Trigger Point Therapy

Question 1

Characteristics of Trigger Points

Answer 1

• Are a hyperirritable spot
• Are usually painful upon compression
• Refer pain in a predicable pattern
• Cause a shortening of the affected muscle
• Decrease contractile ability (create weakness)
• Usually found within a taut band of skeletal muscle or it’s fascia.
• May also be found ligaments, joint capsules, and periosteum

Question 2

Characteristics of Referral Pain

Answer 2

• Occurs typically distal to the activated/palpated trigger point
• Is reported by clients as dull and achy, or as a burning sensation
• Is rarely accompanied by numbness and tingling
• Disappears by resolving the trigger point

Question 3

Characteristics of Active Trigger Points

Answer 3

• Produce pain when the affected muscle is at rest or moving
• Create referral pain upon being palpated or during contraction or stretching of the affected muscle
• Cause a shortening of the affected muscle
• Decrease the ability of the affected muscle to fully contract, causing weakness
• Prevent affected muscle from fully lengthening
• Cause a local twitch response in client
• Are not likely to resolve on their own

Question 4

5 Types of Trigger Points

Answer 4

• Active
• Latent
• Primary
• Secondary
• Satellite

Question 5

Characteristics of Latent Trigger Points

Answer 5

• Usually are not noticed as painful until palpated/activated
• Decrease the ability of the affected muscle to fully contract
• Prevent affected muscle form fully lengthening
• More common than active trigger points
• May persist for years after an injury
• May become active if overuse, overstretching, or chilling of the affected muscle occurs

Question 6

Characteristics of Primary Triggers Points

Answer 6

• Found in the AGONIST muscle
• May be activated by acute or chronic mechanical strain as well as overload of the affected muscle

Question 7

Characteristics of Secondary Trigger Points

Answer 7

• Found in overworked synergist or antagonist muscles

Question 8

Characteristics of Satellite Triggers Points

Answer 8

• Found in muscles that lie with the referral zone of primary or secondary trigger points

Question 9

Difference Between Tender Points and Trigger Points

Answer 9

Are painful upon palpation, but do not create referral pain

Question 10

Perpetuating Factors that Activate Latent Trigger Points

Answer 10

• Mechanical stress, including bone asymmetries
• Postural stress
• Muscle constriction
• Nutritional imbalances
• Metabolic imbalances
• Electrolyte imbalances
• Psychological factors
• Chronic infections
• Impaired sleep
• Allergies
• Sudden increase in activity

Question 11

The 2 Ways of Palpating Trigger Points

Answer 11

• Flat Palpation (cross fiber sweeps)
• Pincer Grasp

Question 12

General Protocol Prior to Trigger Point Therapy

Answer 12

• Communications
• Resting Position
• Initial Warming
• Fascial Techniques
• Joint Mobilizations
• Clearing
• Deeper Warming

Question 13

The 2 Techniques for Treating Trigger Points

Answer 13

• Ischemic Compression
• Muscle Stripping

Question 14

Technique for Locating Trigger Points

Answer 14

• Use fast muscle stripping in the direction of the muscle fiber at a speed of 3 to 6” per second
• As an alternative to fast muscle stripping, use palpation
• Observe for local twitch response
• Allow client to guide you

Question 15

Ischemic Compression Technique

Answer 15

• Pin the trigger point against underlying structures
• Produce discomfort between 4 and 5
• Hold for 10 to 12 seconds and then ask when there’s referral pain (marker of a true trigger point)
• If pain decreases, hold compression until clients feel no pain or referral pain
• If pain doesn’t decrease, slowly release compression
• Superficially smooth out area
• Stretch treated muscle to restore it length
• Address referral zone for about 10 seconds to discourage the development of satellite trigger points

Question 16

Muscle Stripping Technique

Answer 16

• Strip in direction of muscle at a speed of 1” per 3 seconds
• Continue stripping until pain and referral is gone.
• Stop stripping if pain doesn’t decrease
• Address the referral zone
• Stretch the worked muscle

Question 17

General Rule on when to Stop Trigger Point Therapy

Answer 17

5 minutes before the session ends

Question 18

Causes of Overworking Trigger Point During Therapy

Answer 18

• Too Much Pressure
• Indirect Pressure
• Insufficient Tissue Warming
• Not remaining stationary on trigger point

Question 19

Post Trigger Point Therapy Self Care

Answer 19

• Avoid alcohol, tobacco, and caffeine
• Drink plenty of water
• Perform light, pain- free movements
• Use warm, most heat applications
• Avoid chilling of muscles

Question 20

Founder of Trigger Point Therapy

Answer 20

Janet Travell