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Why is knowledge about T.P's important for your daily work?.
Let's start with looking at 2 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!
GRIP STRENGTH IN KG (JAMAR)
| 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 T.P deactivation
important for our profession?
When the soft tissue injury shoulder guidlines were introduced by ACC, they were presented in
Christchurch by orthopaedic surgeon Mr. Khalid Mohammed.
The guidlines list the extrinsic causes of shoulder pain. Mr. Mohammed stated that to 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 N.Z.
T.P de-activation seems a basic part of the knowledge of Musculo Skeletal Medicin doctors and massage therapists.
As a profession, are we staying behind?
Click here for information about the tutor and endorsements by Prof D. Simons,
Author of "The triggerpoint manual" and Endorsement by Steve Bentley For the New Zealand Musculosceletal Medicine Doctors
Click here for Pre course reading requirements and course content
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