So. We've been talking a lot about latent trigger points, and how they can fire constant nociception into the nervous system, causing chronic pain.
(By the way, if you happened to miss my most recent article about this, you can read it here.)
But what about active trigger points?
Many therapists and non-bodyworking-professionals know something about "trigger points." As in—a trigger point = a 'knot' in a muscle, that sends pain somewhere else.
There are some typical examples that are often used, such as the forearm muscles causing wrist pain or the high trap causing certain kinds of headaches.
This understanding isn't WRONG, per se—but it's too narrow, too zeroed in.
Active trigger points make it seem like you've found "The Problem." You press on the trigger point; the pain subsides. Ta-da!
The problem is that this is the extent of how most therapists understand and treat of trigger points.
But it's only the tip of the iceberg.
An active trigger point is often a symptom of a deeper issue. Sometimes treating it is all that's necessary, but most of the time the situation is more complex.
Trigger Point Therapy 1.0
When I first discovered the maps of pain referral created by Travell & Simons, and the original Trigger Point Workbook by Clair Davies, I was THRILLED.
In my burgeoning Thai massage practice, I was seeing more and more people with serious pain issues—issues that were really wreaking havoc in their lives— and I wanted very much to help them.
So, based on the new knowledge I'd gleaned from these resources, I began to look for the (active) trigger points that were causing my clients pain.
Sometimes, it worked! Like magic.
But most of the time the pain would either not change very much, or return— even when I was sure I'd found the problem.
Honestly, it was pretty discouraging.
It took me another few years to put this together, but the approach I was using was missing a crucial factor. Here's why...
Clair Davies' system at that time was very much focused on the idea of direct referral—finding the muscle responsible for the pain and treating it with some cross-fiber strokes.
It was basically a massage approach to treating trigger points, and it didn't involve changing the length of the muscles, or moving them through ROM.
Trigger Points, Meet Thai Massage
My background was in Thai massage, so I was naturally more inclined to use more integrative techniques and movement in my work.
At that time, I was just trying to integrate my previous training with this new information about trigger points. In short, I was goofing around—trying stuff, just to see what would happen.
(In a very clinical, professional way, of course. 😉)
What I didn't know then, but would grow to understand over the next several years, was that the principles of traditional Thai massage—movement, distraction, and working with a system vs. pieces in isolation—were the exact things that were missing from Trigger Point Therapy 1.0.
Ironically, though, my Thai training didn't equip me with a granular understanding of what these techniques were actually doing to the muscles themselves. I couldn't see how a given muscle changed in response to treatment.
This just isn't part of traditional Thai medicine. Basically, I had to teach myself functional anatomy. As one does.
It took me many years of research, documentation, and clinical practice to fully understand how and why the Thai techniques I'd learned could be applied to the principles of trigger point therapy.
As my practice and teaching evolved, I realized that all those direct referral charts created an oversimplified understanding of trigger points. There's so much more to treating pain than finding the active trigger point, pressing on it, and moving on.
There's so much more to it—and if you're not aware of the big old pain iceberg underneath the surface, you won't be successful in treating it.
And because most bodyworkers have been only been taught about the part above the surface, they think things like "Trigger point therapy doesn't work," and "I already learned that in school!" and "I must be in the wrong profession, because I'm doing all this stuff I was taught, and all my clients are STILL in pain."
Updating The Model: Trigger Point Therapy 2.0
I have infinite respect for what Travell & Simons accomplished. They just didn't have time left in their careers to effectively adapt their ideas to a manual therapy paradigm. (They were mostly working with physicians at the time.)
(Incidentally, they did discover the idea of satellite referral; it just wasn't very fully developed. And some of the more recent ideas in neuroscience regarding pain wouldn't appear for several decades.)
Based on what I'd learned so far, I knew I had to shift my focus away from the "symptom" muscle, and look at networks and systems of muscles instead.
It took me a long time to map out all different functional relationships between muscles, and an even longer time to develop reliable treatment protocols to address them.
But... I did it!
My Coaching The Body™ approach was designed to enhance the basic ideas of trigger point therapy with a more systematic analysis, based on our current understanding of pain and neuroplasticity.
And you can learn it...
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How You Can Become A Pain Hacker
After developing these concepts for the last 15 years, we have a much better understanding of the hidden networks that set up direct referral.
Referring muscles are usually the end of a chain. Fortunately, there are highly predictable patterns that tend to set up most pain (the other links in the chain), and we've documented those patterns for the most common pain conditions.
My goal is to help practitioners who are struggling to treat their clients' pain become what we call pain hackers.
A pain hacker is someone who understands that trigger point therapy isn't an esoteric bullet point or a pointless sideline— it's a highly effective way to resolve pain and limitation in most of your clinical cases.
IF you understand and apply the 'Trigger Point Therapy 2.0' model.
I want as many people as possible to benefit from all that research I did, so we're trying to make it easy for you...
Here are some of your options if you would like to learn more:
- In person study - Our program is built around weekend workshops, and we have some excellent entry level classes coming up. Functional Anatomy is one of the best, as is Level 1: Thai Bodywork Fundamentals. Both are offered several times per year.
- Online learning - We offer many standalone online courses, including specialized workshops for specific areas of the body. There is also an intensive online study program, our CTB Membership.
Dive deep into Coaching The Body™ from the comfort of your home!
See some actual treatment examples and learn about the CTB Yearly Membership in my FREE webinar on How To Treat Pain Using Coaching The Body™.