What You Will Find in the Treatment Manual
The manual features 257 pages with over 100 full-scale images covering the entire musculoskeletal system. On this page, we present two sample treatments, each with detailed images illustrating trigger point locations. These samples provide suggested techniques and tools for effective treatment. Whether you are a practitioner seeking to enhance your therapeutic approach or an individual looking to manage your pain, this guide will equip you with the knowledge and methods to alleviate discomfort and improve your quality of life.
Explanation of Trigger Point Treatment Images:
Each image displays the trigger point (TrP) area related to the referred pain location. The TrP is marked with a corresponding number overlaid on a color, indicating the approximate pain location. For example, in Figure 1, trigger points are numbered 1 to 4. The first TrP is red, indicating possible discomfort or pain shown in red on the opposite image. The #4 TrP is blue, with discomfort typically located closer to behind the ear, while the red TrP can cause discomfort anywhere from the corner of the mouth, over the eye, or into the temple.
At the bottom of each image, icons represent suggested techniques for the TrP area shown. Depending on the muscle area, a selection from the 20 available techniques will be recommended.
Additionally, each image provides the general purpose of the involved muscle, a description of the possible pain experienced, and a list of other muscles that may be involved due to similar referred pain patterns.
The technique setups are described in greater detail within the manual.
Temporalis muscle
Movements/Purpose:
The Temporalis muscle is essential for chewing and closing the jaw, by contracting and relaxing. It generates bite force, aids in chewing, and stabilizes the temporomandibular joint (TMJ) for proper jaw movement.
Additionally, it also contributes to the proper alignment and positioning of the jaw during speech and other activities involving the mouth.
Pain and/or discomfort experience:
Inflammation within the temporalis tendon can lead to various symptoms and discomfort. When the temporalis tendon becomes inflamed or irritated, it can contribute to temporomandibular joint (TMJ) issues. This can cause pain and difficulty in opening and closing the jaw properly.
The pain associated with inflammation in the temporalis tendon may radiate to the front and side of the head, as well as the upper teeth and gums. This can sometimes result in sensitivity to hot or cold temperatures. In cases where biting down or chewing exacerbates the pain, it is possible that TrPs in the temporalis or masseter muscles are involved. (D. T. Simons)
Other possible contributing muscles: Masseter
Possible causes: Direct trauma, tooth clenching, grinding, nail-biting, prolonged mouth opening, or muscle strain.
1st set-up (Hand bar) (Tender area)
Apply pressure with your hand over the entire muscle and feel for any tender areas. You will need to get conductive gel in the hair, cover the tender spots thoroughly. With your client holding the hand bar, you can pull back their hair with your gloved hand to access the trigger points (TrPs) easily. Keep the (AP) pen probe in constant contact with the tissue and stroke lightly with the tip.
2nd set-up (Active probe)
Create satellite points in the referred pain areas illustrated and place the (SN) pen probe there. Stroke the temporalis muscle lightly with the (AP) pen probe.
3rd set-up (Balance) follow the Balance technique. Test the other temporalis muscle, and if it’s tender in any way, it’s advisable to treat it as well.
Piriformis muscle
Movements/Purpose:
The Piriformis muscle is deep to the Gluteus maximus muscle and rotates the femur during the hip extension and abducts the femur during hip flexion. The abduction of the femur is critical during walking as it shifts the bodyweight to the opposite side for balance. (Chang C)
Pain and/or discomfort experience: The Piriformis muscle is usually involved in any buttocks issue and is more common in women. Pain is generally felt at the base of the spine, buttocks, and hips. Sitting and walking can be painful, and a person usually squirms in their seat. (Clair Davis)
The sciatic nerve lies between the piriformis and rotator muscles. When trigger points (TrPs) cause the piriformis muscle to shorten and inflame, it can compress the sciatic nerve, resulting in discomfort. This condition, known as Piriformis Syndrome, typically presents as pain originating in the buttocks and extending down the back of the thigh. Pain intensity often heightens above the knee, and if the sciatic nerve is compressed, it may continue down the lower leg and into the foot.
Other possible contributing muscles: The lower hip rotator muscles also can develop TrPs and refer pain to the same area.
Possible causes: Quick changes in direction in sports activities and work that involves twisting and lifting can also damage this muscle. Idleness and too much sitting can also negatively affect the Piriformis. (Simons, Travell and Simons)
1st set-up (Circle the TrP) Using Active duel probes and Hand bar. Start by palpating the muscle area to find any trigger points (TrPs). Establish satellite points around the TrP for the (SN) pen probe.
Tip: If you find two TrPs on the same muscle, you can treat both at the same time with the Active dual technique.
Tip: Consider utilizing the hand bar technique with a gloved hand to gently compress the tissue, if required, to enhance ease and comfort for the client during treatment.
Apply short, deep, firm strokes using the (AP) pen probe, while being mindful of the client’s tolerance. Adjust pressure as necessary to ensure client comfort.
Note: It’s common for minor bruising and tenderness to occur for a couple of days after treatment. The tenderness is typically only noticeable when pressure is applied directly to the area, and you shouldn’t experience any discomfort during normal activities.
2nd set-up (Electro-pads) Please consult the Electro-pads section in Treatment Techniques & Tools for more information. Follow the general instructions in the 1st set-up.
With the Electro-pads you will place a set on the TrP and satellite point on one buttock and another set on the opposite buttock, if your device can work with multiple pairs of pads at once, also include one behind the knee at the popliteal fossa.
3rd set-up (Balance) It’s recommended to treat the second piriformis muscle on the opposite side, even if there’s no immediate discomfort. This helps address any potential latent trigger point issues on the other side, promoting muscle symmetry and reducing the risk of developing additional problems.
4th set-up (Foot plate) If you are experiencing pain down the leg, consider directing energy down the leg, by placing the foot on the conductive gel prepped foot plate.
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