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Trigger Point Therapy

Trigger point therapy seeks to locate and eliminate trigger points, which are tiny painful knots in the body.

There are two theories to release trigger points: with and without deep tissue massage. What do you think is best?

Kymberly Kula (Lakewood, CO) on Apr 25, 2012
I think a mixture of both is good. It really depends on the client and how their body reacts to pressure. There are other methods of releasing trigger points besides massage, such as tools like the "pointer plus," which uses electrical vibrations to break up the tissues.
Stephanie Grenadier (Hingham, MA) on Apr 25, 2012
In my experience, both methods work but my goal is to use the least amount of force necessary to get the job done. (For every action, there is an equal and opposite reaction). I use myofascial release to "unglue" the surrounding tissue. Then, with a combination of medium tissue Swedish pressure and gentle touch, the trigger points melt away and the client becomes profoundly relaxed, aiding healing. I prefer to help the client unlock stress rather than dig in and apply force on the body, particularly in the neck and shoulder area. It really works!
Richard Jones (Nampa, ID) on Apr 25, 2012
I enjoy the kind of massage that doesn't hurt. That said, traditional trigger point massage, while effective, tends to take a lot of time and has mixed results. I prefer to break down a knot slowly via its fascia layers and mix that with multi-directional friction. It tends to have the same effects as the press and hold techniques more commonly used, only without the soreness.
Tatiana Pandolpho (New Fairfield, CT) on Apr 25, 2012
I like hot packs and cupping followed by icing. Melts trigger points like butter.
Brenda Breedlove (San Francisco, CA) on Apr 25, 2012
I am not sure I understand. With trigger point therapy, in my experience, there must be some sort of deep tissue massage (aka myofascial therapy). Any area you are working on should be sufficiently "warmed" via myofascial manipulation. Without the warming, I find that my clients get incredibly sore afterwards, especially those who are not especially physically active. So I would have to say it is always better to say "Hello" and "Goodbye" to the body with deep tissue massage. Not only does it relax the muscle to allow deeper manipulation, but it also prepares the client mentally.
Janet Duffy (West Chester, PA) on Apr 25, 2012
It depends on how well the client tolerates the pressure. If the client can tolerate deeper pressure then the therapist starts out with the lighter pressure and gradually works into a deeper pressure in order not to cause spasms in the muscle tissue. The deepest pressure can be held only to the clients tolerance for about 2 minutes. For those who have difficulty with deep pressure, the therapist may start out with some heat therapy and gradually work only to the clients tolerance. It may take longer and more frequent sessions may be needed. Heat therapy, especially moist heat can be used on either type of client.
MaryAnn Sumaraga (Modesto, CA) on Apr 25, 2012
It really depends on whether the trigger point is superficial or deep in the muscle. The deeper the trigger point, the deeper the massage should be. In the long run, deep tissue massage can improve posture and eliminate pain. Massages should also be tailored to the individual. Some people are very sensitive and cannot tolerate strong pressure. It is important that you let your massage therapist know if you are experiencing "good" pain or not.
Orlando Harding (Milwaukee, WI) on Apr 25, 2012
I personally love the challenge of trigger points. Depending on if the therapist has warmed the connective tissue and fascia, triggers can be released with a minimum amount of pressure. An obedient trigger will run like water to the therapists efforts, but some triggers can be stubborn! Depending on the type of bodywork session, the therapist may have to hang in there a little longer.
Christine Gross (Grand Rapids, MI) on Apr 25, 2012
I feel it depends on the client and to what degree the area is tight. You can use trigger point therapy, acupressure, or acupuncture. Hot stones are good too.
Friska Streeter (Mokena, IL) on Apr 25, 2012
The most effective one is without a doubt is with deep tissue. However, that doesn't mean massage without deep tissue massage doesn't work. It all depends on the patient's pain tolerance and medical condition. Sometimes new patients will not handle deeper pressure as well as well as those who receives many massages. And some patients, like those using blood thinner medications, cannot get deep tissue massage. The best way to determine the best treatment for you is to communicate with your massage therapist.
Bharat Kalra (Wheaton, IL) on Apr 25, 2012
It will vary from person to person. It is not the technique that is important here because there are no side effects. It is the end result that is important.
Megan Dempsey (Denver, CO) on Apr 25, 2012
In my experience, deeper pressure helps. Everyone has a different tolerance of pressure because every nervous system is different. There is therapeutic value to utilizing that response to reset the way the muscle is responding. From my experience, if that therapeutic value is not achieved, there is not very much therapeutic response, i.e. no release of trigger points.
Sean Elias (Santa Monica, CA) on Apr 25, 2012
That depends. I do not think either point of view is right or wrong. However, my opinion is that if the trigger point is tender when light or medium pressure is applied, the use of deep tissue would be counterproductive. In this case, releasing the trigger point without the use of deep tissue is better for the client. On the other hand, if the client can tolerate medium pressure on the trigger point, then the use of deep tissue to release the affected point would be beneficial.
Jay Farmer (Jacksonville, FL) on Apr 25, 2012
The term "deep tissue" massage is often misused when what is really meant is deep pressure. Deep tissue refers to digging and/or maneuvering past superficial muscles and working directly on more internal parts. Some people respond to light touch, others prefer deep pressure. Neither is better, only better for the particular client. A person may have some trigger points that respond to a light touch and some that need a heavy hand. I personally prefer very deep pressure, but it isn't more effective for everyone. It is only better in the sense that Coke is better than Pepsi. A good routine when dealing with a new client is to start with light acupressure and go deeper if necessary.
George Engelhard (Orlando, FL) on Apr 25, 2012
I place pressure on the trigger point, either constantly or intermittently, depending on the pain tolerance of the client. I want the client to say "That hurts so good," not "Ouch."
Melissa DeFrancesco (Goshen, IN) on Apr 25, 2012
Both can work equally well, depending on the pain tolerance of the client and the response from the tissues.
Jagdish Jindal (Houston, TX) on Apr 25, 2012
To release the trigger point, static pressure combined with a counter-strain technique often works.
Stacey Alzheimer (Bozeman, MT) on Apr 25, 2012
Deep tissue massage is best for trigger points. Using the technique of bringing blood and oxygen to the area will release a trigger point very quickly because lack of local blood circulation is what maintains a trigger point. When a therapist frees the connective tissue in the are, he or she facilitates nutrient/wast exchange allowing the necessary chemicals to get where they need to be to release the trigger point.
Anne Hartley (Gahanna, OH) on Apr 25, 2012
I think it depends on the client.
Graeme Buenaflor (Falls Church, VA) on Apr 25, 2012
It depends on whether the trigger point is superficial or deep in the muscle. The deeper the trigger point, the deeper the massage should be. In the long run, deep tissue massage can improve posture and eliminate pain. Massages should also be tailored to the individual. Some people are very sensitive and cannot tolerate strong pressure.
Jon Tallerico (Springfield, MO) on Apr 25, 2012
I think it is always best to avoid a one-size-fits-all approach to trigger points. The depth of pressure required to release a trigger point is always relative to the muscle that trigger point is in and how many layers of tissue you must press through to reach it. You need to use just enough pressure to create awareness of the significant point, but to create that awareness on a deep muscle requires more force than on a surface muscle.
Nancy Web (Pawtucket, RI) on Apr 25, 2012
As a practitioner and teacher of Shiatsu and having taken classes in trigger point work, I know that all the trigger points are also major acu-points on the meridians. From an Eastern standpoint there is no" best" way. It depends on the constitution of the client and the type of trigger point. To get the best results, you must take into account the client's body and preferences. If the client prefers a deep touch, they will naturally respond to that touch. If the client prefers gentle sustained pressure, that is what they will respond to best. The origin of the trigger point also makes a difference. Is it there due to overuse or injury? Whether the root cause is excess or deficient in nature will influence whether the trigger point should be broken up with deep pressure or supported with a lighter touch.
Jennifer Zukowski (Minneapolis, MN) on Apr 25, 2012
In my experience, trigger points release when the muscles are "invited" to relax into the treatment. Slow, gentle steps - allowing the area undergoing treatment to build a trust relationship with the therapist - will yield the best results.
Jacqueline Cole-Wright (Lehigh Acres, FL) on Apr 25, 2012
Either may work. Not all trigger points are created equal. Some are "local," meaning that the pain doesn't radiate beyond the immediate area. Alternatively, the pain can radiate some distance from the trigger point. There is also the question of location and depth. Deep tissue massage usually addresses problem areas of concern to the client, like trigger points and tight muscles. Your licensed massage therapist should keep your comfort level in mind. They should also warm your tissues (muscles) prior to applying deeper pressure. Note that if you have had trigger points for some time and you continue to do the things that you have always done, trigger points will continue to be a.problem for you.
Cindy Ferrell (Canton, MI) on Apr 25, 2012
I feel if a client does not want deep tissue massage, the best alternatives are hot stone and pressure point massage. You don't have to use deep tissue massage in order to release trigger points, though it may be the most straightforward method.
Deborah Gilmore (Golden, CO) on Apr 25, 2012
It depends on your preference and what works best for your body.
Chavez Walden (Columbia, SC) on Apr 25, 2012
This will depend solely upon the individual's ability to handle deep tissue. I often have clients who request a deep tissue massage when it is not appropriate for their muscles. Deep tissue is meant to reach muscle layers that are far below the surface. In order to reach deeper layers, the muscles on the surface will need to yield easily in order to avoid injury. The problem is that many people choose to tense up their muscles in order to withstand the pressure. This is a horrible idea! And sometimes muscles tense naturally as a defense mechanism. If both cases, deep tissue massage should not be used. If this is not an issue, then deep tissue is the best method for releasing trigger points. A massage should never go beyond the point of "hurts a little but still feels good." More pain does not equal better results. A painful massage can be damaging to muscle tissue!
Gil Rutherford (Novato, CA) on Apr 25, 2012
There are many ways to release the triggers in fascia. A gentle touch will minimize pain.
Rogelio Medina (Arlington, TX) on Apr 25, 2012
Deep tissue massage was designed to correct the muscle imbalances in the body. Keep in mind that deep tissue massage does not have to be deep pressure. As a DT therapist, warming of the muscle is essential. As you warm the different tissues of the body layer by layer, you gain the ability to reach deeper trigger points without deep pressure. It all depends on the therapist and his training. I do not recommend using deep pressure without correctly using deep tissue massage. Deep pressure massage can injure superficial muscle fibers if the muscle is not correctly warmed.
Kevin Franklin (Brandon, FL) on Apr 25, 2012
Not sure if this is what you are looking for, but I would say that some ways to release trigger points include static pressure, stretching, massage, and cold therapy. No two clients are the same, so no two massage sessions will be the same even if they have trigger points in the same area.
JB Harding III (Saint Louis, MO) on Apr 25, 2012
I have found deep tissue massage, along with stretching and circulation massage, to be best for relieving trigger points. Instead of applying direct pressure at a 90 degree angle on the trigger point, I have found that applying pressure at a 45 degree angle in the direction of the muscle's fibers achieves a less painful and better resolution. It is important to allow the tool (fingers, elbows, etc.) to melt into the tissue, therefore causing less trauma to the muscles and connective tissue.
Marcus Webb (Grand Rapids, MI) on Apr 25, 2012
There is no one method that works best. Everyone has a different massage style, so find a therapist who works for you.
George Ottlein (Boca Raton, FL) on Apr 25, 2012
Acupressure is great.
Nicole Scruggs (Detroit, MI) on Apr 25, 2012
It depends on your pain tolerance. If you can withstand the pressure, deep tissue is great.
Efren Jimenez (Burbank, CA) on Apr 25, 2012
Depending on where trigger points are located, and how deep into the muscle tissue they are, massage alone may not be able to reach deeply enough to dissolve these pain points. I had acupuncture applied to my own trigger points by a very skilled acupuncturist. After four sessions my trigger points were less painful.
Jerome Jefferson (Saint Petersburg, FL) on May 31, 2012
It depends on the body. Each body may respond to the different techniques differently. One may work for one person and not for another. Once that is established, you and the therapist will know what is best for you. The most common one is trigger point release therapy which is used to really keep pressure on the point that is causing pain to different areas of your body.
Richard Bartlett (Lansing, MI) on May 11, 2012
There are actually more than two. What is usually called "trigger point" work involves holding direct pressure on a point to relieve knots, which are areas of permanently contracted muscle cells. Other forms of deep tissue work can be effective, and some are not as uncomfortable as trigger point work. Gentle, resisted stretching can also help release trigger points. One method, known as "strain-counterstrain" technique or positional release, involves holding the muscle in a position that shortens it and allows the muscle to release on its own, over about 1-2 minutes. This method can be done with little or no direct pressure, and is good for "fresh" muscle injuries or any problem that is too painful for direct work. Each person is different, and I like to try multiple approaches to a problem, depending on the amount of pain and what seems to help you individually.
Lloyd McElheny (Aurora, CO) on Apr 28, 2012
Proper treatment of trigger points requires "stripping"/"clean up" after the trigger point is released. In my opinion, it would not be a good idea to leave out this step. This isn't the same as "deep tissue massage". Warming up the tissue properly before releasing trigger points is also important.