Trigger Point Therapy - What is the Evidence?

00:00 - Introduction to Evidence Base for Trigger Points
00:07 - Importance of Evidence in Modern Medicine
00:31 - Nerve and Muscle Interaction
01:20 - Motor End Plates and Acetylcholine
02:30 - Measuring Electrical Activity in Muscles
03:53 - David Simons' 2004 Study
06:00 - Findings on Electrical Activity in Trigger Points
07:10 - Hub and Burkov's Study on Acetylcholine Release
08:20 - Micrograph of Muscle Contraction Knots
09:40 - Distribution of Contraction Knots
10:25 - Cinderella Hypothesis by Hågg
12:00 - Type 1 and Type 2 Muscle Fibers
13:50 - Studies Confirming the Cinderella Hypothesis
15:40 - Ters' 2006 Study on Finger Tapping
16:40 - Chen's Study on Piano Players and Trigger Points
17:50 - Uton's Study on Pressure Gradients in Muscles
20:20 - Sidar's 2009 Study Using Ultrasound
22:10 - Ultrasound Images of Trigger Points
23:50 - Blood Flow in Trigger Points
24:30 - Study by Shah and Elizabeth Gillams
26:00 - Analyzing Biochemical Environment of Trigger Points
27:10 - Findings on Substance P and Noradrenaline
29:00 - Noradrenaline and Blood Flow
30:00 - Conclusion and Summary of Findings
For more information about trigger points, please visit our website: www.nielasher.com
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[@DebbieHollandNZ]

Such a great presentation and really filled in a lot of gaps in my understanding thank you!

[@Nielasher]

Thank you very much for your feedback. Please make sure to subscribe or for more information please visit our website www.nielasher.com/blog

[@javierherrera1388]

What a great presentation, I've been practicing Neuromuscular Therapy for about 30 years and TPs have always been an essential part of my treatments to relieve pain in my Patients/Clients. Please continue providing us with more information, May God continue to bless you in your Professional and Personal Life.

[@Nielasher]

Thank you for your feedback and your kind wishes.

[@alllifematters]

Javier Herrera since you do nmt, do you release the trigger points that bother the client or fo you release the ones that you think are causing an imbalance? I guess I'm just trying to understand how exactly it is implemented. I usually focus on releasing the muscles/bones that are tight thereby causing an overstretched muscle typically. When I release the correct muscles the other muscles relax and sometimes trigger points naturally disappear.. but sometimes I have noticed that the only way to relax muscle is to hold those trigger points. Do you have a specific way that you use trigger points? Thank you for your insight!

[@ezcarenursingagency3882]

Where are you located? I have issues always with Levator Scapulae

[@amyalewine]

@@alllifematters Gordon Wallis on KZbin shows how he releases trigger points. He works for a pain management doctor in Alaska. His work is fascinating and also very easy to mimic.

[@pham411]

That was awesome explanation of tp. All your videos are awesome and very helpful, thank you for explaining and helping us understand pain.

[@Nielasher]

Hi Mike, Thank you very much for your feedback🙌🏻
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[@williamrech4458]

Where do go from here to reduce the chemistry and thus eliminate trigger points through out the body. I am riddled with them from head to toe and would love have to a program to follow, and get my life back. I am getting trigger point dry needling and shockwave therapy to get back some movement. I broke my hip a month ago, due to my left hip locking up and falling. About to get out of the hospital and need some direction, to prevent the same thing from happening. Thank you for any assistance that can be offered. Bill

[@wimwum6708]

Thanks for your way of simplifying science...

[@Nielasher]

Thank you for your feedback 🙏

[@newts1964]

every pt I see says stretching these is best way ...if they release the triggerpoints then a day or so after they return

[@alllifematters]

I do agree with trigger point work as a massage therapist, but ultimately the reason that they form is because of an imbalance of muscle pull on the bones... This causes excess stress on the muscles and bones... I have seen trigger points disappear on their own if you just find the tight muscle causing the imbalance which is often on the opposite side from the trigger point(not always) but I am curious about other people's perspectives on this... Do you just release the trigger points or do you release the ones that you think are in the muscles causing the imbalance ? Or do you think that releasing all of the trigger points that you find will automatically allow the body to balance itself? Does that make sense? It always seems like I have a grasp of what I'm thinking until I open my mouth!

[@zackmiller4595]

I'd say that when I'm working on someone, I address the muscle that feels the most painful. after releasing that muscle i think about TP Pain Patterns that would refer to that area. when i find a TP i ask the client how it feels and where its referring to. then release those Tp's. also working the antagonist muscles to "reset" the position of the joint they both act on, like the shoulder. I also recommend they do some strength training to gain strength in those muscles that hurt so they can do their job easier. I'm not entirely clear on what you mean by "an imbalance of muscle pull on the bones". Is that like agonist/antagonist balance in tone? Because if one is way stronger or tighter than that will cause pain and postural dysfunction, which will compound the problem. I was also taught to not just do a "search and destroy" approach to trigger points because that will flush too much of that built up muscular waste into the blood stream, which can make people extra achy and give headaches. Hope this helps.

[@johnathanabrams8434]

Trigger points do not release in their own. Trigger points are a constant source of nociceptive input that lead to both peripheral and central sensitization. Dry needling is the most effective treatment for active myofascial trigger points

[@brettshapiro6289]

Great share. Thank you!

[@Nielasher]

Thank you for your feedback 🙏

[@kennethlee6184]

This is Real, this is no myth. i am not a Professional, yet i applied the pressure release techniques, and i can immediately feel the results, and target the sudden intense and alarming pains.

[@Nielasher]

Thank you for your feedback. For more information regarding trigger point therapy please visit our website www.nielasher.com

[@romellinsleven6983]

Trigger points have always fascinated me. I love when my back is “jabbed” with fingers, elbows or a tool with the sharpness of a pencil just feels intensely good on my back. Everyone else I know says the same thing is very uncomfortable for them

[@Nielasher]

Thank you for your feedback 🙏

[@judyhounsun8766]

Awesome!!! Could you please put the like of those studies on the discrimination box. Thank you for the brilliant channel

[@Nielasher]

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[@BaRhey_Wellness_Relaxation]

Thank you very much.

[@Nielasher]

You are welcome! Thank you for following our channel.

[@nirmaladrieskens4338]

Good video👏👏👏💕💕💕

[@Nielasher]

Thank you for your feedback. For more information please visit the blog section of our website www.nielasher.com

[@MsLina625]

If the blood flow is already lowered in a TP, how does the ischemic technique work? Wouldn't it make it worse?

[@Joegengstah]

its temporary pressure to reduce sensitivity and switch off the tension in the muscle painlessly, vs chronic blood/nutritients starvation of the muscle.

[@conorwalsh2429]

The release of the Ischemic pressure will cause a blood cycling effect into the area, coming on and off the Trp in cycles of 5 on 2 off for example will hydrate the Trp.

[@franklopeziilmtmti603]

@@conorwalsh2429 great explanation!

[@conorwalsh2429]

@@franklopeziilmtmti603 Thanks Frank!

[@farshimelt]

The evidence is when the pain leaves.

[@Nielasher]

Thank you for your feedback 🙏

[@nancyguzman4685]

How do you get rid of excess acetylcholine?

[@alisaadat2339]

Then whats the best way to treat them?

[@xrisos1397]

For me breathing techniques and fasting helped me the most...and not local therapy...like massage..

[@autonomyseeker6082]

@@xrisos1397 interesting! what breathing technique releases trigger points in your body?

[@xrisos1397]

@@autonomyseeker6082 wim hof breathing techniques.. its a way to stabilize your autonomous nervous system...reduce the sympathetic system

[@John-ek5bq]

Excellent presentation! Thank you for sharing with us! So, in this case, could this mean that the real cause of conditions like May Thurner Syndrome or Nutcracker Syndrome could be trigger points that are causing them?