For therapeutic massage and the relief of pain caused by trigger points, I follow 
Doctors Travell & Simon's research and protocol contained in their
Myofascial Pain & Dysfunction Trigger Point Manuals.


Myofascial Trigger Point Therapy — What Is It?

The word myofascial is made up of two words:  myo or muscle, and fascia or connective tissue which is in and around the muscle.  When stressed or injured, muscles form trigger points (think of contracted knots) that cause pain and tightness:  pain because there is restricted blood flow to the area and, therefore, inadequate nourishment to the nerve endings permeating the muscle, and tightness because the "knots" shorten the muscle.

 

Myofascial trigger points are a very common cause of pain. Trigger points are painful when pressed on, cause a shortening of the muscle fibers, and have a special property called referred pain. Referred pain means that a trigger point in one muscle can create pain in another area.  

For example, when the muscle at the top of your shoulder (trapezius) has a trigger point it may refer pain up the side of your neck and head causing a headache, or when a muscle in your hip (piriformis) has a trigger point it may refer pain down the back of your leg or along the crest of your hip, "pseudo sciatica".

When one is diagnosed with a myofascial pain syndrome or chronic myofascial pain it means the primary source of pain is from trigger points.  Many times trigger points are present secondary to other sources of pain, i.e. arthritis, bulging discs.  The trigger points may be causing the painful symptoms connected to these conditions and because of this are often called "the great mimickers." 

Trigger Points:  How do they occur? 

 Repetitive strain injuries
(bricklayer, computer/mouse operator - hand/forearm/shoulder strain).

Lifting/twisting
(carrying babies, boxes, yard work, lifting bedridden patients, or any position your body is not used to causing excessive overload)

Poor Posture
 (sedentary lifestyles, de-conditioning and poorly designed furniture)

Muscle clenching and tensing due to mental/emotional stress.
(jaw pain, forearm pain, etc.)

Direct injury such as a blow, strain, break, twist or tear
(car accidents, sports injuries, falling down stairs, etc.)

Inactivity
(prolonged bed rest or sitting)

How soon will I be back to normal?

• Type and length of time injured - the longer a problem has "festered," supporting muscles become involved, "taking up the slack" for the injured muscle.   
• Overall physical health 
• Level of fitness
• Underlying skeletal abnormalities - as with a repetitive strain injury, therapy may need to be on a regular basis to stay in optimal health
• Nutrition - poor diet affects one's total health.  Eating whole foods gives the body the perfect "fuel" for recovery
• Quality of sleep
• Depression or anxiety
• Patient compliance with self-care

Once trigger points are released the muscle needs to be moved through its full range of motion.  Regular stretching, at home or in a class situation, is important in the rehabilitation and continued flexibility of the muscle and muscle groups. 

I would be happy to answer any questions you may have
and am available by e-mail or telephone.