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A couple weeks ago, I wrote about the differences between acupuncture and “dry needling” to alleviate pain, and in that article I explained a bit about the phenomenon of myofascial trigger points. After I said I believe these are the cause of most of the physical pain humans experience, a number of readers asked me to explain more. For the science lovers out there, I’m going to dive deeper this week.
Besides the most common forms of pain, like lower back and headaches, I’ve had patients with digestive problems, sinus congestion, chest pain, ear ringing, numb hands, painful intercourse, acid reflux, vision changes, and other health issues that were eventually discovered to be due to myofascial trigger points. I believe everyone should know about them and how they work – it could save us a lot of time and worry.
Basically, a trigger point is a small, irritable region in a muscle (or the surrounding connective tissue – “fascia”) that stays stuck in a contracted state, making the muscle fibers taut. This can cause reduced muscle strength and range of motion, pain, numbness, itching, and other forms of dysfunction. Sometimes a trigger point feels like a palpable nodule or “knot,” but to untrained fingers they’re often tricky to find.
A unique property of trigger points is that they’re able to produce symptoms in other parts of the body – from a few inches to a couple feet away. For instance, there’s a trigger point that can form in the soleus muscle of the calf that’s capable of producing pain in the lower back. For this reason, the work of Janet Travell, MD and her colleague David Simons, MD, was groundbreaking. For each muscle in the body, they mapped where trigger points tend to form and what kinds of symptoms they cause.
If you were experiencing pain along the outside of your leg, you might assume that something was wrong with that part of your leg, perhaps with the often-tight iliotibial band (IT band). But this diagram might be helpful. The X’s show where trigger points can occur in a muscle called gluteus minimus above the hip socket. The red shading shows the potential areas of pain that can result. You might not suspect this muscle because, as you can see, there’s no pain at the site of the problem!
There are a handful of mechanisms that can promote trigger point formation, such as irritation of nerves, chronic organ problems, nutritional deficiencies, and autoimmune disorders. Most often, though, the cause is trauma to our connective tissue. When a muscle is strained by being worked too hard, too fast, or beyond its natural range, there is frequently a sort of “recoil” that occurs as segments of the muscle fibers bunch up and remain that way.
This is especially common when someone works out without warming up; when someone does a very ambitious workout after not having exercised for a long time; when someone makes a sudden movement (like reaching out to catch something or trying to stop oneself from falling); and especially when someone does any of the above when in a state of diminished resilience (e.g, when stressed, upset, sleep deprived, eating poorly, etc.).
Even more commonly, the trauma is a form of “postural stress” that’s demanding on muscles in a way that’s difficult to perceive at the time – such as doing the same relatively motionless activity (like sitting at a desk or driving) for hours, days, months, or years. One possible mechanism is known as the “Cinderella hypothesis.” During static muscle exertion – holding a position for a long time, as dentists, musicians, typists, and others engaged in precision handwork do – the body tends to engage a certain group of small muscle fibers, called Cinderella fibers because they’re put to work first and are the last to be disengaged. Even though they’re not doing heavy lifting, these muscle fibers (often in the neck, shoulders, back, and forearms) are continually activated and overworked, which makes them susceptible to trigger point formation.
Whatever the cause, the result is that eventually the muscle never completely relaxes. Muscles are composed of numerous parallel fibers that work together to shorten (contraction of the muscle) and lengthen (the return of the muscle to its relaxed state). Within each of these fibers are many end-to-end contractile units called sarcomeres, and in the case of a trigger point, a group of sarcomeres gets “stuck” in a shortened state. This makes the affected fibers taut and often “stringy” feeling.
To make matters worse, the contracted region clamps down on tiny blood vessels causing local ischemia (inadequate blood supply), reducing in-flow of fresh, oxygenated blood and out-flow of toxins. This leads to a localized hypoxic state (not enough oxygen). The tissue pH changes, local metabolism is impaired, and fluid and waste products tend to build up in the area. This combination of factors ultimately activates pain receptors – it starts to hurt – and when this happens you use the affected muscle less.
Instead, you overload “synergists” – nearby helper muscles. The body makes the surrounding musculature tense as a protective mechanism. Meanwhile, there’s a disruption of the balance between the affected muscles and their “antagonists” – those muscles that lengthen when the primary muscles shorten and vice-versa (for example, the triceps is an antagonist of the biceps). Altogether, this restricts natural movement of the original muscle, which just perpetuates the imbalance. Finally, with longstanding trigger points, the body may deposit gooey lubricant compounds called glycosaminoglycans (GAGs) between these triggered muscle fibers, resulting in a gummy lump called a “myogelosis.”
The good news is that there are now books, charts, online tools, and practitioners that can help track down likely trigger points that may be implicated in your discomfort. I have such a tool in my online pain relief course, Live Pain Free, and I teach many approaches for deactivating trigger points.
The most basic methods involve simple mechanical disruption of this holding pattern. First, drink some water if you’re not well hydrated. Second, you or a friend can methodically feel around (ideally guided by a trigger point chart) for points that are sore, and ideally that reproduce the very sensation you’ve been experiencing. Third, maintain firm pressure on the epicenter of the point (with a finger, elbow, ball, or other tool) for about half a minute, consciously breathing into the area and intending to let it go, until there’s a palpable release. Then move on to all the other nearby points that are tight and tender and do the same.
This approach is called ischemic compression. By compressing the tissue enough to block blood flow, the body responds with reflex vasodilation, meaning it opens these vessels and flushes the tissue with a dramatic increase of blood. This will usually produce a significant improvement in the pain or dysfunction, though it will typically return sooner or later. These points tend to go from being active trigger points to “latent” trigger points, which have a certain “memory” (not the good kind of muscle memory) and are capable of getting reactivated. For this reason, persistence is important. The best results come from working on a trigger point consistently – usually from one to several short sessions per day (or less frequent if the sessions are intense) – and continuing for a while even after everything seems better.
As I said, this is a most basic approach, and while it’s often effective, sometimes a more nuanced intervention is required. There are many techniques that build on compression. We can replace fixed pressure with slow, deep strokes in the direction of the muscle fiber, as if re-lengthening this segment. We can work the trigger point back and forth across the direction of the muscle fibers. We can combine pressure on the trigger point with engagement of the affected muscle or antagonistic muscles. We can combine manual work on trigger points with topical herbs and/or internal herbs and nutrients that improve circulation and reduce inflammation. We can utilize release points on the same acupuncture meridian as where the trigger point occurs - or complementary points on other parts of the body. And more.
If all of this sounds interesting and relevant to you, I encourage you to do a little research. It might well be the end of a problem you thought had no solution. And if you need more guidance, check out my online course, Live Pain Free, where I go deeper into trigger points and much, much more to help people get out of pain of all kinds.
While I said I believe trigger points are the cause of most of our physical pain, I think it’s worth mentioning there are usually even deeper causes, such as stress and withheld emotions, poor body mechanics, dehydration, and an inflammatory diet. Holistically addressing these issues will lead to a more complete resolution of the condition. Always look at the big picture.
Be well,
Dr. Peter Borten
[post_title] => The Science Behind Our Pain: Inquiring Minds Want to Know
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A couple weeks ago, I introduced some concepts on the workings of pain that I think are useful for everyone to know. They’re derived from my explorations into Traditional Chinese Medicine. Here’s a synopsis:
- Virtually all pain is due to stagnation
- Resistance promotes and worsens stagnation
- All levels of our being are interconnected, so
- Stagnation can spread between levels
- Movement on one level can alleviate stagnation on multiple levels
- Relinquishing resistance restores the flow
When I speak of pain here, I don’t just mean physical pain, but also emotional pain and even “existential pain.” Understanding the workings of our pain can be tremendously useful in liberating ourselves from it. Working from this model, our main goal is to get back into a flow state, and there are lots of ways to do this.
First and foremost, when we feel uncomfortable on any level, we can cause an immediate shift by not resisting what we’re feeling. Ultimately this is simply a choice – a choice that’s always available (albeit a choice we usually have to make over and over). However, it’s a choice that sometimes eludes us, so we can employ some methods to facilitate it. Breathing is a good place to start.
When we are in a state of active resistance, this is usually reflected in the state of our breathing, which is restricted. Opening up the breath – breathing deeply and fully into the body and specifically into the area that’s restricted – can help us to feel willingly what’s up and to let go of resistance. Breathing promotes movement and helps to clear stagnation. I cover many different breathing methods in the Live Pain Free course, but the most basic approach is just to lengthen the exhale – that is, emphasizing the letting go phase of the breath. As we do this, we can visualize that the breath is opening and flowing through the body – or a particular region of the body – improving circulation, bringing in fresh blood, and encouraging the removal of waste.
Exercise and stretching are also great for facilitating movement and clearing stagnation for the alleviation of pain of any kind. We can get more out of mobilizing the body if we actively intend that our movement is shaking up, dismantling, and releasing stuck emotions, negative thoughts, and other painful patterns.
Using our voice is another way to promote movement. Whether through toning, singing, chanting, or speaking the truth, both the meaning and the sound vibration we express can have an opening effect on us.
These are just a few of the many ways to restore flow when there is stagnation and thereby alleviate pain. Acceptance, forgiveness of oneself or someone else, letting go, trusting in the process, laughter, loving connections, and spending time admiring beauty such as in nature – all of these tend to have an opening or expansive effect on us that can profoundly affect our experience of pain.
Now, let’s look at a progressive way to understand pain from a scientific lens. A good starting definition is: Pain is the brain or mind telling you it thinks something is wrong. Whether it’s physical pain, emotional pain, or existential pain, there’s an implicit interpretation that this is not how things should be. The pain of depression, for instance, involves an interpretation that, “I shouldn’t feel this way. I should be happy.” The pain of arthritis involves a brain interpretation that a joint shouldn’t be grinding and inflamed the way that it is. In both cases, pain could be seen as an alert that the situation is threatening and requires intervention.
This alert system is more often accurate and useful with acute pain than with chronic pain. For example, you feel burning pain in your fingertips, you move your hand without thinking, and you avoid skin damage from the hot iron you accidentally touched. Chronic pain, on the other hand, is almost always a mistake.
A broader, more technical definition of pain can help us understand why these mistakes occur. Pain is an output – the result of processing in your nervous system – that’s unique to the person that’s experiencing it, and it involves numerous elements – nerves, immune cells, chemical messengers, memory, and emotion – that interact and combine to form a pattern that the brain labels as PAIN. (Thanks to pain researcher Ronald Melzack at McGill University for developing this definition.) This pattern is known as a neurotag or neurosignature and it’s more complex than we tend to think. Pain is as dependent on our psychology as it is on our physiology.
For example, if you were once attacked by a dog and it was frightening and traumatic, something as minor as a dog swiping you with its paw in an attempt to get your attention could be experienced as severely painful because of the elements of memory, emotion, and interpretation. So it’s easy for inaccuracy to enter the pain equation. In this case, there is no danger, nothing wrong that needs to be addressed, but your brain sounds a loud alarm anyway.
Even looking strictly at the biological workings of pain, there is still room for error, though. Acute injuries are usually completely healed within a matter of three to six months at most. The body part can be used normally at that point, so there should be no need for pain after that. However, during the initial event and the healing process, a persistent neurosignature may develop. During all the yelling, crying, and wincing, the nervous system can become sensitized in such a way that the alarm won’t turn off and/or it’s easily retriggered by related images, scents, sounds, thoughts, feelings, and memories.
At this point – and this is true of virtually all chronic pain – it serves no useful purpose. So there’s little value in trying to track down a tissue pathology, and even less in utilizing an addictive mind-numbing pharmaceutical to make it go away. Instead (or in combination with pharmaceutical interventions, if necessary) we can utilize approaches that take advantage of the phenomenon of neuroplasticity – the ability to change our wiring.
We explore many, many such approaches in my online course, Live Pain Free, and I encourage you to check it out if you struggle with pain. The most useful thing, as I discussed in the last installment of this article, may be simply knowing how pain works. I sincerely hope these articles have given you a new way to understand pain that helps liberate you from its grasp.
Be well,
Dr. Peter Borten
[post_title] => Getting Smarter about Pain
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[post_content] => Almost everyone will experience at least one episode of back pain in their life, and many of us will have several bouts or even chronic back pain. While acupuncture, massage, and chiropractic can help, it’s worth having some tools you can use on your own, wherever and whenever the need arises.
I’ve been helping people get out of pain for the past 20+ years, and have discovered many useful strategies for back pain. Today I’ll share five of my favorites.
But first, a little theory. I’ve found that teaching my patients about the mechanisms behind pain often produces an instant reduction in their discomfort. A fundamental principle of Traditional Chinese Medicine (TCM) is that all pain involves some sort of stagnation. Whether it’s stagnant digestion, stagnant blood flow, stagnant lymph, or even stagnant thinking and emotions, stuckness is counter to wellness. Good health, on the other hand, always entails flow – a free-flowing adaptability to challenges, free movement of blood, other fluids, muscles, tendons, and joints, and freely feeling and moving through thoughts and emotions. So everything I recommend below entails opening up stagnation and restoring free movement again.
1. Keep Moving Your Body. After an injury, we’re often told to rest (which has some value), but total immobility usually slows down the recovery process. In nearly all pain, there is muscular tightness and restricted circulation. This stagnation is even more obvious in the case of swelling (e.g., a sprained ankle), where lymph has pooled in the area and gets stuck there. Safely moving the affected area promotes clearing of pooled lymph, elimination of cellular waste and debris, an influx of fresh blood – and a reduction of pain.
In biomedical terms, pain is an alarm that’s trying to warn us of danger or injury – like the pain that arises when you touch a hot pan. But it’s not an infallible system. It can be trained (or mis-trained) to give us a strong pain signal even when we’re not in danger. It can also get “stuck in the ON position” – not turning off the pain even though we’ve resolved whatever the issue was.
Experimenting with ways to safely move the painful part of your body without causing pain is a useful means of retraining the nervous system to deactivate the alarm and lower its sensitivity.
Also, it’s always a good idea to move around frequently throughout your day, since a sedentary lifestyle – and the postural stress it causes – is a major contributor to back pain.
2. Heat + Topical Herbs. Another way to promote circulation and alleviate pain – and especially useful when movement is restricted or not possible – is through the application of heat and circulation-enhancing herbs. Heat application promotes dilation (opening) of blood vessels. It doesn’t have the numbing effect that cold can, but in the long run it’s a more useful treatment.
It’s especially effective when applied in combination with external herbs or essential oils of plants that also enhance circulation. Many of these can be found in our
Muscle Melt products. Some of the most popular are peppermint (or its most active constituent, menthol), eucalyptus, cinnamon, fresh ginger, and capsaicin (chili pepper).
It’s always a good idea when using a heating device to check frequently to make sure you’re not burning yourself, since sensitivity to heat may be impaired due to the pain, pain medications, and/or the external herbs.
3. Stretches + Hydration. Dehydration often plays a role in pain. The suppleness of our tissues and the free flow of – well, everything in the body – depends on water. Especially if you combine dried out muscles with a sedentary lifestyle or exertion without first warming up, you’ve got a recipe for pain. I like to have patients combine hydration with stretching, to help get the water into the affected tissues. There are lots of stretches that can help, depending on the particular nature of your back pain. These are six that tend to be the most helpful.
a. Cat-Cow. On your hands and knees, slowing alternate back and forth between a fully rounded spine and a fully arched spine. Taking a five seconds to move from one position to the other. Repeat ten times.
b. Cobra. Lying face down on the floor, place your hands palm-down under your shoulders and slowly arch your back. Hold, then slowly release back to the floor. Repeat ten times. You’re primarily using your back muscles to lift yourself, with the hands just there for stability. You don’t need to strive for a big stretch here – just enough muscle engagement to warm up the lower back without causing any pain.
c. Child’s Pose. Kneel on the floor, touch your big toes together, sit on your heels, spread your knees as wide as your hips, then lay your torso down between your thighs. Rest your arms at your sides, palms up. You can lie in this position for as long as it feels good. Breathe slowly and deeply.
d. Lying Side Twists. Lie on your back with legs extended. Bring one knee up toward your chest, then take it across your body, aiming past the opposite hip. Your knee may or may not rest on the floor. Hold for ten seconds, then come back to center and repeat. You can also try placing the knee higher and lower to direct the stretch to different parts of your back. Generally, with a high knee (even with the opposite hip, for instance) you’ll target the lowest part of the lumbar spine. With a lower knee (even with the opposite knee, for instance), you’ll target more of the upper lumbar region and lower midback.
e. Lying Glute Stretch. Lying on your back with your knees bent and your feet flat on the floor, cross your left ankle over your right knee. Then interlace your fingers to grasp your right knee (either inside the bend of the knee, holding onto the hamstrings, or – even better – grasping over the front of the knee) and pull the knee toward you. You may need to use your left elbow to press against your left knee to push it away and intensify the stretch. Make sure your left foot is extended (dorsiflexed) toward the left knee. Hold for 30 to 60 seconds, then switch sides.
f. Hamstring Wall Stretch. Lie on the floor near a flat wall. Scoot your butt as close to the wall as you can get it. Gently raise your legs and place them with unbent knees flat against the wall (scoot your butt a little bit more forward if you need to). Tight hamstrings often contribute to a tight lower back and this hamstring stretch tends to be easy on the lower back. Rest in this position for 30 to 60 seconds.
4. Breathe Through It. In TCM, our vital energy – Qi – is considered to be circulated by the breath. That is, breathing moves energy. It’s part of why we sigh when we’re stressed – or relieved. Intentionally breathing “through” a painful area can often quickly reduce pain. Imagine that you’re drawing your inhale through your back, and then exhaling the pain out through your back.
Meanwhile, practice non-resistance. Don’t fight the pain. Just for this moment, allow it to be here, stop struggling against it, and stop telling yourself something is “wrong.” In fact, see if you can even invite the pain to just be here. And breathe.
5. Visualize Movement. There are many useful visualization practices for alleviating pain. A basic place to start is to imagine movement happening in the painful part of your back. Visualize blood coursing through the area, see energy or light moving in and out of your back, “watch” your cells shutting down the inflammation, making repairs, and soothing irritated tissues. Inhale white, healing light, and exhale dark, stagnant pain out of the area. Find a visualization that works for you. I sincerely hope these techniques work for you and that very soon you’re pain free and getting back to what you love.
Be well,
Dr. Peter Borten
P.S. If you’re looking for more support for living pain free, we invite you to join us for an online mini-course my wife, Briana, and I are leading on how to give a relaxing, pain-relieving massage. Briana and I have over 40 years of combined professional experience giving massage and training teams of massage therapists. Massage has so many benefits: It relieves tight and painful muscles and joints. It measurably decreases stress. It strengthens immune function. It improves sleep quality. It promotes better circulation. It reduces fatigue and improves mood. And it facilitates faster recovery from injury and surgery. We should all be taking advantage of it! Since that's not possible due to the pandemic, why not learn how to give each other massages at home?
Unlike massage trainings for people starting a new career, this course is geared toward non-professionals who want to learn the fundamentals of good massage - even if you don't have a massage table or other special equipment. We'll teach you the most effective ways to release tight muscles and promote stress relief. We'll share ways to use your body so that you can work deeper and for longer without getting tired or sore. And we'll explain some things we wish were taught in massage schools that make for a better overall experience for both the giver and receiver.
Learning massage skills is a gift that will provide a lifetime of connection, relaxation, and effective pain relief. If you’ve ever thought, “I’d love to massage my partner, but my hands hurt and I can’t do it for more than a few minutes,” or, “I want to give a good massage but I just don't know what I'm doing”, this is exactly the course you need to gain confidence in your ability to provide a great therapeutic massage. Join us live to have your specific massage questions addressed.
And if you’d like to learn a bunch more about managing your own pain – including both Eastern and Western approaches, psychological tools, special acupressure points, guided meditations, pain relieving herbs, and altogether the most comprehensive course in the world for getting out of pain (I made that up but it’s probably true!), check out Live Pain Free. We’ve gotten only rave reviews from users.
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A couple weeks ago, I wrote about the differences between acupuncture and “dry needling” to alleviate pain, and in that article I explained a bit about the phenomenon of myofascial trigger points. After I said I believe these are the cause of most of the physical pain humans experience, a number of readers asked me to explain more. For the science lovers out there, I’m going to dive deeper this week.
Besides the most common forms of pain, like lower back and headaches, I’ve had patients with digestive problems, sinus congestion, chest pain, ear ringing, numb hands, painful intercourse, acid reflux, vision changes, and other health issues that were eventually discovered to be due to myofascial trigger points. I believe everyone should know about them and how they work – it could save us a lot of time and worry.
Basically, a trigger point is a small, irritable region in a muscle (or the surrounding connective tissue – “fascia”) that stays stuck in a contracted state, making the muscle fibers taut. This can cause reduced muscle strength and range of motion, pain, numbness, itching, and other forms of dysfunction. Sometimes a trigger point feels like a palpable nodule or “knot,” but to untrained fingers they’re often tricky to find.
A unique property of trigger points is that they’re able to produce symptoms in other parts of the body – from a few inches to a couple feet away. For instance, there’s a trigger point that can form in the soleus muscle of the calf that’s capable of producing pain in the lower back. For this reason, the work of Janet Travell, MD and her colleague David Simons, MD, was groundbreaking. For each muscle in the body, they mapped where trigger points tend to form and what kinds of symptoms they cause.
If you were experiencing pain along the outside of your leg, you might assume that something was wrong with that part of your leg, perhaps with the often-tight iliotibial band (IT band). But this diagram might be helpful. The X’s show where trigger points can occur in a muscle called gluteus minimus above the hip socket. The red shading shows the potential areas of pain that can result. You might not suspect this muscle because, as you can see, there’s no pain at the site of the problem!
There are a handful of mechanisms that can promote trigger point formation, such as irritation of nerves, chronic organ problems, nutritional deficiencies, and autoimmune disorders. Most often, though, the cause is trauma to our connective tissue. When a muscle is strained by being worked too hard, too fast, or beyond its natural range, there is frequently a sort of “recoil” that occurs as segments of the muscle fibers bunch up and remain that way.
This is especially common when someone works out without warming up; when someone does a very ambitious workout after not having exercised for a long time; when someone makes a sudden movement (like reaching out to catch something or trying to stop oneself from falling); and especially when someone does any of the above when in a state of diminished resilience (e.g, when stressed, upset, sleep deprived, eating poorly, etc.).
Even more commonly, the trauma is a form of “postural stress” that’s demanding on muscles in a way that’s difficult to perceive at the time – such as doing the same relatively motionless activity (like sitting at a desk or driving) for hours, days, months, or years. One possible mechanism is known as the “Cinderella hypothesis.” During static muscle exertion – holding a position for a long time, as dentists, musicians, typists, and others engaged in precision handwork do – the body tends to engage a certain group of small muscle fibers, called Cinderella fibers because they’re put to work first and are the last to be disengaged. Even though they’re not doing heavy lifting, these muscle fibers (often in the neck, shoulders, back, and forearms) are continually activated and overworked, which makes them susceptible to trigger point formation.
Whatever the cause, the result is that eventually the muscle never completely relaxes. Muscles are composed of numerous parallel fibers that work together to shorten (contraction of the muscle) and lengthen (the return of the muscle to its relaxed state). Within each of these fibers are many end-to-end contractile units called sarcomeres, and in the case of a trigger point, a group of sarcomeres gets “stuck” in a shortened state. This makes the affected fibers taut and often “stringy” feeling.
To make matters worse, the contracted region clamps down on tiny blood vessels causing local ischemia (inadequate blood supply), reducing in-flow of fresh, oxygenated blood and out-flow of toxins. This leads to a localized hypoxic state (not enough oxygen). The tissue pH changes, local metabolism is impaired, and fluid and waste products tend to build up in the area. This combination of factors ultimately activates pain receptors – it starts to hurt – and when this happens you use the affected muscle less.
Instead, you overload “synergists” – nearby helper muscles. The body makes the surrounding musculature tense as a protective mechanism. Meanwhile, there’s a disruption of the balance between the affected muscles and their “antagonists” – those muscles that lengthen when the primary muscles shorten and vice-versa (for example, the triceps is an antagonist of the biceps). Altogether, this restricts natural movement of the original muscle, which just perpetuates the imbalance. Finally, with longstanding trigger points, the body may deposit gooey lubricant compounds called glycosaminoglycans (GAGs) between these triggered muscle fibers, resulting in a gummy lump called a “myogelosis.”
The good news is that there are now books, charts, online tools, and practitioners that can help track down likely trigger points that may be implicated in your discomfort. I have such a tool in my online pain relief course, Live Pain Free, and I teach many approaches for deactivating trigger points.
The most basic methods involve simple mechanical disruption of this holding pattern. First, drink some water if you’re not well hydrated. Second, you or a friend can methodically feel around (ideally guided by a trigger point chart) for points that are sore, and ideally that reproduce the very sensation you’ve been experiencing. Third, maintain firm pressure on the epicenter of the point (with a finger, elbow, ball, or other tool) for about half a minute, consciously breathing into the area and intending to let it go, until there’s a palpable release. Then move on to all the other nearby points that are tight and tender and do the same.
This approach is called ischemic compression. By compressing the tissue enough to block blood flow, the body responds with reflex vasodilation, meaning it opens these vessels and flushes the tissue with a dramatic increase of blood. This will usually produce a significant improvement in the pain or dysfunction, though it will typically return sooner or later. These points tend to go from being active trigger points to “latent” trigger points, which have a certain “memory” (not the good kind of muscle memory) and are capable of getting reactivated. For this reason, persistence is important. The best results come from working on a trigger point consistently – usually from one to several short sessions per day (or less frequent if the sessions are intense) – and continuing for a while even after everything seems better.
As I said, this is a most basic approach, and while it’s often effective, sometimes a more nuanced intervention is required. There are many techniques that build on compression. We can replace fixed pressure with slow, deep strokes in the direction of the muscle fiber, as if re-lengthening this segment. We can work the trigger point back and forth across the direction of the muscle fibers. We can combine pressure on the trigger point with engagement of the affected muscle or antagonistic muscles. We can combine manual work on trigger points with topical herbs and/or internal herbs and nutrients that improve circulation and reduce inflammation. We can utilize release points on the same acupuncture meridian as where the trigger point occurs - or complementary points on other parts of the body. And more.
If all of this sounds interesting and relevant to you, I encourage you to do a little research. It might well be the end of a problem you thought had no solution. And if you need more guidance, check out my online course, Live Pain Free, where I go deeper into trigger points and much, much more to help people get out of pain of all kinds.
While I said I believe trigger points are the cause of most of our physical pain, I think it’s worth mentioning there are usually even deeper causes, such as stress and withheld emotions, poor body mechanics, dehydration, and an inflammatory diet. Holistically addressing these issues will lead to a more complete resolution of the condition. Always look at the big picture.
Be well,
Dr. Peter Borten
[post_title] => The Science Behind Our Pain: Inquiring Minds Want to Know
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[post_modified] => 2022-06-27 03:51:11
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