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I Advice - Trigger Point Therapy
I just had to get into the fray! I’m new to this cyberworld you see and I was surfing the web this morning in search of ways to drum up some traffic for my website. I came across a site called freeviral.com which said it was free! And would work to drive lots of traffic to your site. So I followed the instructions on the page and Lo and Behold I discovered it was just a front for a site called marketit.com owned by one of the so called maketing gurus.When I decided to contact them to let them know I was on to them Lo and Behold I discovered that they were a front for an even bigger operator. It seems these fellas have learned a lot from Da Boys! It was interesting to note how they waxed eloquent about their integrity and commitment to high standards of business practice.Now I don’t mind a scoundrel as long as he doesn’t pretend to be something else but I abhorr an operator who makes himself out to be something other than he is. Personally I,d like to see people like that brought low. In time I’m sure they will be. It is an inescapable truth that sooner or later you reap what you sow,unless of course you see the error of your ways and depart from them.It is difficult though when Integrity has become such a relative term. I’ve never understood why,when there’s plenty to go around that some people want it all for themselves and will resort to whatever means is expediant to get it all for themselves. Initially it angers me, a natural response I’m sure but in the long haul it saddens me and I can’t help but wonder what happens in a persons life to cause such behavior.Even more troubling than that is what happens when that behavior becomes the norm. I’ve done a lot of surfing around this great big net and found it sorely lacking in the areas of honesty and integrity. Now I’m not saying ther
There is no doubt that myofascial pain can be the result of peripheral nerve abnormalities. An example of this would be the irritation of the sciatic nerve by an over-tensed piriformis muscle resulting in the formation of trigger points in muscles innervated by the sciatic nerve. This list can be continued because any peripheral nerve's entrapment in the key areas will cause formation of trigger points in muscles innervated by this nerve.
If one examines a patient with peripheral arterial disorder (e.g., Buerger’s disease) one will find numerous active and dormant trigger points in the leg and foot muscles. It would most certainly be agreeable that insufficient arterial blood supply as a result vascular abnormality is responsible for the formation of trigger points in the skeletal muscles rather than abnormalities in the motor end-plates. The same is true for trigger points in the skeletal muscles, which are developed as a result of chronic visceral disorders (e.g., patients with cardiac disorders exhibit active trigger points in the trapezius, levator scapulae, and rhomboideus muscles). In such cases the end-plate abnormalities do not have anything to do with formation of trigger points in the skeletal muscles. Th
A payday loan is the fastest and most convenient answer to solve an emergency cash gap between paydays. It will give a short-term solution to financial problems such as unexpected plumbing repairs, suddenly increased utility bills, and an expensive school project of the child.To browse the Internet and find a payday loan that will best meet his specific needs, a person may find a long list of payday loan sites. He will also encounter several variations, such as “instant pay day loans”, “same-day payday loans”, “fax-less payday loans”, “paperless payday loans”, “cash advance loans”, and “free payday loans”. The last of these, “free payday loans” is actually a payday loan with waived fees.Free payday loans must not be misunderstood as loans given free without the borrower bothering to pay them on the due date. These are still loans after all. That is, the borrower needs to pay the full amount of his “free payday loan” plus the agreed interest. It is only described as “free” because the lender waives the service fee. There is also one important condition that must be met so that the borrower will not be charged with the service fee: that the loaned amount be paid in full on the due date. Otherwise, the lender will charge the fees.He will fill up the online application form found at the website of the lender. He will provide accurate data, particularly about his employment, his checking account, and his contact information. One personnel of the lender will verify the information given, and if there are no inconsistencies, this personnel will contact the borrower or client by phone or by email.Then, when the loan application is approved, the lender will deposit the loaned amount into the client’s checking account, usually overnight. Thus, the client may use the money he needed e
Medical massage therapy procedure consists of mobilization of skin, fascia and muscular tissue, trigger point therapy, and post-isometric relaxation techniques. Each of these modalities is equally important in order to reach rapid and sustained results. For decades, massive utilization of medical massage has proven to be a safe and very effective method of treatment for the support and movement system disorders, inner organ disorders, stress management, and more.
In the last few years, there have been numerous arguments in within the professional community about practitioners utilizing manual therapy and trigger point therapy. In recent professional publications many authors have been raising the following questions: Is a trigger point a formation of fibroconnective tissue in muscles? Have histological studies ever been done on trigger points? Is there a theory of peripheral nerve pain at the motor end plate a new theory and the only theory? Are ischemic compression techniques for trigger point therapy safe and effective?
The brief answers on aforementioned questions are:
1. Fibroconnective tissue formation in muscles is myogelosis, an incurable muscular pathology.
2. In many cases myogelosis is the result of inadequate treatment of trigger points.
3. A trigger point is a pinpoint localization of pain that can be found in muscles, connective tissue, and periosteum. The morphology of this point of pain is such that the demand of blood supply is much higher than the actual blood supply.
4. The theory of peripheral nerve pain at the motor end plate is not a new theory.
5. Any theory must be supported by clinical output.
6. Ischemic compression as a method of trigger point therapy has been proven by at least 4 decades of massive utilization as a safe and effective method.
7. Ischemic compression techniques are applied by gradually increasing pressure, thus excluding the possibility of doing harm to the patient and to the therapist.
In the search for true understanding of pathophysiology, the body’s sophistication and complexity requires us to take an integrative approach to any issue. Thus I would like to present to the reader a short scientific review of the trigger point issue and the trigger point therapy concept.
The Nature of Trigger Points
There is no statement in the modern scientific literature that calls a trigger point a "taut band of fibro-connective tissue." However, it was once used in the late 19th/early 20th century until histological studies conducted by German scientists (Glogowski, and Wallraff, 1951; Miehlke et al., 1950) showed that there is no connective tissue proliferation (myogelosis) in the area of a trigger point in muscles. "In our opinion, fibrositis (in regard to trigger points) has become a hopelessly ambiguous diagnosis... is best avoided" (Travell, Simons, 1983). However, connective tissue will grow between muscle fibers when a core of the myogelosis is formed (Glogowski, and Wallraff, 1951). Myogelosis is a clinical outcome of years of reactivation of the active trigger point in the same area. At the same time, trigger point therapy is useless if the core of the myogelosis is already formed.
In 1843, for the first time, the German physician Dr. F. Froriep described trigger points as painful formation in skeletal muscles. In 1921 another German scientist, Dr. H. Schade, examined them histologically and formed the concept of myogelosis. In 1923 the British physician Dr. J. Mackenzie offered the first pathophysiological explanation of the trigger point formation mechanism and formulated the concept of the reflex zones in the skeletal muscles where the central and peripheral nervous system play a critical role. The reflex zones concept was further developed by the American scientist Prof. I. Korr in 1941 in a series of brilliantly designed experimental studies. Thus, the trigger point concept was developed long before the work of Travell and Simons, who based their publication (see references in "Trigger Point Manual" by Travell and Simons) on the works of the scientists mentioned.
There are numerous published results of histological evaluations of the trigger point areas. Even in the short list of references at the end of this article you can find ample evidence under references 5, 6, 7, 13, and 15.
It is misleading to state that Dr. Travell and Dr. Simons recommended using ischemic compression for trigger point therapy. They advocated injection, stretch and spray techniques, and muscle energy techniques for trigger point therapy. Although, Travell and Simons did mention ischemic compression as an option based on the European medical sources, they never recommended it as a treatment method.
The Role of Vasodilators in Local Ischemia
Awad (1973) examined biopsy tissues from trigger points using an electron microscope and detected a significant increase in the number of platelets, which caused the release of serotonin and mast cells, which in turn released histamine. Both serotonin and histamine are potent vasodilators and their increase is a clear sign that body is trying to fight the local ischemia in the trigger point area. In his now classical work, Fassbender (1975) conducted a histological examination of the circulation in the area of the trigger point and proved once and for all that "... the trigger point represents a region of local ischemia." The same results were obtained by Popelansky et al., (1986) who used radioisotope evaluation of blood circulation in the area of the trigger point.
The End Plate Theory
The end plate theory is not a new theory. Travell and Simmons constantly emphasize the nervous system as a critical factor in the development of the trigger point and point out the importance of end-plate zones. They even name special types of trigger points called “motor trigger points,” which are located in the middle of the muscle belly at the neuromuscular junction. "The functionally significant structure with regard to the innervation of muscle fibers is the myoneural junction (end-plate zone)..." and "Some trigger points are closely associated with myoneural junctions, others not." (Travell and Simmons, 1983). The idea of the nervous system and the role of end-plate zones is not a new concept. As early as 1947 Prof. Korr addressed the same issues in his research.
According to histological studies (Heine, 1997; Gogoleva, 2001) chronic pain and low grade tension in the skeletal muscles and fascia are responsible for the low grade inflammation around the terminal parts of the sensory and motor neurons which end in the soft tissues. This chronic inflammation activates the local fibroblasts, which deposit collagen around the nerve endings forming so-called "collagen cuffs.” This additional irritating factor triggers an afferent sensory flow to the central nervous system, which is interpreted by the brain as pain. This mechanism is partially described by the generation of pain in the area of motor trigger points. We have to consider that the terminal parts of the sensory and motor neurons are located in the soft tissues, including skeletal muscles. In other words, it would be logical to assume that something must irritate the terminal parts of sensory and motor neurons. This something is a tension in the skeletal muscles, including trigger points that are not associated with motor trigger points (since they are located in other parts of the skeletal muscle). Keep in mind that any inflammatory condition, whether in motor end plates or in muscular tissue, means that there is a decreased amount of blood supply to this inflamed tissue. From this it follows that gradual ischemic compression can be viewed as an anti-inflammatory effort.
There is no doubt that myofascial pain can be the result of peripheral nerve abnormalities. An example of this would be the irritation of the sciatic nerve by an over-tensed piriformis muscle resulting in the formation of trigger points in muscles innervated by the sciatic nerve. This list can be continued because any peripheral nerve's entrapment in the key areas will cause formation of trigger points in muscles innervated by this nerve.
If one examines a patient with peripheral arterial disorder (e.g., Buerger’s disease) one will find numerous active and dormant trigger points in the leg and foot muscles. It would most certainly be agreeable that insufficient arterial blood supply as a result vascular abnormality is responsible for the formation of trigger points in the skeletal muscles rather than abnormalities in the motor end-plates. The same is true for trigger points in the skeletal muscles, which are developed as a result of chronic visceral disorders (e.g., patients with cardiac disorders exhibit active trigger points in the trapezius, levator scapulae, and rhomboideus muscles). In such cases the end-plate abnormalities do not have anything to do with formation of trigger points in the skeletal muscles. Th
Travel writing jobs are few and far between. Getting into this field is hard to do and requires a lot of training and experience. But, there are many benefits to them. There are many individuals who would love to get employment opportunities in this field. And, because the world is faster and faster becoming accessible to more people, increasing employment availability can be found for travel jobs as well. But, how does a person get in and how do they do their job?Travel writer jobs belong mainly to freelance authors, travelling far and wide. They learn about the amusements, the attractions, and the little secrets of the towns, cities, and countries they visit. Then, they provide this knowledge to the general public in the form of articles, books, or even transcriptions. It is amazing that many people go from location to location by simply learning about different areas and using this knowledge to write. But, this work is far from easy. It may be costly to afford to do this type of traveling. It often does not pan out as a worthwhile adventure anyway. It is often difficult to find publishers or employment vacancies in this area as well.To get these types of jobs, it will often take experience in the writing field and the researching field. Freelance opportunities, in which the author will visit locations at his own expense, are necessary. In other, simpler cases, a breakthrough into the business can be done by working for the local newspaper or through a magazine. In any case, though, it will require time to develop the necessary knowledge.When looking for vacancies like these, it would be wise to realize that it will take time to build up the reputation needed to get these opportunities. Perhaps working on less glamorous writing jobs will have to be taken in order to have ste
7. Ischemic compression techniques are applied by gradually increasing pressure, thus excluding the possibility of doing harm to the patient and to the therapist.
In the search for true understanding of pathophysiology, the body’s sophistication and complexity requires us to take an integrative approach to any issue. Thus I would like to present to the reader a short scientific review of the trigger point issue and the trigger point therapy concept.
The Nature of Trigger Points
There is no statement in the modern scientific literature that calls a trigger point a "taut band of fibro-connective tissue." However, it was once used in the late 19th/early 20th century until histological studies conducted by German scientists (Glogowski, and Wallraff, 1951; Miehlke et al., 1950) showed that there is no connective tissue proliferation (myogelosis) in the area of a trigger point in muscles. "In our opinion, fibrositis (in regard to trigger points) has become a hopelessly ambiguous diagnosis... is best avoided" (Travell, Simons, 1983). However, connective tissue will grow between muscle fibers when a core of the myogelosis is formed (Glogowski, and Wallraff, 1951). Myogelosis is a clinical outcome of years of reactivation of the active trigger point in the same area. At the same time, trigger point therapy is useless if the core of the myogelosis is already formed.
In 1843, for the first time, the German physician Dr. F. Froriep described trigger points as painful formation in skeletal muscles. In 1921 another German scientist, Dr. H. Schade, examined them histologically and formed the concept of myogelosis. In 1923 the British physician Dr. J. Mackenzie offered the first pathophysiological explanation of the trigger point formation mechanism and formulated the concept of the reflex zones in the skeletal muscles where the central and peripheral nervous system play a critical role. The reflex zones concept was further developed by the American scientist Prof. I. Korr in 1941 in a series of brilliantly designed experimental studies. Thus, the trigger point concept was developed long before the work of Travell and Simons, who based their publication (see references in "Trigger Point Manual" by Travell and Simons) on the works of the scientists mentioned.
There are numerous published results of histological evaluations of the trigger point areas. Even in the short list of references at the end of this article you can find ample evidence under references 5, 6, 7, 13, and 15.
It is misleading to state that Dr. Travell and Dr. Simons recommended using ischemic compression for trigger point therapy. They advocated injection, stretch and spray techniques, and muscle energy techniques for trigger point therapy. Although, Travell and Simons did mention ischemic compression as an option based on the European medical sources, they never recommended it as a treatment method.
The Role of Vasodilators in Local Ischemia
Awad (1973) examined biopsy tissues from trigger points using an electron microscope and detected a significant increase in the number of platelets, which caused the release of serotonin and mast cells, which in turn released histamine. Both serotonin and histamine are potent vasodilators and their increase is a clear sign that body is trying to fight the local ischemia in the trigger point area. In his now classical work, Fassbender (1975) conducted a histological examination of the circulation in the area of the trigger point and proved once and for all that "... the trigger point represents a region of local ischemia." The same results were obtained by Popelansky et al., (1986) who used radioisotope evaluation of blood circulation in the area of the trigger point.
The End Plate Theory
The end plate theory is not a new theory. Travell and Simmons constantly emphasize the nervous system as a critical factor in the development of the trigger point and point out the importance of end-plate zones. They even name special types of trigger points called “motor trigger points,” which are located in the middle of the muscle belly at the neuromuscular junction. "The functionally significant structure with regard to the innervation of muscle fibers is the myoneural junction (end-plate zone)..." and "Some trigger points are closely associated with myoneural junctions, others not." (Travell and Simmons, 1983). The idea of the nervous system and the role of end-plate zones is not a new concept. As early as 1947 Prof. Korr addressed the same issues in his research.
According to histological studies (Heine, 1997; Gogoleva, 2001) chronic pain and low grade tension in the skeletal muscles and fascia are responsible for the low grade inflammation around the terminal parts of the sensory and motor neurons which end in the soft tissues. This chronic inflammation activates the local fibroblasts, which deposit collagen around the nerve endings forming so-called "collagen cuffs.” This additional irritating factor triggers an afferent sensory flow to the central nervous system, which is interpreted by the brain as pain. This mechanism is partially described by the generation of pain in the area of motor trigger points. We have to consider that the terminal parts of the sensory and motor neurons are located in the soft tissues, including skeletal muscles. In other words, it would be logical to assume that something must irritate the terminal parts of sensory and motor neurons. This something is a tension in the skeletal muscles, including trigger points that are not associated with motor trigger points (since they are located in other parts of the skeletal muscle). Keep in mind that any inflammatory condition, whether in motor end plates or in muscular tissue, means that there is a decreased amount of blood supply to this inflamed tissue. From this it follows that gradual ischemic compression can be viewed as an anti-inflammatory effort.
There is no doubt that myofascial pain can be the result of peripheral nerve abnormalities. An example of this would be the irritation of the sciatic nerve by an over-tensed piriformis muscle resulting in the formation of trigger points in muscles innervated by the sciatic nerve. This list can be continued because any peripheral nerve's entrapment in the key areas will cause formation of trigger points in muscles innervated by this nerve.
If one examines a patient with peripheral arterial disorder (e.g., Buerger’s disease) one will find numerous active and dormant trigger points in the leg and foot muscles. It would most certainly be agreeable that insufficient arterial blood supply as a result vascular abnormality is responsible for the formation of trigger points in the skeletal muscles rather than abnormalities in the motor end-plates. The same is true for trigger points in the skeletal muscles, which are developed as a result of chronic visceral disorders (e.g., patients with cardiac disorders exhibit active trigger points in the trapezius, levator scapulae, and rhomboideus muscles). In such cases the end-plate abnormalities do not have anything to do with formation of trigger points in the skeletal muscles. Th
One thing you do not want to do is doom your business to failure before you ever start. After all, we start our business with the goal of making money and becoming successful, right? However did you know that the vast majority of the people (I would say over 99%) who embark on their journey to start an Internet Business have doomed themselves to failure long before they ever started?While many experts could cite many reasons for why most Internet Businesses will fail, today I will discuss with you one that I consider near the top of the list.Is it laziness? Lazy people will most likely never succeed with their business, but there are just as many people who worked incredibly hard and did not make any money either. Working hard, or a lack thereof does not guarantee success of failure. If you want proof of this, all you have to do is look at someone you know has worked insanely hard for most of their life, yet they are still stuck in the same rut year after year. We all know someone who lives like this, and in my case, it was me!Is it a lack of knowledge? I started my Internet business with nothing but a handful of E-books I bought for $5, and started selling on eBay with no knowledge whatsoever. However I was able to learn what was necessary to develop my own Internet Business within a year. I knew nothing when I started except how to write HTML, and have had more success than I could have ever imagined. So even if you have no money and know nothing about how to make money on the Internet, you can surpass your wildest expectations.I could literally go on about any reason, and give you an example of how people can be successful despite being lazy, unknowledgeable, poor, too busy, and anything else. Yet despite these missing pieces, I have seen people do very well with their Internet bus
There are numerous published results of histological evaluations of the trigger point areas. Even in the short list of references at the end of this article you can find ample evidence under references 5, 6, 7, 13, and 15.
It is misleading to state that Dr. Travell and Dr. Simons recommended using ischemic compression for trigger point therapy. They advocated injection, stretch and spray techniques, and muscle energy techniques for trigger point therapy. Although, Travell and Simons did mention ischemic compression as an option based on the European medical sources, they never recommended it as a treatment method.
The Role of Vasodilators in Local Ischemia
Awad (1973) examined biopsy tissues from trigger points using an electron microscope and detected a significant increase in the number of platelets, which caused the release of serotonin and mast cells, which in turn released histamine. Both serotonin and histamine are potent vasodilators and their increase is a clear sign that body is trying to fight the local ischemia in the trigger point area. In his now classical work, Fassbender (1975) conducted a histological examination of the circulation in the area of the trigger point and proved once and for all that "... the trigger point represents a region of local ischemia." The same results were obtained by Popelansky et al., (1986) who used radioisotope evaluation of blood circulation in the area of the trigger point.
The End Plate Theory
The end plate theory is not a new theory. Travell and Simmons constantly emphasize the nervous system as a critical factor in the development of the trigger point and point out the importance of end-plate zones. They even name special types of trigger points called “motor trigger points,” which are located in the middle of the muscle belly at the neuromuscular junction. "The functionally significant structure with regard to the innervation of muscle fibers is the myoneural junction (end-plate zone)..." and "Some trigger points are closely associated with myoneural junctions, others not." (Travell and Simmons, 1983). The idea of the nervous system and the role of end-plate zones is not a new concept. As early as 1947 Prof. Korr addressed the same issues in his research.
According to histological studies (Heine, 1997; Gogoleva, 2001) chronic pain and low grade tension in the skeletal muscles and fascia are responsible for the low grade inflammation around the terminal parts of the sensory and motor neurons which end in the soft tissues. This chronic inflammation activates the local fibroblasts, which deposit collagen around the nerve endings forming so-called "collagen cuffs.” This additional irritating factor triggers an afferent sensory flow to the central nervous system, which is interpreted by the brain as pain. This mechanism is partially described by the generation of pain in the area of motor trigger points. We have to consider that the terminal parts of the sensory and motor neurons are located in the soft tissues, including skeletal muscles. In other words, it would be logical to assume that something must irritate the terminal parts of sensory and motor neurons. This something is a tension in the skeletal muscles, including trigger points that are not associated with motor trigger points (since they are located in other parts of the skeletal muscle). Keep in mind that any inflammatory condition, whether in motor end plates or in muscular tissue, means that there is a decreased amount of blood supply to this inflamed tissue. From this it follows that gradual ischemic compression can be viewed as an anti-inflammatory effort.
There is no doubt that myofascial pain can be the result of peripheral nerve abnormalities. An example of this would be the irritation of the sciatic nerve by an over-tensed piriformis muscle resulting in the formation of trigger points in muscles innervated by the sciatic nerve. This list can be continued because any peripheral nerve's entrapment in the key areas will cause formation of trigger points in muscles innervated by this nerve.
If one examines a patient with peripheral arterial disorder (e.g., Buerger’s disease) one will find numerous active and dormant trigger points in the leg and foot muscles. It would most certainly be agreeable that insufficient arterial blood supply as a result vascular abnormality is responsible for the formation of trigger points in the skeletal muscles rather than abnormalities in the motor end-plates. The same is true for trigger points in the skeletal muscles, which are developed as a result of chronic visceral disorders (e.g., patients with cardiac disorders exhibit active trigger points in the trapezius, levator scapulae, and rhomboideus muscles). In such cases the end-plate abnormalities do not have anything to do with formation of trigger points in the skeletal muscles. Th
Most books and courses on the subject of currency trading say that it is normal for beginners to lose money at first. Some even go as far as to say that it is normal to have a losing streak that lasts several months! This philosophy stems from the rationale that after losing significant amount of money, you will have more experience and knowledge in your future trading endeavors. If you went by their standards, how much of your hard earned money will be left in a few months? This type of attitude sets you up to fail. Why enter a battle if you are destined to lose?The only purpose for such advice is for currency and futures brokers and dealers to make money on the spreads and commissions that you will pay to them. More often you trade, more profits for your broker or dealer. Day trading in its purest form may have worked in the late 90`s for traders who were trading volatile high tech stocks. Some traders also called "Scalpers" were getting in and out of positions in matters of minutes, even seconds and were making their profits on small differences between bid and ask price. However, those days are now gone.In currency trading, if you are planning to scalp, or if you are planning to jump in and out of positions all day long you will not last long. I can guarantee you that. Also if you plan to purchase an X amount of Euros, GBP, or Swiss Francs and just forget about them in a "buy and hold" fashion most likely you won`t get anywhere. Currencies do not behave in the same fashion as stocks or stock market indexes. Well, if you should not day trade and you should not buy and hold, what should you do? The best approach to currency trading is called swing trading or short term trading where you hold your positions for periods anywhere from few days to few weeks, and very rarely for a few months.
The End Plate Theory
The end plate theory is not a new theory. Travell and Simmons constantly emphasize the nervous system as a critical factor in the development of the trigger point and point out the importance of end-plate zones. They even name special types of trigger points called “motor trigger points,” which are located in the middle of the muscle belly at the neuromuscular junction. "The functionally significant structure with regard to the innervation of muscle fibers is the myoneural junction (end-plate zone)..." and "Some trigger points are closely associated with myoneural junctions, others not." (Travell and Simmons, 1983). The idea of the nervous system and the role of end-plate zones is not a new concept. As early as 1947 Prof. Korr addressed the same issues in his research.
According to histological studies (Heine, 1997; Gogoleva, 2001) chronic pain and low grade tension in the skeletal muscles and fascia are responsible for the low grade inflammation around the terminal parts of the sensory and motor neurons which end in the soft tissues. This chronic inflammation activates the local fibroblasts, which deposit collagen around the nerve endings forming so-called "collagen cuffs.” This additional irritating factor triggers an afferent sensory flow to the central nervous system, which is interpreted by the brain as pain. This mechanism is partially described by the generation of pain in the area of motor trigger points. We have to consider that the terminal parts of the sensory and motor neurons are located in the soft tissues, including skeletal muscles. In other words, it would be logical to assume that something must irritate the terminal parts of sensory and motor neurons. This something is a tension in the skeletal muscles, including trigger points that are not associated with motor trigger points (since they are located in other parts of the skeletal muscle). Keep in mind that any inflammatory condition, whether in motor end plates or in muscular tissue, means that there is a decreased amount of blood supply to this inflamed tissue. From this it follows that gradual ischemic compression can be viewed as an anti-inflammatory effort.
There is no doubt that myofascial pain can be the result of peripheral nerve abnormalities. An example of this would be the irritation of the sciatic nerve by an over-tensed piriformis muscle resulting in the formation of trigger points in muscles innervated by the sciatic nerve. This list can be continued because any peripheral nerve's entrapment in the key areas will cause formation of trigger points in muscles innervated by this nerve.
If one examines a patient with peripheral arterial disorder (e.g., Buerger’s disease) one will find numerous active and dormant trigger points in the leg and foot muscles. It would most certainly be agreeable that insufficient arterial blood supply as a result vascular abnormality is responsible for the formation of trigger points in the skeletal muscles rather than abnormalities in the motor end-plates. The same is true for trigger points in the skeletal muscles, which are developed as a result of chronic visceral disorders (e.g., patients with cardiac disorders exhibit active trigger points in the trapezius, levator scapulae, and rhomboideus muscles). In such cases the end-plate abnormalities do not have anything to do with formation of trigger points in the skeletal muscles. Th
Dear Candace,I'm 35 years old and ready to open my heart to a true partner. I have honored myself in the past by leaving relationships that weren't right, yet I wonder if my idea of how I think it is supposed to be is preventing me from creating what I truly want. I don't want to settle.I met a man recently and was very excited after our first date, but on our 2nd date, he seemed more excited about the possibility of sex than having a relationship. my prayer request is this: Do you have any insight that would give me more peace and love in this part of my life? ~ Lisa“Greetings and blessings to you precious one. It is important to not have too many ideas about how a spiritual partnership should look. One cannot know what is best for them and can only open up to allowing the universe to partner them up with the right person. There is not one particular person that is a soul mate to you. That is the bad news. The good news is that most of the men on the planet could be a soul mate to you when you truly become ready.“To have the relationship that you want, it is as if you become ripe and ready to be plucked from being single, learning, growing, experiencing, and questioning. You become ripe for relationship. At the same moment that you become ripe, someone else on the planet will become ripe, and your paths will cross.“There are many degrees of ripeness. You have crossed paths with some when you were unripe and so were they, and yet there was an attraction drawing you together. This was a process of learning and growing, so that you could become ripened and ready for plucking. You are still in that process and are very near to being ripe. It is now truly a matter of making a very deep decision. ‘Now is the time, and I am open and ready to do this.’ Then nothing will keep you from
There is no doubt that myofascial pain can be the result of peripheral nerve abnormalities. An example of this would be the irritation of the sciatic nerve by an over-tensed piriformis muscle resulting in the formation of trigger points in muscles innervated by the sciatic nerve. This list can be continued because any peripheral nerve's entrapment in the key areas will cause formation of trigger points in muscles innervated by this nerve.
If one examines a patient with peripheral arterial disorder (e.g., Buerger’s disease) one will find numerous active and dormant trigger points in the leg and foot muscles. It would most certainly be agreeable that insufficient arterial blood supply as a result vascular abnormality is responsible for the formation of trigger points in the skeletal muscles rather than abnormalities in the motor end-plates. The same is true for trigger points in the skeletal muscles, which are developed as a result of chronic visceral disorders (e.g., patients with cardiac disorders exhibit active trigger points in the trapezius, levator scapulae, and rhomboideus muscles). In such cases the end-plate abnormalities do not have anything to do with formation of trigger points in the skeletal muscles. They are the result of the phenomenon of convergence of pain stimuli within the same segments of the spinal cord, which are responsible for the innervation of both the affected inner organ and the skeletal muscles. In 1955 Dr. Glezer and Dalicho formulated the theory that still stands clinically proven. They proposed and developed maps of reflex zone abnormalities of the skin, fascia and muscles, including trigger point development.
The Energy Crisis Theory
There is another theory, which links formation of trigger points with the shortage of ATP in the affected muscles as a result of insufficient arterial circulation. ATP is the energy source for cellular function, including muscles. Authors of this theory, called the Energy Crisis Theory, pointed out the formation of the trigger points in very healthy athletes who did not have signs of peripheral nerve abnormalities and still developed active trigger points. Gradual increase of the resting muscular tone in normal muscles triggers local vasoconstriction, interstitial edema, and ATP exhaustion with the subsequent formation of active trigger points. Prof. D. Simons reviewed this theory as well, and even used extensively works done by his colleagues, Dr. D.R Hubbard and Dr. G.M. Berkoff, in his own research.
Trigger Point Therapy Protocol
Ultimately trigger point therapy has the following goals:
1. Eliminate protective muscular tension in the muscles that harbor active trigger points.
2. Eliminate condition of the hyperirritability of the peripheral receptors, especially pain receptors.
3. Block the pain-analyzing system of the patient.
4. Produce reflex vasodilation.
5. Eliminate local ischemia.
To effectively achieve these goals the practitioner should conduct trigger point therapy utilizing several equally important components:
1. Detect location of the active trigger point.
2. Detect the pathway of pain radiation and examine tissues along this pathway in case satellite trigger points are formed.
3. Place finger in the trigger point. Slowly apply vertical compression of the tissues until the patient feels the first sign of pain. As soon as he or she reports it stop increasing pressure but maintain it at that same level. After 10 seconds of pressure application, the pain that the patient initially felt will disappear. The patient should immediately report to you as soon as he or she feels the pain cease. During the next 20 seconds the practitioner will be able to get to the "bottom" of the trigger point without unwanted activation of the pain analyzing system and generating protective muscular tension in the affected muscle or muscles in the region.
4. To accomplish the first three goals apply effleurage and kneading techniques on the affected muscles in the inhibitory regime for 5-7 minutes (comfortable gradual increase of pressure, in the same direction of the strokes).
5. Exit the trigger point as fast as possible to produce quick and effective vasodilation and elimination of the local ischemia.
The correct protocol of trigger point therapy does not have pitfalls. This protocol is equally effective for the motor trigger points, as well as for other trigger points. The applied pressure is never strong enough to go over the patient's threshold of pain, causing the pain and injury of motor nerve endings. Peripheral vasodilation restores local pH to normal, increases oxygenation of the tissues in the area of the trigger point, and gradually eliminates the trigger point.
References
1. Awad, E.A.: Interstitial myofibrositis: hypothesis of the mechanism, Arch. Phys. Med. Rehab, 54(10):449-453, 1973
2. Fassbender H.G. Pathology of the Rheumatic Diseases. Springer-Verlag, New York, 1975
3. Froriep, F. Ein Beitrag zur Pathologie und Therapie des Rheumatismus. Weimar, 1843.
4. Glezer, O., Dalicho, V.A. Segmentmassage. Leipzig, 1955
5. Glogowski, G., Wallraff, J. "Ein beitrag zur Klinik und Histologie der Muskkelharten (Myogelosen)", Z. Orthop., 80:237-268, 1951
6. Gogoleva, E.F. "New Approaches to Diagnosis and Therapy of Fibromyalgia associated with Spondylosis." Ther. Arch., 4:40-45, 2001.
7. Heine, H. Lehbruh der biologischen Medicine. Stuttgart, Hippokrates, 1997.
8. Hubbard, D.R., Berkoff, G.M. "Myofascial trigger points show spontaneous needle EMG activity", Spine, 18:1803-1807, 1993.
9. Korr, I.M. "The Neural Basis of the Osteopathic Lesion." JAOA, 47(4): 191-198, 1947.
10. Kreymer, A.Y. Vibration Massage in Diseases of the Nervous System.
Tomsk University, Tomsk, 1987.
11. Mackenzie, J. Angina Pectoris. Henry, Frowde & Hodder & Stroughton, London, 1923.
12. Mezlack, R., Wall, P. “Pain Mechanism: A New Theory.” Science, 150 (Nov): 971-979, 1965.
13. Miehlke, K., Schulze, G., Eger, W. " Klinische und experimentelle Untersuchungen zum Fibrositis-syndrom. Z. Rheumaforsch, 19:310-330, 1960.
14. Popelansky, Y.Y., Zaslavsky, E.S., Veselovsky, V.P. Medicosocial significance, etiology, pathogenesis, and diagnosis of non-articular diseases of soft tissues of the lims and back. Vorpr. Rheumat., 3:38-43, 1986.
15. Schade, H. "Untersuchungen in der Erkaltungstrade: III. Uber den Rheumatismus, in besondere den Muskelrheumatismus (Myogelose)." Munch. Med. Wschr., 68, 95-99, 1921.
16. Travell, J.G., Simons, D.G. Myofascial Pain and Dysfunction. The Trigger Points Manual. Williams & Wilkins, Baltimore, 1983.
17. Wall, P.D., Crowly-Dillon, J.R. “Pain, Itch and Vibration.” A.M.A. Arch. Neurol., 2: 19-29, 1960.
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