Before You Needle or Mash That Trigger Point, Give it Some Slack First | Modern Manual Therapy Blog

Before You Needle or Mash That Trigger Point, Give it Some Slack First

Just when you thought it was safe to move, Trigger Points 2, Referral Overdrive! 

I'm not here to hate on TDN, but friction massage and "ischemic" release have got to go!


As a novel stimulus, TDN's power seems to be that it is invasive, almost shocking the nervous system; add that up with a possible twitch response and you have a lot of potential information the CNS has to process.

Whatever the treatment is
Try slacking the tissue first and holding it for about 30-60 seconds. Make sure you passively slack it. If the increased tone/tenderness does not abate, try activating the antagonist for some reciprocal inhibition. 

You'll often find that the TrP you wanted to "release" in the first place is no longer there, or it's greatly diminished. I view TrPs not as the cause of pain, but a consequence of a sensitized nervous system. Decrease the threat through repeated motions, light IASTM (not on the tender areas), light compression wrapping, etc, and you'll find that mobility is often restored and in a pain free manner.

Are there some people that respond better to TDN? Sure, perhaps they greatly prefer it as a treatment due to prior success. Perhaps other treatments have been exhausted and are no longer novel stimuli.

Pain Free Positional Inhibition for Hip Flexors






Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...






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