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Trigger Points

Discussion in 'General Issues and Discussion Forum' started by ginger, Jun 18, 2011.

  1. ginger

    ginger Active Member


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    I would like to learn more about trigger points and their application in Podiatry. Can anyone tell me where is a good place to start in learning about them? Those of you who use trigger points in treatments, where did you learn about them and how to use them? Any help would be very much appreciated :)
     
  2. Griff

    Griff Moderator

  3. lusnanlaogh

    lusnanlaogh Active Member

    Ian G's first link to Trigger Point Therapy for Myofascial Pain: The Practice of Informed Touch
    is a good one - excellent book!

    'Trigger point' is an excellent therapy IMHO.
     
  4. ginger

    ginger Active Member

    Thanks to you both, I'll get that first one ordered now. I've read the reviews and it sounds perfect. Are there courses available on trigger points?
     
  5. lusnanlaogh

    lusnanlaogh Active Member

    I would imagine, in the UK, that Trigger Point therapy courses would be mostly aimed at physios, ginger.

    Have you tried looking on physio forums? or looking at physio courses?
     
  6. ginger

    ginger Active Member

    I have found a place in Edinburgh which does courses in trigger point therapy and myofascial release. I have sent an enquiry as to whether or not their courses would be suitable for Pods. Thank you again :)
     
  7. Admin2

    Admin2 Administrator Staff Member

  8. Ian Linane

    Ian Linane Well-Known Member

    Hi Ginger
    La Trobe University website has some good stuff (images and basic application for Podiatry) from Travel and Simons book. (Vol 2. Good book but pricy, I think mine was £70 for volume 2)

    Trigger points (TrP) can be useful things to work but generally, in my experience, they would form part of an overall soft tissue mob treatment (STM). Equally it is not always necessary to take active trigger points out directly. I was doing soft tissue mobs (STM) on a physio's calf muscles Friday (competitive runner who completed last years Brighton Marathon in 2:45) and there was a clear trigger point issue. It resolved, without specific treatment of TrP work, to good massage. Another time I have treated TrP's in the calf for some heel pain issues, again as part of an STM treatment.

    Useful skill to eventually develop as part of over all palpation skills.
     
  9. ginger

    ginger Active Member

    Will be good to learn a wee bit more then as it will be good to put it together with the mobs after the course next month. Thanks Ian. Where did you learn your massage skills?
     
  10. Ian Linane

    Ian Linane Well-Known Member

    Hi
    With physiotherapists. I still go on some Physio cpd stuff.
    I was in Ireland on one 3 weeks ago and am on another in
    a few weeks.
     
  11. Shane Toohey

    Shane Toohey Active Member

    Hi Ginger et al,

    I've been infrequent in the Arena lately but the tag was close to my heart.

    On references, the true master resource is Travell and Simons, Myofascial Pain and Dysfunction, The Trigger Point Manual and for us pods we want Vol 2 The Lower Extremities. You will find it at Amazon and elsewhere. This reference is so thorough about the trigger points (TrP's) and anatomy - it educates you to a new level.

    While there are numerous ways to release TrP's the most effective is with a technique commonly called Dry Needling, which is an acupuncture technique.
    Dry needling and manual techniques are practical skills to master and as such are learnt as Ian has advised from those experienced in the techniques i.e. in workshops.
    There may be some visual aids out soon as well but nothing beats hands on training.

    I've been teaching these skills for quite a few years in Australia and have presented in UK and Ireland as well.
    For the UK you need to do a SOCAP approved workshop to gain insurance cover for dry needling.
    We have now incorporated this content into our Clinical Masters programme at UWA. The intention as always is to provide skills required to use these techniques in the treatment of conditions being commonly presented to Podiatrists.

    Cheers
    Shane
     
  12. ginger

    ginger Active Member

    Fantastic info Shane, thank you. I am hoping to do a course in podiatric accupuncture either at the end of this year or start of next, depending on funds and timing! The more you read about the more you want to learn, I currently have a course wish list as long as my arm!
     
  13. Shane Toohey

    Shane Toohey Active Member

    That is a great place to be Ginger

    I've had numerous conversations with Pods who say that they have found a new lease on their careers, that they are now excited again and want to learn more.
    These comments are driven by the outcomes they are now achieving that were not even considered possible.

    One of my personal imperatives is that practical training for new skills being hands on and undersupplied. You can make far more difference to your outcomes with practical hands on training more so than sitting alongside hundreds of others listening to presentations (although they are important for other reasons). It is difficult to do practical at universities. I think that you can't do too much training, that you can learn something from everyone, and that it never ends.

    Lastly, once you start producing enhanced outcomes you will find that your practice changes and gets busier. The training will pay for itself in no time.

    Good luck
    Shane
     
  14. Tim VS

    Tim VS Active Member

    Is there any evidence base for the effectiveness of dry needling over ischemic pressure in trigger point therapy? Just wondered.

    Regards,

    Tim
     
  15. Shane Toohey

    Shane Toohey Active Member

    Hi Tim,

    Good question, thanks

    There is good evidence for the existence of myofascial trigger points (MTrP's) including histological differences from surrounding tissue and also the ability of blinded examiners consistently and reliably achieving correlation in locating them.
    I'd refer you to another very good text " An Introduction to Western Medical Acupuncture" , White, Cummings and Filshie, Churchill Livingston, 2008, chapter 7 for a full exploration.
    "Needling is not the only way to treat MTrP's, but it is quick and effective", p73

    Quite simply the effort involved to achieve a release is minimal with needling but using ischemic pressure (compression) using hands, elbows and various tools can be destructive in the long term to the therapist. It takes far more contact time which can become a real problem when treatment of more than a few MTrP's is required.

    I still use I.C. sometimes for isolated points or when they are located in places I don't want to go for one reason or another.

    Overall, you need to look after yourself. Many therapists (physio, remedial etc) have to change their treatment modalities as their body parts wear out. It is one of the reasons that dry needling has become so popular - it has prolonged the careers of worn out therapists.

    Cheers
    Shane
     
  16. Peter1234

    Peter1234 Active Member

    Hi ginger,

    if you send my your email adress i can send you the trigger point manual of the lower extremities
     
  17. ginger

    ginger Active Member

    Peter that would be fantastic, thank you so much! I'll pm you my address.
     
  18. Ella Hurrell

    Ella Hurrell Active Member

  19. ginger

    ginger Active Member

    That must have just happened, it was working a few days ago!
     
  20. Ella Hurrell

    Ella Hurrell Active Member

    I know - perhaps the site is just down?
     
  21. lusnanlaogh

    lusnanlaogh Active Member

    It looks to me as though they've taken the page down. :(
     
  22. Shane Toohey

    Shane Toohey Active Member

    As useful as it may appear that page is a summary of the literature (mostly Travell and Simons) - so really an overview. Good for context. Once you have got that under your belt it makes it easier to go into the literature and practice with more depth.

    Cheers
     
  23. Shane Toohey

    Shane Toohey Active Member

    Hi Ginger,

    Just reviewing the year on Arena, so seemed worth adding a last note to the thread you started.

    I have two workshops coming up in April. As advised earlier you need to do a SCP approved workshop to use acupuncture needles with insurance cover in podiatric practice. The workshop is developed by myself as a podiatrist and acupuncturist for the treatment of commonly presented conditions - so it has a podiatric perspective.
    The workshop includes 'dry needling' for trigger point release but also includes other acupuncture techniques that are useful when treating joint pain and nerve dysfunction. More info is available on the website.

    The first workshop is in Dublin, 20-22nd April and the second is at the University of Huddersfield on 22-29th April.

    Please go to www.acupunctureinpodiatry.com

    Cheers
    Shane
     
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