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.
- 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