| Perspectives in Myofascial Trigger Point Therapy |
Perspectives in Myofascial Trigger Point Therapy
Myofascial Trigger Point Therapy (MTPT) is believed by many to be a fairly new area of endeavor. This
understanding is not correct. The medical literature is replete with information regarding Myofascial pain and
dysfunction since the mid 1800’s. Entire books were written on the subject from the early 1900’s to a number
of texts in print in the last few years.
These texts are written from the particular perspective of the individual authors. Each of these volumes are of
use in communicating something unique to that perspective. They are each and every one, of value. Each of
these perspectives has an intrinsic value.
Each of these valuable texts is also limited by its perspective. A perspective on MTPT determines what it will
be used for and what its adherents will do. Understanding the perspective of a particular author tells us what
we may expect of that view. It is a window to the therapeutic soul.
It is my belief that a competent therapist will work to master at least one perspective. A therapist with a deep
understanding of a particular perspective of treatment will be able to treat a number of individuals utilizing
only that perspective and will get good results in so doing.
Given time, experience, and enough treatment failures, most therapists will recognize the need for expanding
their perspective. The more this happens the better the results. This is where many therapists find
themselves. These are very good therapists.
Exceptional therapists develop the ability to view MTPT from a variety of intersecting perspectives. When one
perspective is not producing results they take a different view of the situation. They treat the same dysfunction
from different angles until they get a good result or run out of perspectives. Here are a few of the perspectives
that I have found useful in practice:
Pain Pattern – This is the perspective developed in the Travell & Simons textbooks in the pain and
muscle guides and is an excellent foundational perspective. These volumes document each muscle’s
distinctive pain pattern. These muscles are then treated. Attention is paid to each muscle’s individual as
well as the more global perpetuating factors. This is most therapists’ primary perspective. It is absolutely
foundational. This is a great perspective to begin with.
Biomechanics of Injury – This perspective, while present in Travell and Simons, has been
developed into an art form by Dimitrios Kostopoulos and Constantine Rizopoulos. Essentially it boils down
to delving into the actual mechanics of the injury and determining what muscles would have been affected.
Treat those muscles and watch the magic happen.
Neurological – It has been understood for many years that the pain referral of the individual muscles
does not follow individual dermatomes. The work of Gunn, Hocking, and Fischer demonstrates that the pain
patterns do occur in dermatomes. These can be identified and the pain treated according to a neurological
model in a very effective manner. This may well be the most medically understood model. I find it to be of
great value.
Functional – I have developed a functional model of treatment based on the foundational research of
Gabriel Sella MD. The results of 5,940 S-EMG readings of 138 muscles have been visually presented on 3
charts documenting what each muscle does at each joint. Functional approaches can be developed on an
individual muscle, joint, or movement basis. This is a very useful model that explains many before
misunderstood treatment failures. These charts are available at www.cafepress.com/paineducation.
Biomechanical – There are a number of classic biomechanical approaches to MTPT. My personal
favorite is the Anatomy Trains metaphor developed by Tom Myers. His book explains the development of
postural distortion in terms of fascial pull. I believe it to be the best biomechanical explanation yet offered.
There are many other perspectives utilized by myself and others. These include energy approaches, yoga,
and others. All can be of use. In treatment at this office these are a few of our perspectives. We can be
contacted for training in these perspectives for therapists as well.
Myofascial Trigger Point Therapy (MTPT) is believed by many to be a fairly new area of endeavor. This
understanding is not correct. The medical literature is replete with information regarding Myofascial pain and
dysfunction since the mid 1800’s. Entire books were written on the subject from the early 1900’s to a number
of texts in print in the last few years.
These texts are written from the particular perspective of the individual authors. Each of these volumes are of
use in communicating something unique to that perspective. They are each and every one, of value. Each of
these perspectives has an intrinsic value.
Each of these valuable texts is also limited by its perspective. A perspective on MTPT determines what it will
be used for and what its adherents will do. Understanding the perspective of a particular author tells us what
we may expect of that view. It is a window to the therapeutic soul.
It is my belief that a competent therapist will work to master at least one perspective. A therapist with a deep
understanding of a particular perspective of treatment will be able to treat a number of individuals utilizing
only that perspective and will get good results in so doing.
Given time, experience, and enough treatment failures, most therapists will recognize the need for expanding
their perspective. The more this happens the better the results. This is where many therapists find
themselves. These are very good therapists.
Exceptional therapists develop the ability to view MTPT from a variety of intersecting perspectives. When one
perspective is not producing results they take a different view of the situation. They treat the same dysfunction
from different angles until they get a good result or run out of perspectives. Here are a few of the perspectives
that I have found useful in practice:
Pain Pattern – This is the perspective developed in the Travell & Simons textbooks in the pain and
muscle guides and is an excellent foundational perspective. These volumes document each muscle’s
distinctive pain pattern. These muscles are then treated. Attention is paid to each muscle’s individual as
well as the more global perpetuating factors. This is most therapists’ primary perspective. It is absolutely
foundational. This is a great perspective to begin with.
Biomechanics of Injury – This perspective, while present in Travell and Simons, has been
developed into an art form by Dimitrios Kostopoulos and Constantine Rizopoulos. Essentially it boils down
to delving into the actual mechanics of the injury and determining what muscles would have been affected.
Treat those muscles and watch the magic happen.
Neurological – It has been understood for many years that the pain referral of the individual muscles
does not follow individual dermatomes. The work of Gunn, Hocking, and Fischer demonstrates that the pain
patterns do occur in dermatomes. These can be identified and the pain treated according to a neurological
model in a very effective manner. This may well be the most medically understood model. I find it to be of
great value.
Functional – I have developed a functional model of treatment based on the foundational research of
Gabriel Sella MD. The results of 5,940 S-EMG readings of 138 muscles have been visually presented on 3
charts documenting what each muscle does at each joint. Functional approaches can be developed on an
individual muscle, joint, or movement basis. This is a very useful model that explains many before
misunderstood treatment failures. These charts are available at www.cafepress.com/paineducation.
Biomechanical – There are a number of classic biomechanical approaches to MTPT. My personal
favorite is the Anatomy Trains metaphor developed by Tom Myers. His book explains the development of
postural distortion in terms of fascial pull. I believe it to be the best biomechanical explanation yet offered.
There are many other perspectives utilized by myself and others. These include energy approaches, yoga,
and others. All can be of use. In treatment at this office these are a few of our perspectives. We can be
contacted for training in these perspectives for therapists as well.
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Carol Finn MTPT Richard Finn, CMTPT
412-266-2359 412-779-7822
carolmfinn@gmail.com pittsburghpainrelief@hotmail.com
412-266-2359 412-779-7822
carolmfinn@gmail.com pittsburghpainrelief@hotmail.com