Many patients at our integrated health center in Kailua often times ask about the difference between Trigger Point Release and Manual Therapy.
Trigger Point Release
Trigger points are hyper irritable nodules or knots in our muscle fibers. The inside of the body is covered with soft tissue called fascia. This tissue covers every structure including organs, muscles, nerves and blood vessels. When the fascia is strained from overuse or trauma it can tear and adhere together. These adhesions are called “trigger points” and can prevent the muscles from working the way they are supposed to. Trigger points lead to an increase in muscle stiffness and tenderness and a decrease in range-of-motion. In addition, the discomfort from trigger points can radiate from the adhesion. This is called referred pain.
What is a trigger point massage?
As your therapist the first thing we want to do is find the trigger point. To do this we have to palpate the area until we find it. Sometimes we might not always be able to find them so we depend on our patient to tell us if that spot is irritable. Once we find the trigger point we hold pressure at about no more than a seven on your pain scale. We hold it there for about anywhere for ten seconds to thirty seconds or whenever we feel the tissue to release. Sometimes you can feel it soften under your skin or, the person will begin to feel a decrease in the pain referral pattern. Once the tissue releases and the referral starts to dissipate, either we go deeper into the tissue or move on and look for other trigger points in the cluster.
One of the treatments we use in physical therapy to make patients feel better in regards to pain management is manual therapy. Manual therapy is the use of hand movements in contact with a patient’s skin to decrease muscle tension, increase ROM, promotes relaxation, manage pain, reduce swelling, inflammation and joint restrictions.
Manual therapy is indicated to treat faulty motion that causes pain, loss of ROM and disability. We use different types of manual therapy techniques like joint manipulation or thrust which is a high velocity, low amplitude movement that creates distraction or small movement in the joints. Sometimes patient will experience a “crack” noise or “popping” that follows release of tension and feeling of relief.
The second technique we use is called joint mobilization which is a passive movement, meaning the therapist will be moving the joint with no effort from the patients. Joint mobilization uses slower motions than thrust and can be in the form of graded oscillation, progressive loading and sustained loading in the joints. This technique should be comfortable for the patient with no reports of increased pain or discomfort while doing the treatment.
Muscle Energy Technique
The third type of manual therapy we use is what we call muscle energy technique where a patient actively contract their muscle after the joint is passively taken to its restrictive motion. Patient participation or work is expected as an extra force to help in this technique. We use this technique in the clinic a lot with sacroiliac joint dysfunction. The patient is asked to lie down on their back and the therapist checks if one leg is longer than the other by using the supine to long sitting test. If the therapist determines the patient is positive for the test, he/she will administer MET as one part of the treatment. Sometimes patient and therapist will hear a “pop” on SI joint area sometimes not. Followed by strengthening exercises, this technique is effective in aligning minimal SI joint dysfunction manifested by leg length discrepancy.
Soft Tissue Mobilization
The last type of manual therapy we use is soft tissue mobilization. It is a technique that enhances muscle tissue extensibility, increases blood flow, promotes healing and decreases pain and discomfort in the area being worked on.
When the normal curvature of the spine is altered beyond normal that can result in spinal deformities that are structural or non functional such as scoliosis, hyperkyphosis, etc., manipulation or thrust cannot straighten the curve. But when there is temporary loss of normal spinal curvature like in the case of whiplash injury or lateral lumbopelvic list non aggressive techniques like soft tissue mobilization followed by joint mobilization can be use to decrease spasm, increase ROM and normalize spinal curvature
General contraindications are:
- Infectious Arthritis
- Joint AnkylosisAcute Inflammatory Disorders
Overall, trigger point and manual therapy techniques are effective treatment strategies that we use here at OSR in Kailua to help our patients reach the goal of normalizing joint restrictions, muscle tissue tension and manage symptoms of pain and discomfort. Contact us today for a free consultation!