Principles Of Advanced Trigger Point Therapy

When we have one or even 4 trigger points to deal with, chances are that these 4 could be somewhat “connected” if they are all referring to the same type or source of pain. This constitutes a single “Cluster”. If the client has injuries that occurred in different parts of the body, as neck, arms, or legs, then these would develop their own individual “Clusters”. As this continues to build, It can and will become more complex because more muscles are involved.
Major and Minor, Active and Latent
Active TP: Ongoing, alive and active trigger point. This Active TP can be subdivided between Major and Minor.
Latent TP: This is a trigger point that is not causing any problems or you hardly even notice it is there, that was found during palpation exam. It is Local in the area and has no pain that travels or is referred to another part of the body.
Major TP: This division is not found in the Trigger Point Manual but will become evident when we start trigger point tracking. These TP’s are big time painful, are referred or travel to another part of body. They are the starting point of TP1.
Minor TP: These are small or little TP’s found within the cluster. Their pain level is moderate and sometimes almost not worth the bother. But don’t pass them up. They are a little time consuming but will speed up the clients recovery.
Trigger Point Stacking: When you have multiple muscles over lapping, stacking can occur in close proximity of each other but on different muscles. Each one needs to be released. One of them could be local and the other, referred. I have found this where both of them are referred and going different directions.
Trigger Point Tracking: This is also not in the manual but a few therapist have discovered this already. If we can track, we can chart. This is also similar to TP Linking. We start off with a Major TP. While still engaging this TP, you go down to where the client shows you it is being referred to “Another Major TP”. This one becomes TP2. Letting go of TP1 you engage TP2 and see where that one is referred. This TP2 can refer back to TP1 or it will go on to another area. Have the client find that area and you test it for the epicenter, and this becomes TP3. Repeat the same thing to see where this one is referred to and locate TP4. The therapist is writing this down on a chart and he now has done tracking to form the Link. If the last TP is local with little minors, then you have reached the end.
We are not done yet. These TP1-TP4 make up Link1. You got to be kidding! This is nothing like doing 2 or 3 and the client is happy and done. When you deal with Fibro and any other Multiple trigger points, this is what you are going to get into.
Go back to TP1 and circle the area for another Major that most likely will refer in a different direction and track that one. Take one link at a time and get the little minors if you have time and complete those. Complete your link before looking for another one.
One more tip! When dealing with a link and you mapped it out before releasing it, you may run across a stubborn one where you may have to release for example, TP1 & TP2 at the same time. I found this to be true if TP1 refers to TP2 and back to TP1. If you have a long link, this example could apply to the other TP’s referring back.
Each TP in the link is going to solicit a different response from the client and when it is released, find out what it did, location, and write it down. Start your own link chart and description of each TP and what it did.
I came close one time when I thought there were two link chains that linked together. When you get done with a client and charted all the TP’s and links, you just might find that they could have been linked to each other.
In keeping this simple, if you have a situation as an LMP where these TP’s return and it is not a perpetuating factor being brought on by the client, try thinking along this line of the Link and you missed one. That one you missed and somehow it has formed a bond or link, will refer back or forward and activate the one you thought you had taken care of. This could explain why sometimes the client keeps coming back and some of the TP’s come back. Just remember, when you work with Trigger Points, you are a Pioneer and you may very well discover something no one else has.
Dr. Simmon and Dr. Janet Travell have pioneered many years of their life devoted to understanding trigger points. As LMP’s it is now up to us to continue where they left off and do our mapping. Maybe sometime later, we could send copies of our notes and link and tracking charts to have them all published under one cover.

For contact or Consultation, please write or send email to:
hopalong18@excite.com For Fibro clients, will make house calls.