Thursday Thoughts: Treating Trigger Points | Modern Manual Therapy Blog

Thursday Thoughts: Treating Trigger Points

In New York State we currently cannot do dry needling. We can debridge already open huge decubitus ulcers, do intravaginal and intraoral manual therapy (DCs cannot do any of these), but DN, forget it!

However, since I am getting licensed in Texas for my concierge practice for pro-athletes and high end clientelle, I decided to take KinetaCore's Functional Dry Needling Level 1 next month. I am excited!

I got away from treating TrPs directly many years ago. I used to do anything from ischaemic release- OW, DFM - more OW, to functional release - patient controlled OW. Treating the soft tissue pattern proximal and distal to the chain with light IASTM is much less threatening and often the TrP is improved. It makes zero sense to fight pain with pain.

I find these comfortable treatments much more helpful than "traditional" TrP OMPT techniques I listed above

  • IASTM to areas proximal and distal to the painful site
  • PNF agonist reversals or reciprocal inhibition using the antagonist of the muscle that has the TrP
  • postural correction and cervical retraction for upper trap TrPs that everyone complaints about "I have a knot in my shoulder"

If I am going to actually tackle a TrP which does seem to reproduce a headache, and no repeated movement or other manual therapy technique is tolerated, I still find strain counterstrain to be very useful since it only alleviates the pain positionally. Similar to a passive but non end range loading strategy, but held at mid range until the tenderness and tone resets.

I wonder how I will feel about directly treating TrPs after taking FDN next month. There will definitely be a course review, pics, and movies up after that weekend. Those of you doing DN out there, how much of your practice is it, and what has it replaced as a reset? For many, I hear doing less thrust manipulation or mobilization after learning and becoming proficient in DN.

Keeping it Eclectic...

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