your patient to for whichever ones you can’t diagnose and treat yourself.

Though Travell & Simons was written for doctors who did injections, most of the text is still pertinent to anyone who treats trigger points.  And they were updated -- Volume 1 was updated, and I know Simons was working on updated Volume 2 before he died (don't know what the status of that is). Noel, I’m going to refer you to http://triggerpointrelief.com/cdrom/triggerpts.html for more info on trigger point points.  There is no brief answer to identifying causes and then treating them -- each muscle has its on set of perpetuating factors & treatments, in addition to systemic perpetuating factors.  That’s why extensive training and/or reading is necessary to become proficient.

Thanks all for participating in this discussion, and glad the awareness is growing and trigger point knowledge/treatment is getting incorporated into your practice, whatever it is.  That, to me, is by far the most important thing.

Valerie

Comment by Boris Prilutsky on August 30, 2011 at 1:45pm

Hi Valerie .

My feeling that we having some miss clarification in prospective of needed  hrs. for training.

No doubt in my mind, if one will have to be trained in approximately 50 (full medical and sports massage scope of practice )different  protocols, and in case if one already professional and taking CEs, then I agree with you, most likely for this type of training ,it will be needed in  an average 500 hrs. This 50 case presentations is a typical subjects that all of us facing and no matter what methodology we are practicing. Therefore I do believe that for full scope of practice in cases of CEs 500 hours can be reasonable training  time.Sorry I didn't have a chance to read from your books, but planning to purchase it. My feeling you are  know what you are talking about. I don't know you but it's my pure intuition and therefore I'm looking forward to read from it. There is many different methodologies to address pathologies and all of them can be safe and effective. What I have learned,  is that,there is no silver bullet and by sharing knowledge on this side, including respectfully agree and disagree every one can learn from each other. I hope you agree with me on this.

Look forward to hear from you and to continue productive discussion.

Best wishes.

Boris

Comment by Nancy L. Ring on August 29, 2011 at 9:52pm
I have had the injection type and they don't hurt. They feel like getting a shot. I have had the spray as well. It has a numbing effect. There are contradiction we can't work on and nursing allows me to work on an actual incision before it becomes a scar and to work on it while it heals without waiting. In many states we are limited. I agree 15 hours to learn TPT is few. In just trigger point therapy alone I have 192 hours plus I have kinesiology, muscles, a&p, swedish, dt, and many more modalities. When I graduated I had about 1200 hours or so. I have an AOS in massage therapy. All the other classes where given for when that 192 hours came about, I wouldn't be lost. I had to learn nerves, ligaments, tendons, and every contradictions know to man. I have the best education possible in massage in my opinion. I had the best teachers. At the time, Colorado Springs law was we had to have 1050 hours to receive their licensure. Tack on a few hours and there is the associates degree. I am very grateful to my massage education, it has made nursing school much easier. I already have a great knowledge of medical terminology which made that class a breeze. I already knew how to write up SOAP notes which made the SOAP/CARE writing class much easier. My massage education has put me ahead in nursing classes. I have learned plenty because of nursing that I never understood as an MT especially with Dr. Travell. You are right she wrote those books for medical personnel and not MTs. Remember massage wasn't huge back when and most people didn't work on injuries. The only ones who did where PTs, nurses and doctors. We have come a very long way.
Comment by Larry Warnock on August 29, 2011 at 6:36pm

Jef...I just finished providing a stress management workshop with about 40 athletes.  It is called CHILL TIME. As a psychologist, I developed this because there is no one more stressed out than a student/athletes...except maybe some of our members. 

 

Take a deep breath everyone...and then go back to work...whatever that is for you.

Comment by Jeff Sims on August 29, 2011 at 5:37pm
I highly recommend a stress management massage for everyone. 8-)
Comment by Boris Prilutsky on August 29, 2011 at 5:27pm

Hi Larry.

Of course you don't have to extent if you don't want or cannot  to extent. Then why you would make all this statements :” Suffice it to say  that a trigger point therapist is a very advanced massage therapist who has studied the body far beyond the "storefront bodyworkers".”

Larry, With no explaining what is the “advance body studies ”and why and how  you “far beyond the "storefront bodyworkers”? This monologues just not useful. What we can learn from it? Or what we can learn from this:” Like all my patients, I want to kinow something about lifestyle as I believe that stress, work, family, nutrition, etc. may be factors. for many of my patients, I am the first one who actually cared about them beyond prescribing pills.” Absolutely nothing possible to understand or learn from your sentences.

Doesn't matter what is trigger point therapist’s curriculum is, I am disagree with you in regards  you  being advance/superior. According to many surveys, 90% of  Drs. visits are stress related, essential hypertension, anxieties, diabetes type II, clinical depression  and more very difficult diseases. There is massage therapists, that specialize in providing full body medical stress management massage (not relaxation but stress management) which is most powerful methodology in stress management. From painful disorders, cases when we incorporating trigger points therapy, people suffering but from heart attacks and other stress related diseases people dying. Why would you feel advance to massage therapists who performing full body massage?

To feel “advance” it's wrong because it dividing our community , and we have to try to stay united, to respect each other, and to try to share knowledge in order to advance entire industry. This is important. More successful outcomes we all will deliver, more recognition of general public and medical society we will get. Second time you replying to me, and do not including my name. I suspect that you feel too advance to call me by name. Another example why it is not good to feel superior.BTW. To feel superior is a symptoms, of not tolerance, anger, bitterness, ego out of proportion, selfdistractions. Wouldn't recommend to feel superior and of course not in professional discussions, because feeling superior and advanced  you actually delivered nothing to learn from your statements. Simply nothing.

On this one below I strongly disagree. One who feel superior having close  mind and just cannot learn: You said“And, unlike many, I am still learning even with 40 years experience in trigger point therapy.”

Still wishing you the best.

Boris

Comment by Noel Norwick on August 29, 2011 at 1:37pm

Larry & Valerie:  I would appreciate both of you providing your expert's working definition for the term; "trigger point", as well as providing a brief description of assessment protocols that a licensed/certified massage practitioner might legally use for locating one, identifying its most likely cause and then how to properly treat it.  

My concern is the Travell & Simons books were written for M.D.s and published in 1983 & 1992.  They present medical opinions & treatment methods that may well be considered by today's M.D.s to be outdated and for the most part are outside of a massage practitioner's scope of practice in the USA.

 

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