Massage styles: Trigger Point Therapy

Welcome to post #3 in my series of different types of massages. If you have a specific style you'd like to see covered or have a question about any style I cover, feel free to leave a comment and I will address it for you!

Note: terms marked with a * have a short explanation at the bottom for your information!

Trigger point therapy is another one of the most requested types of massage. It is highly effective in alleviating chronic pain and dysfunction and can either be integrated into full-body massage such as a Swedish massage or can be done on its own like what you would receive at a chiropractic clinic. Low back pain, sciatica, headaches, fibromyalgia, and headaches are just a few examples of the many conditions that can be treated with Trigger Point Therapy (or TrPT).

So what is a trigger point? Also known as Myofascial* Trigger Points, trigger points are firm, palpable*, highly irritable spots in a tight band of muscle fibers or fascia* characterized by exquisite tenderness, referred pain, and loss of range of motion. Commonly referred to as "knots", they resemble a callus on the muscle.

You might have felt the pain of a trigger point during a massage before. The most common symptoms can be one or a combination of the following:

• A deep, aching pain
• A more superficial aching
• "Pins and needles" sensation
• Numbness
• Inflammation
• Loss of range of motion (such as experiencing pain when turning your head to the side)
• Sudden weakness in a muscle or group of muscles
• Sharp, shooting pain

The way that these trigger points are treated is by using compression anywhere from 3 to 30 seconds directly on the knot. The reason this works is because the therapist pushes blood out of the area (you can see this when the skin turns white) then allows it to flood back by letting go (the skin will turn red very quickly). With the increased blood flow, the muscle can then heal itself more quickly with the additional nutrients the blood brings.

With all the different types of pain I described, this question often comes up: Does TrPT hurt? The short answer is yes, sometimes it hurts. However, this has been misunderstood by a lot of people, so I'm going to give a more in-depth answer. Yes, TrPT and other types of therapeutic massage can hurt a little, but it should never, ever be painful. A good indicator of what pressure is optimal is to use a pain scale from 1-10.

At level 1, you should feel no pain whatsoever. Level 10 is unbearable pain which might feel like you are getting a bruise and feel you must hold your breath to stand it. Around 7 to 8 is where you might feel slight discomfort but can still relax and breathe normally. Often described as a "hurts so good" feeling, this is where trigger points can be relaxed and healed without additional damage occurring.

A lot of clients have come to me asking for the absolute deepest pressure I can give and they like the pain; they have been told that pain is the only way to get any "real" work done. I use this pain scale with every massage that I give because I don't believe that a massage should be painful. Not only is it exhausting on me, but your body knows when too much is too much and will tense up to protect itself. Not only does this un-do any relaxing you've done, but forcing pressure beyond that point can cause damage to blood vessels and create a bruise or cause damage to the muscle itself, creating an even larger and more painful knot. You might be a little sore after a massage*, but it's just silly to be in more pain than before you came in.

Notes:
*Fascia and myo-fascia- Fascia is the tough connective tissue that holds our whole body together. Imagine a chicken breast; there's a layer of fascia that you must un-attach to get the skin off, and myo-fascia is what is between the meat (muscles) holding it together. Fascia also needs to be relaxed during a massage for optimal muscle function. In case you were wondering, massaging chicken or beef does make it more tender! ;)

*Palpable- this means that you can feel a knot when you touch- or palpate- it. Some knots are slightly moveable along with the entire muscle. Deeper ones in muscles that don't have much movement might not move and at times are hard to distinguish from bone.

*Drinking a lot of water after your massage can prevent being sore! This is a big reason you will always get told to drink at least a few extra glasses of water when you get a massage.