When the client sits down and talks about their pain, they are telling me why they’re paying to be there. Nothing connects me to the specific spot, in the specific muscle, like trigger points assessment. The course of action might vary, based on many factors but NMT assessment pinpoints the spot that I need to resolve by the end of the session.
Pain in the shoulder while brushing teeth? Supraspinatis. Pain in the shoulder with weakness in grip? Infraspinatus. Pain in the shoulder when the arm is extended out to the side? Deltoid. I love this game and can play it all day. Better yet, I actually do play it all day, it makes people very happy and I get paid for it. Nah-nah-nah-nah-NAH-nah. I digress.
Let’s look at an example.
Pain on the inside of the knee. There are 4 muscle that refer pain on the inside of the knee. Sartorius, Medial head of Gastrocnemius, medial hamstring and Vastus medialis. How do we sort it out? We look at more detailed assessment. If you’re a therapist and would like to see more about that look at this brief paper on hamstrings.
But what if it is something that is very involved?
How do we figure out if that trigger point is activated by something very involved, like a torn meniscus? More detailed assessment. But this post is not about that. This is about figuring out the starting (trigger) point. Sometimes, we just need the starting point to begin the journey. Here’s a post about a seizing hamstring. It points us back to the gluteus minimus for trigger point work. This trigger point in the gluteus minimus is predicated on a displaced sacroiliac joint. That displaced sacroiliac joint is perpetuated by restrictions in the atlas and occipitomastoid suture. I want to deal with the underlying causes but if I want to take down the Godfather of Organized Pain, I need to start by putting out fires and looking at the clues that lead me back to him.
Even in a very complicated case like the Client Who Recovered From ALS, the assessment started with evaluating trigger point activity. Weak grip? Okay, I know the trigger points that create that problem. Let’s temporarily disable the trigger points that weaken grip with a stroke of ice. Oh, that improved the grip. we have a starting point. Now, let’s track down the perpetuating causes.
I love this game. It is not as complicated as all the levels of Warcraft or the rules of social media BUT it is pretty darn rewarding to watch those people get off the table in pain.
Tony Preston has a practice in Atlanta, Georgia where he sees clients.
He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.