Manual Trigger Point therapy: The General Trigger Point Therapy
Manual Trigger Point therapy is a manual technique to treat trigger points. It uses strong manual pressure and can be uncomfortable or somewhat painful for the patient. However, as with Dry Needling, this pain is usually regarded as a "good and releasing pain". A distinction is made between the different Manual Trigger Point Therapy techniques that directly treat the trigger point and the fascia techniques, which affect a larger area on the whole muscle and its fascia.
History of the Manual Trigger Point Therapy
Janet Travell had introduced the concept of myofascial trigger points in the early 1940s. Various manual therapy methods to treat trigger points have since been developed such the Ischemic Compression, the Myofascial Release, the Post Isometric Relaxation and others. Classical massage has always treated trigger points, without, however, the use of the trigger point nomenclature and probably also less systematically. Corresponding documents date back to the 15th century. Dr. Ida Rolf (1896 – 1979) is one of the first scientists to study the characteristics of the human connective tissue and developed the Rolfing technique, which has become the basis for Manual Trigger Point Therapy.
The Manual Trigger Point therapy that we teach, was developed in the early 1980s by the Swiss physician Dr. Beat Dejung. Inspired by the work of Ida Rolf (1896 - 1979) and Simons and Travell’s concept of trigger point therapy, Dejung developed together with a group of physiotherapists, a systematic Manual Trigger Point Therapy. It is also known as "The Swiss Approach to Trigger Point Therapy". The Manual Trigger Point Therapy treats trigger points as well as the connective tissue and the fascia.
The Techniques of the Manual Trigger Point Therapy
There are several trigger point techniques. Some techniques focus directly on the trigger point and taut band, while others are fascial release techniques, which affect a larger area of the muscle and its fascia. They don't only focus on trigger points. Each technique is numbered from I to VI. The trigger point techniques (I and II) and the inter-muscular mobilization (IV) include a strong manual pressure. This is why Trigger Point therapy is often uncomfortable or somewhat painful. It's important to follow the principle that the pain should be tolerable for the patient and, if possible, reported as "good pain". The more accurately the trigger point is treated, the less pressure has to be applied. Relevant contraindications have to be excluded and patients should be informed about the possible side effects. The trigger point compression technique (technique I) may be combined with simultaneous passive or active change in muscle length in order to optimize the effect. The fascia technique (III) should be painless. The decision to treat a certain trigger point with Dry Needling, Manual Trigger Point Therapy or a combination of the two techniques, is made by the therapist and the patient. We also provide valuable knowledge on these topics in our courses.
Trigger Point Techniques
- Technique I: local compression of a trigger point
- Technique II: local manual stretching along the taut band where multiple trigger points are located, as well as adjacent parts of the taut band.
Fascia Release Techniques
- Technique III: broad manual release of the connective tissue and fascia around the trigger point
- Technique IV: manual release of the connective tissue and fascia between two muscles (intramuscular mobilization)