Triggerpoint deactivation,

  • Introducing the presenter
  • Content New Zealand Course
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  • Why is knowledge about TPs important for your daily work?

    Let's start with looking at two practical examples.
    Say that you have a client with thumb pain due to keyboard use.
    What factors would you look at ?
    Position of thumb during work?
    Overuse of thumb out side work?
    The way the thumb is used on the spacebar, breaks, micropasues, posture, task variation, etc,?

    Now say that you had knowledge of this triggerpoint:

    Now all of a sudden neck position, frequent or sustained neck rotation, breathing technique and stress could be the main factors!

    This is just one of many examples!

    Strength loss
    Few therapists realise that de-activating triggerpoints does not only restore length, it also restores strength.
    I did the following outcome measurements on a group of our clients with elbow/ 4-arm/ wrist complaints. These clients were not given any strengthening exercises!

    Injury Start End
    Lateral Epicondylitis 9.1 20.6
    Medial Epicondylitis 38.3 48.3
    Lateral Epicondylitis 20.6 20
    Elbow/Forearm sprain 19 26
    Lateral Epicondylitis 36 44
    Fibromyalgia 7 21
    Wrist injury 14 26.6
    Lateral Epicondylitis 17.5 24.3
    Tennis elbow 18.6 38.6
    Total average 20 30

    Why is knowledge of TP deactivation important for our profession?
    When the soft tissue injury shoulder guidelines were introduced by ACC, they were presented in Christchurch by orthopaedic surgeon Mr. Khalid Mohammed. The guidelines list the extrinsic causes of shoulder pain. Mr Mohammed stated that in his opinion myofascial pain is the most prevalent extrinsic cause.
    In January 2006, the Musculoskeletal Medicine Doctors organised a course on core stability. This was presented by Dr Pavel Kolar. Dr Kolar regards de-activation of triggerpoints as an essential part of his treatments. The Kinetic control people (again core stability) also use triggerpoint de-activation as a way to achieve muscle lengthening.
    In the spring of 2005, the Canterbury Physiotherapy Branch organised a seminar. Several speakers mentioned Triggerpoint De-activation as one of their chosen strategies to reach treatment goals.
    It appears that triggerpoint de-activation is becoming more and more mainstream. South Africa is one nation where thorough knowledge of triggerpoints is a requirement to obtain a diploma in physiotherapy. in NZ TP de-activation seems a basic part of the knowledge of Musculo Skeletal Medicine doctors and massage therapists. As a profession, are we staying behind?