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Trigger Point Chart | Active vs Latent Trigger Points

What is a trigger point chart?

A trigger point is a hypersensitive spot in any muscle that has the ability to cause pain or other clinical manifestations. Trigger points can either be active or latent and can result in muscle shortness, weakness, and reduced range of motion. Let’s take a look at the difference between active and latent trigger points and how a trigger point chart can help diagnose it.

What is an Active Trigger Point?

An active trigger point means that it causes pain. Not only does it cause pain, it causes the muscles to exhibit tautness or shortening, spasm, and weakness relative to its normal state. Once the trigger points are completely eliminated the muscle will once again return to its normal strength. The longer a trigger point remains active, the more weakness occurs and the more dysfunctional the muscle becomes.

Where can I find a trigger point chart?

What is a Latent Trigger Point?

A latent trigger point won’t cause any discomfort unless it is sufficiently compressed. A latent trigger point is basically an active trigger point in waiting. It won’t cause discomfort unless it is activated. Latent trigger points may persist for months, even years, before they become active trigger points. While it might not be noticeable, the latent trigger point will still cause dysfunction, or prevent full motion and normal muscle strength.

Where Can I Find a Trigger Point Chart?

A great way to determine, and help diagnose a trigger point, is with a trigger point chart. If you are looking for trigger point charts, contact us today at Kent Health Systems.

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Posture Chart | Forward Head Posture

Where can I find a posture chart?

Forward head posture is the anterior positioning of the cervical spine. It is a posture problem that is caused by several factors including sleeping with the head elevated too high, extended use of computers and cell phones, lack of developed back muscle strength and lack of nutrients such as calcium. Forward head posture can cause issues throughout your body. Let’s take a look at a few of them that can be fixed with a posture chart.

Headaches TrP 1

Believe it or not, a headache can be directly caused by bad posture. Specifically, forward head posture places strain on your upper back and neck muscles. When this happens, those muscles must work as though they are supporting an additional ten pounds of weight for every inch your head moves forward. The added strain puts pressure on the nerves in your neck and keeps upper back and neck muscles in a constant state of contraction, causing headaches.

Who sells a posture chart?

Neck and Arm Pain

One of the most common things that cause neck pain is forward head posture. The forward pull of the weight of the head puts undue stress on the vertebrae of the lower neck, contributing to degenerative disc disease and other degenerative neck problems. It can also cause shoulder and arm pain since the position often goes hand-in-hand with forward shoulders and a rounded upper back.

Are You Interested in a Posture Chart?

If you have patients that come to you with these issues, a posture chart can be a great way to show them how a simple posture change can fix these issues. Contact us today to learn about the posture charts that we offer.

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Posture Charts | Importance of Good Posture

Who offers posture charts?

When you were a kid, chances are your mom told you to sit up straight or fix your posture. While you might have thought she was just nagging you, there was a real reason for it too. Having a good posture can prevent back and other medical issues later in life. Let’s take a look at just a few of the reason why a good posture on posture charts is important.

Eliminates Neck and Back Pain

When you have proper posture, your bones and spine can easily and efficiently balance and support your body’s weight. When you have improper posture, muscles, tendons, and ligaments have to constantly work to support that same weight. The extra strain that is put on your back from bad posture can lead to neck pain, back pain, and even headaches.

Improves Memory

Studies have shown that there may be a connection between good posture and memory retention when learning new things. That’s probably why your teacher in school would tell you to sit up straight at your desk. The theory is, good posture enhances your breathing. This allows you to take in more oxygen, and when you take in more oxygen, your cognition improves.

 Where can I find posture charts?

Makes You Look Slimmer

Poor posture can cause your stomach to protrude over your belt line, sometimes referred to as a “beer belly”. Standing up straight will make you look skinnier and taller.

Are You Looking for Posture Charts?

At Kent Health Systems we offer all sorts of charts and training aids for your practice, including posture charts. Contact us today to learn more.

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Trigger Point Chart | Pain Management Without Opioids

Where can I find a trigger point chart?

Trigger points are small areas of spasm inside your muscle. When “struck” trigger points can sometimes cause debilitating pain that can make it difficult or temporarily even impossible to move. For generations, the answer to pain caused by trigger points was opioids. However, with the use of a trigger point chart some hospitals have begun using alternative methods for pain management. Let’s take a look at one of those alternative methods.

Dry Needling

It’s no secret that the country is currently in the middle of an opioid epidemic. It’s also no secret that a hospital ER is the biggest prescriber of opioids in the United States. Some hospitals, like St. Joseph’s University Medical Center in Paterson, N.J. have begun using alternative methods though when treating patients for pain. In fact, the strategy has led to a 58% drop in the ER’s opioid prescriptions in just the first year that the program has been in place.

One of the methods that St. Joseph’s uses is dry needling the trigger point of the pain. Unlike opioids which are rarely actually able to penetrate the spasm and trigger point, a dry needle can break up the muscle tissue and mechanically stop the spasm and the pain. The dry needling is followed with a small injection of a local anesthetic for the soreness caused by the needle.

What is a trigger point chart?

Are You in Need of a Trigger Point Chart?

At Kent Health Systems we offer charts and training aids to better help you serve your patients. Contact us today to learn more about the products and services we offer.

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Back Pain from Gluteus Medius Trigger Points

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By: David Kent, LMT, NCTMB

Each week, I treat several clients who complain of “low back pain.” For many patients, however, the primary cause of pain is not the lower back but the gluteus medius muscle. No matter what kind of massage practice you have, a great deal of your success will depend on how quickly you are able to determine the origin of a patient’s complaint and your ability to produce measurable results. This article will review some ways to identify when the gluteus medius muscle is responsible for causing pain.

Anatomy:

The gluteus medius muscle lies superficial to the gluteus minimus muscle and deep to the gluteus maximus muscle. Proximally, it attaches along the external surface of the ilium between the anterior and posterior gluteal lines. Distally, it attaches to the lateral surface of the greater trochanter of the femur (See Photo 1).

The gluteus medius muscle “abducts the hip joint; the anterior fibers medially rotate and may assist in flexion of the hip joint; [and] the posterior fibers laterally rotate and may assist in extension.”1 It also helps to keep the pelvis level when the opposite leg is raised during activities such as walking, running, or standing on one leg.

Intake and History:

The first step to designing and implementing an effective treatment plan is to understand the client’s medical history and current circumstances. Utilizing health history intake forms will help you gather the appropriate information; they will also reveal important factors that could be relevant to a patient’s condition.

Using pain scales to document a client’s pain patterns are beneficial, as well. Ask the client to color the diagram form illustrating where on the body he/she experiences pain. Then ask the client to add modifiers that adequately describe the pain, followed by a number from 1-10 to rate its intensity (See Photo 2 ). This diagram provides a helpful visual tool that you can reference during the session. You will also see how pain patterns often match common trigger point patterns, which are discussed in more detail below.

Ask the client if any of his/her daily activities are affected by the pain. If the answer is yes, ask the client which muscles hurt, what movements aggravate the pain, and what he/she believes caused the pain. Ask if the client has recently started or modified an exercise program. Answers like walking, running, tennis, aerobics and other types of activities may indicate gluteus medius involvement. Has the client had any falls or sustained any hip injuries? What is the client’s occupation? Does the client place a wallet or tools in a back pocket? All of these questions will help you narrow down the origin of pain. (Read “Questions with Direction,”)

Gait & Postural Analysis:

Observe the client as he/she walks. A painful or “weak gluteus medius muscle forces the client to lurch toward the involved side to place the center of gravity over the hip; such movement is called an abduction, or gluteus medius lurch.”2

Show your client the relationship between posture and pain, and describe how you can help. Just like chiropractors advertise free “spinal exams” to attract new patients, you could provide free postural analysis to attract new clients. Market the postural analysis as a value that you include during the initial visit; then include a second postural analysis taken upon completing a series of treatments. This is a great way to sell packages, and it also demonstrates postural progress. (Read “Getting Comfortable with Postural Analysis,”) When conducting a postural analysis, look for signs of gluteus medius muscle involvement. Shortness of the gluteus medius muscle “may be seen as a lateral pelvic tilt, low on the side of tightness, along with some abduction of the extremity.”3

Trigger Points

“Myofascial trigger points (TrPs) in the gluteus medius are a commonly overlooked source of low back pain.”4 There are three trigger points frequently identified in the gluteus medius muscle. TrP1 (See Photo 1) is located lateral and superior to the posterior superior iliac spine (PSIS) just below the iliac crest. TrP1 refers pain and tenderness over the sacrum, above the iliac crest into the lumbar region, and throughout the gluteal region on the same side of the body as the trigger point.

TrP2 (See Photo 1) is positioned midway between the anterior superior iliac spine (ASIS) and the PSIS just below the iliac crest. “Pain referred from TrP2 is projected more laterally and to the midgluteal region; [and] may extend into the upper thigh posteriorly and laterally.”5

TrP3 (See Photo 1) is rarely present and can be located just posterior to the ASIS and just below the iliac crest. Referred pain is primarily produced over the sacrum bilaterally.

Educate your clients about trigger points. Use wall charts or flip charts to demonstrate their location on the body. Using charts and other aids will not only help the client, but it will also build your credibility with the client. This is also an excellent time to explain how the muscle affects posture.

Pain is a symptom. As massage therapists, our job is to address the cause of the pain and work to prevent its return. Educate your clients. Discuss proper ergonomics, stretching and strengthening. Identifying the gluteus medius as a source of back pain is easy once you have the knowledge.

David Kent, LMT, NCTMB

David Kent, LMT, NCTMB, is an international presenter, product innovator and writer. His clinic, Muscular Pain Relief Center, is in Deltona, Florida, where he receives referrals from various healthcare providers. David is President and Founder of Kent Health Systems which teaches Human Dissection, Deep Tissue Medical Massage and Practice Building seminars, and has developed a line of products, including the Postural Analysis Grid Chart™, Trigger Point Charts, Personalized Essential Office Forms™, and DVD programs. Visit www.KentHealth.com or call (888) 574-5600 for more information.

1, 3 Kendell FP, McCreary, et al. Muscle Testing and Function with Posture and Pain, 5th ed.  Lippincott, Williams and Wilkins: 2005.

2 Hoppenfeld S. Physical Examination of the Spine & Extremities. Appleton & Lange: 1976

4 Simons DG, Travell JG. “Myofascial Origins of Low Back Pain, 3: Pelvic and Lower Extremity Muscles,” Postgrad Med 73:99-108, 1983.

5 Simons DG, Travell JG. Myofascial Pain and Dysfunction, The Trigger Point Manual: The Lower Extremities, 2. Lippincott, Williams and Wilkins: 1992

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