Winning Hands Massage
A trigger point is simply a point on the body that, when pressed, refers
pain elsewhere in the body. As an example, pressing a specific shoulder
point refers pain down the arm. The “bible” on the subject is a two volume
set by Travell and Simons. A more user friendly book is “The Trigger Point
Therapy Workbook” by Clair Davies. Pain patterns are very, very specific and
well documented. As information, the Travell mentioned is Dr. Janet Travell,
who happened to have been John F. Kennedy’s personal physician while JFK was
Typical allopathic treatment involves an injection with Lidocaine, Botox or
a Saline solution. Botox, as an example, works by paralyzing the surrounding
muscle tissue, lasts about 3-4 months, is very painful to receive, and costs
about $500 per injection. It does NOT, however, cure the problem. It merely
The typical bodywork treatment is called Direct Ischemic Pressure. It is the
epitome of simplicity. Apply direct pressure into the trigger point until
the maximum referral has been achieved as well as the maximum degree of
pain. Then simply maintain that level of pressure. After a few seconds, the
referral pattern will start shifting until it is only under the pressure
point. After that has been achieved, the pain level will decrease to the
point where it is merely pressure and no longer painful. Unlike injections,
this DOES have the potential over time to cure the problem. And it need not
cost anything because it is something that people can easily do for
themselves and those around them.
But as a point of FACT (although disputed by most Western Medical folks),
ALL trigger points are in reality acupoints. Because of this, I find it to
be much quicker, easier, and less painful to receive if treated
energetically by holding two acupoints simultaneously. Just a fraction of
the pressure is required and the results are 3-4 times faster. Trigger
Trigger Points are no where near the irritant to me that my three Pet Peeves
are. They are, however, what got me “actively involved” in the first place
beyond just my immediate family.
As I was learning how to do things while in massage school, my daughter
benefited from getting worked on at least every other week (She and her
mother took turns while I was learning the Swedish relaxation fluff and buff
stuff saying “It’s MY turn. No it’s not. He worked on you last week.” This
switched to “It’s YOUR turn” once we got into learning treatment techniques.
Don’t ever ask either one of them about cross fiber friction to treat shin
I was not a member of any support groups at the time. My daughter, however,
belonged to probably two dozen or more. Whenever I would learn something and
practice it on her with good results, she would post the information to the
various support groups. Before long, she was getting posts and emails saying
“Barb – I know your Dad is in massage school. Has he learned anything about
treating X, Y, or Z?” She would forward the question to me, I would reply to
her, and she would then send the answer out to the groups.
About six months after I graduated, she forwarded a post to me from someone
in Florida about a person who DIED from an allergic reaction to the Botox
injection used to treat her trigger points. Specifically, she died from
cardiac arrest while receiving Botox injections to treat trigger points
stemming from her Fibromyalgia. . She was 43 years old. I went stark raving
ballistic. I was so hot about it, I was over the moon. I also stopped
sitting on the side-lines and got actively involved with the support groups.
Anyone with a reasonable knowledge about trigger points is probably already
aware that the “bible” on trigger points is the two volume set “Myofascial
Pain and Dysfunction” by Janet Travell and David Simons. At close to 1700
pages for the two volumes, it is very, very detailed. At $195 new and $161
used from Amazon, it is also very, very expensive. A much more reasonable
alternative is “The Trigger Point Therapy Workbook” by Clair Davies. It is
less than 300 pages but it is also less than $20 new and even less than that
Both sources COMPARE trigger points to acupoints. On page 2, Davies says
“Why has the medical profession not embraced the idea of trigger points?
Partly it’s because trigger points are commonly confused with acupressure
points.” He goes on from there, perpetuating the myth and lie that has
surrounded trigger points/acupoints for the last 50-60 years.
What most people don’t know is that Janet Travell was John F. Kennedy’s
personal physician when Kennedy was President. This means that much of her
formative period was BEFORE Nixon went to China. And it was not until the
reporters who traveled to China with Nixon came home and wrote about the use
of acupuncture in China in lieu of sedatives during surgery that there was
even a glimmer of mainstream understanding about meridian theory, let alone
acceptance. There is also that lovely thing called Prevailing Standard of
Care, which meant that any mainstream “real” (as in card carrying AMA
member) doctor who even considered something as outlandish as acupuncture
risked losing their license to practice. Consequently, all of the early
literature on trigger points was deliberately distanced from anything having
to do with acupoints. There is some similarity, BUT they are NOT acupoints.
That attitude is still prevalent in mainstream medical literature.
It was incorrect 60 years ago. It is incorrect today. They are not just
“similar.” ALL trigger points are in fact acupoints.
There are many different ways to “treat” trigger points, ranging from very
gentle to very invasive, from totally free to very expensive, from painless
to excruciating, from what actually works to simply throwing your money
away. The mainstream medical approach these days more often than not is an
injection with Botox, Lidocaine, or a Saline Solution. Those who have gone
through it that I have discussed it with tell me that the average is about
$500 per injection and lasts on average of about three months. It in no way
makes the problem go away. It merely masks it for from 2-4 months. And it
does so by paralyzing the surrounding tissue and in essence deadening the
trigger point. However, once the injection wears off, the point returns in
all its painful glory. They also tell me the procedure itself is very
painful to receive.
The standard bodywork treatment taught in any massage school in the country
that gets into treatment techniques is direct ischemic pressure. This is
just one of my fifty cent words that simply means applying direct pressure
into the point and holding it until the pain stops.
Before getting into more detail, a bit more background about trigger points.
Trigger points don’t just suddenly appear with no warning signs. They always
start out first as tender points. If left untreated, tender points have the
nasty habit of turning into trigger points. The distinction between the two
and what defines a point as being either a tender point or a trigger point
is whether pain is referred elsewhere in the body when pressure is applied.
If the pain is local to the point, it is a tender point. If pain is referred
elsewhere, to some location in the body other than the point being pressed,
it is a trigger point. These referral patterns are very specific and very
well documented in the literature.
To treat using direct pressure, use a fingertip, thumb or some blunt object
to press into the point. On a scale of 0-10, press until the maximum pain
level is reached AND the maximum referral distance from the point has been
achieved. As an example, say the involved point is in the Infraspinatus on
the scapula and the referral is in front on the biceps. Continue increasing
the pressure until the maximum distance from the point itself is achieved,
Then simply maintain that pressure. That’s it. As the point releases, the
referral pattern will withdraw to being just local to the spot being
pressed. The pain LEVEL usually doesn’t change during this withdrawing. If
it was a 7 to start, it will stay at a 7 until the pain becomes localized.
But once it is localized, the pain level itself will diminish. Just maintain
the same amount of pressure, start to finish, until the pain is gone.
Will one treatment be a permanent fix or cure? Probably not, if the problem
has been chronic. But you CAN make the trigger point go away in time using
this technique. More importantly, you can show your clients how they can
treat themselves (I know, bad for repeat business but think of all the
referrals they will hopefully send your way). If the point is difficult for
them to reach, have them get a Theracane and show them how to use it. The
technique is simple, easy to do, non-invasive, relatively painless
(certainly compared to injections), and very, very inexpensive since they
can treat themselves.
All of the above discusses the standard, manual, bodywork protocol. But
knowing that trigger points are in fact acupoints puts things in an entirely
different light. You can achieve identical results in a fraction of the time
and with a fraction of the pressure (less painful for your client and easier
on your own thumb and finger joints) if you treat the point energetically
using a local and distal point simultaneously. One point is the trigger
point. The point I generally use for the second point is Gall Bladder 20. (I
tend to use Gall Bladder 20 as my second point for most things because it is
a cross-over point with the meridians). Accessing the two points
simultaneously and then simply holding for an energetic balance is all that
Aside from the fact that my books on acupressure/acupuncture/meridian theory
SAY that trigger points and acupoints are the same thing, I have other,
empirical reasons for believing this to be true. One is that I have taken
out literally hundreds of trigger points on dozens of bodies in the last
couple of years by simply holding a local and distal point and waiting for
the balance. After you get used to doing it that way, you will suddenly
realize that you can actually tell by the changes in the sense of energy
what is happening in the body; that the pain has become localized, and even
where the pain is on the 0-10 scale. The other reason is because of what my
knowledge of anatomy, muscle structure, nerve pathways, and fascia tell me.
It doesn’t take much cross checking or comparison of these to pain referral
patterns to realize that the pain referral patterns do not track with
muscles and nerves. You can’t draw a direct line through a muscle or along a
nerve to get from the trigger point to where it hurts. If there is no direct
muscle/nerve link, what connects the two? There is only one thing that I can
think of and that is fascia. And since I personally, absolutely do believe
that the energy pathways are in fact physically embedded in the fascia, it
makes perfect sense that the pain referral is traveling along the energy
channels, through the fascia. Besides, the Eastern literature on meridian
theory goes back at least 5000 years. The Western literature on trigger
points only goes back 60. Until proven otherwise, I think I will stick with
the longer track record.
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