December 1, 2018

That Nasty Trigger Point. You Know The One

There’s that trigger point (TrPt) again. You know it well: just inside the shoulder blade and a little up. That cherry sized knot that sits there waiting like a speed bump. You find it every time. 

Here’s the big secret to treating trigger points: reciprocal muscle groups. 

Imagine our old friend the trigger point in the rhomboid-trapezius area. Guess what? The solution is not always in treating the TrPt. The solution can be in treating the reciprocal muscle. Do you remember reciprocal muscles? (hint- biceps/triceps quadriceps/hamstrings). To relieve the pain in the rhomboids (posterior) consider treating pec major/minor (anterior). Shocker! Yes. Treat the front to relieve the back. Is your memory is kicking in? Your massage school instructor may have even taught you this in class. So how do we do it?

Here’s how:
Client is supine. Soup. Yes could they hold a cup of soup in their hands. So your client is face up. Start by securing the drape. Don’t bother with the arm over the sheet–albeit secure, we may need to move the arm to effectively work the area, so while holding the arm away from the body, put your palm on the table and tuck under the rib cage.  Please pause to imagine: Palm down on the massage table. Tuck the sheet under the rib cage just below the armpit. Now we’re ready to go.
Your choice: sit behind the head or stand on the opposite side of the trigger point. Find the sternum. Palpate the 1st 3 costo-sternal joints. Do any feel bumpy or lumpy? First clue something is amiss. Back to school for a moment: check the intercostal muscle tissue. That’s the tissue in-between the ribs. Ribs=costals. Intercostal = in-between the ribs. 100% of the time the tissue immediately in front of the TrPt is tender. Why? That would take longer to explain than a quick newsletter. So email or FB message me if you want more details. Just know, the spot immediately in-front of the TrPts is always tender.
Working the front tender spots takes 3-5 minutes when done efficiently with intention. Find the ribs. Glide with one or two fingers between the ribs. You have done this in the past, intuitively. Now, do so with intention. Focus. Glide.
For me, I get more pressure from standing to the side. Consider larger clients, full time computer users and nursing moms. Work the front to treat the back. Welcome to being an intentional bodyworker! Namaste my friend.

A teacher’s final thought. I started to recognize a stage of development within MTs I affectionately call the this the ‘seek and destroy’ phase. I recognize the stage because I went thru it. At one point in my career I would seek out a trigger point and I could destroy it. If this sounds a little like you, well, good job. Palpation is key to developing true talent as an MT. However, a caution: how we treat that trigger point makes all the difference. Worst case scenario: We irritate the tissue, making the trigger point worse & the client more sore the next day. Best case: The trigger point releases. The client is feeling relief and new, improved range of motion.(ROM) Keep up the good work!

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