Tag Archives: trigger point

Dry Needling

Dry needling session on the patient's back

Myofascial Dry Needling (MDN) treats sore muscles and trigger points. How does Dry Needling work? As discussed in another blog post, muscles are made of many individual fibres. As the fibre contract and stretches, this does give the muscle the ability to have strength and elasticity. Along with repetitive movements and lack of posture, the muscle fibres can accumulate tension that we generally call knots. Those “knots” are also known as trigger points. This is one of the many theories behind the formation of trigger points. Said so, a trigger point is a terminology used to describe a painful spot. And still, nowadays, there is no exact explanation for how trigger point forms and what exactly they are. But what we know for sure is that not everyone develops trigger points in the same spot. Now, to release the tension out of the trigger points, we can either apply external pressure, with the thumb or the elbow, in case of a Remedial Massage or even the knee or the heel of the foot with a Thai Massage, or we can break the fibres from within by using a needle. What a needle is like? The needles used in this practice have a diameter from 0.15 to 0.25mm, so really thin needles. Whereas the length can vary from 15mm to 90mm. Depending on the target muscle, the length of the needle is different. So, as we penetrate the muscle with the needle, we brake the fibre, and we recall an inflammatory response from the patient’s immune system. Which drives more blood and nutrients to the target area. As discussed further in this study published on PubMed, Dry Needling is effective for chronic non-specific neck pain 1. Is dry needling safe? Yes, it is, as long as the practitioner offering the service is qualified for it, and well knows the anatomy of the muscles. Said so, when you receive dry needling, there are a few things that you may want to consider. Firstly you better not have any metal allergy. Also, Dry Needling is not recommended if you have just done any strong physical activity or training, as the muscles would be in an acute inflammatory stage. In addition to this, other contraindications are: If the patient is on a blood thinner Diabetes type 1 The area is affected by Lymphedema The patient is unable to give the consent The patient would not be able to stay still as the needle is in the body Book now, your next Myotherapy session at Melbourne Massage and Treatment, Fitzroy North Clinic. How long the needle stays in the body? Depending on the area needing treatment, the needle may stay in the body for 3 to 10 minutes. And always based on the target muscle that needs to be treated would also depend on the type of treatment. Indeed, the needle could be placed in the muscle and left there to sit and create the physiological response needed, or it could even be partially extracted, moved around and placed back. This type of technique is called “peppering”. Peppering along a dry needling session allows the therapist to target other fibres around the muscle fibre area.     1. Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I, Perez-Muñoz M, Mayoral-Del-Moral O, Lluch-Girbés E, Prieto-Valiente L, Falla D. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain. 2016 Sep;157(9):1905-1917. DOI: 10.1097/j.pain.0000000000000591. PMID: 27537209.  

Muscle Firing Pattern

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Muscle Firing pattern Muscle firing pattern is the sequence in which muscle should get activated to complete an action or movement. Whenever we move a joint, is not just 1 muscle to do that action there are multiple numbers of muscles that allow the action to happen, and other multiple numbers of muscles counterbalance that action. So, the muscles that control the action are called agonist muscles and the antagonist are the muscles that counterbalance that action. The antagonists are usually the muscles that do the opposite action to the one played. Said so we have also to introduce another term, that in the massage industry is known as synergetic muscles. Synergetic muscles work together to make allow a joint to complete an action. But let’s look into an example. Leg extension firing pattern. Leg extension is controlled by the synergetic muscle: gluteus max (GM) hamstring (HM erectors spine (Esp o) (opposite side of the leg) erectors spine (Esp s) (same side of the leg) The antagonist in the leg extensions are the Quadriceps. So, let’s focus on the agonist of this action for now. If the GM is weak or inactive, when we go for leg extension the Hm gets overpowered. As the Hm gets overpowered the ES starts firing too early to stabilize the pelvis abandoned from the weakness of the gluteus. Moving forward with this unbalance, the ES on the same side could end up to start being the first muscle that gets fired for doing the action of leg extension when it should be the last one. And this could happen because the Esp o is holding the body still to get the action done. Lower back pain or hamstring tear can be often a consequence of these unbalances. Lower back pain can happen when the firing pattern is like: 1st Erectos Spine (opposite or same side) 2nd Hamstring 3rd Gluteus Max (because if weak or inactive) Hamstring tear can happen when the firing pattern is like: 1st) Hamstring 2nd) Eroctos Spine (opposite or same side) 3rd) Gluteus Max (because if weak or inactive) But nothing is lost, and the firing pattern can be reorganised. For doing that we have to look into exercises for firing pattern reestablishment. For the leg extension, for example, the exercises would be: Lying in a prone position (face down) Tugged the toes under the feet Squeeze the gluteus one against the other With the gluteus, squeeze and extend the knee Still with the gluteus squeezed to release the knee The final step, release the gluteus. Repeat 30 times for 6 weeks every day. To don’t fall back into an incorrect firing pattern, make sure to strengthen the gluteus. Massage would help to release the trigger point in the GM. Thanks to the release of trigger points the muscle can start to be trained to get stronger. Are you struggling with pain and or body ache? Book now your next massage appointment, at Melbourne Massage and Treatment. Also, massage can help in fastening the process of firing pattern reestablishment, by reducing tension in the hamstring and or reducing pain in the lower back by flashing out the tensions that have been accumulated over time.  


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