Clinical Trigger Point Massage;
a New Approach to the
Treatment of Myofascial Pain
A New Chapter
In the first three years after the first edition of The Trigger Point Therapy Workbook was published, my daughter Amber and I taught trigger point therapy to more than eight-hundred massage therapists from thirty-eight states all around the country. In our workshops, participants have been very interested in the way our self-treatment and clinical techniques complement one another.
As you may know, only our self-treatment techniques were presented in the first edition of the Trigger Point Therapy Workbook. Workshop participants have continued to urge us to write a chapter on the clinical approach for the second edition of the book. The second edition is now available and it includes just such a chapter.
Clinical Trigger Point Massage
We feel that massage therapists need to take a much more systematic approach to the treatment of pain. Unfortunately, true clinical therapy requires a far greater facility in finding and treating trigger points than is currently attainable in most massage schools.
In general, too many modalities are lumped into clinical massage therapy programs and trigger point therapy is given no emphasis. Trigger point massage is presented as just one of a dozen or more other treatment systems supposedly of equal value in the treatment of pain.
This suggests that school administrators lack a clear sense of what actually works and are giving the student every weapon in the arsenal in the brave hope that something will hit the target.
The integrated “whole person” approach to pain therapy so much in vogue in the wider healthcare community has much the same flavor. It does make sense to target improved health for the whole of the body, mind, and spirit, but we’ve found that our simplified approach to trigger point massage does the job of getting rid of pain quite well by itself.
We believe that trigger point massage is the safest, most practical and most effective means for treating pain and other problems that have a myofascial origin. As a stand-alone therapy, trigger point massage can be done anywhere, not necessarily requiring a massage table or massage chair. If need be, it can even be done through the clothing.
Trigger point massage can be the sole therapy employed in the massage studio, or it can be integrated into other massage modalities to greatly increase their effectiveness. As a purely clinical modality, trigger point massage can be limited to specific problems and specific muscles and doesn’t have to be part of a full-body treatment. We hope that physicians and health insurance companies will see the potential in this for helping cut the heavy cost of healthcare.
The New Stroke
In our method, a single, exceedingly simple therapeutic stroke is used for addressing trigger points everywhere in the body. It’s exactly the same very short, repeated stroke that is used for self-treatment. Different hand positions are used in clinical work, of course, with even greater attention to ergonomics and safety, because of the extraordinary physical demands made on the professional therapist’s arms, fingers, and hands.
The Dangers of Petrissage
Some of the traditional ways of using the hands for massage are actually quite damaging to the hands when overused. Petrissage, specifically, (kneading with unsupported thumbs) is a technique that can very quickly lead to overuse injuries. Many professional therapists have told us that they graduated from massage school with hands and forearms already in trouble. We save petrissage with unsupported thumbs to the places where nothing else will do.
No More “Press and Hold”
We believe that the techniques shown in our new chapter are not only safer for the hands than the traditional “press and hold” technique (ischemic compression) but are greatly more effective in treating trigger points and the pain they cause. The new techniques are very specific and efficient, requiring much less effort than pressing and holding.
Treatment of trigger points with our method is comparatively brief. Pressure is focused and relatively light. Trigger point massage can be nearly as pleasant and as deeply relaxing as “feel-good” massage when done correctly.
The New Treatment Protocol
Amber and I collaborated on the new clinical chapter, and she is featured in all the illustrations. As an example of our approach to therapy, the following two illustrations show how we treat trigger points in the subscapularis muscle, which are usually the primary source of the trouble with a frozen shoulder. Additional anatomical drawings help clarify the procedure.
Subscapularis massage with the fingers of the right hand in the slot between the shoulder blade and ribs. Start with the backs of the nails tight against the ribs. The blunt ends of the fingers are in contact with the muscle and stroke toward the therapist with a very short scooping action.
To expose more of the muscle, the left hand gently pulls the scapula toward the therapist. Note what the client is doing with his arm.
In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies simplifies Travell and Simons' extensive research into myofascial pain and makes it accessible to the profession therapist.
To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.