CANference Workshop: Trigger Points in Recliners

LarryG is my new hero.  He led a fantastic workshop on trigger points yesterday.  AND his handouts were fantastic.  I'm guessing he will post them.  If not, I'm sure he'll be good natured about taking your harrassing comments and emails.  🙂

My only exposure to trigger point therapy until now had been some quick and dirty training from a fellow acupuncturist who is quite passionate about trigger points.  The problem for me has been finding a way to make this type of needling fit within a CA setting.  And the concerns are about more than just finding and needling points in a recliner.  Trigger point enthusiasts can spend A LOT of time triggering points repeatedly and triggering multiple points in an area (all the major muscles of the shoulder, for instance), leaving little to no time for balancing treatments of any sort.  Also, heavy triggering can leave patients sore (the more points trigger and the more each particular point is triggered can lead to intense soreness which can really have an impact on patient satisfaction and retention.  And when depending on trigger points too heavily, you run the risk of creating trigger point  “addicts” who only want trigger points and want it every treatment which can create difficulties with your ability to provide a well-rounded treatment and it can also add to the “I only want to be treated by PUNK X.”  I have been struggling with each of these issues.  Larry's approach to trigger points was very helpful in addressing these issues.  Here are the basics of his approach (from my very non-expert perspective):

  • Standard needles for triggering points.  I was taught to use heavy gauge needles which create much stronger trigger sensation (intolerable to some patients) and also create more post-treatment soreness.
  • Choosing to needle motor points which have the most bang for your buck in terms of needling and can result in relief at several points, not just at the point of triggering.  Larry's selected points in his handout highlight several of these motor points.  He also referenced 2 books (not cheap) that have some great diagrams for trigger/motor point location and referential pain pattern for each point.
Larry's handouts include:
  • Definitions of types of trigger points
  • How to identify a latent or active trigger point
  • Some points on the relationship between trigger points and fibromyalgia
  • Causes of trigger point activation
  • Excellent notes about which points he uses most: muscle action for affected muscles, precautions, palpation, needling, and some discussion
I spoke with Larry in the hall.  He said he'd provide notes, probably in the CAN forums, I'm guessing.  Which means if you are not a CAN member, maybe you'd like to join in order to get his wonderful notes!
Now I'm off to David Lessep's Armchair Treatment Strategies
Author: NancyS

I've been a member of POCA since the early CAN days. My first CA training was in Oct. 2006 and I've been hooked ever since. In 2010, I started a CA clinic in Salem, Oregon. We've grown to about 150 visits per week. I'm moving to San Luis Obispo this summer (2012) for my partner's job and to be near family. I'm not eligible for licensure in California so my acupunk days are limited and will be on hold for a while. But I plan to stick around POCA.

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  1. thanks for the report .would

    thanks for the report .would love to see any notes /charts . I know trigger points ,but what are the motor points?

    A great reference book is -The Trigger Point Workshop by Clair Davies it cost about $22 . I have used and recommended this book for years . i often use my understanding of trigger points  to see the bigger picture of my patients   pain and might recommend some self trigger point work for them as home work but I dont always do a lot of needling of trigger points specifically .so more thoughts on this would be helpful.l  


  2. HI!


      Glad you enjoyed the breakout session, Nancy.  And it was so great to meet you!

    I’ll get the notes up in the forums in a bit.