Myofascial Therapy
Areas of Pain
About Janet G Travell, Founder of Myofascial Trigger Point Knowledge in the USA
Pain does not always mean you need surgery or medical intervention! Trigger Points, taught banded areas in muscle tissue, can be 90% of the cause of soft tissue pain. So knowing about these pesky areas can bring all of us great relief. Myofascial Trigger Point Therapy has a easy to follow road map developed in the 1950’s through the 80's by a pioneering doctor named Janet Travell. She was the first female White House Physician, serving for President John F. Kennedy then for Lyndon B. Johnson. Dr. Travell is credited with helping Kennedy get out of his debilitating pain caused by a accident aboard the PT 109 submarine many years before his presidency. Under the medical care and guidance of Dr Travell, and while using her techniques, Kennedy was brought back into almost full function and strength, and was able to stop using his crutch under his arm. He felt so fit and able, John F Kennedy decided he was able to run for the office of President. Travell served in the White House, until a few months before Kennedy was shot. She went back to working on her research into Trigger Points. Then she was asked to serve at the White House again serving the interum President, Lyndon B Johnson.
We have learned from Dr Travell, that just because we have pain or sensation in a particular area DOES NOT necessarily warrant a surgical intervention. Even in the presence of degeneration in a joint or bones, that does not PROVE that is what is causing the pain.
This is where myofascial trigger points come into the picture. Dr Robert Gerwin, hypothesized that up to 90% of pain outside true pathology (like cancer or liver disease) comes from trigger points in muscles. Often just a few treatments using our Myofascial Trigger Point Therapy Treatment Protocol, people have a HUGE reduction in their pain and have improved strength and function of a given area of the body.
Here are some common areas of pain, and commonly used words to describe them, and some suggestions on how to get rid of this pain.
Scroll down for self-care video suggestions. (check with your healthcare provider to ensure you are healthy enough to engage in activities)
- What to expect on your first visit with a MTPT practitioner.
- Headaches caused by Trigger Points? YES; explained.
- Pain near the spinal muscles.
- Knee pain caused by TrPs in the thigh muscles.
- Headaches caused by Trapezius TrPs
- Eliminate Heel pain by using the Tiger Tail 18" hand held roller.
- Shin Splints caused by TrP's in the tibialas anterior muscle.
- Eliminate Lower Back/ glute pain using the Backnobber.
- Front of shoulder pain caused by infraspinatus.
- Elbow pain when flexing elbow, Biceps treatment.
- Stiff Neck
- Back of arm pain
- Bunion or big toe pain.
Your first visit to our Trigger Point Clinic
Are Trigger Points Causing Your Head Pain
Multifidi Muscles; Trigger Point Treatment for Back Pain Near Spine
Knee Pain
Pain in the knees, knee pain, can be debilitating. It can prevent us from doing the things we want with the people we love. Often pain in or around the knee is often wrongly diagnosed as arthritis. It can also be wrongly diagnosed as a meniscus tear or other more sinister or scary conditions with medical terms for names . Both of these conditions must be evaluated for via MRI, and even then, most often, muscles can be the cause of unnecessary tension in and around the knee joint. We use our myofascial trigger point therapy techniques to lengthen chronically tight and painful muscles in the thigh, hip, leg and to bring them to full pain-free function.
KNEE PAIN: Trigger Points in the major quad muscles can refer pain and cause weakness, buckling or can cause faulty tracking of the knees as we walk. It is very important to get a good trigger point evaluation of the muscles of the hip, waist, low back, thigh and even lower leg and foot to ensure that all supporting muscles are in tip top shape and allow the knee to have excellent neutral tracking. Click on this short YouTube video to learn ways you can eliminate your own knee pain and restore strength and function to your thighs/hips.
Headaches
Headaches can be debilitating and also can be very scary. Headaches and the pain caused by them, can vary widely from person to person. Some people describe their headaches as absolutely debilitating and in contrast, some people claim they can go to work and live their life with a migraine headache. No matter what kind of headaches you have, it is almost certain that myofascial trigger points play a contributing role. The muscles of the shoulder, neck and head can be contributing to this pain in the head. The trapezius muscle, as describe the by Dr. Janet Travell, is the most probable cause of head pain. As we humans stand up straight, this trapezius muscle is constantly working to keep our shoulders attached or body. We all know what it feels like to be filled with stress and tension, then realize we’ve been holding tension in our shoulders, and this in turn, raises the shoulders up toward the ear. This hard-working muscle when harboring trigger points, can cause referred pain up the side of the neck around behind the ear, in front of the temples into the eye into the jaw and even into the back of the head.
Plantar Fasciitis
Pain in the bottom of the foot can stop a runner or exerciser in their tracks. This type of pain is often misdiagnosed as a swelling in the plantar fascia. Just because you have pain at the bottom of the foot (and yes, it can hurt a LOT), that does NOT mean you “Have Plantar Fascitis” Just because we have pain anywhere does not mean that should be the basis of a diagnosis! We find that tightness and trigger points in specific muscles in the calf, when eliminated, can reduce and eliminate pain that refers to the bottom of the foot. These muscles can be soleus, gastrocnemius and tibialis posterior. Addressing proper foot wear, and correcting for hyperpronation (when the feet “fall inward”) with Posture Control Insoles is also extremely important in eliminating any type of foot/ankle/hip pain.
Shin Splints
Pain at the front of the lower leg bone, the Tibia, can prevent us from running, walking and can wake us up at night. The trigger point therapy protocol reminds us to consider that trigger points in the upper-most part of the Tibialis Anterior muscle can refer pain downward along the front of the shin. Making simple changes in sleep posture and foot wear can have a positive impact in eliminating this pain. Watch this video for some very helpful suggestions on how to eliminate those trigger points via self-compression and stretching.
Lower Back pain
Torso and lower back- Self-compression techniques for Paraspinals, Middle/Lower Trapezius, Quadratus Lumborum, Abs
by using Self Care Tools.
Common symptoms arising from Trigger Points in these muscles include nagging lower back pain. People often report weakness and tightness with or without pain in their mid and lower back. The term “My back went out” is often used to describe an acute spasm of the back or abdominal muscles that causes pain in the back. What many people don’t know however is often, the discomfort in the lower and mid back can actually be referred pain coming from the abdominal muscles. The other source of pain in the back can be the spinal erector muscles or the upper gluteals. The mid and lower back muscles can become chronically weak and tight due to poor sitting and standing posture. Most of us spend too much time sitting. Watch this YouTube video for some easy tips on how to eliminate your own pain due to trigger points. Better yet, find a trigger point therapist near you by clicking on our “find a Therapist” page. They can assess your case and see how you can quickly get rid of your pain!
Prevention Tips:
Keep a pillow between your legs when sleeping on your side and allow your legs and hips to be moderately straight, not crunched up in the fetal position. When seated in a car, be sure to have your seat tilted forward and have your knees below your hips. Be sure to take a thick wallet out of your back pocket when you are sitting.
Common injury/ pain DX:
Common terms used when describing pain in the mid and lower back: failed low back surgery, pinched nerve, lumbago, back thrown out, herniated disk or bulging disk pain.
Prevention Tips:
Maintain neutral sleep posture. Try not to sleep on your stomach. If sleeping on the side, keep head, torso and legs close to neutral (not too bent or scrunched up). Your arms should remain near your sides, no matter what position you sleep in, not over your head, or crossed over your chest.
Shoulder pain
(Rotator Cuff Injury) It can be very worrisome to have pain in or around the shoulder area. The Trigger Point Protocol gives us a clinical road map to follow to determine which muscles can be causing pain at a particular area in or around the shoulder. One of the most frequently problematic muscles is the infraspinatus. It is located on the shoulder blade bone and helps to outwardly rotate the arm. Trigger Points in this muscle can cause debilitating pain in the front of the shoulder. Yes, a muscle in the back of the shoulder, causes pain in the front. Find a trigger point therapist near you by clicking on our “find a Therapist” page. They can assess your case and see how you can quickly get rid of your pain!
Frozen Shoulder
At many times of our lives, we can have conditions that arise for seemingly no particular reason. Frozen shoulder, or the inability to freely move the shoulder in proper range of motion, can creep up slowly, or can be present one morning when we wake up. Often the person has engaged in new or unaccustomed activities, and/ or has had some recent stressful periods in their life. Chronic dehydration, low vitamins or minerals or even anemia can be a precipitating circumstance prior to the shoulder “locking up”. Trigger Point Therapy takes a clinical look at all the muscles around the shoulder joint and though our full protocol, we eliminate the dysfunction and restore full mobility. Key muscles are subscapularis, latissimus dorsi, deltoids, infraspinatus, pectorals, teres, supraspinatus.
Carpal Tunnel:
Pain, weakness, tingling or numbness into the fingers and wrist can lead us to automatically believe we have carpal tunnel syndrome. The first course of action should be to determine if any of the 16 muscles that can refer sensation to the wrist and hand are actually the source of the problem. We need to look as far away as the muscles in the side of the neck, the chest and shoulder. Then we assess for other perpetuating factors like poor sleep posture, work ergonomics and nutrition. Just because we have pain or sensation in a particular area DOES NOT warrant a diagnosis of something we cannot view without MRI or X-ray. Even in the presence of degeneration in a joint or bones, or even narrowing of the Carpal Tunnel, that does not PROVE that is what is causing the pain. 90% of pain outside true pathology (like cancer or liver disease) comes from trigger points in muscles. Often just a few treatments using our Myofascial Trigger Point Therapy Treatment Protocol, people have a HUGE reduction in their pain and have improved strength and function of a given area of the body.Find a trigger point therapist near you by clicking on our “find a Therapist” page. They can assess your case and see how you can quickly get rid of your pain!
Bunion Pain
Hallux valgus, or bunions, is often accompanied by pain in the big toe joint. This joint can also be swollen or red. Using our Myofascial Trigger Point Therapy Treatment Protocol, we look at all the muscles that can cause a non-neutral shift in the big toe, and work to deactivate taut bands in the muscle fibers. Once these muscles are lengthened and the pulling at the joint is reduced, other interventions are applied to begin to reduce the size of the joint, and to encourage the bone to go back to closer to neutral. We also correct for hyperpronation of the foot
(falling inward of the foot at the inside ankle), to allow the foot/ankle/toes to be in better position and to not stress out the first toe joint. We use Posture Control Insoles to correct for this problem. find a trigger point therapist near you by clicking on our “find a Therapist” page. They can assess your case and see how you can quickly get rid of your pain!
Heel Spurs (heel pain)
Pain into the heel can be debilitating and can prevent us from participating in everyday activities. Misdiagnosis of “heel spurs” without evidence from MRI or X-ray can be misleading. The Trigger Point Therapy protocol gives us a road map to follow to look for and eliminate dysfunctional segments in the muscles in the calf that can refer pain into the heel. Even if there is image proven spurs, we ask the question:
What muscles attach to the heel and how can we lengthen them and provide relief from this strong pulling at the attachment?
Clinical example:
A woman came to us with heel pain, and after we took a detailed history, she revealed that she often spent hours at her desk with her legs tucked under her chair with her toes perched on the support pegs of the chair. This put her gastroc/soleus (muscled in the back of the calf) always on the stretch, thereby constantly pulling on the area of the upper heel where the attached via the Achilles tendon)
Stiff neck
Common symptoms arising from Trigger Points in the Neck and shoulder muscles. We have all heard of the term “stiff neck”. When it is difficult to turn our head to one side, or in any particular direction. We may wake up one day and be suffering from a stiff neck, or stiff shoulder. Headache is also a common symptom arising from referred pain into the head from trigger points in the muscles in of the neck and shoulders.
Common symptoms arising from Trigger Points in the Neck and shoulder muscles. We have all heard of the term “stiff neck”. When it is difficult to turn our head to one side, or in any particular direction. We may wake up one day and be suffering from a stiff neck, or stiff shoulder. Headache is also a common symptom arising from referred pain into the head from trigger points in the muscles in of the neck and shoulders.
Common injury/ pain DX: Some of the more common names for problems in the neck and shoulder are: Stiff neck, pinched nerve, swimmer’s shoulder, repetitive overuse shoulder syndrome, torticollis, wry neck, driver’s neck (unable to look over shoulder as when moving car in reverse).
You can watch this video to learn how to best self-treat muscles in the neck and shoulder using. The Original Backnobber Self Care Tools:
For the neck, the knob at end of the smaller curve of the Backnobber, or the inside surface of the curved section can be used. Treating upper shoulder. Start seated on a chair, comfortably supported. Reach the smaller curved end of the Backnobber over the shoulder and with the opposite side hand, press into the uppermost curve of the tool so the pressure goes downward directly into the upper shoulder muscles and lower portions of the longer neck muscles. (Trapezius, levator scapulae, longissimus cervices) If you feel referred pain or sensation upward into your head, in the areas of the eyebrows, jaw or cheeks, that is a very common referral pattern from the trigger points in the upper trapezius muscle. (will we show this referral pattern and TrP #1 in Traps?)
Prevention Tips: Try to sleep in neutral posture. Keep the head and neck in an upright position in alignment with your shoulders. Review your seated posture in your car, desk and couch. Be sure that your back and neck/head are in alignment and that you do not have too much of a forward head posture.
Sciatica
Pain that travels from our low back/ buttocks area, down into the side or back of the thigh and even into the side of the lower leg can often be mis-diagnosed as “Sciatica”. While this pattern of pain or sensation DOES mimic a true nerve impingement, there are lots of other reasons why this sensation is occurring. The Gluteus Minimus
muscle, when harboring trigger Points, causes sometimes strong and sometimes weak sensation to travel in the described pattern. This muscle can develop these trigger points in people who hyperpronate at their ankle (Feet fall inward), people who walk with their feet splayed outward, those who wear flip-flops, or those who wear poor shoes like Crocs or Dansko’s. Also, sleeping on a soft mattress in a sidelying position can cause the gluteus minimus muscle to be chronically tight, and it in turn can develop trigger points that can refer down the leg. Watch this YouTube video for some easy tips on how to eliminate your own pain due to trigger points. Better yet, find a trigger point therapist near you by clicking on our “find a Therapist” page. They can assess your case and see how you can quickly get rid of your pain!
Click on this short Youtube video to learn how to eliminate “Sciatica”-type pain in your thigh and lower leg.
Shoulder, Arm and Hand Problems
Many of us have front of shoulder or upper arm pain or weakness at one time or another in our lives. We also may have been stricken with “Frozen Shoulder” or we may have been told we have “artihrits of the shoulder” or “bursitis”. Just because we have pain or sensation in a particular area DOES NOT warrant a diagnosis of something we cannot view without MRI or X-ray. Even in teh presence of degeneration in a joint or bones, is not a way to PROVE that is what is causing the pain. 90% of pain outside true pathology (like cancer or liver disease) comes from trigger points in muscles. Often just a few treatments using our Myofascial Trigger Point Therapy Treatment Protocol, people have a HUGE reduction in their pain and have improved strength and function of a given area of the body.
What causes shoulder/arm problems?
- Sleeping with the arms strongly bent at the elbow, or tucked under a pillow under or overhead
- bent elbows all day during typing and mousing
- elbows held in the bent position for long car rides
- Bent elbows held for texting and gaming
- Holding a phone up to the ear for long phone calls
All these postures can cause trigger points and muscle dysfunction. The biceps muscle in the front of the arm, when harboring trigger points can cause front of shoulder and upper arm pain.
Whiplash
Car accidents can certainly be jarring to our muscular system. Whiplash is a common term to describe a painful neck and headaches that occur after a MVA Motor vehicle accident. She SCM muscle is a strong stabilizer muscle in the neck that is especially affected in a car accident. This same muscle can be overworked from those who look downward at a computer screen all day, or even worse, those who have to look upward at a screen for long periods of time. When harboring trigger points, this muscle can refer pain and sensation to the face, cheeks, eyebrow area, forehead, top of head and even into the jaw. Click on this short Youtube video to learn how to eliminate trigger points in the SCM muscle.
Back of Arm Pain
Pain that is felt at the back of the arm can make it hard to work at a computer, perform in sports, carry things or even drive. Lucky for us, we know that Trigger Points in the Triceps muscles can cause pain at the back of the upper arm and can also cause weakness, loss of endurance, loss of coordination in the arms.
Find a trigger point therapist near you by clicking on our “find a Therapist” page. They can assess your case and see how you can quickly get rid of your pain!
